Sunday, February 12, 2012

On Creating Poverty

Poverty does not destroy the initiative and self-reliance of a people. But that is precisely what racism does.
- Jacob Holdt, Development Aid and Racism

Overcoming poverty is not a gesture of charity, it is an act of justice.
- Nelson Mandela



Last week I attended the inauguration of a vocational program at a Western-run childrens’ home. It was the materialization of the power dynamics associated with race that are so pervasive in Ugandan aid work.

This childrens’ home takes in severely abused and utterly abandoned children and gives them great food, clothing, and a very high-standard of education. It does this the Western way. The children do not learn a local language. They are grouped into family units that are meant to make up for the fact they have no ties to a Ugandan village. Each unit has its own TV, DVD-player, and set of donated toys. They are surrounded by random influxes of Western volunteers who bring them exotic goodies and introduce them to Justin Beiber and Silly Banz.

When I arrived I was greeted by some of the children who were clothed in bright yellow that read, “This Shirt Helps”. As the program commenced different local and national officials lauded the work and sacrifice of the live-in Western founders, funders, and directors. Let’s call them Papa and Mama. When Papa and Mama were invited to speak, both stood up and Papa went on a diatribe that included a line that went something like this:

"It was not me who brought this great miracle to these children, it was God. He called me to Africa, to this work and everything I’ve done is simply His will."


Mama stood next to her husband during his pontificating. When he concluded, someone signaled we were short on time so she just sat down. Thus ended the presentation of the only female on the program.

Then it came time for Papa to hand an official invitation to the deputy of a ministry that had all but officially announced it would assist the program with a government grant. Papa paused before handing over the document. His disclaimer: “I have now become a professional Ugandan beggar. But it's better for a white man to ask a Ugandan…." He trailed off as his views became too transparent. "….but anyway I am begging for support from the Ugandan government, though much of this money comes from outside..." He couldn’t help but point out that really the money originated in the West. "...because I love these children.” He concluded with his views on unity. “Though I do this just because I love children, and you are employed to do this as your profession. We have a common work. ”

The deputy shifted awkwardly and accepted the letter with a smile that was just a bit too wide. I was too embarrassed to look at anyone in the crowd, so I looked down at the newsletter I had been handed when I arrived. In the middle of a section titled “Classic Quotes” there was this:

Ruth (5) saying goodbye to a volunteer said: “When I grow up and become white, I will visit you with the airplane”


It is this phrase that summarizes my fears for this project, the internalized racism it leaves with the children, and the structural violence inherent in international aid that it represents.

This type of project and the rhetoric that surrounds it simply reinforces harmful ideas of who the poor are and what they are capable (or rather, incapable) of. It teaches helplessness, in this case by literally labeling children with t-shirts. From childhood they see whites as their saviors and progress as something only made possible through outside help. It keeps both sides from seeing the complexity of each culture and the common potential of all human beings.

One of my favorite aid bloggers put it like this: “Rather, the kind of harm being done is simply a perpetuation of stereotypes….I would argue that poverty, like institutional racism, is held in place at least in part by our inability to see it for what it is. And our inability to see poverty for what it is is at least partially due to the fact that we continue to caricature the poor, rather than seeing them as real, whole, people.”


Now, I am sure some people will read this and think, “Well aren’t these kids better off? Surely these Westerners are just trying to help?” Yes, it is likely that these individual children are better off, but the system responsible for their vulnerability is strengthened. It is the “soft bigotry of low expectations”. This sort of approach to ‘helping’ is ultimately violent. It first imagines helplessness, poverty, and dependence, then creates it.

This is how Micheal Fairbanks said it: “…you create that parental relationship. I’m helping you. You should be guided by me because I have a bag of money. The responsibility for your future is actually on me, not on you because I have the resources to develop you. It’s patron-client; it’s master-slave; it’s donor-recipient. It’s all broken.”


