A 111-Year-Old Organization Lost a Third of Its Revenue Overnight: How Helen Keller International’s CEO Turned Crisis Into Reinvention

Sarah Bouchie, CEO of Helen Keller International

Denver: Your second-grade teacher in rural Minnesota, she pinned photos of accomplished women on the classroom wall, and Helen Keller was one of them. So, decades later, Sarah, you get this call to lead the organization that bears her name. What went through your mind, and did that little girl from Minnesota feel like she was finally answering something that had been quietly shaping her all along?

Sarah: It’s a really good question, Denver. I think when they reached out to me about Helen Keller, it was one of those pinch-yourself moments where you think having the opportunity to lead an organization that is in the name of this woman who did so much in her life and that embodied social justice and perseverance… it was just incredible.

And I still feel that way. I’ve been in the role for two years and still feel like there are so many moments where I pinch myself about the opportunity to lead such an incredible organization.

“So, we reach over 80 million people every year. We do it with extremely cost-effective measures. We really pride ourselves on being able to see innovations that work, and then just take them to scale. And we usually do that in collaboration with governments…we work in those three areas of eye health, neglected tropical diseases, and nutrition.”

Denver: For listeners who may not be familiar with Helen Keller International, give us a snapshot of the organization, what you do, where you do it, and the scale of the people you reach.

Sarah: So, we reach over 80 million people every year. We do it with extremely cost-effective measures. We really pride ourselves on being able to see innovations that work, and then just take them to scale. And we usually do that in collaboration with governments.

And Helen Keller being one of our co-founders, it’s really clear why. She was a deaf-blind woman. She started the organization that became eventually Helen Keller International with a focus on helping soldiers who had been blinded after World War I.

And we’ve taken that legacy to look at not only people who are suffering from vision loss, where we do a lot of support to end cataract and refractive error– which are the two leading causes of preventable blindness around the world– and then we’ve sort of taken that a step back.

And if you step back, you think about neglected tropical diseases, which contribute quite a bit to reasons why people go blind, and then nutrition… which a lot of people don’t really make the connection to, but proper nutrition helps to preserve eyesight and has all of these other wonderful benefits, including child survival and better health outcomes, and eventually better life outcomes.

So, we work in those three areas of eye health, neglected tropical diseases, and nutrition.

Denver: Fascinating combination, that’s for sure.

Sarah: Yeah, it sure is.

“And I think that’s one of the wonderful things about being at Helen Keller because we do try to look at: it’s not just what happens now, but when you’re in an organization that’s been around for over a century, you have this luxury of looking into the future. It’s been a great learning.”

Denver: You have spent nearly three decades on both sides of the international development table. I mean, you’re over at CARE, and then ChildFund, and then you helped triple philanthropic investments at the LEGO Foundation. After sitting inside a funder’s decision-making process, Sarah, what is the one discipline, whether it be around portfolio thinking, risk, how money actually gets allocated, that most nonprofits would be well advised to adopt?

Sarah: I think being able to sit on that funder side for the five years that I did was an enormous privilege, especially at a place like the LEGO Foundation, which is, Denver, exactly as much fun as it sounds like it would be. It was a great place to work. We played with LEGO all the time.

I would say the thing about being on the funder side is you really recognize that at least our board was very interested in what are the long-term outcomes. So, they didn’t want to look at just the two or three-year  “what was going to happen in the immediate term,” but: How were things going to change over time, and how were our grantees going to be a part of that change so that there would be a sustainable difference?

And I think that’s one of the wonderful things about being at Helen Keller because we do try to look at: it’s not just what happens now, but when you’re in an organization that’s been around for over a century, you have this luxury of looking into the future. It’s been a great learning.

The other thing I would say is people always say that they listen a little bit harder when you are a donor, which is true. I’m the same person in the room, but I got a different kind of an audience when I said something as a donor than I do as an implementer. And it keeps you humble. It sure does.

Denver: So, I know, we’re not quite as good looking as we think we are, not quite as witty as we are, but when you’re giving it away, you really are, you know?

Sarah: You sure are. People spend a little more time listening.

Denver: I was really on today.

Sarah: Yes. They do; they spend a little bit more time listening to you.

