Tag Archives: Funding

Politics

No Time to Rejoice

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Hip hip hooray? The British government has announced it will welcome thousands of Syrian refugees, an abrupt reversal of fortunes for those dreaming of barbed wire boundaries.  So much for the previous day’s logic that the UK’s generous aid / involvement ‘over there’ somehow cancelled out legal and moral obligations right here.  It would be difficult to concoct a more perfect example of abusing the purpose of aid.

There are many who will view this as a victory of politics, a democracy where the voice of the people was heard.  It is certainly a case where the shift in public opinion, not to mention the shame of having even the likes of Nigel Farage (UK’s anti-immigration demagogue) call on the government to do more for the refugees, prompted better policy. But this remains a political failing.

What do Aylan Kurdi and Thomas Eric Duncan have in common?  They are both dead.  And their deaths changed public opinion.  And so their deaths changed prime ministerial / presidential policy.  That is the problem with democracy, its inability to act against the will of the people when the will of the people is too slow to embrace what is right.  David Cameron has long known what is right – legally and morally – in terms of those seeking asylum from Syria, or places like Eritrea, Yemen and Libya.

Both Cameron and Barack Obama knew that their countries needed to launch an urgent response to Ebola long before their catastrophically late (September 2014) interventions.  But they could not act because the increasingly deadly combination of the high stakes of power plus the brutal oppositionalism of domestic politics means that politicians cannot afford to act in accordance with necessity, principles, or even in line with their own moral compass.  When it comes to these sorts of foreign policy issues, it means they must wait for the public because they will not sacrifice political capital to lead the public. So they watched Syrians drown and Sierra Leoneans perish.  We all watched.

Political (and financial) dynamics thus twist the financial and proverbial logic, creating a structural preference for pounds of ‘cure’ rather than ounces of ‘prevention’. In other words, for late intervention, after the weight of a crisis has gained sufficient media attention to tip public sympathy.  The well-foreseen, slow-onset 2011 famine in south central Somalia provides a well-documented example. The humanitarian community needed those images of starving children to unblock funding, many fatal months late.  It is not a victory when doing what’s right in the face of (impending) crisis means waiting for the likes of the crumpled little boy on the beach or the feverish Liberian man in a Dallas hospital.

Critique of Aid

Called Out

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Story 1. The Daily Mail’s recent investigation revealed that charity fundraising agents employ aggressive techniques, harassing everyone, even people with dementia in order to score a donation. The DM trumpets a revolting story of how one lovely old woman, 92-year-old Olivia Cooke, was killed by cold calling.

Story 2. All these charities have ‘robust’ measures in place, none of these charities ‘tolerate’ unethical call practices, all these charities have elaborate systems to ensure their telephone fundraising agents comply with the ‘highest standards’ of practice, none of them knew what was going on, all of them are ‘outraged’ and will get to the bottom of this… (see here, for example)

Point 1: Something does not quite add up.

Question 1: Which conclusion is worse? That charities all know exactly how cold-call fundraising campaigns function, and yet make a calculated compromise? That it is largely the charities who dictate a game in which call agencies must deliver the greatest bang for the buck – an equation doomed to sideline ethical concerns? Or that nobody knew the path that was being taken in their names (conveniently, in that case, all we need to do is change paths by hiring a different agency)?

Answer 1: No answer to those questions gets rid of the queasy feeling that more of the public now thinks of us in terms usually reserved for celebrities who get caught cheating on their spouses.

Point 2.  We are all in this together. Trust is the primary precondition for the aid world.

Story 3: The aftermath has been predictable. Now, the industry trots out sincere handwringing, apologies and pledges for investigations/change. Now, announcements to stop using cold call tactics and a new supporter pledge to behave better. Now, the politicians, fundraising industry and aid business have jumped on the bandwagon of salvation.  Tough measures will be taken! Abuse will be stamped out! A new morality will rule the day because it turns out humanitarians – like the politicians and bankers in opposition to whom we routinely define our goodness – need a new morality.

Question 2. The question isn’t whether NGOs should wean themselves from cold calling or establish confidence-building supporter pledges. The question is why supporter promises, a relatively ancient, tried-and-true practice, were not in place long ago. The question is why cold calling is ever used to raise money for humanitarian ends.

Answer 2 (literal version): Decisions were taken not to make a supporter promise.  Decisions were taken to ignore the ethical concerns around cold calling in order to deliver on cash.

