1: What are you trying to accomplish?
2: What's your evidence that you can accomplish it?
3: How is it possible that you can provide an open heart surgery in Iraq for less than $1,000? Is that the full cost?
4: So is that the same thing as saying that my donation doesn't really make a difference? That the "up to 85%" funded locally by those inside Iraq is all that is really necessary to make this work?
5: Any other costs?
6: What is the bottleneck to more surgeries: money or skilled labor?
7: I'm skeptical of non-profits and charities because they always seem to be asking for more money. How can I be sure that Preemptive Love Coalition has "room for more funding" and that I'm not paying into a huge savings account, "Rainy Day Fund", or something similar?
8: Do you have enough volunteer surgeons available for unfunded Remedy Missions? (i.e., are there trips that you could fund if you had more money, or is there a labor bottleneck?)
9: Many heart surgeries require follow-up treatment (including additional surgeries). Do you have a way of providing these to patients?
10: How do you assess whether surgeries are completed competently and appropriately?
11: What is the rate of complications during and following surgery?
12: How do you assess whether surgeons are performing additional surgeries that they would have not had the funding or motivation to perform otherwise?
13: How do you assess whether surgeons are charging their patients for the surgeries you fund?
14: Do you follow up with the surgeons you've trained to assess whether they are correctly applying their training?
15: What information is available on the activities - and competence - of the surgeons you've trained?
16: Where do surgeons work after completing training? Do they serve poor patients?
17: How much do you spend each year on "program" expenses and how much on "overhead?"


----------

 Q: What are you trying to accomplish?

A: Train Iraqi heart surgeons and nurses so they can eradicate the backlog of tens of thousands of Iraqi children waiting in line for lifesaving heart surgery. [Back to Top]

 Q: What's your evidence that you can accomplish it?

A: Each year we continue to increase Iraq's total number of pediatric cardiac surgeries with new surgeries in Iraqi centers that would not - indeed could not - have been accomplished otherwise. Ministry of Health (MOH) officials speculate 500 surgeries were accomplished in 2009 (of which we provided 23 - 4.6% - outside the country). The addition of our 82 surgeries in FY 2010 - to the 500 baseline - for a total of 582 approximated surgeries, represents an increase created by PLC of 14% over 2009. In FY 2011 we anticipate increasing Iraq's total number of pediatric cardiac surgeries to at least 719 (or another 19% over FY 2010 directly attributable to our surgeons and our training).

Each year the local teams with which we work will become more proficient, and each year they will independently take on a larger case load than they could have the year before. None of these figures yet account for that additional output.

In March 2010 the Iraqi Ministry of Health asked us to expand our work to three additional sites. In May 2010 we began additional discussions about establishing a fellowship program in which international surgeons and nurses would take up residence in the Iraqi system to train locally for 40 weeks out of the year.

Our model does not rely strictly on volunteers because the level of need in Iraq outstrips what we could reasonably supply through volunteer labor alone. Accordingly, we set our budgets so as to actually contract the international surgical and nursing staff we need to accomplish our mission.

Sure, this increases the cost-per-mission (and thereby, cost-per-child) over early "mission" models in which volunteerism was idealized and training was not necessarily prioritized. But our contract labor + volunteerism model is inarguably the only way to create a nationwide quarterly training program and fellowships inside Iraq with international experts across approximately 6-8 surgical sites. Moreover, our model does not face the same sluggishness of learning that other surgery organizations suffer because we do not have the same rates of turnover; we have incredible consistency across our programs and missions. [Back to Top]

 Q: How is it possible that you can provide an open heart surgery in Iraq for less than $1,000? Is that the full cost?

A: The "less than $1k" numbers we routinely publish represent the amount in "program costs" we spend from our international donor money. The figure does not necessarily account for every single management, overhead, or fundraising expense.

Our total expenditures for FY 2010 were $188,919. We performed 82 surgeries during the same period for a per child total of $2,304 (though this data is a bit moot moving into 2010-11 as we abandon our very expensive "surgery exports" program(s) in Turkey, etc. and focus henceforth on more cost-effective in-country surgeries alone).

When all of our Remedy Mission partners are taken into consideration - including the Iraqi Government, medical companies that donate medicines and supplies, and local organizations - the real Remedy Mission cost to all donors is in the range of $5,400 - $7,000. Put another way, up to 85% of the total cost of a single surgical/training mission is now subsidized by local, Iraqi constituent institutions. [Back to Top]

 Q: So is that the same thing as saying that my donation doesn't really make a difference? That the "up to 85%" funded locally by those inside Iraq is all that is really necessary to make this work?