Denver: After the LEGO Foundation, you took a little bit of a sabbatical, and you were coaching executives pro bono, and you were consulting with small African NGOs on scaling, training over at UNICEF, how did that deliberate pause reshape how you lead? And what was one insight that’s proved most valuable once you were sitting in the chair you’re currently sitting in?

Sarah: I think there were a lot of things about those moments. I really appreciated that I was in a more of an advisory space. And I got to listen to executives sort of struggle with the day to day, and reminding them that taking a step and breathing and knowing that where you want to go doesn’t all have to happen overnight.

And in that process, communicating where you want to be really lifts the way that your organization follows you. And that was a wonderful gift of being able to take the break of learning and seeing from different executives, and working with some pretty amazing people around the world who had that sort of space of being a good coach means telling people to slow down and acknowledge the moment, live in the present, with a vision about the future.

Denver: Perfect. Before the ground shifted underneath our feet in 2025, you did have a bit of a window to shape Helen Keller International. What were one of the two early moves that you made during that time that gave you more leverage when the crisis arrived?

Sarah: So, we went through a process right after I started that was all about listening to the organization. What did people think we could be doing better as Helen Keller? And one of them was people saying, “Well, we should be talking about our work more. People should know more about what we do and who we are.”

So, we started to think about, as an executive team: How could we do a better job of positioning ourselves, of talking about our work, of seeing how it is that we could accomplish things? And it just happened to be that this crisis that happened when foreign aid was scaled so far back and changed in such significant ways, Helen Keller was at the ready.

We could talk about how it impacted our work, how communities that we were serving and our government partners really had to pivot, and the trade-offs that they were making. So, I think that positioning was important to us as an organization.

Denver: You were prepared. Let’s go back to that moment.

Sarah: Do we need to, Denver?

Denver: Essentially, one-third of your revenue just went poof.

Sarah: Yeah.

Denver: Disappeared.

Sarah: Yeah.

Denver: What did you do in those first 72 hours? And how did those early decisions set the tone for everything that followed?

Sarah: I’ve talked to quite a few of my peer CEOs in this moment because the thing that happened when USAID sort of went away, it was a slow disappearing over a couple of weeks.

And those disappearing was a beginning of understanding, “Oh, our projects could be put on hold. So, what would happen if…?” And then, it was, “Our projects might not get reimbursed through the end of the fiscal year.” And then, it was, “Well, our projects might end altogether.” And then, it was, “Well, we might not get reimbursed for the work that we have done.”

And each of those really caused our leadership team to sit down and say, “Okay, so what will we do?” We were doing a lot of scenario planning at that time. Luckily, we had also been talking about what were the other sources of funding that we would be trying to pursue as we wanted to grow. Little did we know that it would be sort of backfilling some of our work rather than growing our work. But it was an important time to reflect and sort of sit back.

A lot of time spent with my leadership, we were meeting at least two or three times a week.

Denver: Yeah, yeah. Well, the PRO Initiative came along, and that was a vetted funding list built by some former, I guess, USAID staffers.

Sarah: That’s right.

Denver: And it connected you with some private funders who kept critical programs running, but at dramatically reduced budgets.

Sarah: Right. Right.

Denver: What did that experience reveal about what is truly essential in your operating model, and what turned out to be maybe a little bit more flexible than you had once believed?

Sarah: Yeah, so it’s a good question. I think with us, it’s always important that we’re working with and through governments. So, the kinds of things that we ask governments to step up and do, and the work that was essential to being able to deliver… neglected tropical diseases, medication, preventing those diseases from spreading… became a different kind of a partnership with the ways that we talked about government, of being really clear of what were the minimum things that would have to be in place.

It was not an easy set of trade-offs that we had to make at all, but in the end, I think it’s allowed us to ensure we’re not doing the backsliding in the countries where we’ve been working for so long.

Denver: Well, let’s turn to something more positive, and that would be the Kristof Holiday Impact Prize, which was just huge. I was so thrilled when I saw that in the paper. What did that experience teach you about the difference between being really respected inside the field, and being visible to the broader giving public? And that certainly did.

Sarah: Yeah, it did. We’re very fortunate we’ve raised almost $13 million…

Denver: Wow.

Sarah: …as a result of the Kristof Impact Prize, which has been a wonderful gift at a time of such transition and change.

I think there are a couple of things that I would point out. First of all, it was incredible for our staff that have been laboring at these issues for decades to see this kind of recognition and acknowledgement of our work. So, there was a huge morale boost. And you remember, just six months earlier, we laid off about 300 people. It was a third of our workforce.

