1. The Partnership for Public Service presented eight Service to America Medals to outstanding public servants whose remarkable work is making the world safer, healthier and greener – at a Washington, D.C. gala held in their honor, September 16.

    The Service to America Medals have earned a reputation as one of the most prestigious awards dedicated to celebrating America’s civil servants.

    The top medal - Federal Employee of the Year - went to USAID’s Richard Greene, whose work has the ultimate impact: it saves lives. Greene leads the President's Malaria Initiative which has provided potentially life-saving services to more than 25 million vulnerable women and children in 15 African countries.

    Additional Service to America Medals were presented to federal workers who boast achievements in renewable energy, patient care, foreign affairs, law enforcement, homeland security, and combating climate change. Medalists come from the Departments of the Air Force, Veterans Affairs, Justice, State, Energy, the National Oceanic and Atmospheric Administration, the U.S. Agency for International Development and the U.S. Environmental Protection Agency. They work and live in Washington, D.C., Seattle, Pittsburgh, and San Antonio.

    “The recipients of the Service to America Medal exemplify the very best of our public servants,” said Partnership for Public Service President Max Stier. “The work that they do touches our lives each and every day – from securing our homeland to international affairs.”

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  2. One million deaths remind us malaria is lethal. Richard Greene reminds us it is preventable.

    Malaria claims the lives of 1 million people each year. Eighty percent of these deaths are children under five, and 80 percent are in Sub-Saharan Africa. What makes these losses even more tragic is the fact that malaria is both preventable and treatable. The U.S. Agency for International Development’s (USAID) Richard Greene is the day-to-day manager of an unprecedented government effort to fight this deadly disease. And it’s succeeding. Within its first two years, this effort provided services to 25 million children and pregnant women, and these services are having the ultimate impact: they are saving lives.

    In June 2005, President Bush launched the President’s Malaria Initiative (PMI) and pledged more than $1.2 billion over five years to reduce malaria deaths by 50 percent in 15 African countries. To achieve this goal, the initiative sought to reach 85 percent of children under five and pregnant women with the tools needed to prevent and treat malaria, such as insecticide-treated mosquito nets, anti-malarial drugs and indoor spraying programs.

    The PMI is an interagency initiative led by USAID in partnership with the Centers for Disease Control and Prevention (CDC). The effort is overseen by a coordinator appointed by the President. Greene, who was already running USAID’s central office to combat infectious diseases abroad, was chosen to develop the plan and launch the initiative.

    When taking on a disease that kills a child in Africa every 30 seconds, it is not enough to simply purchase the insecticides, nets and medicines, and give them to countries that need them. To make the PMI most effective, Greene provided hands-on leadership to establish supply chains and other management systems that ensure these life-saving supplies reach the people that need them. The PMI trains residents in remote villages to become community health workers, who in turn educate the community and distribute the resources to prevent and treat malaria. The PMI also improves malaria diagnosis and treatment practices in public and private health facilities.

    The results achieved during the first two years of this program have been remarkable. In its first year, the initiative reached more than 6 million people with insecticide-treated mosquito nets, spraying and therapeutic drugs. By the end of its second year, it had protected more than 17 million people through spraying, distributed more than 4.7 million insecticide-treated nets and distributed life-saving drugs to 6.2 million people. In year three, the program expanded from eight countries to 15.

    Greene’s dedication and leadership were critical to the program’s early success. He led the day-to-day implementation of the plan, and is credited with mobilizing programs and helping to launch services in record time while tailoring different approaches to fit the needs of each individual country. He has led his own team from USAID, coordinating their efforts with staff at CDC as well as government officials in host countries and multinational institutions.

    Greene’s work on the PMI is the pinnacle of a life spent in service to others around the globe. He began his career as a Peace Corps volunteer in the Ivory Coast in 1978. After taking a job with USAID in 1984, he spent 15 consecutive years overseas in places ranging from Sudan to Cameroon to Bangladesh. He eventually settled in as the head of USAID’s Office of Health, Infectious Diseases and Nutrition in the Bureau for Global Health, and he has put the agency on the cutting edge of addressing key global health issues.

    The President’s Malaria Initiative and these other efforts represent America at its best, exemplifying the generosity of the American people and our commitment to helping those most in need. In that same vein, Richard Greene represents government at its best. He reminds us that when we come together in service of a common cause, we discover the best in ourselves and we can transform the lives of others across the globe.

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  3. Thousands of veterans are coping with traumatic injuries. Dave Carballeyra is helping our wounded soldiers recover faster and more fully.

    Due to advances in medicine and technology, the fatality rate for service members wounded in combat has been dramatically reduced. Once a life has been saved, our government has an obligation to use all the tools at its disposal to restore the quality of life for these injured veterans. Dave Carballeyra, 25, is helping surgeons rebuild veterans’ bodies, so veterans can rebuild their lives.

