Behold, behold: the NGO spectacle

I met an American undergraduate a few weeks ago who was writing his senior thesis on the “NGO circus” in Uganda.

His point (I think — it was hard to get past his carefully cultivated skepticism and the unlit cigar he carried around in his mouth like an über-cool oral security blanket) was that the proliferation of NGOs in Uganda in the last 20 years has made it more, not less, difficult for the country to develop. He focused on international organizations, but I see the same thing happening at the local level.

I spent last week in Gulu talking to several Ugandan non-profit and community-based groups about their projects. I hoped to learn about national reconciliation from the grassroots level and to come home more informed about what needs to happen in the north for peace to become a reality. Instead, I found myself wading through a swamp of catchy development terminology that didn’t seem to make any more sense to the people I met with than it did to me.

The project leaders talked animatedly to me about microfinance and community mobilization and adult literacy programs. They all wanted to address every single problem in northern Uganda, from HIV to education to arts and sports to cultural renewal to child soldiers to agriculture. One group had a total of three volunteers but was working on eight separate multi-year, multi-district proposals, each covering a multiple aspects of rebuilding. The proposals were full of attractive phrases and energetic language, but after spending an hour with the director, I could tell he had no understanding of the economic theory, organizational principles or sheer manpower required to turn his projects into realities.

Those I spoke with clung to their CBOs and PRSPs and QUIPs as if the very letters would save them. Some seemed to think that creating a successful income-generating activity was as easy as saying “IGA.” It truly was a circus — the directors spouting acronyms like desperate ringmasters while their projects flopped around like mistreated, malnourished performance animals.

Uganda doesn’t need another project proposal from another would-be community leader with an over-inflated vocabulary and no training to back it up. These people are well-meaning, but as influenced as they are by the development industry talk in Uganda, their Big Ideas are just as much top-down (as opposed to local-level) as international initiatives. A thousand times better would be an organization that actually consulted the people around it to find out what they need and how best to achieve it, rather than succumbing to the Ringling-Bros.-esque attraction of development novelty acts.

PEPFAR contributing to spread of AIDS

The Washington Post recently reported that the AIDS rate is rising in Uganda. Peter Piot, director of UNAIDS, attributes the increase (from 5.6 to 6.5 percent in rural men and from 6.9 to 8.8 percent in rural women) to “a period of ‘decreased credibility’ of condoms, the consequence of messages by some fundamentalist groups, a run of defective condoms and then a shortage of condoms.”

This article comes on the heels of the Global Fund’s rejection of a Ugandan grant proposal for $111 million to fight HIV/AIDS. Corruption and poor management ripple throughout Uganda’s handling of its HIV/AIDS programs — the last two years have been a recurring pattern of fraud, lies and incompetence. What concerns me even more, however, is the United States’ ineffectual response to a disease that is threatening to engulf the nation yet again.

A full thirty-three percent of the money USAID spends on HIV prevention goes towards abstinence. In 2004, the number of condoms provided by USAID’s PEPFAR (the President’s Emergency Plan for AIDS Relief) dropped by 60 percent, a decrease which coincided with the Ugandan government’s confiscation of all free health-center condoms due to concerns about their quality; the condoms were tested and proven to be perfectly usable but were never re-released. These two events triggered a shortage of condoms in the country and widespread doubt of their effectiveness from which Uganda has not yet recovered.

The U.S. attitude towards condoms is frightening. In an April 2005 meeting of the International Committee of the House of Representatives to review the U.S. response to the global AIDS crisis, Ted Poe (R-TX) 25% more effective than natural family planning (the method USAID is pushing with Janet Museveni).

Still, USAID is increasingly funding abstinence-only programs to the detriment of more comprehensive, more effective organizations: in November 2004, PEPFAR overrode the recommendations of their Technical Review Committee and funded an organization deemed unsuitable for grant money. The pro-abstinence organization, Children’s Aid Fund, has close ties to both the Bush administration and to Janet Museveni, which was seen as justification enough to fund their program. Furthermore, the U.S. has been steadily decreasing the amount of money it gives to international organizations that provide reproductive health services — in 2002, the government withdrew over $36 million from the World Health Organization and the UN Population Fund.

AIDS is making a comeback in Uganda, and U.S. efforts are doing little to stop it. USAID needs to get their act together and start providing factual, practical information about STDs, STD prevention and reproductive health instead of funding misguided projects that skirt the issues at hand.

Cavities and broken records: Africa’s lack of self-confidence

I quit my job this week (not the one with the peanut butter life saver — no worries, my life is still in good hands). I left for several reasons, but the last straw was a conversation that went something like this:

Me: You can’t rely solely on international volunteers to make this work. You need to recruit Ugandan volunteers as well, or even more heavily.

Director: But Ugandan volunteers are not as good as international volunteers.

Me: Why not? None of the international volunteers here right now have teaching degrees, but you’ve turned down three Ugandans who wanted to work here who all have teaching experience.