And even those that stayed really had to feel like and think about, “So, how do I get recommitted to this mission and to our ability to make change?” So, that boost was really important and helpful for us.

I think we’ve also been exposed to a new audience of people who are interested in our work, and we want to be able to talk about how these are cost-effective, scalable, solvable solutions and problems that Helen Keller has to bring. And that’s been really sharpening the way that we talk about our work, for sure.

Denver: Well, you learned a lot about Helen Keller, but what did you learn about the sector at large? And what this disruption revealed to some of the structural vulnerabilities of the international development sector, things that may have been hiding in plain sight before the funding disappeared?

Sarah: Well, one of the really obvious things is the siloed nature of funding. We did a lot of funding in these verticals where you could be solving one disease, but not really thinking about strengthening the health system. Or you were strengthening the health system, but you weren’t doing it in collaboration with another vertical that was going on.

All of that really has changed the conversation, especially for many of our peer organizations. Helen Keller has always worked hand in hand with governments. We even work with them to support what their agenda has been.

And we’re seeing that kind of opening that aperture to support them to think more broadly about their workforce development, or the way that they manage logistics has been important to help really change and shape, and I would say make the most out of every dollar that is going through a government system.

Denver: Well, you do make the most out of every dollar. I mean, what you do…

Sarah: We sure try.

Denver: …a dollar for protecting a child, treating diseases is amazing, but I know numbers alone can’t do it, and it has to be balanced with storytelling. So, talk a little bit about how you try to keep that balance, I don’t know, between a great story and a great data set. I don’t know what you would prefer.

Sarah: Yeah.

Denver: If you integrate…

Sarah: Well, we recognize people come to Helen Keller for all kinds of reasons.

Denver: Yeah.

Sarah: So, some people come to us because we’re extremely cost-effective. So, for just over a dollar a dose twice a year, you can save a child’s life, really. And some of the areas that we’re working in, there’s such vitamin A deficiency that two doses of vitamin A can reduce child mortality by up to 25%.

There are many people that are driven very, very clearly by that kind of a story and think, “I want to be able to put my dollar in the most impactful place.” And who doesn’t want to save a kid’s life for less than a dollar a dose of this lifesaving essential medicine?

On the other hand, I feel like one of my jobs as the CEO is to do a good job of telling the story of the people that are a part of our programs. I remember when I was out in Kenya, I met this woman, and she was at a health clinic with her little baby boy. His name was Ethan, and he was this, like when you see a baby…You see a baby, and you look at the bottoms or the tops of their feet and they’ve got that little chubby roll over the top.

Denver: Oh, yeah.

Sarah: And you know they’re really well-fed and they’re happy. And it’s before they start walking, so they still have that extra roll. That’s a healthy baby to me.

And when I saw Ethan and met his mother, Frida, in this health clinic in a highly densely populated area… some people might call them slums; we don’t… those really high-density population areas where you know that nutrition is not easily accessible, but you can see these families that are thriving.

That’s why we do the work that we do. It’s for the Ethans and their mothers of the world that really makes a difference.

“If Helen Keller has a whole piece of our work, that’s always about innovation. But 80% of our work is saying: Get better at what we do well, and then take that 10%, 20% and try to get the new next thing up and running.

And that’s one of the reasons why rigor is one of our values that we really think about because we want to make sure that every dollar that we’re spending is going to the best, most useful cause.”

Denver: Do you think, Sarah, that there is a bias in philanthropy towards funding new ideas, the shiny new button…

Sarah: Of course. Of course.

Denver: …compared to much of the work that you do, which is really scaling solutions? And what do you do to even that up some?

Sarah: Yeah. So, I think it’s interesting. Even when I was a part of the LEGO Foundation, we really felt like it was the job of bilateral, institutional, multilateral organizations to do the stuff that works. And we in philanthropy, we’re in a space to be in the more innovative… like: try stuff; have the moonshots; do those things that could really bring a leapfrog.

I think what the calculus of things has changed is: those bilateral, multilateral funding sources don’t really exist in the same way as they did even two years ago. So, the need for philanthropy to understand that when you have things that work, we need to make sure they’re actually working. And by working, I mean getting deployed to the people that need them.