    Within his first year as a civilian employee of the Air Force, Carballeyra transformed the United States Air Force’s sole three-dimensional medical modeling laboratory, the Department of Defense’s first lab of this type, into a cutting-edge facility that provides innovative aids to surgeons and rehabilitative specialists treating wounded fighters.

    Three-dimensional modeling is a tool increasingly used in the medical profession to prepare for complex surgeries and to develop surgical guides. It involves using computers to analyze patients’ injuries and create virtual models that are used to shape and fit prostheses and provide guides for surgeries. The result is surgical procedures that are dramatically safer, simpler and faster. For example, when preparing to attach an ear prosthesis, doctors would review scan images and use a needle to mark the bone with dye. Then, they drilled into the bone to place implants for attaching the prosthesis. If a hole was not drilled in exactly the right place to hold the implant correctly, they repeated the procedure. It was not uncommon for doctors to have to drill five or six holes before correctly anchoring two or three implants. With the technology Carballeyra has introduced at Lackland Air Force Base, they can accurately determine the optimal places to drill and create a surgical guide that is laid over the patient to ensure precise placement during the procedure. So far, doctors using this technology with Carballeyra’s assistance have drilled in the right place 100 percent of the time.

    Technology introduced by Carballeyra also enables virtual sculpting of tissues lost in battle by soldiers returning from Iraq and Afghanistan with burns over 80 percent of their bodies. These injuries require a longer and more complex rehabilitation process than other wounds. Severe cases often require the rebuilding of facial extremities with lifelike prostheses, which greatly help these patients reintegrate into society.

    In addition to using 3-D imaging to design reconstructions, Carballeyra also creates detailed models on which surgeons can practice and perfect new techniques. This technology allows doctors to hone their precision and increase the success rate of each surgery by practicing on a digital model that reacts like an actual body. The practice scalpel is connected to a computer, and it can simulate the resistance of cutting through bone and muscle.

    By allowing for less invasive procedures, Carballeyra’s efforts have cut surgical time for some procedures in half. Fewer X-rays are needed during surgery to ensure proper placement. Surgeons make fewer and smaller incisions. Patients spend less time under anesthesia. Most important, surgeries using these technologies and methods result in better outcomes for the patients.

    With limited resources, 25-year-old Dave Carballeyra has introduced the latest practices into our military’s medical care system. In turn, our most severely wounded veterans can resume living full and productive lives.

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  4. Many people are asking if we can tackle an environmental challenge as great as climate change. Dr. Stephen Andersen proves that we can.

    Our nation and our planet face a significant challenge. Human activities are causing changes that could have a devastating impact on our health and environment. The big question is, Can we do anything about it? Thanks to a lot of hard work, the answer is a definitive yes. We know this because this question predates today’s debate about climate change. It was asked more than 20 years ago, when the global community sought solutions to the problem of ozone depletion. The United States and 23 nations responded with the Montreal Protocol, a landmark treaty that has restored the earth’s ozone layer by eliminating 95 percent of the world’s ozone-depleting substances. Dr. Stephen Andersen of the Environmental Protection Agency was one of the key people who implemented the Montreal Protocol. Two decades later, he is still working at EPA to combat threats to our environment, and he is a big reason to be hopeful that we can beat climate change the same way we beat ozone depletion.

    Dr. Andersen has made a career of organizing and inspiring people to solve daunting environmental challenges. He began work on climate and ozone protection in 1974, when he participated in a project to study the environmental effects of supersonic aircrafts. In 1986, he came to work at the EPA’s fledgling Stratospheric Protection Team.

    The timing of Dr. Andersen’s arrival at EPA was fortuitous, because the following year would prove to be a watershed moment in the effort to stop ozone depletion, which increased risks of skin cancer and threatened to wipe out crops and ecosystems, among many adverse impacts. The Montreal Protocol of 1987 created a timetable to phase out and eliminate the production of substances that deplete the stratospheric ozone layer, and is widely recognized as the most successful international environmental agreement. In 1988, Dr. Andersen became the founding co-chair of the Montreal Protocol Technology and Economic Assessment Panel. In this position, he secured the voluntary participation of hundreds of industry and military experts to advance the goals of the treaty, which has successfully eliminated virtually all of the world’s ozone-depleting substances.

    In many ways, the Montreal Protocol was a victim of its own success. By 2006, some called for dismantling the treaty, claiming it had achieved its goals and outlived its usefulness. Dr. Andersen knew that the Protocol needed to be not only preserved, but strengthened. He assembled a team of scientists to produce a groundbreaking 2007 article entitled, “The Importance of the Montreal Protocol in Protecting Climate.” The team quantified the benefits of the Montreal Protocol, and found that it helped prevent 11 billion metric tons of carbon-dioxide equivalent emissions per year from 1990 to 2010. These reductions have delayed the impacts of climate change by 7 to 12 years. When combined with voluntary and national measures in the 1970s, the delay in climate change is 35 to 41 years.

