Closing down his orphanages must have been one of hardest decisions of Mulugeta Gebru's life. The Jerusalem Children and Community Development Organisation (JeCCDO) he ran had homes across Ethiopia for orphaned and vulnerable children. There were over a thousand children in Mulugeta's care. But by 1996, he had decided that the children would thrive better back within communities.
This idea wasn't immediately popular. But Mulugeta persevered and found that placing a child back into the care of a community could raise the standard of life for everyone. He transformed the orphanages into resource centres. Part of his model was practical; helping adopting families to set up small businesses or low-cost food production schemes. But Mulugeta's greatest legacy has been the community groups he has fostered, which have triggered fundamental shifts in attitudes and customs around health, rights and child protection.
During these peer-led conversations, difficult issues that would normally be taboo are up for discussion. The breakthroughs have been phenomenal. One group recently took the decision to end early marriage. Another agreed to end female genital mutilation and arranged an amnesty of the knives used in the practice. In the south, a young rape victim was able to put her attacker behind bars thanks to the unprecedented support of her local women's group. Mulugeta's confidence in the capacity of communities and the power of consensus has proved to be well founded. By closing the door on one idea he has thrown open countless others for the future of Ethiopia's communities.
Fatima Jibrell is a woman who moves against the tide. While most people were fleeing Somalia during the 1991 civil war, she was returning. Having grown up in a Somali herder community, Fatima had left as a teenager and built a new life in the United States. But she realised things would only change if Somalis converged to bring ideas, solutions and energy back to Somalia. In response, Fatima founded the Horn of Africa Relief and Development Organization - Adeso (later Horn Relief).
Fatima saw the connection between peace, empowerment and resource protection. The war had destroyed natural resource management systems, jeopardising traditional ways of life. She co-founded the Resource Management Somali Network (RMSN), one of the few cross-clan networks, and was instrumental in the Puntland government's ban on the export of charcoal. But she hasn't just changed minds; she's changed the landscape. Through her "rock dam" initiative, communities have learnt to manage rainfall using stone piles, which halt water wastage and create spaces for plants to germinate.
One of her greatest achievements has been empowering women and girls to take the lead in peace and conservation. She has helped to secure a constitutional minimum of 30% of government seats for women and fostered a Women's Coalition for Peace in northern Somalia. Under her guidance, youth and elder pastoralists have shared ideas around the use of fragile resources, healthcare and peace. By encouraging change from the bottom up, Fatima has ensured that the capacity for action will outlast her work.
Keith's pride peaks when he is not needed. For three decades he has travelled through Uganda training eye care workers, setting up clinics and performing thousands of operations a year to cure or prevent blindness. His Land Rover contains everything needed for a rural surgical theatre. From the front seat, he has pioneered a countrywide eye care service without pausing for civil war. Now in his seventies, he knows he has succeeded when those he has trained can save a child's sight in a tiny rural clinic without his help.
Arriving in Uganda as a young doctor in 1964, he recognised the huge shortfall in quality care, particularly in the rural areas. He began training paramedical staff to conduct routine work. Hundreds are now running their own centres. Keith was Ocapacity building decades before it became popular.
Over the years, Keith kept abreast of cutting-edge techniques and introduced them to Africa. When these fail, he devises his own, relieving thousands from the pain and disability caused by eye disease. His prolific research and seminal papers have helped guide treatment across Africa bringing fresh insight on childhood blindness and complications associated with leprosy, cataracts, antimalarial drugs and HIV.
Nothing illustrates this better than his pioneering treatment programme for retinoblastoma - a fatal childhood eye cancer. Such a complex programme would stretch a top UK hospital. Keith has done it single-handedly. After a lifetime of work, Keith has been involved in the treatment of almost every blind child in Uganda. And he is still on the road.
Dr Kshama Metre
Sometimes you need to step back to see a solution, but sometimes you need to move closer. Paediatrician Kshama Metre left a flourishing medical practice in Delhi to provide healthcare to isolated Himalayan villagers. Moving between communities, she was faced with an inextricable web of social and economic issues: illiteracy, unemployment, an exodus of skilled labour, poverty, alcoholism, gender violence. For Kshama, it was clear that any practical solution would need to be holistic and look beyond the symptoms to tackle the causes.
She founded Chinmaya Organisation for Rural Development (Cord), establishing a multi-faceted programme as a direct response to the multi-layer rural poverty that affects 70% of India's population. 25 years later and Cord has worked with almost 700 remote communities. To combat widespread unemployment, it has sparked income generation schemes. Responding to urban-centric government investment, Cord pioneered the first micro-financing programme in India. Bridging the uneasy relationship between villagers and the police, they trained lawyers to ensure disputes and complaints could be aired without intimidation.
Drawing on her background as a doctor, Kshama has used maternal and child health as a gateway into communities, drawing over 10,000 women and girls into peer support groups. One particular women's group, The Mahila Mandals, has grown into a force for change, challenging the government, unruly citizens and corruption, all while managing their own households. Their success is a prime example of how one woman's insight has triggered a wave of development through empowerment as opposed to welfare dependence.
Young men in rural Pakistan do not talk publicly about breasts. But Qamar Naseem never paid much attention to the rules. From a conservative family, his mother was beaten as a child because she wanted to go to school. Qamar would also put himself at risk to stand up for women's rights. Along with 11 others, he formed Blue Veins, a campaign about breast cancer awareness. Speaking openly about the importance of breast self-examination and sexual health, Qamar found himself a target of the ultra-conservative and militant Muslim groups. He was undeterred by the intimidation.
He saw a critical gap in the way women's health education programmes failed to include men. He found ways to reach out to imams and village leaders and has since established over 300 community committees for women and men to discuss issues such as child marriage or domestic violence. He has supported and sparked a myriad of community and infrastructural projects that foster gender equality.
During the 2010 floods, Qamar openly criticised the lack of reproductive and sexual health facilities in the emergency camps, triggering the establishment of a national disaster response desk for women. He has since lobbied for women's rights legislation in tribal areas where such laws rarely apply. He has highlighted the correlation between keeping young girls out of marriage and in school and their economic potential as wage earners.
By using gender as a lens, Qamar has introduced a broader perspective on national development to the benefit of the whole society.