And that doesn’t mean there’s not a space for innovation. If Helen Keller has a whole piece of our work, that’s always about innovation. But 80% of our work is saying: Get better at what we do well, and then take that 10%, 20% and try to get the new next thing up and running.

And that’s one of the reasons why rigor is one of our values that we really think about because we want to make sure that every dollar that we’re spending is going to the best, most useful cause.

Denver: Yeah. And that 80:20 or 85:15 ratio seems about right.

Sarah: Yeah, it has worked really well for us. We’ve been around for a century to be able to say that, that’s for sure.

Denver: There you go. Your Leading Locally, Fortifying Futures strategy talks about elevating local expertise into leadership. What’s one of the concrete changes that you’ve made, whether it be in hiring or decision making or power sharing that signals that this isn’t just aspirational, but it really is an operational reality at Keller?

Sarah: Yeah. Yeah. So, when the funding crisis hit us last year, we were really clear to say one of the things that will not happen under this watch is closing any of our country offices. We have a commitment to those nations, and we want to do our best to stay in place. And to do that effectively, we need leaders that understand what’s going on in those country offices.

But I think this sector has been plagued by… you have people at a country office who were seen as part of a project. So when the project ended, those staff left. And that meant that you didn’t invest regularly in the staff that were needed to run our programs. And I want to change that at Helen Keller.

So, we’ve been very deliberate about leadership programs for our country office leaders because they’re our future. And then, giving them an aspiration and clarity that there’s a path to be at the decision-making table at an executive level has been personally really important to me.

So, I just hired three new executives, all of them women, all of them from the countries where we work. And they’re leading our portfolio globally and really making a difference, I think, in showing that at a leadership level, we’re taking into account what it’s like to live and work and have family, and experience some of the things that Helen Keller tries to find every day.

Denver: Cool. Sarah, tell us a little bit about your partnerships. And I know you look at partnerships not as a supplement, but as a delivery system or a platform, whether it be medicine distribution, or logistics, or community health. What separates those partnerships that generally multiply impact from one that maybe just adds a bunch of meetings?

Sarah: Yeah, that’s a good question. So, I think for us, Helen Keller is always trying to be in a place where: How can we add value to something that already exists?

Denver: Yep.

Sarah: So, a great example is you have pharmaceutical companies who want to be able to deliver medicines to people. We’re there to make bridges and connections happen so that we can see the dollar that is invested in one of our programs can be returned 28 times by the kinds of medicines that pharmaceutical companies want to be able to put onto the table.

Similarly, when we talk about our partnerships with governments, they have a responsibility to meet the health needs of the communities that we serve. So, why not just help them to do it better?

Those are the multiplying sort of spaces where you figure out: How can I not just add value, but multiply in a way where you’re helping them to gain the skills, or the delivery system, or potentially the real technical know-how to do something a little bit better. And we’ve been very fortunate to be in those spaces in all of our work, really.

Denver: Yeah. I don’t know if this is a branding question or not, maybe it is, but Helen Keller is one of the most iconic names in the nonprofit world.

Sarah: Yeah.

Denver: And I guess the question is: How do you honor that legacy while making the work feel urgent and immediate to generations of donors who have no personal memory, in fact…

Sarah: No idea.

Denver: …not having any personal memory of what happened the day before yesterday, if I… you know, of Helen Keller?

Sarah: Yeah. Sure, sure. Yeah. So, our tagline at Helen Keller is “Continuing Her Work.”  And I have to say that starts with our values. We have four core values. It’s how we manage the organization. It’s about having…

Denver: What are those core values?

Sarah: Compassion, courage, integrity, and rigor. And those really embody who I think Helen Keller was in the world, the way that she tried to walk, and it grounds all of our decisions.

So, first of all, it’s a unifying force when you’ve got that persona of what good looks like and what we’re trying to aspire to as an organization. So, inside the organization, it’s a pretty motivating and inspiring space to be in.

And I think when we can describe that to people who might not know who Helen Keller is, but can see and feel the ethos that we have as an organization about what drives us, then the connection back to her is a pretty natural one.

She was an incredible human being. Think about somebody who lost their sight and hearing as a toddler, who was born in a time when women couldn’t even vote. And by the time that she ended her career, she was meeting with heads of state and writing books that were changing the way people thought about people with disabilities, who was really changing the way that equity was thought about in the world.

She’s a pretty motivating person for all of us to aspire to.

