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Rapid Responses: Rapid Responses published:
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Where does the aid go?
- Shiv S Budihal (24 December 2007)
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Talk to the real aid workers!
- Erik H. Grangaard, Rotorua 3201, New Zealand (31 December 2007)
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Combating poverty: Are silver bullet solutions delivered by NGOs enough? – even if they do cost $2.3 trillion
- Marko Kerac (1 January 2008)
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Sri Lankan Experience
- Visahan Y Sabaratnam (1 January 2008)
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Encourage local community participation in development aid implementation
- Abdu S Opaluwa (1 January 2008)
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Shiv S Budihal, Consultant North Hampshire Hospital Basingstoke RG24 9NA
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Professor Ncayiyana has hit the nail on its head.Indian PM Rajiv Gandhi once said 70% of the central government aid does not reach the needy. World Bank and International monetary fund who are the big donors to the developing countries have an obligation to make sure that majority of the aid does not end up in the pockets of the corrupt politicians and officials. Competing interests: None declared |
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Erik H. Grangaard, Paediatric consultant WCF Service Rotorua Hospital, Rotorua 3201, New Zealand
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Having been in contact with friends who are workers in the field during the so-called famine in Niger a few years ago put the main aid work and the function of the media into a very unpleasant and revealing light. The handouts changed many families from working toward sustaining solutions into beggars borrowing sich children from each other to achieve maximum support. If you want to learn how to do it the best way log into www.eden- foundation.org. It is now the second generation carrying much of the work load in this revolutionary and pioneering work. To achieve food from draft resistant perennials can take as long as 10 years, but they can then be harvested for several years. No in and out with fancy new four-wheelers and TV cameras will ever do the trick. There is no quick fix here, only consistant work over long periods of time with education of the whole society. This really achieves what we are all after! Competing interests: Former Board Member of Eden Foundation |
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Marko Kerac, Hon Lectuter & PhD student College of Medicine, Malawi & UCL Centre for International Health & Development, UK
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Sir, Professor Ncayiyana rightly calls for action to tackle the scourge of global poverty(1). However, would replacing charades with a game of pass- the-funding parcel really have the desired impact? Development is a long and complex process. One single, simple, ‘silver bullet’ solution is unlikely to work everywhere. Even in many “developed” countries, relative poverty and inequality continue and have serious adverse effects on health and wellbeing(2),(3). Effective civil society organizations are indeed vital players. But they are also unelected and have their own agendas, notably organizational survival. It is difficult to see them scaling up to run national programmes in the same way as properly functioning, democratically accountable governments. Surely both non-governmental and governmental organizations have important roles which deserve support? $2.3 trillion over 50 years sounds impressive, but works out as $46 billion per year. Compare to: - $1001 billion global military expenditure in 2005(4) - A $41.9 billion global ice cream market in 2006(5) Few would argue that wars and conflict have not changed the course of human history in profound ways. Ice cream meanwhile sounds nice and tastes sweet - but lacks real nutritional substance and melts away far too quickly. Sometimes, the return is proportional to the size of investment as well as the wisdom with which it is spent… Dr Marko Kerac, mkerac@hotmail.com 1. Ncayiyana D. Combating Poverty: the charade of development aid. BMJ 2007;335:1272-3. 2. Siegrist J, Marmot M. Health inequalities and the psychosocial environment-two scientific challenges. Soc Sci Med 2004;58(8):1463-73. 3. Marmot M. Social determinants of health inequalities. Lancet 2005;365(9464):1099-104. 4. chapter 8 of the Stockholm International Peace Research Institute (SPIRI)’s 2006 Year Book. [cited; Available from: http://yearbook2006.sipri.org/chap8 5. Ice cream: Global Industry Guide. Research and Markets. 2006 [cited 29.12.2007]; Available from: http://www.researchandmarkets.com/reports/53588/ Competing interests: i) Spent some time working in the Malawi government sector and could not help but occasionally envy the far bigger salaries paid by many non-governmental organisations. ii) Especially peeved if NGO people get all righteous and claim to be "supporting inadequate government services" - whilst simultaneously recruiting nurses away from already understaffed government hospital wards. |
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Visahan Y Sabaratnam, Consultant General Surgeon Teaching Hospital, Batticoloa, Sri Lanka.
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This is my experience. I belive all articles and papers on aid cannot be trusted. Sri Lanka is a small island nation south of India. This was affected by the Tsunami in 2004. More than 200,000 people died. Aid poured in from all over the world. The value of the rupee rose by 15% purely due to this influx of money. People call Tsunami as "Thanga Tsunami" in tamil. What means is Golden Tsunami. Most affected by the Tsunami live in huts. Houses have not been built while some have bought more than 3 houses, vehicles, jwellery, travelled around the world more than 20 times and have hefty bank balance.These are politicians, doctors, administrators and others who are controlling the tsunami funding and development. It is a club. When I approached the UN, USAID, OXFAM, WORLD VISION and other major organization they were only interested in talking to the peopele "friendly" people. They know only the corrupt will give a favourable report after a conference which be held in a five star hotel with worlds most expensive drinks being served in plenty. They usually have these coference over few days. Money spent on each coference could build more than 20 houses for the poor. I have never seen a representative of this organization travelling in a normal vehicle. It is always the most expenxive SUV. I discussed this issue with a UN official in Geneva. She was a good friend. She asked me to shut up or to get "bumped off". Any alternative......... Competing interests: None declared |
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Abdu S Opaluwa, Staff Grade General Surgery The Queen Elizabeth Hospital, Gayton Road, Kings Lynn, Norfolk, PE30 4ET
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Sir, I support Ncayiyana's suggestion that international aid should be managed by independent and accountable agencies instead of politicians and bureaucracies of donor and recipient countries [1]. Although there are no easy answers for the dismal result for the $2.3 trillion spent on aid in the past fifty years, corruption and misplaced priorities, have no doubt contributed significantly to the outcome. There is an urgent need for a change of direction. Community involvement needs to be encouraged if the impact of development aid is to be felt at local levels. The local people for whom projects are meant know their priorities and must be carried along in the formulation and execution of projects with local content being taken into consideration. In Nigeria, some communities undertake self-help projects based on their local needs and priorities. They raise funds and execute the projects through their district/divisional development associations. Community schools, primary health centres and roads are examples of some projects undertaken this way by communities. Local people directly participate in the implementation and maintenance of the projects with a sense of belonging. Accountability and transparency are ensured by the people who closely scrutinise the projects. Community leaders and elders regularly inspect the projects to ensure compliance with agreed plan and design. However,financial constraints hamper the execution of some of such projects in some communities. Direct partnership between donors and recipient communities will ensure that the aid goes directly into projects for the people for whom it is intended. 1. Ncayiyana, D J. Combating poverty: the charade of development aid. BMJ 2007; 335: 1272-1273 (22 December 2007). Competing interests: None declared |
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