Answer 2 (simple version):  We have large headquarters and we have massive needs to fulfill – a globe of human suffering no less –and that costs money.

Answer 2 (complex version): The incentives in a supply-driven aid system emphasize financial bottom lines over operational effectiveness.

Answer 2 (deep version): Across many dimensions of our work, the humanitarian has a vested interest in believing that ends justify means.

Main Point: The Daily Mail – and we should expect as much – almost defines the “shark kills surfer” school of journalism.  Shock sells news.  Little old ladies with Alzheimer’s became the story. So little old ladies become the problem and then drive the solution.  In whipping up the lurid tale of our fallen humanitarian nobility, the media buried the greater imperative. A focus on the extremities of harassment veils the banality of aid’s hard-fought principles being eroded by the business of self-interest.

Story 4:  Where have we heard this saga of disenchantment before? Just about everywhere.

Uncategorized

Making development work for humanitarian response–and vice versa

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[This is the first of a series of posts aimed at the World Humanitarian Summit.  More generally, this post and the next one offer ideas on how development and humanitarian organizations can work better together. Many thanks to WhyDev for their encouragement, editorial help and posting of this blog. Check out their excellent site if you don’t know it. – MD]

How many times have we seen this: a complex emergency with a decade or two of heavy humanitarian intervention (maybe some development organisations and peacekeeping forces as well), scores or even hundreds of millions of dollars spent by aid agencies, legions of expats trafficked through–and yet close to zero planned impact on local economic development or resilience? Sound like Eastern DRC? Haiti? South Sudan?

Foreign aid policy and practice have failed to view humanitarian crisis as an opportunity for development. This gap highlights a missed potential to capitalise on the presence of such a well-resourced foreign enterprise as humanitarian intervention.

A house divided

The aid community has improved its performance these past years by learning that, particularly in complex emergencies, contexts cannot be shoehorned into one end or the other of a false continuum, designated as either “humanitarian” or “development”, with one-size-fits-all implications for the aid response. Nonetheless, this divide is deeply ingrained, reinforced by the two-pronged architecture of the aid system, from funding streams to academic departments to organigrams of agencies and governmental ministries.

This divide has given rise to a fair amount of acrimony, and to a blind spot when it comes to opportunity. It is good–but not good enough–to comprehend that humanitarian crisis and developmental needs lie side by side. We must take the next step and see long-term development opportunities as residing within crisis. It’s time for development agencies to seize the presence of the humanitarian machine, by exploiting its potential as a source for financially sustainable (small) businesses. It’s time to make friends with the enemy.

Mind the gap

We understand almost intuitively how humanitarian crisis, whether conflict, flows of refugees or natural disaster, generates destruction, including damage to the local economy. Yet crisis often means that business is booming for the humanitarian endeavour. Viewed through an entrepreneurial lens, humanitarian response, particularly those stereotypical Western-led interventions in long-standing emergencies, resembles a pretty fat cash cow.

In crisis contexts, INGOs possess relatively massive resources, and they often represent the biggest fish in the pond. In line with these resources, humanitarian NGOs also have needs–many of which could be met locally. Why is it, then, that an organisation like MSF/Doctors without Borders works in Goma for decades, and still expends resources on importing and servicing its own vehicles? Or why in Nyala were there so few restaurants where an expat could go out to eat, even at the height of the Darfur response?

With a large, wealthy and needy humanitarian community present for decades, why do we still find development NGOs teaching women to make soap? Okay, that’s an exaggeration. There is nothing wrong with soap. The point is that many income-generating efforts are not successful, in part because of the lack of people willing or able to buy. But the humanitarian industry and the expats it employs are willing and able – so why aren’t development NGOs helping local people meet this demand?

In places like Port-au-Prince and Goma and Nyala, there are, of course, some local businesses and people who take advantage of the presence of foreign NGOs and expats alike, such as landlords, nightclubs and security services. Typically, though, the untapped demand is much larger, particularly for in-house service at NGOs; and, these businesses are either ad-hoc or pre-existing (especially in the early stages of a humanitarian response). Importantly, they are not the result of development agencies capitalising on opportunity, and so do not by design benefit the community, contribute to self-reliance or help establish an entrepreneurial culture.

