Posts Tagged ‘Foreign Aid’

Designed to Fail: Why Foreign Aid Doesn’t Deliver

November 2, 2011

By Sakuntala Narasimhan

The World Health Organisation (WHO) notes in a publication released earlier this month that a “huge amount of new financial commitment, worth over $40 billion,” has been pledged by a collective of global agencies, towards maternal and child health projects in developing countries. The strategies that these projects will focus on include “innovative approaches” like the use of mobile phones “to create awareness and promote health” so that individuals and communities can have the information they need to make decisions about their health. Although the publication mentions the need to “address structural barriers to health,” the assumption is that lack of information and knowledge is the limiting factor. This assumption shows a woeful ignorance of the socio-cultural complexities that make up the local matrices within which “development” work has to be undertaken, which is why in spite of the hundreds of billions of dollars that have been poured into developing countries as aid in the last five decades, there has been no commensurate improvement in the social sector parameters in terms of adequate food, shelter, access to healthcare and education. (more…)

US Aid to Pakistan: Response to CGD

June 25, 2011

By Anjum Altaf

My critique of the Center for Global Development’s report on US aid to Pakistan has elicited a comment from the authors. I appreciate their willingness to engage in a discussion and reproduce their comment in full before offering my own reactions to explain why I remain unconvinced by their arguments.

The most scathing review so far of our recent report Beyond Bullets and Bombs: Fixing the U.S. Approach to Development in Pakistan, comes from Anjum Altaf, a Pakistani academic who represents this viewpoint well. (more…)

Aid to Pakistan: Advocacy or Analysis?

June 9, 2011

By Anjum Altaf

Beyond Bullets and Bombs is the title of the latest report on aid to Pakistan from the Center for Global Development in Washington, DC. In light of the increasingly anti-Pakistan sentiment in the U.S., the report, addressed to decision and policy makers in Washington, takes on the brief to make the best possible case for the continuation of aid. Hence the subtitle: Fixing the U.S. Approach to Development in Pakistan. The report is a revealing illustration of advocacy over analysis; a more open examination would have begun by questioning the impacts of U.S. aid to Pakistan, before deciding if the total benefits of “fixing” it exceeded the total cost to both sides.

It is to the report’s credit that it is forthright and includes all the relevant pieces of information, but the way it uses that information is determined by the choice it makes. (more…)

A Primer on Foreign Aid – 3: Real Issues

May 31, 2011

We are now in a position, having described the evidence (A Primer on Foreign Aid – 2), to discuss the less obvious dimensions of foreign aid which address issues of whether aid can be effective and under what kinds of conditions. (more…)

A Primer on Foreign Aid – 2: Rationale and Results

May 30, 2011

With the basic definitions out of the way (A Primer on Foreign Aid – 1) we can move on to the rationale of foreign aid and its results and consequences. (more…)

A Primer on Foreign Aid – 1: Essential Definitions

May 29, 2011

Foreign aid is almost always in the news, at times more than others. All sorts of questions keep swirling in the air: questions about its nature, rationale, aims, effects, results, justification, symbolism, and even about its quantum. All through this heated debate the issue remains surrounded by a thick fog of obfuscation; many remain unclear of what exactly is being talked about. In this post, I intend to present a primer on foreign aid. Each of the opinions offered in the following sections can be contested; the aim is not to provide a definitive conclusion but to set the stage for an informed debate that employs common definitions and a shared point of departure. (more…)

“Helping the Poor”: The Idea, the Reality and the Shadow

February 22, 2011

By Anjum Altaf

Between the idea and the reality, Eliot wrote, falls the shadow. The phrase is so well known as to be almost cliché, but as with many clichés, there is truth to it. There is universality, too – the metaphor could extend to many areas; there are shadows everywhere. Foreign aid, for example: there is the idea and the reality, the theory and the practice, the intent and the execution.

The theory of foreign aid is simple enough: If those lacking capital and technology and ideas were provided with such, they could be launched on the path of progress. In practice it has rarely ever worked like that – there is more to the equation than capital and technology and ideas.

