Handshakes not handouts

To expand on the comment ‘handshakes not handouts’; it’s a theme that traverses daily life and work here in my little part of Ethiopia. We are told before we come that the major nuisance is ‘verbal hassle although rarely offensive’. On the most part that means children excitedly running at you shouting ‘hello’, ‘ferenji’ and desperately wanting to shake your hand. Unfortunately, some of the older children including school children will shout ‘hello’ and then ‘give me money’ or ‘give me pen’, with a cheeky smile on their faces. Again not particularly offensive, unless you’re nearer the tourist attractions where they can be more persistent. Sadly it’s a learned habit because foreigners do handout money and do handout pens, and while for the most part seemingly innocuous, there are some older children who instead of attending school find it more lucrative to befriend well-meaning ferenji who supply money, pens (which are sold for money), and electronic devices such as laptops (which are again sold for money).

In terms of how this theme transfers to the workplace and the world of NGOs and volunteering was something I did not really understand before arriving here. VSO, the organization I am here with specifically aims to provide trained professionals as the resource to foster sustainable development i.e. VSO will not donate you money to build a hospital but rather give you a trained paediatrician to support your staff and improve systems and care within the hospital that already exists.   After spending some time here and working within the hospital setting, it has become apparent that some feel we would be best placed to simply donate a new building and new equipment, and that as volunteers we are a conduit for cash. I must stress that is not a universal opinion, and many of the fantastic staff I have worked with are delighted to have support and teaching.

Sadly however I think this is not a new phenomenon of foreign input serving as a means of cash flow, and there are preceding decades of examples from developed countries to support the belief by developing countries that the best ways to get things done are via donations. The biggest problem with this is that it bypasses the need to improve the infrastructure of the developing country to provide its own money to support adequate healthcare, to develop systems of reliable medical equipment and maintenance, and indeed make it easier for local medical personnel to access the supplies they need to run their hospitals effectively. After a discussion here with staff I was told that it is preferable to get money and equipment from NGOs as the process via government channels can take up to 2 years and is heavily bureaucratic. If it takes 2 years to obtain specific equipment, then it is not feasible to account for it in planning an annual budget. So are donations doing more harm than good? I don’t know the answer or indeed the solution to that question.

There is certainly an argument to support that donations are best served by research locally into what is required and appropriate within certain institutions. For example, does a hospital which serves 1.5 million population, has some beds in a tent due to overflow, no cardiac monitoring, not enough midwives to attend C-sections and no paediatric doctors really need a digitalized X-ray system which can only be accessed in the outpatient department? But if that’s what the money is donated for, then that’s what’s going to happen.

Since being here I have had a lot of time to read about the history of aid and development, and in particular the growing body of literature on why aid is no longer working. Dambisa Moyo (Zambian female economist) writes in “Dead Aid…” that aid is no longer working in Africa, that is promoting a culture of dependency and lack of development, and suggests different economic solutions to the problems in Africa, first of which is placing a time limit on aid and giving say 5 years to a country to sort out its finances and plan for withdrawal of aid over a set time period. She quotes figures stating that 97% of Ethiopia’s government budget comes from aid. The original argument for aid is based on the success of the Marshall Plan after the Second World War providing assistance to Europe. This example is entirely different from the situation in many African countries today as in Europe at that time there was infrastructure and a skilled workforce, which simply needed assistance to repair. In a number of African countries, they are requiring complete development, including adequate governance and infrastructure; and that’s why simply throwing money at the problem isn’t working.

Despite reading into the subject, I don’t believe all aid should be stopped, particularly in humanitarian emergencies; I believe aid still has a role to play. Again I don’t know the best solution or indeed whether we should stop donating entirely as it is always the poorest who suffer most from lack of resources. But I do know something needs to change and that development of independence and infrastructure will be the key to success.

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