Announcements March 30, 2021

Defining PIVOT’s Commitment to Diversity, Equity & Inclusion

Reflections from Amy Donahue, US Engagement Officer


After five years on the US-based PIVOT support team, it was easy to think of our commitment to social justice as implicit. What could be more social justice-oriented than working to prevent needless suffering in a resource-constrained setting like rural Madagascar? On top of that, we were making a concerted effort to do our part in the movement to localize the global health sector, shifting more resources and authority to our Madagascar-based colleagues in an effort to mitigate the growing trend of undue deference given to those of us in the US, furthest from the work. 

(For our executive director’s recent piece on PIVOT’s localization efforts, click here.)

Indeed, by May of 2020, we felt like we were on the right track. Then, like so many other organizations, George Floyd’s murder catalyzed a long overdue moment of reckoning for our team. The US staff gathered virtually to discuss our response, and it became immediately clear that we were ill-prepared to speak as a collective on racial injustice in the US. Were we, as individuals, unanimously horrified by this and the countless other manifestations of systemic racial violence throughout our country’s history? Absolutely. Were we moved to do something about it on a personal level? Also yes. But did PIVOT, as an organization, have the right or responsibility to speak or act upon this in some way? Disappointingly (to all of us), we weren’t sure.

Having spent many months concertedly thinking and talking about how to strengthen our identity as a Malagasy-led organization, we fumbled for what to do or say in the face of a major social injustice in the US. It took us far too long to decide whether we’d make a statement, let alone what message it should convey. After hours spent on group calls between board and staff members to discuss, the result was the release of the following statement:

Today marks two weeks since George Floyd’s murder. His death – along with that of countless other Black men, women, and children – occurred because the US is riddled with racial inequality, discrimination, and trauma that occurs regularly and systemically to Black and Brown communities. Not all lives are treated equally. As PIVOT board member Paul Farmer has said, “the idea that some lives matter less is the root of all that is wrong with the world.” Only by removing our country’s pervasive structural inequalities can we hope to ensure that every Black life is truly regarded as equal. It is the time for everyone to intensify the fight for justice and equality. We at PIVOT are examining our own actions as an organization to exemplify a more inclusive and just world – here in the US, in Madagascar, and globally.

As a member of the US staff who has been with PIVOT for most of its existence, I left the experience feeling that we lacked a clear path forward in “examining our own actions” – something we are extremely good at when it comes to our program delivery, which is perhaps why this aimlessness felt so stark in comparison. And of course we love Paul Farmer, a lead advocate for social justice in public health, and a member of the PIVOT board. But did we need to elevate another white voice in the conversation around racial disparities? Probably not.

We decided the next step for our US team was to launch an anti-racist reading club. We started with Ibram Kendi’s How to Be an Antiracist, which I think to some degree we believed (or hoped) might guide our path. But it quickly became clear that there was more to be done if we hoped to be able to make an authentic claim that we are organizational allies to marginalized communities in the US. Weekly book discussions weren’t going to cut it. We started thinking about ways to actualize our commitment to antiracism, including opportunities for our site-based colleagues to join the effort, potentially getting involved with antiracist initiatives in Madagascar.

Meanwhile, the PIVOT Science team was onboarding a new member to their team. In September, Dr. Demetrice Jordan joined PIVOT’s research network as a postdoctoral fellow in the Department of Global Health and Social Medicine at Harvard Medical School, having just completed a dual-doctorate in Geography and Environmental Science and Policy. Dr. Jordan, who goes by “Dee,” was introduced to the rest of the team as a health geographer focused on ecological and environmental drivers of vector-borne, parasitic illnesses of sub-Saharan Africa. But we soon also learned that she also had extensive experience in the field of diversity, equity, and inclusion (DEI). While working on her PhD at Michigan State University (MSU), Dee founded the Advancing Geography Through Diversity Program, to address the persistent underrepresentation of African Americans, Latinx Americans, and Native Americans in geography doctoral programs. She is an advocate for creating safe, supportive environments for students of color, and planned and led workshops developed to “engage students, faculty, and the broader MSU community in meaningful dialogues on microaggressions, privilege, cultural sensitivity and diversity.” As a postdoc, Dee developed the Celebrating Black Geographers anthology hosted by the American Geographical Society to highlight the contributions of Black Geographers to the discipline.

