Aid That Works

Did you watch any of the BCS Bowl Games this year? If so, did you see the commercials asking you to donate $10 toward providing mosquito nets for Africa? If you did, did you donate?

I hope not.

That’s probably not what you were expecting me to say, so I’ll repeat it. I hope not.*

Wow, I must be meaner than you thought. How could I be opposed to providing mosquito nets to Africans, people I talk about with much fondness? Am I not in support of ending malaria, the deadliest disease in Africa?

Well, it’s not that simple. Of course I am in favor of ending malaria, and yes, I think that using mosquito nets is an effective method of prevention. But I don’t believe that handing them out for free is the answer.

As we traveled around the world, we encountered many different types of aid, and what we witnessed over and over is that as an everyday form of charity, handouts don’t work.** Sometimes what is being given is not what the people most need. Sometimes what is being given might work for us but doesn’t work within the recipients’ set of values and beliefs or with their lifestyles. And sometimes what is being given is taken not because it’s wanted, but because it’s free.

Come on, admit it, you do the same thing. Free stuff is hard to resist.

But when you receive something for free, it has no value to you. You didn’t have to give up anything to get it, you didn’t have to decide that that item was worth the price or the sacrifice of getting it. So if it’s lost or broken,  if it crumbles to the ground, if it sits around and is never used, it’s no sweat off your back.

Also, sometimes when you get enough free stuff, you begin to expect that you’ll continue to get free stuff. You start to believe that you don’t have to work hard to get what you need and want, that you don’t have to hold those who are actually supposed to be providing for you (i.e. family, government institutions, etc.) responsible for delivering on their promises, but instead you just have to put your hand out at the right time.

Time and again in Africa, we encountered the case of the free mosquito net. In theory, it sounds like a great idea. In practice, it doesn’t work. Rarely was the free mosquito net being used properly; most of the time, it was actually being used as a net for catching fish, birds, or other animals that could be turned into dinner. I’m not saying that’s a completely invalid use; I’m just saying that using the net in such a way doesn’t help prevent malaria. And as far as I’m aware, that’s what all these charities giving away the nets are trying to do.

So what’s the answer then? Should we deny people the simple protection they need to prevent an often fatal disease? Should we demand that people with little money pay a hefty portion of it for a net?

No and no. What we need to offer people in cases such as this is the skills and knowledge that they might not currently have but once acquired can put to good use themselves (for instance, in regards to the mosquito nets, knowledge about what malaria is, how it’s transmitted, and how it can be prevented). We can also offer them stuff, things that they need but cannot for whatever reason get, but we shouldn’t give it away for free. That doesn’t mean it has to cost much, or even anything. But, those in want or need of the item should have to “pay” for it, whether with money or through barter of goods or services. This means that the “purchaser” will truly want whatever it is on offer and thus be more likely to put it to good use. It also means that they will feel like a valuable person; someone who has something to give, not just someone who takes. I think most of us want to feel this way.

You might now be wondering if this works, if people are willing to pay for things that some charities give away for free. I can tell you that yes, it does work. I’ve seen it firsthand.

One of the most outstanding aid outfits we saw while on our trip was the Bwindi Community Hospital, a place we were invited to tour while staying in Bwindi to trek with the mountain gorillas. Here, a British couple run an Anglican-sponsored hospital for locals (and by local, I mean people who can walk to the hospital in a couple of days). They take in a few foreign volunteers each year, but other than that, all staff is Ugandan–nurses, doctors, janitors, secretaries, AIDS counselors, etc. This hospital is vested in the community. (The couple running the hospital are even drawing up plans to eventually remove themselves from their roles.) And though they offer excellent mendical services–a maternity ward that allows women to stay for their entire third trimester, preventing multi-day walks to and from the hospital; x-ray and surgery facilities; health workers who go out into the community and seek out those in need of treatment–what they’re most proud of, and rightfully so, is their education program.

The “Small Families are Rich Families” campaign has helped lower the birth rate in a country with one of the highest, by educating men on the benefits of having a small family they can take care of and by providing women with access to birth control (which is often literally a lifesaver).  The Village Health Promoter program means that each of 200 villages in the area has at least one trained resident teaching his/her neighbors basic health care practices, thus helping lower the number of cases of easily preventable diseases like dysentery. The Community Garden program teaches mothers not only how to grow food that is nutritious but also how to cook food that is healthy. And the sale of mosquito nets has translated into 15,000 children protected from the disease.