The major humanitarian NGOs (and the UN) continue to be the managers and providers of an internal set of non-humanitarian services, which is inefficient. Here, one could talk of NGOs that hire and manage staff to clean their offices or residences, rather than having a development NGO work with a local group to create a cleaning service business. Ditto for vehicle maintenance, transport, catering, many aspects of supply and other functions that typically remain in-house to the INGO. And what of demand for highly-skilled counselling or consulting services (why do Westerners get so many of those contracts?), outsourced not necessarily due to a lack of local expertise, but because the local expertise lacks the know-how to package and market itself effectively?

Closing the gap

There needs to be a convergence of policy and practice aimed at the progressive outsourcing of services from within the foreign humanitarian community to local NGOs and businesses. The first step requires a teaming of development NGOs with their humanitarian cousins to delineate the concept. What services already exist? What services and businesses might comprise “easy wins”? What are the no-go areas (where humanitarian NGOs should retain direct control)? In what contexts would outsourcing be most likely to work? How can the development actors reduce the risks of negative impact when the humanitarians go home?

Next, the development agency must negotiate with national and local authorities, humanitarian NGOs and institutional donors to establish coordinated action and goals. NGOs will need to progressively cede control over important components of their activities. Donors may need to nudge them towards compliance, and national governments may be able to encourage change through regulation.

Most importantly, NGOs will have to work in the local community to build the actual businesses and services. This requires working in tandem with humanitarian organisations to ensure that needs are met and the quality of services is sufficient. The point is to create sustainable local capacity–businesses, services, NGOs, etc.–that can fill gaps or replace existing services that are owned or managed by humanitarians themselves.

Even to the extent that the activities proposed here already exist, they remain exceptions, haphazard in their genesis and limited in their impact. They do not reflect policy choices aimed at exploiting large-scale, protracted humanitarian interventions for the benefit of local development. Can we not imagine increasing local businesses’ support and service to the humanitarian community, to the point where it becomes a successful core component of development aid?

This opportunity may prove infeasible in some contexts, or it may be counter-productive to become dependent on cash cows whose presence is temporary. But, there is significant potentially successful development work in transforming existing functions into sound, income-generating local businesses.

Critique of Aid, Health, Politics

The Product of Systems

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Who is in charge? Part 1.

The richest 1% of the world will soon have a greater share of the world’s wealth than the other 99%. With that eye-catcher of a stat, Oxfam launched a report and a discussion on extreme global inequality. Great stuff. Do not let the quibbling distract you. This is a street child face down on a busy sidewalk in a pool of excrement. Trust your gut: imbalance on this scale is inherently and dramatically wrong. The only debate should be which is worse – what this says about wealth distribution or what this says about power.

But what if I told you that I just read about a place where the richest few control 99.8% of the wealth? Not 48%, as Oxfam’s report denounces, but the whole enchilada? Ninety-nine point eight percent represents an astounding achievement in disparity. Can you guess where? No, not mega-corrupt states like Angola or Equatorial Guinea. No, not the petrol-rich like Qatar or Bahrain. No, not even Mark Zuckerberg’s family. Give up?

The surprise winner of the award for the most inequitable distribution of wealth and control on the planet is none other than us, the ensemble of humanitarian NGOs. Congrats to the likes of MSF and Save and (of course) Oxfam. Here’s Development Initiative’s excellent financial analysis of the humanitarian system (see p. 55ff): National and local NGOs form an essential part of the humanitarian response, but in 2013 only directly received US$49 million – just 0.2% of the total international humanitarian response. That’s US$49M out of about $2.3 billion hitting NGO coffers worldwide.

You can quibble with that figure – it’s not counting indirect flows to national NGOs – but my advice is to trust your gut. Eat your heart out, Donald Trump.

Who is in charge? Part 2

Bill Gates talks solutions. Bill Gates is right. Bill Gates calling for “germ games”. Bill Gates is all over my Twitter feed.

Gates has published an Op-Ed in the New York Times, an article in the New England Medical Journal and done a lot of media work to proclaim that good old human “ingenuity and innovation” can avoid the next Ebola disaster.

Gates makes sense, of course, calling for the development of vaccines, for better surveillance, for a global logistical and medical epidemic response capacity. Gates’ central point, though, is only half correct, and therein lies the flaw in his cunning plan. Gates claims (NYT piece): The problem isn’t so much that the system didn’t work well enough. The problem is that we hardly have a system at all.

Really? Is it that the system doesn’t exist? Or is it that the non-system of epidemic response is the direct product of another system, a highly inequitable international system of interests and power that does not typically place the public good as its paramount ambition? In other words, the very same international system upon whom Gates calls to act.

