Oregon-based Medical Teams International CEO on operations during federal freeze

Medical Teams International is based in Tigard but its workers and volunteers bring life-saving, humanitarian aid around the world. The faith-based nonprofit’s president and CEO Eric Ha says the refugees they serve in East Africa fled violence, war or natural disasters. Many of them came years ago from Uganda, Ethiopia, Sudan, Tanzania and other countries. The camps over time have become settlements, and in some cases the MTI programs are people’s only access to any kind of medical care - from treating common diseases like cholera and malaria to providing vaccinations to child health to maternity care. Ha joins us to tell us how MTI is handling the Trump-Musk freeze of federal funds from the state department and USAID.

Note: The following transcript was transcribed digitally and validated for accuracy, readability and formatting by an OPB volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. Medical Teams International is based in Tigard, but its workers and volunteers bring life-saving humanitarian aid to people in sub-Saharan Africa, Ukraine and Colombia. Eric Ha is the nonprofit’s president and CEO. He joins us now to talk about MTI’s work and the Trump-Musk freeze on federal funds from the state department and USAID. Eric Ha, welcome to the show.

Eric Ha: Hi, Dave. Thanks for having me.

Miller: Yeah, thanks for making time for us. Can you give us a broad sense for the work that’s done around the world by Medical Teams International?

Ha: Sure. To put it very simply, Medical Teams International provides life-saving health care to people in crisis and vulnerability all around the world.

Miller: What does that look like in Sudan?

Ha: It’s a great example. I’ll give you maybe a story that puts a face, a name and some color to the people that we serve, and the impact of our work. If you can picture with me, Dave, a young woman in Sudan named Kinana. Kinana lives in a community that is directly impacted by the incredible violence that persists in Sudan. She’s six-months pregnant, has small children and driven by this instinct, this maternal instinct, parental instinct, human instinct to protect innocent children – she has to flee. And she ends up traveling over 400 miles, much of it on foot with her children and the child that she’s carrying.

She arrives at a refugee settlement. And you can just imagine after a journey like that, she is tired, she has not eaten, she has not bathed. She’s dehydrated and exhausted. And at the settlement, she is given the opportunity to have these essential needs that human dignity requires to be met. And a portion of those needs, her health care needs, are met by organizations like Medical Teams. So we’re able to provide her and her children the health care that they need to survive, the health care that she needs to deliver a child safely and in health, and from other organizations, to get basic things like food, water and shelter.

Miller: There is so much need in the world. How do you decide as an organization where to focus your resources?

Ha: Yeah, it’s a great question. In many respects, the demand and need, for not just our services but humanitarian services generally, outpaces the supply. So we cannot be everywhere that we would like to be. We go to the places where there is an intersection of a concrete need for the very specific set of services that we can provide, along with operational capacity to be present in those places and the resources that we need to be able to do our work.

Miller: Speaking of resources, how much do you rely on federal funding?

Ha: So about 15% of our annual budget comes from U.S. government funding. It’s a material part of our resourcing portfolio, so the suspension has had a significant impact on us.

Miller: What form or forms does that 15% from the U.S. government take?

Ha: All of them are grants from the state department or USAID, in particular from two bureaus: the Bureau of Population, Refugee and Migration, part of the state department, and the Bureau of Humanitarian Aid, which is part of USAID.

Miller: On Tuesday, the newly-appointed deputy administrator, Peter Marocco, said that since January 20, the state department had terminated more than 700 foreign assistance fund grants and suspended more than 7,000 grants. Was your organization affected by any of those specific terminations or suspensions?

Ha: No, none of our grants were affected by those decisions. The work that is funded by the grants that we received do very much fall within the core of life-saving humanitarian aid that the state department has announced at least an intention to be waived from the suspension orders. So we’re quite confident and optimistic that the administration will honor that waiver.

Miller: Is there infrastructure at the state department or at USAID to actually enable those grants to keep flowing and the work you do to keep happening? Because it’s one thing to say, no, if you’re doing life-saving work, then you can go ahead. But if the people who are administering those grants have been fired, can the money even get to you?

Ha: That’s a great question, Dave. It is very much the tension point that we’re operating under right now. So there have been some recent developments that are quite encouraging, in terms of the machinery actually starting to be put in place to process those existing grants and to implement those waivers. But in many respects, this is unprecedented action. There aren’t existing processes and mechanisms in place, so they have to be built.

We have seen some encouraging signs just in the last several days, indicating that that machinery is being built. But the actual timing of when it’ll be working and fully functioning is still a little bit of an unknown. Even with some measure of confidence that the waivers that were announced will actually be honored and be put in place, the longer it takes to build the machinery, financially, it just becomes harder and harder for organizations like medical teams to balance continuing operations, while still waiting with an unknown timeline for the funding for those activities.

Miller: And just to be clear, Secretary of State Marco Rubio put this out at the end of January: “Implementers of existing life-saving humanitarian assistance programs should continue or resume work if they have stopped, subject to the directions outlined in this waiver … ” And then there are more details after that. Given that you’re providing medical care, it seems pretty clear to be life-saving humanitarian assistance.

Are there other kinds of assistance that you would argue are life-saving but are not being seen as such by the administration?

Ha: The short answer is I’m not sure because there is not yet particularity in terms of what the administration is going to consider life-saving or not. There’s been more information and more guidance that has been trickling out that, again, is quite encouraging and honestly quite broad in its definition. But until the drawdown and reimbursement requests under these grants are actually processed and payments made, we don’t know for certain what is or is not going to be considered a life-saving humanitarian aid.

