Everything changed for Elly Sukup the first time she encountered poverty.

She was an Iowa State University junior studying agriculture and part of the school's first service-learning trip to Uganda.

“It was the first time I had seen anyone truly hungry before,” Sukup said.

That was in 2006.

This summer, Sukup made her fifth trip to the Kamuli District in eastern Uganda, this time to lead a new group of ISU students working to improve rampant poverty and malnutrition in the sub-Saharan Africa nation.

The annual student trip — this year was the 10th — is part of a much larger ISU program launched in 2004 with a $10 million endowment from alumni Gerald and Karen Kolschowsky.

The ISU-Uganda Program's goal: Create an alternative to drop-and-ditch philanthropy by forging sustainable programs with local residents. It's an approach that experts say global organizations are beginning to embrace so that billions of dollars in foreign aid can yield permanent benefits.

Today, the ISU-Uganda Program has reached more than 10,000 Ugandans with year-round programs that help them improve farming, launch home businesses, keep children in school and build food security.

“The focus is on finding local resources, rather than airlifting (aid) from other countries,” said Pat Hipple, an ISU professor involved with the program.

Success: Better bananas

The program, known by most as the Center for Sustainable Rural Livelihoods, has established a permanent presence in Kamuli, a small town 90 miles northeast of the capital, Kampala, where it employs 10 people year-round and has dozens of volunteers.

Iowa State’s main contribution is technical knowledge. The college shares best practices on topics such as farming, sanitation and hygiene, nutritional health and family planning.

The program began and grows today, ISU officials say, by listening to the local community and partnering with a Kampala nonprofit.

In 2004, ISU officials quickly learned that tiny parasites and insects in Kamuli District were infecting most of the region’s bananas. The university shared some basic farming techniques, including soaking stems in water before planting, to prevent the spread.

The information was an economic boon for farmers and families. Bananas are the No. 1 dietary staple of Uganda, the world’s second-largest banana-producing nation.

“If you have bananas, you have money, you have food,” said Dorothy Masinde, who was hired as the program’s first field manager.

Originally from Kenya, Masinde now lives in Ames, where she is a lecturer at Iowa State. She helps lead annual trips to the Kamuli District, where ISU students work with Uganda’s Makerere University, an integral program partner.

Growing program

In July, I visited with ISU students in Uganda to see the program's efforts first-hand.

On Day 1, Sukup and Masinde led me to a well at Namasagali primary school that was built nine years ago during the first ISU student trip.

Sukup recalled how classrooms emptied the day it was installed and everyone gathered to celebrate. It was the defining moment of her first visit to Uganda.

“You could just tell that big things and big changes were coming,” she said. That winter, her only request for Christmas was money to drill more boreholes.

The well at Namasagali primary school still works today. Masinde washed her hands while a teacher pumped cool water from deep beneath the African soil.

I toured the thriving fields surrounding the school that yield amaranth grain, collard greens, eggplant and other vegetables, as well as fruit trees. Across the horizon stretches the Nile River, where children and teachers used to trek daily to collect water for the gardens.

Simon Peter Mukaya, an agriculture teacher at Namasagali primary school, proudly showed the bounty managed and harvested by teachers, parents and students. It contributes to 2,000-plus nutritional lunches each week.

“We are very grateful, madam,” he told Masinde. She helped organize the school's food program, which has boosted nutrition for students from 50 to 850 calories per meal.

Many of the big changes that Sukup predicted nine years ago have unfolded gradually in the Kamuli District, home to roughly half a million Ugandans.

Kamuli has seen an influx of paved roads and economic infrastructure such as banks and ATMs. Outside of town, treacherous dirt roads connect small villages and mud huts, and motor vehicles are scarce.

The ISU-Uganda Program itself has expanded to include four other schools in surrounding villages. A new youth entrepreneurship club was chartered two years ago and touts more than 100 members, who receive guidance, and for some, micro-financing for small-business startups.

Sustainable future

Academics say traditional aid and foreign philanthropy models are undergoing more scrutiny than ever. Billions of humanitarian dollars have poured into developing nations, particularly those in sub-Saharan Africa, over the past 20 years. The results have been mixed.

Uganda, with a population of roughly 38 million, has been among the top 20 nations receiving humanitarian food aid over the past decade. Yet data last year showed access to basics such as education and health services, particularly for HIV, has stagnated, according to the United Nations and the African Economic Outlook.

RELATED: Reporter finds Iowa ties in Uganda

Muna Ndulo, director of the Institute for African Development at Cornell University, says the key to successful foreign development is building local leadership and programs that can survive after its founders exit.

“If you’re not building capacity and it’s not sustainable, the thing will collapse,” said Ndulo, who edited a book released last year called “Problems, Promises, and Paradoxes of Aid: Africa’s Experience.”