A: There is not a single site across Iraq for which our Remedy Missions are fully funded. If we fail to provide our 15-19% of the overall budget, Remedy Missions fail, surgeons and nurses do not get trained regularly, on-site audits from our international team do not happen, up to 20 children are delayed from receiving surgery, and a few may even die or become inoperable. Your role in funding the remaining 15-19% is as critical in the short term as any other entity. A single Remedy Mission is binary - it either happens or it doesn't. Your money makes it happen. But our goal is to continue to graduate all our programs so they are 100% funded locally in the next 5-10 years. [Back to Top]

 Q: Any other costs?

A: Our numbers per Remedy Mission do not account for "indirect costs," such as the cost (or value) of our volunteer medical staff from around the world, costs to local healthcare systems, the cost of a family to travel to the surgery site, the opportunity costs of lost income for families as they wait for surgery, etc. The reason we think it's important to note this here is because lifesaving is actually quite difficult. Building a pediatric cardiac surgery system for the entire country of Iraq is laborious and full of complexities. [Back to Top]

 Q: What is the bottleneck to more surgeries: money or skilled labor?

A: People often assume that the biggest need is more Iraqi heart surgeons. We could use a few more, but the real bottleneck is skilled nurses, technicians, and non-surgical physicians. A surgeon is only as good as his support staff. One of our biggest challenges is training pediatric cardiac intensive care nurses. To date, we haven't found a better model than our Remedy Missions through which we bring quarterly hands-on training to local nurses (and surgeons) in Iraq. Rather than exporting the nurses to Europe or the USA for training (whose medical systems barely resemble the Iraqi system), we train them with what they have on hand in their local environment. [Back to Top]

 Q: I'm skeptical of non-profits and charities because they always seem to be asking for more money. How can I be sure that Preemptive Love Coalition has "room for more funding" and that I'm not paying into a huge savings account, "Rainy Day Fund", or something similar?

A: For the record, we are skeptical of non-profits as well! In 2012 PLC needs $350,000 on hand at any given time to cover our cash flow needs for up to three Remedy Missions per quarter. We are still 30% under-funded against that goal. In addition to cash flow needs, we still require 15-19% funding on most of our missions after local sources contribute their portion; we have un-funded pilot programs in new cities where local doctors have been requesting our help (but where weve yet to woo local philanthropists or health directors); and we have research and social service initiatives through our Followthrough program that require funding at present because we have not yet sought local funding for those initiatives (seeing as how they relate mostly to our Monitoring & Impact Evaluation objectives). Please see our "Funding Gap" page to look deeper into our anticipated program costs, the sources of funding we are counting on, and the funding gap between the two for the next few years. [Back to Top]

 Q: Do you have enough volunteer surgeons available for unfunded Remedy Missions? (i.e., are there trips that you could fund if you had more money, or is there a labor bottleneck?)

A: Great question! We use a hybrid volunteer/staff model. Roughly 25-30% of any one of our Remedy Mission teams is employed by the International Children's Heart Foundation (typically the surgeon, scrub nurse, anesthesiologist, ICU doctor, and often a part-time ICU nurse). The remainder of the team typically comprises volunteer physicians, technicians, and nurses from across the world. Because the hardest-to-come-by positions are contract labor for us and NOT volunteers, we have never failed to run a mission for lack of personnel. We have only cancelled or turned down a request for a future mission due to lack of funding. [Back to Top]

 Q: Many heart surgeries require follow-up treatment (including additional surgeries). Do you have a way of providing these to patients?

A: Yes, we do. Our model dictates quarterly visits to each program site (a hospital inside a regional hub). Our reliance on local cardiologists ensures that the local team prioritizes and almost entirely sets the agenda for patient selection (within a development curricula) - after all, Iraqi doctors are the ones who are most intimately connected to the patients and their daily progress! When a local cardiologist sees a child who has either (1) deteriorated and requires another intervention or (2) advanced as expected to the next step of a complex, staged intervention, the child is prioritized for follow-up treatment. [Back to Top]

 Q: How do you assess whether surgeries are completed competently and appropriately?

A: Because we are a broker and play a combination administrative and financier role in the coalition of partners working in Iraq to develop pediatric cardiac care, we are able to stand in-between the local surgical team and the international surgical team (whom we contract as a third-party to train and perform surgeries in Iraq). If the local team or health directorate suspects a lack of competence in the international team, a cavalier attitude, or a single poor judgement call, our role is to be the go-between - to be the advocate for the local healthcare providers vis-a-vis the international surgical team.