On one level, Gates forgets what happens to good ideas when their basis for attention and funding is fear and insecurity. What happens when you employ scaremongering to mobilize politicians and Western publics into funding better healthcare systems for the world? My guess: skewed priorities (epidemiological surveillance trumps maternal mortality) and unforeseen consequences, like helping to justify military expansion into global health and humanitarian action. It has not exactly served the lofty goals of international development to have become an integral tool in the global war on terror.

Most importantly, though, Gates seems to be addressing symptoms, not causes. In calling for an international epidemic response system, Gates essentially advocates the same superpower and global institutional approach that helped deliver WHO’s ineffectiveness, Sierra Leone’s woefully inadequate healthcare, or an Ebola response in West Africa that was too late, too slow and too focused on staunching the Westward flow of Ebola rather than healing those who already had it.

Bill Gates outlines a system the world needs to build. Dead right. Now he needs to outline the world that will build it, because he is silent on the need for changes in the way global institutions are conceived, controlled and built in the first place.

Health, Politics

“Pound of Cure” Politics

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Who hasn’t heard this one: An ounce of prevention is worth a pound of cure. The old adage presents a truism well relevant to the world of international aid. Ebola comes quickly to mind as the latest in a long list of lessons not learned. To wit, at what point – March? May? – would a fairly modest ten million or so have staved off the need for the $1.3B intervention that has been launched to date?

But the proverbial equation generates a false comparison. The “pound of cure” logic dissimulates. That tail of the proverb represents the cost of an intervention at a later stage – the bill for the fix (i.e., action after the problem has materialized). The mistake is to confuse the cost of the fix with the value of the damage. Pound of cure thinking hides ten, twenty or maybe thousands of pounds of loss – 11,000 orphans, schools shuttered, crops unsown or harvests unharvested, businesses bankrupted, national economic growth about-faced. And over 9600 people who are no longer people.

Let’s not be too hard on the proverb. Let’s be hard on ourselves. In the deeply politicized world of international aid and emergency response, the availability of the proverbial ounce of prevention turns out to be part mirage, hence a solid track record of paying for pounds of cure. This study of the 2011 famine in Somalia seems clear enough: Famine early warning systems clearly identified the risk of famine in South Central Somalia in 2010–2011 but timely action to prevent the onset of famine was not taken.

It too often proves more difficult from a political perspective to prevent a problem from arising than to deal later with the consequences of the problem itself. That is because mobilizing preventative action often proves trickier than launching a curative response. Humans seem hardwired to contend with the urgent at the expense of the important. In proverbial terms, that is also because frogs don’t hop out of water brought slowly to boil. And because screeching wheels get the grease before those that merely squeak. Tired yet? How about this? In the aid world, few will pay the early bird to catch the worm.

Enough of the proverbs. Let’s try fairytales. Is it even fair to balance a pound of cure against one sole ounce of prevention? What does the story of the Boy who cried “Wolf!” tell us? If not a boy, then what about the Western NGO? We belong to a business that depends on the production of a veritable smorgasbord of impending disasters; of persistent, strident calls for action (read: squeaky wheels in search of grease). That makes for a fast drip of public alarm, elbow-steered lobbying, and celebrity-endorsed impending doom. Act now! (Or: Send cash!). How many cures – how many actual crises – have actually been averted? Perhaps this is not just a tale of a Boy. Perhaps this is also the work of Chicken Little.

If we flip this around: the emergency aid business is of necessity an industry of alarm. Is there today a cacophony of alarm and media hype that deadens the ear? Have we reached the point where it is actually more efficient and more financially prudent for key donor governments and international institutions to wait and pay for the cure?

And what about the lessons of those fairytales? Cries of “Wolf!” or “The sky is falling” became quite pertinent in the Ebola crisis, where MSF’s early alarm was derided or dismissed in some quarters as yet another NGO fundraising ploy. The NGO cried out that Ebola was real and nobody listened. Real it was. A ton of cure that could have been averted by an ounce of prevention? Seems so. And maybe also a ton of cure that was necessitated by the perception of too many false ounces?