While we were touring the hospital, I specifically asked how the mosquito nets were sold, finding it interesting that they weren’t given away for free. What I learned is that the nets have a set price, a small amount less than $1 that people can pay for them, but that if even that small amount is too much, they can offer whatever it is that they have that they feel is worth the set price. I was laughingly told that they have an entire closet of carved masks and animals that they have accepted as payment. It’s not money; but it is an item of value. They could, after all, probably sell those carved goods to gorilla trekking tourists for much more than $1.

When we left the hospital, I felt uplifted. This, I thought, is how aid is supposed to work. It is supposed to promote empowerment, rather than dependence, to create systems that works whether the aid workers remain or go, to ultimately render itself unnecessary. So many times, we’d seen the remains of projects that simply didn’t work; it felt good to now see one that not only worked but worked well.

Aid is a tricky issue. What works one in one time and place doesn’t always work in another. And for those of us wanting to give, trying to determine what organizations are doing work that works can be nearly impossible. If you’ve been thinking about giving to a new organization this year, or if that mosquito net campaign from the BCS bowl games got you pondering how you could really make a difference, may I suggest Bwindi Community Hospital? There are lots of aid organizations doing good work, but this is one I’ve witnessed firsthand. For more information, or to make a donation that will help the hospital to help others, please visit their website.

*If you did give, good for you. It’s not that giving mosquito nets away for free is bad; it’s just that I think there are more effective ways of providing aid.

**I’m not referring here to the giving of aid during one-time disasters such as the current one in Haiti, but to prolonged aid efforts.

14 Replies to “Aid That Works”

  1. I think Americans serving in the middle east have a similar outlook as you. I think there is a large amount of frustration at the Afghans and Iraqi’s who expect *things* when ever they encounter soldiers or contractors.

  2. The more we travel, the more we see that the traditional aid model of handouts and grants just doesn’t work in the long term. And we haven’t traveled in Africa yet. I imagine we’ll see even more examples of failed traditional aid projects there.

    The president of a microfinance organization in Bolivia explained that the organization switched from being a grants-based NGO to being a microfinance organization years ago. They found that their grant projects (build a school, pump, etc.) would fall apart because the community didn’t take care of them, they weren’t invested. When they switched to offering the money to communities as a loan, he said it was amazing how quickly the community organized and got things together. We saw the results at a project that invested a group loan into a pump to irrigate the fields of twenty farmers. The community was so proud of their pump and had created maintenance schedules and everyone was involved. They had increased their harvests from one to three (rotating crops) each year because of the pump.

    Thanks for sharing your thoughts on this. I’m curious about what we’ll see in Africa and how that compares with other aid projects we’ve seen in other places.

  3. Im confused as to why there cannot be different types of efforts employed at once ?
    brilliant quote by the way
    “We can also offer them stuff, things that they need but cannot for whatever reason get, but we shouldn’t give it away for free. That doesn’t mean it has to cost much, or even anything. (costing nothing is free- contradiction) But, those in want or need of the item should have to “pay” for it, whether with money or through barter of goods or services.”
    Ah yes, lets make thoes who suffer most “pay” for things that will help them. They already have it hard enough but heck!

  4. Oh how I love comments like yours, Victoria. Can I ask what you thought you were contributing to the conversation? I like insightful comments. I like supportive comments. And I even I like comments that challenge my view in constructive and substantial ways. But what mean-spirited and ignorant comments add to such conversations, I haven’t yet determined. Are you having a bad day?

    I think most people understand that cost doesn’t always mean dollars. Things cost time. Things cost effort. Something can cost you without you losing a single cent. And, as for why other types of aid can’t work, I don’t believe I ever said they can’t. I said that in most cases handouts don’t work. But I also I explicitly said that what works in one place doesn’t work in another.

    Do you have any experience with aid that has helped you form your judgments? If so, maybe you should share your experience so people can understand where you are coming from rather than calling the insights of those who do have firsthand observations that they’re willing to share “lame”. Just a thought.

  5. The problem with the type of aid you are describing Theresa, is that it requires such an investment from those providing the aid. Giving away feeds the “giving feels good” and it it so simple. It doesn’t take as much time. It doesn’t require developing deep, trusting relationships with people. If I give a mosquito net, I can feel good about myself and my mosquito net that is made off wood and vinyl siding and covers 1300 sq. feet.

    I use the term “problem” sarcastically. I love that to hear this stuff from someone other than missionary who fully emerse themselves in a culture, fully investment themselves in a community and fully dedicate themselves to making a change for the better. It is great to see that someone who just loves people and has travelled so broadly understands that true change takes more than handouts.