Similarly, if the international surgical team feels pushed by the local surgical team to perform procedures with which they are uncomfortable or for which they think the local system is ill-prepared, they are able to refuse children for surgery and/or use us (PLC) as a go-between.

The checks-and-balance between the two teams helps us ensure surgeries are performed in a competent, appropriate manner. [Back to Top]

 Q: What is the rate of complications during and following surgery?

A: We report our in-hospital and 60-day mortality after each Remedy Mission. You can finds those numbers here. We also produce reports after each Remedy Mission detailing the trip, including data on intraoperative complications, post-operative complications, and mortality. You can find those reports here. We are also deliberately raising the funds necessary to help us bring our various heart hospitals into compliance with the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing Countries. If this kind of quality improvement and reporting initiative interests you, we are currently looking for financial partners for our Followthrough program. [Back to Top]

 Q: How do you assess whether surgeons are performing additional surgeries that they would have not had the funding or motivation to perform otherwise?

A: Pediatric heart surgery in Iraq is almost nonexistent without our work. There are two active programs for relatively simple surgeries (one in Erbil and one in Baghdad). Local surgeons claim that combined they perform no more than a few hundred pediatric surgeries a year. In every location where we work, pediatric heart surgery is effectively nonexistent. Therefore, every surgery performed at our program sites (both when we are present and when we are not) are "additional surgeries" that they would not have had the SKILL to perform without the FUNDING we employed to train them in their local environment. [Back to Top]

 Q: How do you assess whether surgeons are charging their patients for the surgeries you fund?

A: Because we work in public (government) hospitals - and because healthcare in Iraq is provided almost entirely free of charge - it is widely known that any cardiologist, surgeon, or administrator seeking compensation for services is acting outside of Iraqi law. [Back to Top]

 Q: Do you follow up with the surgeons you've trained to assess whether they are correctly applying their training?

A: We see them quarterly in their local environment and perform real-time audits of their skills, recollection of past training, application of new techniques, etc. Additionally, our international surgeon remains on call at any time via phone, Skype, or email for consultation. [Back to Top]

 Q: What information is available on the activities - and competence - of the surgeons you've trained?

A: Because our Remedy Mission training program only began in late 2010 - and pediatric heart surgery at our sites across Iraq is the same age - there is still relatively little independent practice to report, and therefore little data on the activities and competence of our surgeons and their teams. But as they begin performing more surgeries independently, we are trying to align each site/surgical team with the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing Countries (a data collection and tracking initiative of Children's Hospital Boston and Harvard University). [Back to Top]

 Q: Where do surgeons work after completing training? Do they serve poor patients?

A: As of Q2 2011 there was only one private hospital in Iraq (to our knowledge) providing pediatric heart surgery (and those surgeries were on the lower end of the complexity scale). Our work does not necessarily mean to exclude private hospitals as they continue to come online and become viable options, but at present the government system has a better equipped foundation for training local surgical teams. As we look to fully graduate our local surgical teams in the next 5-10 years, we imagine that most of them will stay in the public sector for all of the stability, pensions, and benefits of loyalty provided to those who stick with it. But, undoubtedly, some will seek positions at private hospitals (assuming private hospitals are willing to invest in the requisite capital purchases necessary to establish a credible program). In the public sector, rich and poor are served alike. In the private sector, poorer patients would be at an obvious disadvantage. [Back to Top]

 Q: How much do you spend each year on "program" expenses and how much on "overhead?"

A: As a rule, we do not adhere to the model that claims that "overhead" is somehow bad and "program" is somehow good. There are very bad program expenses. There are overhead expenses that are excellent investments. We agree with Paul Brest, President of the Hewlett Foundation, when he said, "Achieving a low overhead ratio drives many charities to behaviors that make them less effective and means more, not less, wasted dollars." Therefore, we spend as much on overhead as we need to accomplish our mission. The mission itself is our North Star - not arbitrary (even harmful) standards about overhead-vs-program expenditures. For the record, however, you can find a current pie chart of our expenditures here (and if you're into that sort of thing, you'll probably be impressed!). [Back to Top]

Jeremy Courtney Founder, Executive Director Twitter: @Jeremy_Courtney

“I'd love to hear any critique or questions you might have!”