    As a direct result of his efforts, nine countries, including the United States, agreed in September 2007 to strengthen the treaty, specifically by speeding up the phase-out of hydrofluorocarbons (HCFCs) by more than a decade. The treaty was also strengthened to include mandatory requirements for the first time, and Dr. Andersen provided scientific and technical information to secure the endorsement of officials in China, which is essential to any international effort to combat climate change.

    In addition to his work on the Montreal Protocol, the most distinguishing characteristic of Dr. Andersen’s career has been his ability to build partnerships. In 1986, he teamed with Soviet authorities to negotiate the launch of an ozone-mapping spectrometer on a Russian spacecraft — the first cooperative effort by the Russians and Americans to use space technology peacefully. He helped negotiate the phaseout of CFC refrigerator manufacturing in Thailand, and he has succeeded in multiple efforts to forge voluntary partnerships between EPA and industry to advance pro-environment practices.

    Dr. Stephen Andersen has proven that we can build the necessary coalitions and take actions to tackle major environmental challenges like climate change. The American people are lucky to have him leading our government’s efforts to confront this historic issue.

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  5. Hospital-borne infections kill more people each year than HIV-AIDS. Dr. Rajiv Jain is reducing these preventable ailments and saving lives.

    When people go the hospital, they expect the visit to make them well, not sick. But the Institute of Medicine estimates that 2 million patients acquire infections in U.S. hospitals every year, and 100,000 of those patients die — often following what began as a routine procedure. Dr. Rajiv Jain and his team at the Department of Veterans Affairs’ Pittsburgh Healthcare System (VAPHS) are leading the effort to dramatically reduce that number. These efforts have already cut infections at the Pittsburgh facility by 60 percent and are providing a model for infection reduction that is being replicated across the country and in other parts of the world.

    A significant cause of hospital-acquired infections is the virulent pathogen, Methicillin-Resistant Staphylococcus Aureus, commonly known as MRSA (pronounced Mer-sah). It cannot be killed by most antibiotics. It can cause debilitating illness, excruciating suffering and death. The cost of treating infections is quite significant. MRSA is rampant in health care facilities and medical experts consider it one of the nation’s most alarming public health threats. This “superbug” kills more people than AIDS, diabetes or Alzheimers, according to the Centers for Disease Control and Prevention (CDC). However, as Dr. Jain and his MRSA Prevention Team have proven, MRSA infections are preventable.

    Dr. Jain and his team used a four-pronged prevention strategy, referred to as the MRSA Bundle — Hand Hygiene, Active Surveillance, Contact Precautions and Cultural Transformation. With the guidance and encouragement of Dr. Jain, infection control is now everyone’s job at the Pittsburgh hospital. Front-line staff and MRSA coordinators (a position created by Dr. Jain) review data weekly to determine how any transmissions occurred and identify barriers to controlling infection. Dr. Jain’s adaptation of “positive deviance,” an innovative approach to behavioral and culture change, is used to foster leadership support of staff-owned and -operated solutions.

    The evidence is in. The plan is working. The number of MRSA infections at Dr. Jain’s hospital dropped from an average of 60 infections annually to 17 last year. The surgical unit at the hospital has cut its rate by 70 percent. The success of the MRSA Prevention Initiative has not only improved the safety and quality of life for patients, but it has also resulted in substantial cost savings and efficiencies.

    People across the country, including teams at CDC, have taken notice of this success. Under Dr. Jain’s leadership, the MRSA Bundle has been implemented at all 153 VA hospitals, and the Department of Veterans Affairs is planning to expand this effort to its community living centers.

    The Governor of Pennsylvania visited VA Pittsburgh to highlight the work done at the Hospital to reduce MRSA infections and has called on hospitals across the commonwealth of Pennsylvania to do the same.

    Based in part on work by Dr. Jain and his team, three state legislatures broke new ground in 2007 by passing bills requiring hospitals to test high-risk patients routinely. Eighteen states now require hospitals to publish their infection rates.

    This MRSA Prevention Initiative has attracted visitors to VAPHS from hospitals around the U.S. and abroad, including Germany and, most recently, the United Kingdom. The delegates from these countries come to learn more about VAPHS’ research and see first-hand the improvements achieved.

    Dr. Rajiv Jain’s team’s accomplishments are remarkable, dramatically reducing the rates of a deadly affliction. But he is still not satisfied. He often says, “One infection is too many.” Hopefully, his efforts will inspire others to be more proactive in preventing these infections. He is certainly off to a great start.

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2008 Service to America Medal Recipients

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