    Don’t blame Victoria for her stance or her response. She is the product of a society that has taught her that now is better, free is best and all giving is better than investing. She is the product of a society that excuses everything by blaming it on the system (please catch the satire). It i like the new Kaplan University commercials that has a professor apologizing for not adapting to the students, instead of expecting the student to adapt to the professor. After all, those who have been through it and experienced it, should bend for and coddle those who haven’t. That is the real world works, after all.

  6. First, I’m uncomfortable with the rhetoric of blog commenting in line with the issues Theresa mentions above. Instead of posting my “edict of thoughts that are surely correct,” I’m just going to post the questions that are going throw my head. References to “your” are directed at Theresa (as the author), but are open to everyone.

    1. Isn’t your whole argument centered in a Western capitalistic view of “how things work?”. Couldn’t value be defined prior to or outside of economic systems, or, hopefully, as being of more importance to some economic system?

    2. Wouldn’t it be better to prioritize an act of caring – a simple, human expression – before trying to establish what value that act has, or worse yet, expecting the “other” to understand and operate within our system.

    3. Who are we to decide how people use the materials that are donated? There’s a danger here of us (as first-world, rationale Westerners) speaking “as” and/or “for” the people who are receiving the supplies. So what if they want to use the malaria net as a fishing net? Should we refuse their need to feed themselves and their families?

    4. Isn’t there a whole danger to this argument that if you say substituted, “health care” for aid, you’d be making the basic argument that people should have to “pay” for heath care before they understand the value of it?

    I don’t want you to say you are blaming the victim here, but it sure seems that the issue here is with how First-World, Western ideas have power and currency in this world. Whole conversations of “value,” undermine the very human, very ethical principle that basic human rights and acts of “care” should not be bartered on economic scales. Is the problem their dependency or our “guilt giving”?

    It seems to me that the challenge of “aid” is negotiating cultural differences in regards to worldview and definitions of care and value. Asking “them” to operate through our worldview seems problematic, but also possibly effective.

  7. Matthew,
    1. I’m not 100% sure what you’re asking here. Of course, my view is based on my background. And of course, value doesn’t have to be economic. I’m not sure what to say beyond that.
    2. An act of caring is great. No argument there. That people try to help other people in any way, shape, or form is good. But here’s the problem as I see it. There’s a finite amount of aid available–in regards to both money and human assistance. We can continue to throw money at developing nations and hope that some of it sticks (is successful in our definition or theirs). Or we can take a good hard look at what works and what doesn’t work, and make a decision to use the money wisely on what works. I think most people who care, who want to perform an act of caring (by giving money or things or by giving themselves) want their donation to go toward something that works.
    3. I don’t think it is up to us to decide how things we donate are used per say, but I think that as responsible donors we should first determine what it is that a community really needs and then provide that. If they need fishing nets and not mosquito nets, maybe we should provide fishing nets. This all goes back to the idea of value. If the people we’re donating to don’t value an item (whether through lack of knowledge or because it does not work for them), then we’re wasting our limited aid resources by giving it to them. (And as an aside, we should be considered about people using mosquito nets as fishing nets because of the environmental impact. Most are coated in permetherin, which can’t be good for our lakes and oceans. And additionally, fishing with mosquito nets results in huge amounts of waste and destruction, because a mosquito net catches everything in its way…remember the holes are so small that mosquitoes can’t pass through.)
    4. Rhetorically, sure I see your point. But in application, I don’t. I don’t necessarily believe that everything should be “paid” for, at least in currency, but I do believe that for the aid to be effective it must be valued by the recipient. Everything has a cost though it’s not always financial. Consider the health care debate here in the U.S. If we say that we think everyone is entitled to health care, if we value that, then we say that we’re willing to pay for it (through taxes in this case). If we say that staying having children is important to us, if we value that, then we say we’re willing to pay for them by giving up the freedom of being childless and by taking on additional responsibilities…emotionally, financially, psychologically, etc.

    I think the point that is being missed here is that by value I don’t necessarily mean economic value. In fact, I hardly mean economic value; I’m pretty sure that I never defined it as such above. The problem with aid, as far as I witnessed it first hand in numerous situations, is that we don’t understand what other cultures value and then when we provide the items we think they need they are often not valued. I’m not arguing that people “owe” us in any way for the aid we provide, or that we should put a price on aid. I’m arguing that aid must have a value (to the receiver in particular) in order for it to be effective. We’ve built too many schools in communities that don’t have teachers, given away too many mosquito nets to people who don’t understand their benefits, and given too many fish to people who don’t know how to cast a line. Aid should empower, educate, and be of value to the recipient. Otherwise, we are just throwing money to the wind.