Now, it’s not my intention to rebuke Papa and Mama, so much. They clearly love the children at the home and have recently built a health clinic that will save lives. However, they are an anecdote of a wider system gone wrong:

Western donors assume poor nations are incapable of good governance so they work around government, then complain about corruption and lack of democracy. The wealthy make their money in a system that favors them, then help poor villages on the assumption that local leadership will yield to their paternalistic demands and afterwards cute brown children will sing and dance to show their deep gratitude. Development workers make a career of advancing social justice then spend their weekends at restaurants and bars that actively discourage “local” or “peasant” clientele.

Of course this is a particularly negative sketch of international development work and it is certainly not true of all organizations or all individuals. I feel lucky to know and work with many people who are committed to getting it right. But this paternalism is pervasive enough to create a power dynamic and racial tension that undermines the many well-intentioned Ugandans and outsiders that are working towards a healthier, more prosperous, more equitable country.

Thursday, January 19, 2012

Crowdsourcing: Participation

I just got back from Rwanda for the Global Health Corps mid-year retreat. As part of the program, each fellowship team was asked to write a case study on a topic that they would like to get ideas and feedback on from the other fellows. Edmund and I met last week and decided we want help brainstorming how to approach the creation of a new health clinic, which will be one of our main tasks for the later part of our fellowship. We were so excited and uplifted by the insight of other GHC Fellows that we thought it would be interesting to get opinions and advise from a wider community. Thus, I am asking you to read the situation below and give us ideas on how to foster community ownership of the project.

(To help spark some creativity, check out this really interesting article, Tales of Shit: Community-Led Total Sanitation. It outlines an innovative and controversial take on community ownership. What lessons from this article should we employ? What tactics should we avoid?)

OK, here is the case study:

Main Challenge
After completing a needs assessment that covered 247 households and 1200 individuals in Nama sub-county, Mpoma Community HIV/AIDS Initiative (Mpoma) met with its health partners to review the data, understand the recommendations of Mpoma beneficiaries, and discuss how to move forward.

(You can find the health assessment here, I would love your feedback on this as well! Ok, back to the case study….)

At the meeting, everyone agreed to build a new clinic near the current Mpoma offices. Partners were enthusiastic to help, pledging resources, expertise and funding. However, Mpoma has not yet held any community meetings to discuss the project. Mpoma staff wants to maintain the excitement of outside partners and the momentum of the project, but they also want to ensure that the community “owns” the clinic.

Background Information
The health assessment revealed that many people that want health services (including: family planning services, malaria treatment, HIV testing, first aid, and so on) do not receive them either because health clinics are too expensive to travel to or because clinics are out of drugs. Mpoma hopes to increase health access by building a health center II that is more accessible, and conducting regular outreach programs for malaria nets, family planning, and eventually other services. Included in Mpoma’s programming is a primary school where many community children receive free or subsidized education. The children at the school will also receive free services from the clinic.

Mpoma is located in a semi-urban area but also does outreach work in the surrounding rural villages. Currently, Mpoma does much of its health outreach work through Village Health Teams (VHTs). These individuals have been trained by the Ministry of Health and given bicycles by the government to aid their efforts. VHTs participated in the health assessment through a series of focus groups in which they helped interpreted and clarify the results of household surveys and offer suggestions for Mpoma’s future programming.

Mpoma staff is extremely small. Currently it consists of a program manager, social worker, nurse, education secretary, agriculture manager, two community volunteers, and two lovely GHC Fellows. Mpoma is supported by a board, which consisted exclusively of members of the community. Mpoma has good relationships with the Local Council (LC1s), sub-county officials, and administrators from neighboring schools.

Now, its your turn!

1. What steps should Mpoma take to promote community ownership of the clinic while still maintaining the excitement of outside partners and momentum of the project?

2. How should Mpoma communicate with its community and beneficiaries? What types of forums, advertisements, and messages would you suggest?

3. How should Mpoma communicate with its partners and funders?

4. What potential pitfalls do you foresee? How could Mpoma work to ameliorate these?