Denver: Quite remarkable. Yeah.

Sarah: Yes.

Denver: Quite remarkable.

Sarah: Exactly.

Denver: Let’s talk about the last couple years. This has been a pretty intense stretch, I’m guessing.

Sarah: Sure has.

Denver: Of disruption and tough decisions, laying off people, relieving the pressure. What have you learned about sustaining yourself as a leader when the work never really lets up and the stakes really never come down?

Sarah: Yeah. I stay really grounded in my family. I have two beautiful children and my husband, they make sure that I don’t take myself too seriously. It’s really important that your ego doesn’t get in the way of things, and you take the time you need to recharge.

I have a wonderful team. My executive team is so committed to the cause, and we take time to appreciate each other. I think that’s also really important. And then, to recognize when things don’t go right, it’s all in a perspective of history. When you’ve been around for 110 years, 111 years in our case, things are going to happen, and you get through. And that resilience is put in a certain sense of perspective, that’s for sure.

Denver: Yeah, I look back at the crises that I had last year, and I look at them now and I laugh at them. And I’m like: I was really all worked up about that?

Sarah: Truly, truly. I remember being in the financial crisis in 2008, and I was much younger in my career, and looking around and thinking, “All of the philanthropy, it’s gone!  And things are changing in a deep sort of way!” And of course, we recovered and we renewed.

And sometimes those opportunities, those inflection points are also opportunities for growth and improving and tweaking your model in ways that help you to grow. And that’s certainly the perspective we’ve taken at Helen Keller.

Denver: Well then, you just set me up for my final question. Okay.

Sarah: Hmm. Nice.

Denver: Yeah. We’re sitting here five years from now, what would you want people to say about what Helen Keller International built during this period? Not just what you weathered through this directly, but what you created because of it that made the organization and the people it serves permanently stronger.

Sarah: Yeah, I think one of the most exciting things that’s going on at Helen Keller right now is we’re thinking into the future of: What’s the role of an international organization? So, what are the issues, the ideas, the solutions that cross borders? So, if we can hand off even more of the work that we’re doing to national governments, but really look at solutions like food fortification that has a multinational reach.

Most companies are feeding people across borders. How can we really help to lift the floor of the ways that we solve problems? And I think that’s really exciting and has potential for scale, and is a place where Helen Keller will continue to push the envelope.

Denver: Yeah. And just sort of plug into already established systems.

Sarah: That’s right. Everybody’s still…

Denver: …instead of something outside it, you know, that’s independent.

Sarah: Yes. That’s right.

Denver:  Which makes absolutely no sense whatsoever. Absolutely.

Sarah: Yeah. People will always eat flour. They continue to put oil in their food. These are solutions and things that don’t have to make big changes, but if you can change the regulatory environment and the incentives for manufacturers to be doing things in better ways, it makes a big difference.

Denver: Sarah, for listeners who want to learn more about Helen Keller International, or financially support this life-changing work, tell us about your website and the kind of information they’ll find there.

Sarah: Yep, absolutely. So, please take a look at helenkellerintl.org. That’s our website. We have all kinds of information about our core programs, about the price points. I already talked about some of them– being able to reach children and child survival for less than a dollar a dose, $2 at total.

Our work here in the United States, you’ll find out more about how we’re helping school children to see blackboards and be able to thrive in the classroom more effectively. And reach out to us there, and help sign up to be a sustaining donor, or to support our work in ways that you feel is really important.

Denver: Great stuff. Well, I want to thank you so much for being here today, Sarah. It was a real pleasure to have you on the program.

Sarah: It was lovely to be here. Thank you so much for taking the time.

Every weekday morning at 7:00 a.m. Eastern, I publish a short Leadership Note from the Field. These reflections draw on fifty years in the nonprofit sector and nearly 1,000 conversations with nonprofit leaders.
They are designed to help leaders step back from the noise, see the deeper pattern, and lead with greater clarity.
A recent note explores a distinction I believe matters enormously right now.
In philanthropy, don’t confuse headlines with forces.
Headlines dominate the moment. But deeper forces such as the $124 trillion wealth transfer, the rise of women as philanthropic decision makers, and the growth of giving across the Global South will shape the next twenty-five years.
You can read the full note, along with a new one posted every weekday morning, on my blog at denver-frederick.com or on LinkedIn.