“The more common model is that you’re creating dependency.”

Back in Uganda

Ndulo's words echo a sentiment I heard in Kamuli from Gideon Nadiode, a 48-year-old veterinarian who manages year-round field operations for the ISU-Uganda Program.

“You must show the households the way to get out of the bad situations and then keep going by themselves,” he said.

That philosophy laid the foundation for the ISU-Uganda Program's livestock exchange program.

With more than 400 participants, it has become the most effective way for many Kamuli households to build economic capital and put food on the table.

Rose Namuyomba, one of the program's first participants, received a few pigs from ISU in 2004. Through breeding and sales, she now cares for 50 pigs and has already paid back the initial investment, as the program requires.

Besi Balwana struggled to feed her eight children before receiving chickens and roosting beds. She now sells eggs and provides her family with protein-rich meals.

"It has given me financial security," Balwana told me through a translator.

Those who get startup livestock through the program receive training on how to turn the investment into a sustainable business. They must meet goals and maintain a close mentoring relationship with program organizers, which presents a substantial challenge.

During one of our farm visits this summer, Masinde and a field trainer found a small litter of pigs that appeared gaunt and filthy.

“She is not feeding them,” Masinde said, wondering aloud what the owner was doing with the feed designated for the animals.

The situation would be addressed with a follow-up visit, questions and additional training.

Saving lives

The most tangible stories of lives saved through the ISU-Uganda Program come from nutritional education lessons for nursing and pregnant mothers.

Chronic malnutrition and limited protein in Uganda often prevent new mothers from producing breast milk.

I heard stories from half-a-dozen women who feared they would lose their babies before discovering the nutritional education centers, weekly classes held on tarps spread on the ground in local villages.

The first baby I met was born one month early but weighed only slightly more than two pounds because of malnutrition.

One mother, Sanula Nakisige, recalled a morning when she found her baby swollen, with yellow skin. A neighbor recommended the nutritional center, which she credits with saving her baby’s life.

“When I came here, I found porridge with eggs, milk, amaranth, sugar, water,” Nakisige said through a translator. “The child took it immediately.”

A trainer sent her home with a jerrycan of porridge designed to battle malnutrition. Her child's health improved within two weeks.

During nutritional center gatherings, mothers and their children receive nutrient-dense meals while learning health and sanitation practices through modified traditional songs and dances.

They're also tested for HIV and receive immunizations through partnerships with local clinics.

In the past year alone, the reach of the centers has doubled. More than 1,000 women and children are now served at eight locations — four of them added in 2014 and another this year.

News of the program spreads mostly through word of mouth. Participants have graduated to become crucial leaders at new sites.

On our visit, trainer Kevin Babirye led women in a song and dance thanking the faculty and students at Iowa State.

Babirye recently became a trainer after receiving help for her own malnourished baby and completing the nutritional education program.

Nurses and trainers made her child well, she said, which prompted her to promote the gatherings throughout the region.

“We thank Iowa for what you have done,” Babirye said.

ISU-Uganda Program by the numbers

The Center for Sustainable Rural Livelihoods operates year-round in Uganda on a budget of approximately $1 million a year, mostly covered through private donations.

The nonprofit includes 10 full-time staff with specialties in animal sciences, agronomy, nutrition and agriculture education, and more than 20 volunteers who coordinate and supervise work in the Kamuli District, in eastern Uganda.

Here are measurements of the program's impact since it began in 2004:

School lunches served each week: 5,200

Calories per lunch: 850 (compared with roughly 50 previously)

Nutritional education centers in villages throughout Kamuli District: 8

Pregnant and nursing women and their malnourished children served at nutritional centers: 1,000+

Borehole and well watering systems installed: 18

Households that have gained access to clean water: 5,000

Ugandans enrolled in a youth entrepreneurship program: 149

Iowa State students who have worked in Uganda through a service-learning program: 80

What the program does

Iowa State University-Uganda Program efforts include:

• Nutritional education centers for nursing and pregnant mothers.
• A livestock exchange that helps participants start their own farms
• A primary school food program that serves 5,000 protein-rich meals a week and draws more children to classrooms.
• Construction of essential infrastructure, like boreholes for wells or dormitories and homes for teachers.

Two weeks in Uganda

Des Moines Register reporter Timothy Meinch spent two weeks reporting from Uganda in July in collaboration with freelance journalist Jeff Chu, who was supported by a fellowship from the International Reporting Project.

Meinch spent most of his time reporting with Chu in the capital city of Kampala, where they explored the topic of faith within Uganda’s embattled LGBT community and documented the story of a South Sudanese bishop trying to send his refugee children to Iowa.

During the trip, Meinch joined up with Iowa State University for three days to document the work of their nonprofit activity in the rural Kamuli District.