DROP A NOTE OR DONATION BY MAIL: Preemptive Love Coalition 1300 Darbyton Dr. Hewitt, TX 76643 GIVE BY PHONE: To make a gift over the phone, using your credit card (Visa, MasterCard, American Express, or Discover), please call +1 (806) 853-9131 during normal business hours. IRAQ OFFICE: +964 770-355-6298 (local)

Grab Your Backpack, Let’s Go—Zahraa Is Leaving The ICU!

February 20, 2012 by matt · Leave a Comment 

Good news! Zahraa (AKA the girl in the red coat) made it through surgery and is now in the ICU resting up.

In an effort to cheer her up, the ICU nurses gave her Dora the Explorer stickers and have been singing the theme song with her. It was a sweet moment, but now I can’t get that song out of my head!

Zahraa’s operation went so well that they are releasing her from the ICU soon. She will then spend a day or two in the ward, and after that she goes home!

I plan to visit the family’s hospital room after Zahraa is released, so come back tomorrow to hear more about this precious little girl and her trek toward recovery.

Come on, vamanos!

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

Her Name Is Zahraa, And She Probably Loves You

February 20, 2012 by matt · Leave a Comment 

We passed the midway point of Remedy Mission IX, and, for me, everything seemed to be moving in slow-motion.

It was the best problem any hospital could hope for: boredom.

When the alternatives are problems like drama between medical staff, complications in the ICU, or even death, I’ll take boredom any day!

I had already completed my morning rounds of photos and family meet-’n-greets, and I was back dozing in the break room, debating whether or not to eat an extremely unripe banana.

Then the break room door opened and in walked the little girl in the red coat. She was hugging a doll and squeaking something at me in Arabic.

Her dad poked his head into the room, apparently glad to have found her. He seemed embarrassed by her intrusion, but we invited them to sit and share their story.

I learned that the girl’s name is Zahraa, she is 6 years old, she has a beyond-your-typical-little-girl obsession with dolls, and she needs an urgent heart surgery.

While talking with her father, Zahraa leaned toward me from her dad’s arms and whispered something to me in Arabic.

“She says she loves you,” a translator explained.

Initiating heart meltdown.

As if that wasn’t enough, she proceeded to grab my head and kiss me on the cheek and then to tell everyone else in the room that she loved them, too. Her malformed heart certainly has no trouble expressing love! But she still needs an operation and, according to her father, it is scheduled to happen soon.

Come back tomorrow and I’ll tell you more about the little girl in the red coat and her (hopefully) lifesaving operation!

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

“His Surgery Would Be Five Years Away”—A Father Shares His Story!

February 15, 2012 by matt · Leave a Comment 

Doctors assigned little Nassir a number—119—and then told him to get in line.

“Should I get a hotel near the hospital for a few days?” his father asked. “No, come back in 5 or 6 years.” So Nassir’s father went home dejected with nothing to do but wait. But waiting could render Nassir inoperable, and then it would be too late.

But, thanks to you, Nassir and his family are getting another chance. Click here to listen to a father tell of his search for a surgery.

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

“…The Feeling of Being About to Reach My Dream!”

February 13, 2012 by matt · Leave a Comment 

“But nothing else makes me feel like this; just the feeling of internal happiness; the feeling of being on the short way to being a cardiac surgeon—even a beginner one—the feeling of being about to reach my dream!”

This came in an email from one of the local surgeons receiving training right now in southern Iraq! This doctor’s excitement is so contagious—he even makes me want to learn more about medicine. Thank you for empowering his compassion for his compatriots!

###

We are now halfway through our ninth surgical mission in Iraq, and the excitement has yet to die down. The press are swarming our break room even as I write this, and we’re looking into every lens and delivering the same message: there is a Coalition that is committed to eradicating this backlog of children in need of surgery!

Seven days in, and we have already seen ten children receive surgery. Come back tomorrow to meet one of my favorites!

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

No More Crying—Hamma Is Going Home!

February 12, 2012 by matt · Leave a Comment 

I was a little worried when Hamma had to be carried from the ICU into the children’s ward. But the doctors said he is doing well and should be able to go home in a few hours. Then, sure enough, he perked up and now he’s walking all over the place!

After a sick heart, a smashed nose, and a surgery, I finally got what seems to be a smile out of this little boy. Isn’t he cute?

And he has reason to smile! His surgery was a complete success, and he is going home. Thank you for making Hamma’s surgery possible, and thank you for putting his best days ahead of him!

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

Hamma Is In Surgery!