Director: But Ugandan volunteers are not as good as international volunteers.
His monomaniacal, unsubstantiated claim that the qualified Ugandans who have been clamoring to work for the organization are “not as good” as inexperienced college students from the U.S. was, shall we say, mildly unsettling. Earlier this month, Angelo Izama wrote on the sub-Saharan African roundtable about what he calls modern shamba boys. He laments what he considers to be the prevailing attitude among Africans, and especially African leaders, that they are inferior to the West:

“The shamba boy mentality is built on a conspiracy of history and circumstances that make it acceptable for our leaders to play second fiddle to their white masters and others whiter than them including Asians and Chinese nowadays. This complacency replaces their responsibility to become their own masters….”
Wendy Glauser also claims that “many Africans embrace a collective inferiority complex. Their governments are backward, corrupt and care only about power. Their people are tribalist, selfish, war-loving. This perception, like Canada’s public perception of itself, is one-sided and simple-minded, devoid of the complex current and historical international forces that determine the behaviour of a society and its government.”

Vividly illustrating the claims of these two authors is Dennis Matanda, who states that “Africans are not inferior to whites” but also writes that “Africa is not a cursed continent and neither is it ravaged by disease and poverty. The poverty you have is at the top [in the heads of the leaders so to speak] and the only rampant diseases are dental ones where the leaders have large holes in the back of their teeth.” He goes on to say that all African leaders are “mad” and that Africans are, as a whole, “lazy.”

Izama argues that the only way out of this attitude is for Africans to take charge of their own problems — “to find that desire to stop serving others and begin serving ourselves.” Glauser seconds this opinion, suggesting more indigenous lobbies and better African investigative journalism. Matanda offers no solution.

My two cents? The impending failure of the organization I just left is directly proportional to its leader’s reliance upon Western volunteers to swoop down and save it. I would argue that the persistence of many “African problems” is related to a belief that, eventually, donor money or foreign troops will come. This belief in the supremacy of Western aid, I think, makes many Africans less likely to take the steps needed to pull themselves out of poverty, disease and war. It’s an endless, self-perpetuating cycle of dependency: I want the West to save me, so I do nothing. I do nothing, so the West sends help. The West sends help, so I believe I am incapable of solving my own problems. I believe I am incapable of solving my own problems, so I want the West to save me.

Breaking out of this cycle is possibly the single most difficult challenge Africa faces today. Unfortunately for those of us who work in the realm of “humanitarian aid,” there’s not much we can do to help (kind of defeats the purpose, doesn’t it?) except stand by and encourage those we meet to take charge of their own futures.

plastic beads as birth control? how Janet missed the mark

Last week Ugandan First Lady Janet Museveni introduced a system of birth control called Moon Beads. Designed to help women track their menstrual cycles and, by doing so, avoid sex when fertile, the beads are part of a five-year family planning program sponsored by the United States Agency for International Development. Museveni encourages women to “work selflessly” to use the beads.

The Ugandan birth control system desperately needs a revision. Uganda is currently the fastest-growing country in the world, with a population that could exceed that of Russia or Japan by 2050. This population explosion threatens to permanently mire the nation in poverty, increasing conflicts over land and resources in an already unstable environment. One half of all pregnancies in Uganda are unintended, and one in four results in an abortion — almost twice the abortion rate in East Africa as a whole.

Over one third of all women have expressed their desire for contraception, but only one in five married women actually has access to it. Oral contraceptives cost approximately 8 cents per month — a price affordable for much of the Uganda population — but clinics are few and generally inaccessible, making this option unavailable to most women. Condoms are theoretically free — to men only — in clinics, but they are often poorly stored, causing them to expire before they can be distributed. In 2004 the government recalled all free health clinic condoms, citing concerns about their quality. The condoms were checked and determined to be fine, but the government did not redistribute them, causing a shortage that has raised prices for the remaining stock to nearly 20 cents per condom.

Though Mrs. Museveni’s plan recognizes the need for better family planning in Uganda, it is sorely misguided. The natural family planning method is intended for monogamous couples and requires the women to carefully observe her periods for three to six months before implementing the system (the Moon Beads are intended to be used immediately and do not account for varying menstrual cycles). Even then, the method is only 75-90% effective, as compared to 95-99% for oral contraceptives and 86-98% for condoms.

Furthermore, the reality is that over 25% of men and 13% of women in Uganda admit to having sex with more than one partner (this does not include rape statistics, which are especially high in the north). Moon Beads and other methods of natural family planning do nothing to prevent the spread of HIV and other STDs. What Uganda needs if it is to avoid unwanted pregnancies, further lower the prevalence of AIDS, curb its wild population growth and prevent the medical complications that over 80,000 women face each year as a result of abortions is not a string of colored beads but better access to both information about birth control methods and to the methods themselves. Instead of encouraging women to use a method that is often ineffective and can contribute to the spread of disease, Mrs. Museveni should campaign to open more clinics throughout the country and to make both condoms and oral contraceptives widely and easily available to women.