Miller: But am I right that for all of this so far, we’ve been talking about grants that have already been applied for and approved?

Ha: Yes, these are existing grants.

Miller: I asked that because there was also this line in the announcement from Secretary Rubio: “This resumption is temporary in nature and with limited exceptions as needed to continue life-saving humanitarian assistance programs. No new contracts shall be entered into.” So, what are you thinking about when you look in the longer-term?

Ha: Well, that is the big question, Dave. We have been initially very much focused on how to sustain as much of our work as we can over this 90-day suspension period. The big question I think medical teams, and our peer and partner organizations across the sector are having to really start turning our attention to is, what are the macro implications to the international humanitarian ecosystem? The 90-day suspension was put in place so that the new administration could reevaluate/reassess their funding priorities and their foreign aid priorities. Obviously, they need to go through that process to determine what that’s going to be. But it could be a significant change in the resourcing that is available, not just from the U.S. government but from other agencies and institutions that have worked with the U.S. government for humanitarian assistance.

So for medical teams, we are looking at a wide range of scenarios and trying to proactively prepare ourselves for a wide range of potential outcomes over the next several months. But there are a lot of unknowns and ambiguity as to what outcome is going to be.

Miller: What kinds of conversations are you having with your colleagues in the humanitarian world? I’m imagining text threads blowing up over the last month, but I’m truly curious what you all have been saying to each other.

Ha: There’s quite a lot of solidarity and honestly a lot of grieving, because even to this point, the uncertainty and some of the actions that have been taken have resulted in really significant outcomes. So whether it’s thousands of faithful, good people at USAID having now lost their jobs; or because of the financial uncertainty, staff having to be significantly reduced; or as I mentioned before, really significant populations of people in extreme vulnerability, all of a sudden losing access to really critical essential services and care – there’s a lot of grieving happening over all of that.

But I think it is also one of those galvanizing things that can bring a community together to bear the power of collective action. So whether it is advocacy efforts or mutual support and partnership to continue services, to even strategizing on alternative resources and places from which we can draw resources to continue our work, the solidarity and collaboration amongst the community has been really encouraging to see.

Miller: You wrote a recent op-ed in Time Magazine that had these lines: “If U.S. government support for humanitarian aid is retreating, then the church must advance, not simply to fill a void left by the withdrawal of the U.S. government but to live into the fullness of the church’s calling and purpose.” You did go on to say that the church needs to challenge that governmental retreat. But I can easily imagine members of the Trump administration reading parts of your piece and saying, excellent, this is our plan. Nonprofits and religious organizations, they can step in, they can be the do-gooders, so we don’t have to be, so we don’t have to spend U.S. taxpayer money outside our country.

How do you think about the balance between the public sector and the private sector, when it comes to this kind of aid?

Ha: Just to be crystal clear that that is not what I was suggesting in that piece.

Miller: No, I hope I made that clear as well. I mean, you specifically said we need to challenge this. But do you disagree that somebody could, with their own interest in mind, read parts of your essay and say “Great, they’ll take care of it. We don’t need to”?

Ha: Absolutely, it’s a totally fair question. One of the things that I also state in there, and as I said before, the need for these types of services and care, and the number of people who are being put in just incredible places of crisis and vulnerability, far exceeds the existing supply and capacity to meet it. So government aid versus the church, civil society and people of goodwill engaging in that work is not a zero-sum or competitive environment. It’s a collaborative one. It’s one of partnership. So it’s not something that any of those parties should feel like can be outsourced and be fully carried by the other, because the need is just too great.

For the United States, in particular, there are reasons ranging from sort of the principles and values upon which this country was founded, to its own national security and national interests that make a really compelling case for the United States to continue … and not just continue but to expand and devote more resources to humanitarian work all around the world. And to continue doing that in partnership with the church, with faith communities, with people of goodwill. There is an extraordinary amount of need in the world and there’s plenty of room for all actors to have a part in it.

Miller: Medical Teams International, as I mentioned briefly at the beginning, operates in Ukraine, in addition to a lot of work in sub-Saharan Africa. As I’m sure our listeners know it – and as we’re going to talk about in detail on Monday – this week, President Trump embraced Russia, blamed Ukraine for starting a war it did not start and broadly threatened to upend the last 80 years of the post-World War II order in Europe. How might this affect the work that your nonprofit is doing in Ukraine?

Ha: We’re certainly very mindful of all of those developments. What it’s creating is continued instability and in an environment where a nation that has been in a really precarious state for years now has even further anxiety and concern.

So first and foremost, we are, of course, always mindful of just the increase in security and safety risks that might come with further instability. But any allowance of further conflict and violence in the region is going to create more displacement and more vulnerability. Right now, we do work with U.S. funding for our work in Ukraine as well. So again, the availability of resources, whether it’s from the U.S. or from other international agencies to continue meeting what will be a persistent and potentially growing need, is very much on our radar.

Miller: How much faith do you think your international partners have in the U.S. right now?

Ha: Well, that’s a really great question, Dave. I don’t know if I have a great answer. The way in which the administration has taken such a broad-stroke approach to suspending work, it certainly hasn’t done anything to help our credibility. There are so many international organizations, partners that rely on the commitments that were made through grants and through contracts. And pausing them, suspending them, freezing them without some of these critical mechanisms in place to honor the commitments that have been made, it’s really, really difficult. It’s a very difficult situation and I can only imagine that it is calling into question our reliability as a partner.

Miller: Eric Ha, thanks very much.

Ha: Thank you very much, Dave.

Miller: Eric Ha is the president and CEO of Oregon-based Medical Teams International.

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