 

Politics

Cyber Warfare: Think about who might be next

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International cyber warfare did not begin with somebody stealing the launch codes to the nuclear arsenal on a U.S. Navy Triton submarine. It did not begin with a cabal of MIT geeksquad eco-terrorists shutting down oil production in the Arctic Circle. No, those are Hollywood story lines. In the end, international cyber warfare began with the revelation that Angelina Jolie is a “spoiled brat.” It began, funnily enough, with Hollywood itself; with a powerful movie studio pulling the release of its $42 million movie, shamed by outings of internal secrets, hurt by stolen scripts, threatened with violence. So much for The Interview.

Have you followed this story (e.g., here, here or here)? Did you feel a bit catty early on, as I did, a little too elated to see Tinseltown’s top brass squirm as their personal emails became Gawker headlines? Be careful. Here’s a test. Aside from a Hollywood studio about to poke fun at the oddball ruler of a pariah country, can you think of another Western entity, or body of entities, who might occasionally humiliate the leaders of relatively powerless countries? Who might ritually indulge in the arrogance of airing someone else’s dirty underwear? Who might just irritate some nation enough, or threaten enough reputational damage, that the allure of socking one of these self-appointed voices of global conscience in the gut might appear both justified and quite delicious?

On the surface, the Sony saga has some appeal to those of us who root for the underdog: marginalized basketcase government jumps corporate behemoth and beats them into surrender. There is glory in that. And power. We NGOs in particular should understand the apparatus at play. The North Korean government (allegedly) has rode the vehicle of celebrity to guarantee viral coverage for its story, in the process shaming the would-be shamers. I can think of a few other governments who might be interested in that kind of power, and instead of a second rate comedy being canned it might be a documentary about rape in Darfur, or a report on the deliberate destruction of health facilities in Syria.

Let’s face it, in terms of our cyber security large Western NGOs have erected far less of a fortress than a company like Sony Pictures. We are exposed. Crucially, we are easily more vulnerable than the movie biz to blackmail when public perception and trust are at stake. It wasn’t pretty, but those Sony emails certainly didn’t say anything we didn’t already think about Scott Rudin, Amy Pascal or that entire industry. The public is titillated, not abhorred, by their sneering. In contrast, what do aid execs write when nobody is looking? I’m guessing that donors contributing a million a year would not appreciate email musings refering to them as, say, egomaniacal , dandruffy pains in the ass. Not to mention direct orders to strengthen the facade that the agency is working through local partners, or the truth about bloated HQ staff travel budgets and long-running projects with little impact.

Politics

Tony Blair and Global NGOs: Not so strange bedfellows

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The verdict arrived as furiously as in Ferguson: widespread condemnation, both public and internal, for Save the Children’s decision to present Tony Blair with a humanitarian award (see e.g., here). In an act designed to beef up my own award credentials, let me be the first to perform the selfless humanitarian act of extending a hand to STC (John McTernan defended the award, so I’m not the first, but then again he is essentially a Blair protege).

The humanitarian enterprise hardly needs a further injection of public distrust. The criticism focuses primarily on the moral offense of his track record in Iraq – not quite pro-children – or as PR frontman for dictators. Others lament the ugliness of this type of NGO self-promotion rendered naked. To those complaints, let’s add the potential impact in places like Iraq, where armed groups find yet another shining example of the proximity of global NGOs to their political enemies. So much for the perception of neutrality and independence.

Yet it is too easy to mock STC’s self-inflicted wounds. The true humanitarian does not judge the wounded and sick, nor deny assistance, even if it’s all their own bloody fault. The point here is that nobody should be shocked or even surprised that STC gave Blair a big fat and very public award.

The political world requires compromise, and major NGOs, including global aid organizations, labour to make themselves part of that same political world. They do so to be effective. What about Clinton? What about the many NGOs who accept funding from the Clinton foundation? Would it be fair to say that his blind eye to genocide in Rwanda had a negative consequence or two? Or that his almost farcical abuse of power damaged women across the world? What about Obama in the future? Will his legacy of healthcare to poor Americans (or whatever social issues he takes up post-presidency) be permanently tainted by his policy of drone terror? NGOs operate in this same arena, one where compromise is both inevitable and frequent. That is not a justification. That is an explanation.

Many global NGOs establish close relationships with governments and political parties, in order to obtain vital funding and in order to affect policy change (see this 2012 blog). They pepper their offices with the ranks of ex-political figures and their boards with the establishment’s great and the good (hence the blind spot at the top of STC, who did not seeing this coming). STC and Blair have very close ties (see e.g., here).