(For more on Dee’s DEI work, click here).

It was upon joining our group’s regular discussions on Zoom and Slack that Dee pointed out a key nuance that the rest of us had failed to see up to this point: our decolonization work did not undo the fact that we had a US presence, nor did it serve as a replacement for antiracism work.

In the midst of our active push to emphasize Malagasy leadership and reposition the US-based staff as a “support” tier rather than one of direction, we had lost sight of the fact that our presence in the US can’t simply be overlooked. Not only do we have several US staff and board members, but also a community of hundreds of individuals and foundations who support our work, academic institutions we collaborate with, and vendors whose services we invest in – most of whom are American.

As such, consensus has been established in our US team’s DEI working group around the notion that we can’t effectively advance change elsewhere if we aren’t taking an active part in the movement for change at home. As an organization that espouses the crucial importance of advancing health equity, it is our responsibility to take action against threats to human rights and social justice here in the US. 

We are fortunate that Dee arrived on the scene when she did, and even more so that she was willing to take on the work of guiding our DEI journey. We were awarded a grant to support this very work, which enabled us to contract Dee as our DEI consultant for one year starting in January 2021. For the duration of this first quarter, she has been not only sharing her expertise with us, but also her personal lived experience as an African American woman, all in an effort to help PIVOT better define its organizational contribution to the fight for justice in the US.

Though we’re currently a more racially homogenous group than we’d like to be, each of us comes to these conversations carrying extremely different life experiences, with systems of oppression having touched our lives to varying degrees. But, at the end of the day, we are brought together by a desire to eliminate structural violence of the sort that brought PIVOT into existence in the first place. As a junior member of our team and as a queer woman, I have especially found value in the equalizing effect that this process has had on our group. Weekly conversations across board, management, and staff have ranged from enlightening to uncomfortable, and everything between. Under an umbrella of trust, vulnerability, and a shared desire to do better, we are all learning, we are all making mistakes, and – with much grace from one another – we are evolving. 

Despite what we may feel about the depth of our long standing commitments to social justice on a personal level, as an organization, we are still early in our journey. And, as Dee puts it, “this work never ends.” We are collectively staring down the path that lies ahead, and the crucial growth we’re experiencing as individuals is making it easier to identify the opportunities PIVOT has to take action for change.

I am happy to be able to share now that we have finalized a social justice positioning statement:

Racism and inequity anywhere, in any form, are counter to PIVOT’s core values. We are deepening our commitment to diversity and fight for justice. We invite you to act with us.

These words are our north star in the DEI space. This, along with the four official pillars of our DEI commitment (which we’ll discuss in writing in the near future), will serve as a measure of accountability for PIVOT, to track our progress in moving our deepened commitment forward.

As a start, we are actively building our strategy to diversify recruitment, creating opportunities for exposure to and involvement in our work among marginalized communities through internship and board apprenticeship programs. We are creating guidelines around intentionality when it comes to the cultivation and engagement of the many who comprise our PIVOT community, examining where our funds come from and which vendors they go to. And we are fully committed to listening and learning with greater consciousness – both internally and externally – when it comes to the intent and impact of our communications.

We know that silence equals complicity, so we are stepping boldly into functional allyship. With the knowledge that we have a great deal to learn along the way, we look forward to sharing more of this journey with you in the months and years ahead.


Below, a familiar scene for anyone working over Zoom these days: our US team / DEI working group during a celebratory moment of one of our discussions. (Photo courtesy of our fearless guide, Dee Jordan.)