When Matthew Bonds began his work in Madagascar, one in seven children in the rural, mountainous Ifanadiana District died before they were 5. Women had a one in 14 chance of dying in childbirth. He was determined to use his expertise to change that.
While a student at UGA, Bonds PhD ’03, PhD ’06 found himself split between two worlds. Not only was he working toward a doctorate in economics at the Terry College of Business but also one in ecology at the Odum School of Ecology.
“If you go from one department to another, a lot shifts,” says Bonds. “You go from the college of businesspeople wearing ties to the college of wearing T-shirts with frogs on them.”
Despite the culture shift, Bonds noticed overlap. Economies are complex systems that grow and change as people within them interact. Ecosystems are, too.
Where those two fields truly converged, though, is human health. Infectious diseases arise from interactions with other organisms, and economic status and the strength of health care systems can play a major role in health outcomes.
But Bonds didn’t want only to publish journal articles on health care systems. He wanted to work directly with the people depending on them.
That drive brought him to Rwanda in 2007, when the country was still recovering from the 1994 genocide. While living there, he worked with Partners In Health, a global health and social justice organization, to strengthen the country’s health care system.
Dramatic drops in both maternal and child mortality rates suggested the impact such a program could have. But could the same approach work in other countries?
Partnering with astrophysicist-philanthropists Jim and Robin Herrnstein and physician Michael Rich, Bonds founded Pivot, a data-driven organization focused on improving human health in Madagascar and building data systems that drive further improvements.
Pivot partners with Madagascar’s government to provide emergency transport, improve infrastructure to remote health care centers, and establish health centers for family planning, safe deliveries, and childhood vaccinations. Pivot also conducts research studying the factors affecting access to care and the impact of the organization’s work.
“It’s not that Pivot provides care, and academics study it. The data systems are part of the health care delivery system,” says Bonds, who is also an associate professor of global health and social medicine at Harvard Medical School. “The goal of our scientists isn’t to produce science. The goal is to save lives. And if we stay focused on the goal, then we will do better science.”
At first, Pivot was “building the plane as we were flying it,” creating and monitoring life-saving systems from the ground up. Now, Bonds balances his responsibilities at Harvard with supporting Pivot through research, strategy, and fundraising. He also spends much of his time writing and giving talks about his team’s research in Madagascar.
“You have to both do the intervention and collect data on it,” says Bonds. “The data tells you whether things are actually working and whether people are getting the services that are being provided.”
Since the organization’s launch in 2014, people seek health care three to four times more than they had before. Mortality rates in Ifanadiana have dropped across the board, with a 30% reduction in mortality for children under 5 and a 50% reduction in maternal mortality.
But these encouraging results don’t mean Pivot’s work is over.
“A challenge for academics is we’re supposed to have answers. It’s our job to find answers,” Bonds says. “But I really do feel like by not having all the answers and having faith in the project of higher education, we’ll learn a lot more, and we’ll be able to solve a lot more problems.
“Let’s produce some good in the world. Let’s test what we know and hold ourselves accountable.”