But even if not directly co-mingling with politicians, global NGOs resemble the Blairs and Clintons of the world – amalgams of brilliant accomplishments with closets of perverse compromises. Being among the elite powers on the planet is no place for unbowed idealism (and make no mistake about the power of the global NGO, be it as a voice of moral conscience, public accuser, or in their dominant relationship to the communities they serve). That reality is a message our publics will understand, if only we stop selling them the myth, and stop selling it to ourselves.

Crucially, the backlash against STC highlights the gulf between the reality of NGO action and the image of NGOs as noble crusaders. People want to believe in NGOs. And I have a feeling this backlash is particularly dangerous because it involves the choir throwing stones at the priest – nobody can blame the Daily Mail crowd for this storm about aid. What surprises me is the degree to which this gulf lies within the organization as well. STC staff appear to be among the most vocal critics, labeling the award as a “betrayal”. Fair enough to be pissed off at the negative consequences and the hit to trust in STC (or donations), but who did they believe they were working for? Who do any of us humanitarians believe we are working for? And how necessary is it to us to maintain this belief?

Perhaps Toby Denskus says it best, commenting matter-of-factly: We can no longer rely on political activism from large, professional charities. This may not be exactly news, but it is worth a reminder: Large NGOs, charities, ‘civil society organizations’ will not be among those organizations that will rock any domestic political boats.

That is no reason to lose faith. It is a reminder that they work through reform rather than revolution, pushing the establishment to do better, helping to create a better status quo. But to ensconced within that status quo to upend it. Which is why they are part of the world of Tony Blair. If only they wouldn’t broadcast it so brazenly.

Critique of Aid, Health, Our Western Identity, Politics

5 Shots on Ebola

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1. Return of the Jedi

Oh no. Just when there was some good news – falling rates of new Ebola cases in Liberia – the Ghost of Aid Mistakes Past has returned to haunt us. Bob Geldof will launch another Band Aid rendition of “Do They Know its Christmas” (One Direction I can understand, but Elbow? – say it ain’t so).

Thankfully, the response is far from a collective sigh of relief. It is refreshing to see still more cracks in the wall of the West’s narrative on aid and Africa. As I discussed in a previous post, we can now hear the voices of “outsiders” (i.e., people who actually come from places like Liberia or Nigeria instead of people like me): challenging the bias in Ebola media coverage (reinforcing the industrial savior complex); lambasting a 60 Minutes piece that treated Liberians strictly as background props; or questioning the methods/intentions of Geldof and company.

Really, African stars should gather and launch a campaign “Do They Know its a Continent?”

That said, even this critique presumes that the 1984 version of Band Aid constituted some sort of historic success. Trashing Sir Bob for promoting an antiquated vision of Africans as helpless victims misses the tragedy of Ethiopia 1984. People were dying less from drought than from the government’s human rights violations (as concluded by Human Rights Watch). In that perverse environment, aid distributions propelled the forced relocation policies that were destroying whole communities, not to mention the more recent and controversial revelation that famine relief funds helped buy arms for rebel secessionists. (See here for David Rieff’s cogent view).

2. Useful Enemies

The outbreak of fear and hysteria in America is neither funny nor accidental. Amplified by the sheer power and influence of the US, the rest of the world should take note. Nobody is safe on the same planet as a drunken giant.

The USA’s partisan cockfighting means a disease such as Ebola cannot be tackled according to sane public policy. That is because for too many leaders, the usefulness of the virus outweighs its risk. In this case, Republicans have seized the opportunity to produce a state of froth, portraying Obama and the Democrats as soft on defense, with Ebola taking the place occupied only a few months ago by ISIS. Watch here as Roosevelt perfectly hit this nail on the head 80 years ago.

If there are ever significant numbers of Ebola cases in the US, this sort of panic, media hype and political dysfunction will have a good chance of driving the disease underground, shutting school systems, fomenting violence, etc. In other words, of causing the shit to hit the fan. That’s what I would call a frightening dry run for airborne avian flu. And in certain cases, that’s what makes American hysteria a risk factor for global outbreak and collateral economic damage.

3. Two-Thirds

Tuesday I took a break from my break and sat in on a roundtable discussion of the crisis. Twenty-five or so aid workers, government officials, academics from around London. Heaps of good analysis. Lots of experience and first hand knowledge of the situation in Liberia and Sierra Leone. And I’m not sure the entire group could have put together one solid paragraph on French-speaking Guinea. Whatever the bias – language, colonial heritage, aid policy – it marks a structural weakness in the international community.

