Leaders can be literal life savers

Lan Bentsen tells the story of how a group of leaders with close relationships came together for an incredibly important project: reducing infant mortality in Houston hospitals.

During the mid 1980s, the infant mortality rate in their community—12.5 per 1000 live births—was about thirty percent above the national average, and almost twice the Surgeon General’s Year 2000 goal of 6.5.

Bentsen knew that his community could do better. From his time as a March of Dimes volunteer he understood that the failure of responsible agencies to coordinate their services was a major cause of the problem. He describes how mundane missteps often led to terrible outcomes:

A high-risk pregnancy patient diagnosed at a city clinic would be handed her records and told to go make an appointment with the county hospital. If she were, say, a 15-year-old, she would likely never get there for any number of reasons—fear, loss of records, inability to get an appointment after working hours, lack of bilingual operators, lack of a “hot line”—all manageable circumstances, assuming cooperation. Left alone, her high-risk conditions prevailed until she went into labor, too often with disastrous results.

ALF Houston Class 3 offered to intervene. We felt a community-wide effort would be required to overcome the inertia of the two agencies. Because the subject of prenatal care in those days had become linked with extenuating social issues, we knew all parties that could “veto” the effort had to be involved. In particular, the March of Dimes and the faith community had to come to the table.

To broaden the collaboration, the ALF class members recruited thirty other community organizations with a range of views on health issues. A mission statement was defined, step by laborious step. Our ALF training had taught us that no step could be taken unless all parties agreed. Confidence grew. Respect for values was developed. Misconceptions were identified and clarified. The ALF collaboration approached the city and the county with a request to implement the changes. All leaders agreed that the steps and recommendations were reasonable and desirable.

But somehow nothing seemed to change.

The ALF collaboration then turned to the media, which was suitably impressed with the breadth and depth of the collaboration and its mission. Media cameras entered the clinics asking to see the (nonexistent) multilingual hot-lines for making appointments. The newspaper tracked on the front page how long it took to get an appointment with the county system for high-risk city pregnancies. The television stations visited the “baby cemetery.” The public pressure was unrelenting.

Things changed fast at that point. Systems were integrated quickly, because they had already been designed and funded. Clinics opened on evenings and weekends. Patient records were hand-delivered and appointment reminders were sent to patients. The bus system offered free passes. And the high-risk city pregnancies began to get first-trimester care.

Within three years, infant deaths dropped from six hundred to three hundred per year in the city and county, even as the local birthrate continued to increase dramatically. Houston achieved its year 2000 Surgeon General goal of 6.5 infant deaths per 1000 live births in five years, ten years ahead of schedule.

As it happened, the lieutenant governor of Texas was a Houston resident and saw this unfold. He convened the Select Committee on Medicaid and Family Services and recruited ALF class members to serve on it and make recommendations to the state. The Maternal Infant Health Improvement Act was subsequently submitted to the Texas Legislature.

Over the next five years infant mortality incidence in Texas declined from 3,000 to 2,000 deaths. The state’s infant mortality ranking improved from 49th to 26th, a ranking it continues to hold more than twenty years later.

Defusing a Needless Crisis

MayYing Ly is a Hmong refugee from Laos who immigrated with her parents to the United States, along with thousands of Laotians in the aftermath of the fall of Laos to communist control in 1975. Many years later a revered leader in exile, General Vang Pao, was charged with violating the U.S. Neutrality Act because of his political activity, and brought to federal court in Sacramento for trial.

When we think about the importance of relationships, Ly’s story is a great example of how inter-connected leaders—with trust between them—can make things happen when it matters the most.

Ly writes:

This was a traumatic flashback of the final evacuation days of Long Cheng, the CIA headquarters in Laos during the Vietnam Conflict where thousands were left stranded not knowing what lay ahead. Young and old were shocked by the allegations of the U.S. government. Gen. Vang Pao was considered by many as Hmoob niam thiab Hmoob txiv, or “Hmong mother and father,” to whom many Hmong owed their lives. A massive Hmong organization emerged across the nation to rally support for the general and demand his release. Over 10,000 people were expected to demonstrate in Sacramento.

Discovering that no permit had been secured, we envisioned thousands of elderly Vang Pao followers who did not speak English getting arrested because they would not understand an order to disperse. If this happened, they could be deported for violating a federal law. It was Sunday evening, hours before the event was to begin, and we knew we had to somehow secure a permit; there was no way to stop the thousands who were already en route from all over California and the world to downtown Sacramento.

Both Sacramento City Police Chief Al Najera and Deputy Chief of Police Steve Segura were American Leadership Forum senior fellows. Steve responded to my call by immediately calling the U.S. marshal, who then called me within minutes. They were thankful that we had informed them of the upcoming rally, especially with the number of people we were expecting. The marshal secured a special verbal permit from the Government Service Agency, instructing me to come downtown early the next morning to complete the paperwork. I did, and over five thousand Hmong demonstrators surrounded the courthouse and the state capitol for a peaceful rally in support of the release of the general and his alleged co-conspirators.

ALF senior fellows in our chapter continued to assist me throughout the years with the case. We had information sessions about the Hmong for all ALF members, including presentations from the police and FBI. At one point the general, who was in ill health, collapsed in jail, prompting fears of possible rioting if he died there. As a networked group, we eventually succeeded in gaining the general’s release on bail. Some time later the federal case against Gen. Vang Pao and other Hmong leaders was dropped.

We can’t know whether my ALF colleagues and I were instrumental in the positive outcome of this historic case in the end. But we know that in the beginning we made a huge difference, because one ALF fellow answered that critical phone call from another.