  8. Theresa,

    There’s obviously issues of meaning transaction from writer to reader through a text complicating things here (such it goes with reading and writing), but my reading of your argument as being couched in economics comes from two points in your text. First, you spend considerable time explaining the dangers of “free” stuff. I would consider “free” to be defined as “free of economic charge.” Second, you do say, “That doesn’t mean it has to cost much, or even anything. But, those in want or need of the item should have to “pay” for it, whether with money or through barter of goods or services.”

    I’m not sure what my argument is. I don’t even like the word argument. I don’t think we are having an argument here. I think my line of thinking has two points, and they might be complicating to each other. First, I think there’s a danger to viewing things primarily in economic terms. Second, it’s hard for all of us to not view the world in economic terms because that’s the current “currency” of most Western conversations. It seems to me that you are trying to complicate this idea of “value” as being defined economically, but you do that by returning to economic examples – such as the dangers of “free.”

    I’ve actually been thinking about issues of “economic conversations” in regards to my dissertation and the compensating of research participants. I’m also teaching an article that looks at students choices to plagiarize as being motivated by their connection with an economic view of authorship and not an intellectual view of authorship. So, I’ve been thinking about this topic alot, and your post made me think about it more. But I don’t have my ideas all together. I’m just beginning to consider, though, how much we talk about value in economic terms and, more problematically, that the move to discuss them in any other way is complicated by the omnipresent nature of these “economic considerations” in our thinking.

    So, how does one pay for something that does not cost anything? On the flip side, how do you provide value to an act without putting a price tag on it? How do those receiving the aid vocalize what is valuable to them? What happens when their value and our value do not match up, both in terms of content and form of “transaction”?

  9. I think it’s wrong to assume that economic currency is merely a Western way. I’ve been to every continent but Australia and Antarctica, and I can tell you that it’s the way of the world. In fact, many of the non-capitalist countries went to had the strongest emphasis on money and economic transactions. Perhaps seeing the world through an economic viewpoint started out as a Western way, but it has spread to most of the world. To assume otherwise is to look at the world through lenses that haven’t been updated in decades. It actually smacks a bit of colonialism to me.

    In an academic bubble it sounds nice to say that human rights shouldn’t cost anything, but that’s not the way the world works. Sure, people should have access to food, health care, shelter, etc. But none of that is free, and nor must it be free. It should be accessible and priced at a point that people can afford, but to say that it should be free is to deny the reality of the way the world works.

    Anyhow, rhetoric doesn’t interest me the way it does you, so I’m done with semantics. I know that as the writer I mean much more than than economic value when I use the word value. The reader can read it however (s)he wishes.

    My main point is that the current system of aid, primarily based around the giving away of money and things, does not work. What we have witnessed as working is aid in which the community is invested (either financially or through time and human interest) and in which recipients of aid are treated as people who have something to bring to the table, not simply people in need of help.

    And I’m done.

  10. Now that I’m talking to myself….

    I’m glad I now have evidence that even very excellent writers resist the idea that maybe there’s something underneath the surface of a written product that is worth investigating. I’ll refer back to this evidence when my “working-to-one-day-be-maybe-possibly-an-excellent-writer” student-writers resist returning to their texts.

    I’m not disagreeing on your main point – and god knows I don’t have the first-person experience to argue some other model – but I am arguing that at least one reader (me!) is saying, “Hey this is a very cool idea, but, from my perspective, you might want to give more thought to X and Y.”

    “Well self, those are two very good points. You should actually go have a conversation about this with someone who cares to listen. Why would I do that, self, when I could just have it with you, I mean me, I mean you, on Theresa’s blog?”

  11. you are right Theresa, most of us do not have your first hand experience,and our only way to help is to contribute to someone providing mosquito nets to a malaria ridden country. We feel like we are helping and do not want or need to be paid in any form. Last year during the ice storm we were lucky enough to have friends who gave us two empty apartments, that had heat and water for as long as we needed. They would not accept any payment, they knew we would do the same for them. we really really appreciated the apartments and cared for them. There is also the tide program that provides free laundry to disaster areas. Now I realize these are not global situations, but as for me, I want to help the world be a better and healthier place,so I depend on organizations to tell me where to contribute and what is needed in global areas and do not expect the recipients to pay for them. Like the Crusade for Children, you contribute to help Ky children.

  12. To be clear, I’m definitely not saying that giving money is a bad way to give. In fact, I think for most people that’s the best way to give, especially when we’re giving money to organizations that we feel are making a true difference. The trick is determining which of the many charities are good recipients for our money. And for each person that’s different–based on what we believe is important and how we believe aid is best distributed. The desire to help another person, whether it be one you know or one you will never meet, is good, period, and should only be encouraged.

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