4. Fear as Policy

Obama has sounded relatively reasonable on the Ebola front. Here’s the Prez hugging medical staff who caught Ebola, and he dispatched Samantha Power to West Africa, both important symbolic gestures which may help curb fears long enough for a little science to sink in.  Or may not. Obama may not like the paranoid response to Ebola, he may even worry that measures like quarantines really will prove to be as counter-productive as the experts say, leading to a greater likelihood of Ebola cases in America, but he can’t be too upset. America’s power, not to mention minor details like its economy and foreign policy, is constructed upon a swirling foundation of irrational fear, not of a virus but of a bewildering series of bogeymen, from Communists to Muslims to terrorism to China.  (For further analysis, see Chapter 8 of David Keen’s excellent Useful Enemies).

Having a budgetary spend greater than the next ten nations combined is not easy to justify through rational political discourse, all the more so in a country (for example) whose infant mortality rate looks more like it belongs to Guinea.  The much-discussed military-industrial complex, firmly rooted in a hysterical reaction to foreign threats, remains impervious to the reality that the security measures of today manufacture ever greater threats in the future. Ditto for the potential of quarantines to increase the likelihood of Ebola cases on American soil.

5. The Secret of Economic Success

Question: What do Las Vegas, personal injury lawsuits, Lady Gaga and Ebola-induced panic all have in common? Answer: Nobody can beat the US when it comes to a penchant for excess.

No wonder West Africa is so poor. Not enough capacity for going OTT. The citizens of Guinea, Sierra Leone and Liberia watched neighbors and family drop dead around them, and yet still didn’t believe Ebola was real. A veritable ostrich head in the sand – never a good model for economic development. With one death to date and 45% of Americans worried a family member will catch Ebola, the greatest nation on Earth more resembles a frantic chicken. That’s the sort of mania needed for a juggernaut economy.

Critique of Aid, Health, Our Western Identity

Ebola: Three Ideas You (hopefully) Haven’t Read

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[Originally posted September 26 and lost due to website issues. Apologies to those whose comments have been lost as well.]

Part 1. The Ebola crisis is in part the self-fulfilling prophesy of the way we think about Africa.

The Ebola crisis in Liberia, Sierra Leone and Guinea consumes no shortage of attention in mainstream Western media. Other African crises like CAR, Libya or Sudan, let alone success stories, should be so lucky. Then again, maybe attention isn’t such a good thing after all. Some of it quite responsible, much of it still trades in outworn stereotypes of a continent awash in warlords, loin cloths and killer microbes.

Hooray for resistance to sloppy Ebola storytelling, for example Dionne and Seay’s nailing Newsweek‘s sensationalist cover story. Or earlier this week Sierra Leonean Ishmael Beah skewering the way lopsided Ebola reporting reinforces the role of Africa as a foil, as a continent whose dismal failure reaffirms our superior Western civilization.

But why dump all the blame on the media? NGOs and the UN – the foreign aid establishment – surely merit some credit for perpetuating the popular notion that Africa is a cauldron of tribal brutality, a crucible of scary diseases and a reservoir of primitivism, all rolled into one waiting-for-a-savior basket. (Not to mention the rather stock idea that Africa is a country. On that geographical malapropism, see this great blog.). The point is firstly one of principle: NGOs should be truthful in their communications. Easier said than done. They appear locked into an audience (the home society public) that demands such a stereotype in order to feel compelled to donate (see e.g., my previous blog on this).

We’ve heard criticism of this stereotyping before, often from within the aid and Western media communities. Is there hope? Importantly, Beah published in the Washington Post, bringing his views to Western eyes. If only for a moment, his piece shakes our monopoly over the narrative. As I’ve written before, these stereotypes will come under increasing pressure as internet media expand access to Western debate and discussion. The question: Is the aid industry simply (!) a promoter of the distortion, or an addict as well? But that is for another blog.

The main point here is that the degree to which the monotonous, stereotyped portrayal of Africa gives rise to the conditions in which Ebola outbreaks occur. Persistent underdevelopment, bureaucratic inertia, low foreign investment, unresponsive government, the cycle of waiting for crisis rather than building systems, dependence on the foreign aid community, etc. These ills are all either caused and/or reinforced by the inaccurate portrait of a continent, in this latest episode with a virus as the star in a long line of unabated indigenous catastrophes. NGO action may be vital in combating Ebola, but aid agencies themselves helped weave the very “basketcase” to which they would nowadays respond.

