More than 50% 0f Haitians live on less than $1 a day. And one of the most striking things about that fact is that most of the people who make up that roughly 50% are not what Haitians themselves would call “poor”.

It’s not that their lives are easy. Those lives are constantly at risk because of the fragility of the livelihoods that support them. In better times, many such Haitians might manage to eat a good meal once a day, maybe even twice. They might eat enough to stay reasonably healthy much of the time, and to ward off the worst hunger pangs. But it’s hard to have a back-up plan when you’re living on the edge. An illness, an accident, a little bad weather: It doesn’t take much to transform difficult lives into misery.

When I say they are not poor, then, I am, in a sense, playing a game with words. The Creole word “pòv” is generally reserved for those whose state is really wretched. There is another word, “malere” for those who are merely badly off. And most of those living on less that $1 a day are probably malere, not pòv. At least until the next disaster strikes. But the word game has a point. The hard reality is that there are also lots of Haitians, many too many, whose lives are worse than bad.

Fonkoze’s programs, especially its credit programs, are mainly for Haiti’s malere. The malere badly need access to the Fonkoze’s services to improve lives that badly need improvement. But from the moment they enter Fonkoze, they already have the wherewithal to make use of the help Fonkoze can provide. If they are entering directly into standard solidarity group credit, they already have a business that the money they borrow will add to. Even if they are entering into Fonkoze’s Tikredi, or “Little Credit” program, which was designed especially for families that aren’t ready for standard loans just yet, they start with an idea for a business and the determination to succeed.

But Fonkoze knew that it could not be satisfied with itself as long as its reach could extend only to Haiti’s malere. Those whose need for change is greatest are those whom its credit programs could never help. They are the poorest of the poor, the extreme poor, and their lives are difficult to understand or even to conceive.

They are landless, without crops to harvest or businesses to invest in or livestock to sell or consume. They have no income-generating assets at all. They eat what they can, when they can, but neither regularly nor well: a few abandoned mangoes might feed them on one day. They might get to glean a cup of corn in exchange for farm work in a neighbor’s garden on another. They go days at a time without ever having reason to light their fire. Their homes provide no shelter. With every rain that falls, they are sure to get wet. Their children are not in school, and may not be at home either. They may have been sent to live with other families in the hopes that they will at least be fed. What’s worse is that Haiti’s extreme poor live without hope, without imagining that they can change their lives. These households, mostly led by women, are locked in a cycle that starts bad and gets only worse.

Fonkoze’s leadership made a commitment years ago to find a way to serve these especially poor families, so they looked around the world at other institutions that have discovered approaches that work.

They founded what they were looking for in Bangladesh. An organization named BRAC had developed an approach that depends on teaching people to manage an income-generating activity and then giving them the assets they need to start their own. It’s a two-year process that depends on very close accompaniment. Program participants get visits once or twice a week from case managers who provide coaching and encouragement.

Fonkoze piloted the program in Haiti for 150 families with BRAC’s help. We call the program CLM, short for “Chemen Lavi Miyò,” or “the Pathway to a Better Life.” Results were excellent. 142 of the families were self-supporting within two years. The pilot demonstrated that, even in as difficult and dysfunctional an environment as Haiti, allowing families to suffer such misery is a choice. We can do something about it. They live that way because we are not sufficiently committed to change.

Fonkoze is now ready to dramatically expand the program. It has hired four new field managers to work beside the one already in place, and is preparing 20 new case managers. We will begin serving 1000 new families right away.

I will be one of those field managers. I left the Marigo branch on Saturday, and on Sunday flew to New York. Monday my three Haitian colleagues and I got visas from the Bangladeshi consulate, and are now on our way for a month’s training with BRAC in Bangladesh. I have seen CLM a number of times over the past couple of years, usually as a translator for Fonkoze’s visitors. I look forward to developing a team of case managers who can succeed at this most important work.

But the stakes are troublingly high. In Marigo, our team was working with women many of whom were just a hair’s breadth from misery. An error or an accident could have brought them to disaster at any time. The women in CLM, however, are already suffering the worst sort of misery. CLM is very simply a matter of life and death. I will owe it to them to keep their danger constantly in mind.