IntroductionTOMS giving programs, specifically on the local economies, in places where TOMS partners with local organizations to distribute shoes and help restore sights with Giving Partners in over 70 countries around the world has great impact on their individual giving programs. However, whether the larger population-level economic impact of these programs, especially in countries where TOMS has established local manufacturing, has changed or not is unclear. TOMS will be moving forward with further expanding its local manufacturing program and establishing a manufacturing plant in another location within the next year. An annual budget of $100,000 for three years has been approved for the facility’s associate program in order to ensure the operation will be benefiting the community. The target location and the strategic business plan for the plant will ensure strong impact of the plant on the local economy as well as economic sustainability of the plant beyond the three-year development period. Establishing a guideline for resource planning within the plant for local employee can maximize on the impact of developing a local manufacturing plant. In order to do so, a wide variety of needs, potentially including health care, financial literacy, education and empowerment, have to be addressed. Our consulting team from USC was hired by TOMS to devise such a strategic plan. The TOMS giving program have benefited many Cambodians. Cambodia is identified as the next target location for greater impact to this society.

The Business of Giving at TOMS: Working together with USC for a healthy future in Cambodia

Country and City ProfileCambodia is close to Vietnam, Timor-Leste, China and Philippines where shoes giving programs are available. Mekong River, Tonle Sap and Bassac river and their tributaries are the heart of the country. Cambodia has 14.86 million population (2013). Their per cap income is $2,360. Agriculture is the traditional mainstay of the Cambodian economy and still the major economic source. Phnom Penh is the capital and largest city of Cambodia. An international airport and 6 Highways locate in Phnom Penh. The convenience of transportation, availability of basic infrastructure, and rich in resources make Phnom Penh well developed in garments industry. The geographical advantage makes it possible to expanse the Shoes giving programs to adjacent countries, such as Thailand and Laos. These above make Phnom Penh our next target location.

Fig. 2. Structure of Cambodian’s health system

Fig. 1. Map of Cambodia

Heath System and Issues in Cambodia The structure of health system as outline:Referral HospitalsThere are national, provincial and district referral hospitals, classified at three levels based on number of staff, beds, medicines, equipment and clinical activities.Health Centers and Health Posts:These are minimum level primary health care services mainly for rural populations. 1,049 facilities cover around 10,000–20,000 people each. Services include initial consultations and primary diagnosis, emergency first aid, chronic disease care, maternal and child care (including normal delivery), birth spacing advice, immunization, health education and referral.

Fig. 3. Leading Causes of Death

Demographical fact:Under 5 Mortality: 45/1000Life Expectancy: 63.5 male/65.1 femaleHIV/AIDS Adult (15-49) prevalence rate (2014): 0.4%Malaria Child (6-11) prevalence rate: 0.6%

Challenges:• Lack of adequate water - Severe infrastructure problems - Sanitation•Communication - Lack of accurate statistics and surveys - Lack of trained personnel•Education -Lack of knowledge of public health and epidemiology •Transportation

Goal 1To reduce the prevalence of HIV/AIDS and other STI in Phnom Penh City, Cambodia by providing comprehensive education.

Process Objective:• Healthcare educational events will be hosted periodically by TOMS in selected HC/HP •All HC/HP in Penh Penh city will provide safety sex manuals and condoms for all appointment/ walk-in patients.

Goal 2To reduce diarrhea and malaria risks among primary school students in Phnom Penh City, Cambodia by applying RO systems

Process objectives: • 164 primary schools in Phnom Penh city will be installed two water drinking fountains with Reverse Osmosis System

Fig. 4. HIV prevention brochure

Fig. 5. HIV/AIDS educational materials

Fig. 6. Reverse osmosis system (RO system)

Annually Education Expense Item Unit expense Unit per HC/HP Cost for 35 HC/HPCondom $0.15 7,500 $39,375/ yrBooklet+ questionnaire

$0.05 15,000 $26,250/ yr

Personnel $1.5/ hr 3 (Personnel works 3 hrs per healthcare events. There are a total of 20 healthcare events in selecting HC/HP monthly 60 hrs per HC/HP)

$90/ mo $1,080/ yr

Annually Water System ExpenseItem Unit expense Unit per School Cost for 163 schoolsERS-105 RO System $200 2 $65,2002 Labors $20 2 $6,250Construction and others

$80 2 $26,080

Total spend on the project for 3 years: $297,915.Table 1. Expense in detail

SWOT AnalysisStrengths - Providing job opportunities in Cambodia - Reducing the shoes expense for Cambodian school children - Rich in resources (cotton and recycled polyesters are available in Cambodia) - Water systems installed in 164 schools Weaknesses - Large laggards and not willing to participate the changes - Question mark for sustainability after 3 years - Lack of equal opportunity in rural povertyOpportunities - Coalition with others - Word of mouths (cultural benefit)Treats - Inefficiency in training - Governmental negotiation

ReferenceLuu, T. T. G., Sthiannopkao, S., & Kim, K. W. (2009). Arsenic and other trace element contamination in groundwater and a risk assessment study for the residents in the Kandal Province of Cambodia. Environmental International, 35, 455–460.Samposon, M. L., Bostick, B., Chiew, H., Hagan, J. M., & Shants, A. (2008). Arsenicosis in Cambodia: case studies and policy response. Applied Geochemistry, 23, 2977–2986.MacLeod M, Pann M, Cantwell R, & Moore S. (2014). Issues in access to safe drinking water and basic hygiene for persons with physical disabilities in rural Cambodia.J Water Health. 12(4):885-95. doi: 10.2166/wh.2014.009.Murray CJL, Vos T, Lozano R: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012, 380:2197-2223

Acknowledgements Supported by TOMS®. The team would also like to thank USC for their contributions to this project.

Yen-Jung Angel Chen*, Shou-Ying Erica Chuang*, Yulin Billy Shen+, Tianjiao Song*, Bei Zhang# * Keck School of Medicine, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA 90089

+ Viterbi School of Engineering, University of Southern California, 3650 McClintock Ave., Los Angeles, CA 90089# Davis School of Gerontology, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089

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