Outside development aid

I had a chance to sit down recently with a surgeon who spent a year volunteering with a well-known international aid organization in an African country. He was part of a three-member team that consisted of a surgeon, an anesthesiologist, and an operating room nurse. The project aimed to identify local people who would spend a year with them, get trained in how to be a surgeon, an anesthesiologist, and an OR nurse, and then head back into their provinces to provide service. The aid organization sent 21 of these teams throughout the country. Ideally, by the end of the year, there would be 21 local teams prepared to provide services to their people.

The surgeon had planned on spending his life doing humanitarian surgery. But his experience so disillusioned him that he’s taken a break from pursuing that as a career.

He told me about how much difficulty he had when he was applying to various international agencies. He was offering his life to them, for free, and only one agency could accommodate him.

He told me that throughout his assigned country, there were many international aid organizations, all in competition with one another, refusing to cooperate or pool their resources. The agencies were more concerned with making their annual reports look good and getting more funding than making sure their work actually made a difference.

He told me that the organization he worked for failed to take the local situation into account. They sent these fancy autoclaves to sterilize instruments—fancy because they had microprocessors with them to control the sterilization process. But the chips were set for sea level, not for the elevation of the country, so they were useless. It would have been better to simply send pots and teach the staff how to sterilize their instruments by boiling them, because that technology would always be available and repairable.

He told me that they used sutures at the central training hospital that would never be available in the provinces.

A year after his departure, of the 21 teams that were trained, only three were still functioning. That’s better than nothing, but it doesn’t make for a success story, especially considering the talent and dedication that poured in through the volunteer surgeons, anesthetists and nurses, who gave a year of their lives for this project.

It again points out the need for development projects to be decided locally, on the ground. For people to become empowered to identify their own problems and create their own solutions and seek the assistance they need. Development projects imposed from the outside are simply folly.