February 11, 2012 by matt · Leave a Comment 

Remember super-sad-faced Hamma?! He’s getting surgery now!

I spent much of the day running in and out of the operating room to check on him. His father kept poking his head in from the hallway and whispering, “Psst! Mister! Photo Hamma?”

I felt like an image delivery boy with all the running back-and-forth, but letting Hamma’s dad ‘watch’ his son’s progress through surgery was extremely rewarding—at one point he even side-hugged me!

Here are a few of the photos I showed dad throughout the day:

(The boy isn’t alone here, the nurse just stepped away from the window)

As you can imagine, each picture I showed them brought on strong emotions, and by the end of the day his parent’s eyes were bloodshot from lack of sleep and crying. But the doctors report that the surgery is going well.

More to come…

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

Believe It Or Not, Things Are Looking Up For Hamma!

February 10, 2012 by matt · Leave a Comment 

This little guy is having a rough day.

And we’ve all been here, haven’t we? Sitting on some cold table with a bunch of strange people poking and prodding. It’s not the kind of photo we show you a lot, but faces like this aren’t uncommon to our work.

With a few exceptions, kids generally hate hospitals—this little guy even more than most. His name is Hamma, and his problems started about a year ago when doctors told his parents of Hamma’s need for heart surgery.

As if that weren’t enough, Hamma fell down the stairs a couple weeks ago while chasing his sister and broke his nose. I’m not sure which was more painful: the shame of being bested by your little sister or actually smashing your face in, but add his oxygen-deprived blood and the fact that he hadn’t eaten all day and this is the kind of face you get.

But there is a light at the end of Hamma’s tunnel! In fact, I think his best days are ahead of him, but he needs surgery first.

I sat with his parents in their hospital room and told them why we’re here, I told them about you, and I explained that the doctors have high hopes for Hamma’s surgery.

He is in line for surgery—come back tomorrow and I’ll let you know how it goes!

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

Seatbelts Fastened & Tray Tables Upright—Remedy Mission IX Is Here!

February 9, 2012 by matt · Leave a Comment 

Remedy Mission IX is here!

This is our first surgical mission in the holy city of Najaf in southern Iraq, and the excitement is electric! The local doctors can’t imagine the extraordinary operations they’re about to see, and families can’t imagine the hope they’re about to find.

And you made that possible! You chipped in, you told your friends, you skateboarded, you ran marathons, and so much more, and now we’re flying south to embody that good will.

Here we go…

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

Three Ways to Pursue Your Vision While in a Holding Pattern

February 3, 2012 by Jeremy · Leave a Comment 

Note: This is the third post of a three-part series on defining and achieving Vision. Click the links to read part one and part two.

I remember those early, heady days when we founded the Preemptive Love Coalition and we envisioned—for the first time—an Iraq free of the burdensome backlog of children waiting in line for heart surgery. I remember calling families to alert them that we could finally send their child to heart surgery, only to hear on the other end of the line a polite-but-devastated, “It’s too late. My child died yesterday.”



I’ve sat in different waiting rooms across the country where children were waiting to be seen by the doctor, and I’ve seen children die before my eyes—literally while waiting in line.

We’ve said from the beginning that our mission is to “eradicate the backlog.” But our vision, stated more positively, is that every Iraqi child would have access to the surgical intervention they require to thrive.

Since 2003 and the start of the war, an estimated 50,000 children have been born into The Backlog. There is no way of knowing how many were already alive and waiting in line before that time; nor do we know how many we have lost during that period nationwide.

In that time, while seeking to serve these children, we have faced bombings, death threats, the imprisonment of our staff, armed conflict in the cities where we’ve worked, political roils, funding crises, and partnerships that have turned predatory.

The minefields you will have to endure while pursuing your vision are complex. All the easy stuff has been accomplished already! The things that remain are usually fraught with risk and even danger. Depending on your context, it will become impossible at times to move forward with your vision at all.

So what do you do when you are placed in a holding pattern? Like these Iraqi children I’ve sat with and held, the “waiting room” is where many a vision has died. Visions need activity. They need momentum. They need progress.

Below are three things I’ve consistently done to nurture vision while stuck, for reasons beyond my control, in the waiting room.

1) Plan. Whether the vision you are nurturing is one for your marriage, your children, your business, or some social issue across the world, nothing gets done well without planning. When you start to become dissatisfied with the world (marriage, business, etc) as it is; when you start to envision a better way to live or a solution to one of the world’s intractable problems, you must begin to plan.