Critique of Aid, Our Western Identity

See No Fogeys. Hear No Fogeys. Help No Fogeys?

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Ten years ago I visited our projects in Pool Province in Congo-Brazzaville.  It was during Pasteur Ntumi’s armed, mystical insurrection; a time when military groups chose videogame names like the “Cobras” or “Ninjas”.  I heard more than once that Ntumi could levitate. But that is a different story.

We lurched down the ersatz road, passing many villages. They looked quiet. They looked abandoned.  Empty, I kept being told. Empty. But they were not empty. Everyone under 45 had long bolted for the IDP camps, but the elderly hadn’t left.  Occasionally I would see a skinny man, somewhat dishevelled and gray, carrying a bundle of wood or wandering the dusty alleys between houses.

If terms of vulnerability, those community guardians must have registered off the charts.  And we weren’t touching them.  We were driving by without seeing them, or seeing their absence in our busy health clinics.

This is not uncommon.  A “neglected generation”, as HelpAge research shows. Or see here. MSF has concluded that aid programmes miss the elderly even though we all intuit their vulnerability.

It shouldn’t be that way.  Impartiality dictates to humanitarians that we make decisions based solely on the needs of people, not their life expectancy after treatment or value to society.  Attaching value to human life is inimical to humanitarian action. Ditto for medical ethics. We don’t value people based on age. Grannies are absolutely equal in value to toddlers. We don’t try to justify differentiation by arguing cost effectiveness in terms of life value.  That kind of thinking will lead you down the path to hell, to saving the owner of the factory over the workers, the teacher over the vagrant, the NGO expat over the NGO local staff.

Impartiality implies that you have done a proper assessment to identify, in this population and in this crisis, those most in need. In a place where the needs overwhelm resources, it implies choices will be made.  As the research shows, though, we don’t do a good enough job of assessing needs when it comes to the elderly.

The problem is not one of mere choices, but of the underlying subconscious preferences; of blinkers. Some of these blindspots have evolved within our work.  For example, we use shorthands to target people/areas of greatest need:  “under fives,” “IDPs,” “pregnant and lactating women” are typical proxy indicators of greatest need.  And with good reason. It is true that you will find higher burdens of needs among these target groups, or overlapping needs (e.g., sick child plus no shelter or clean water), or greater severity of needs (e.g., on average, a toddler with malaria is more at risk than an adult with malaria).  But has looking for proxies meant not seeing others?

The way our brains work, it seems that if you are focused on one thing you will not see something else.  (Here is a great test of selective attention). The elderly have different needs from those of children, and you need to look in a different way. For example, as a starting place, you need to make sure that your assessment tools are able to ‘see’ elderly people. Much of MSF data collection puts people into boxes: < 6 months, 6 months to five years, 5 – 14 years, and > 14 years. We literally lump teenagers in with octogenarians. Where else would that happen except in wedding photos?

With data like that – with the conceptualization of our target population underlying those numbers – busy teams miss those who do not arrive.  That gap in spite of understanding that elderly have special access issues. It’s sometimes really simple. If you’re sick and seventy, trekking 10 km to find healthcare is not ideal.

Research leads to calls for paying attention; for systematic consideration of the elderly in humanitarian response.  But why are the decks stacked against impartiality in the first place? One reason is the way we think about children in our own societies, and in particular the way we think about their well-being. There’s a certain tragic disposability of children in places where birth and mortality rates are high.  And in the West, a tragic overvaluation, with children raised in porcelain towers.  (See my blog on baby helmets).  Apologies, this is the slippery turf of sweeping cultural generalization, but you get what I mean.

In the end, it is not accidental that the humanitarian project prioritises children. What is the UNICEF equivalent for the elderly? There is none. Why is Save the Children so much larger than HelpAge? The quantity of Western NGO resources essentially devoted to children in other parts of the world reflects a very Western valuation of children. That institutionalization of our value system produces a certain set of programme activities, the organisations that deliver them and, ultimately, that thing we call the humanitarian system.

Inherent in those values is the feminisation and infantilisation of victimhood. Powerlessness plus victimhood equates innocence, and that underpins why people give money to a cause. You can sell starving babies – we do it all the time. Try geriatrising it.  Pause the camera on the face of an old man.  You won’t run a billion-per-year NGO on that face.