Planning means different things relative to the vision in question. It might mean quiet research on the problem itself. It might require a lot of info gathering about proposed and enacted solutions currently in the marketplace. If the problem is really so bad, why has no one else tackled it yet? What are the obstacles to success? Is the space crowded with solutions already? What would you need to do in order to bring something new to the field? What will it cost if it all goes well? What will it cost if it all goes terribly? 



Woe to the visionary who jumps in without planning. The waiting room is one of the most important places for a vision to begin, as it gives us time to make our missteps on paper before ever spending a dime or wasting the time of others in the real world.

2) Position. I’ve met many people along this journey who want to eradicate poverty, provide clean water, transform social problems across Iraq and the Middle East, etc. Among the worst things I’ve seen passionate visionaries do is a chronic failure to become well-positioned in the field of choice so that expertise and solutions might flow more naturally.



A well-intentioned twenty-something starts a new non-profit organization out of Idaho to help Darfur. A well-to-do family from the suburbs launches a ministry to the homeless downtown. A businessman seeks to change industries and launch a new venture at the invitation of a friend.

Sometimes these things work well enough. But if you are pursuing a vision for the future as it should be, and not merely as it is, you must position yourself for the desired change.

Whenever possible, I advocate networking and proximity. Trying to engineer a vision for another part of the world from the comfort of your living room in America is usually a bad idea. A reliance on internet material instead of diverse, first-hand accounts from your customers or constituents just won’t cut it. Whether you are in business or in international development—indeed even as a parent or a spouse—vision is about meeting the needs of others. We must be in a position to accurately understand the needs of those for whom we are pursuing our vision.

When the waiting room keeps you from fully acting upon your desired vision, sometimes the best thing you can do is move your body; get closer to the action; and hold more meetings with all relevant parties to ensure that you deeply understand the issues affecting them.

3) Pray. I won’t spend my time on a vision that I can accomplish on my own. Anything small enough to be accomplished by me, without the intervention of God, is a task that I am happy to forgo and leave for someone else.

When I pursue vision, I choose to work on things that overwhelm me and cause me to go to God in prayerful dependence. In fact, one of the greatest things for me about pursuing vision is the act of worship that it can become; not worship of the vision itself, but worship of the God who alone can sovereignly work through human freedom to bring about a better future.

I realize not all readers and visionaries will agree with me on this point. But when I am sitting in the waiting room of vision (or riding the wave of visionary success, for that matter), I commit myself again and again to God who hears, who cares, and who proactively works in this world to set all wrongs to right.

The snares that lay in wait for you on your journey to fulfill your vision are beyond number. The delays and unexpected detours have caused the death of countless visions and visionaries. Planning, positioning and prayer are neither exhaustive nor fool-proof, but without these disciplines, my vision that every Iraqi child would have access to the cardiac surgical intervention they require to thrive in childhood and become fully-contributing members of society would have long-since died in the many waiting rooms that have beset us along the way.

Are you in a holding pattern? Are you waiting on details to be clarified? Is your how still taking shape now that you’ve defined the what of your vision?

Keep planning, get positioned, and by all means I commend to you the God Who Cares.

These things are not passing. They are still a part of the active pursuit of your vision. Do you see it differently? Do you have other disciplines you use when stuck in one of life’s waiting rooms? I would love to hear about it. Send me an email by clicking this link.

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @Jeremy_Courtney.

VIDEO: Watch Jeremy Courtney Speak At TEDxBaghdad!

February 1, 2012 by matt · Leave a Comment 

Iraq’s first-ever TEDx event happened in Baghdad and, as the only westerner to attend TEDxBaghdad’s inaugural conference, it was an honor for us to have Jeremy attend as a speaker.

Jeremy spoke on the concept of ‘preemptive love’ and its ability to heal, reconcile and restore people to right relationship with one another. If you’re having trouble loading the video above, just click here.

As PLC's Press Secretary, Matt Willingham is bent on leveraging words and media to connect hearts and minds to Iraqi children in need. On the side, he likes reading old books, devouring the great food his wife cooks up and dabbling in DSLR video work. He's also mildly obsessed with Twitter: @mehtin.

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Preemptive Love Coalition provides lifesaving heart surgeries for Iraqi kids in pursuit of peace between communities at odds. We offer the 30,000 Iraqi children suffering from life-threatening heart defects a chance at the surgery they need to save their lives. With our world-class international surgical partners we create long-term solutions by training local Iraqi doctors and nurses so they can sustainably save lives without our help.

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