There is the shadow that falls between the theory and the results, a shadow full of objectives stated and unstated, incentives of this party and that (and, of course, their representatives, who develop in the end their own interests, their own goals, their own shadows) – all this, more often than not, causing enough distortions for the reality to mock the idea.

This happens not only in foreign aid, but in any transaction where one party has advice or help or assistance that the other desperately needs, when negotiations are not equal, when representatives of each come with their own axes to grind. Consider the shadow now visible between the idea and the reality of sub-prime mortgage lending: the unstated objectives, the incentive distortions, the regulatory winks and nods, the quick fix to keep the game going for at least one more round. In 1961, Jane Jacobs, who had little to do with foreign aid, was astute enough to realize the pitfalls. Based solely on her observations of how federal assistance was implemented in low-income areas of American cities, she remarked in her seminal book, The Death and Life of Great American Cities: “I hope we disburse foreign aid abroad more intelligently than we disburse it at home.”

Much of this has been obvious for years to those in the aid and lending communities who have kept their eyes and ears open; what has eluded us is that blinding insight that lays it all bare, the kind of insight that comes most often from literature. As literature identified the existence of the shadow, it was literature again that unraveled its nature. Theodore Dalrymple has written an account of the writer Rhys Davies (1901-1978) whom he has called the Welsh Chekhov. I can’t vouch for that since I haven’t yet read Davies but I intend to, especially the story that illuminated for me the shadow of foreign aid – “I Will Keep Her Company,” published in The New Yorker in January 1964.

The story, in Dalrymple’s words, concerns a couple in their eighties, living in an isolated farmhouse in the Welsh hills and snowed in. The old woman has died and the husband, refusing to acknowledge her death, is staying by her bedside. There is in the story a district nurse assigned to the care of the couple:

Meanwhile, Nurse Baldock has geared up a rescue operation involving a snowplow, a van, and a helicopter. She is, as her name seems to suggest, conscientious and bossy and, having completed a diploma in social studies in her spare time, believes herself entitled to a promotion. She had visited Evans a few days previously, when his wife had just died, and was prevented from removing the body by the snow. Now she is returning, determined to get his agreement to leave for the old-age home. When she finds him dead, she utters a bitter yet self-satisfied recrimination:

“This needn’t have happened if he had come with me, as I wanted six days ago! Did he sit there all night deliberately? . . . Old people won’t listen. When I said to him, “Come with me, there’s nothing you can do for her now,” he answered, “Not yet. I will keep her company.” I could have taken him at once to Pistyll Manor Home. It was plain he couldn’t look after himself. One of those unwise men who let themselves be spoilt by their wives.”

In a few pages, with a highly sophisticated simplicity, Davies arouses emotions and thoughts as impossible to resolve into full coherence as life itself. John Evans’s death is both tragic and a triumphant final expression of the love that gave his life meaning; we oscillate between sorrow and joy, between discomfiture and reassurance, as we read. As for Nurse Baldock, she encapsulates the mixture of good intentions, condescension, and careerism that is the modern welfare state. Rationally, we cannot refuse to endorse the efforts to rescue Evans; it would be a terrible world in which his predicament evoked no response. At the same time, we know that these efforts are not only beside the point but, at the deepest level, incapable of being other than beside the point.

There it is: The Evanses are the recipients, Nurse Baldock the donor, “encapsulat[ing] the mixture of good intentions, condescension, and careerism” that is the modern aid enterprise. Her judgments of John Evans echo the familiar comments of the aid executive – poor people “won’t listen,” “men [have] let themselves be spoilt” by their unwise ways. If only he had heeded her advice; if only poor countries would follow the instructions given to them by the well-intentioned donors.

The notion of “helping the poor” is a noble one, but it comes with this shadow that falls between people, states and their citizens, donors and recipients, between individuals and representatives, and this shadow grows darker and deeper as we try to pretend that it is not there, that it can be fixed with one quick step (always one quick step, just to keep us going for the next round).

Perhaps the story offers another insight as well. Nurse Baldock, with her plow and her van and her helicopter, her diploma in social studies, the full weight of the state behind her, is immeasurably more powerful than a weak, devastated, poor old man. Of course to her it is simple; she knows what is right, she knows what he needs far better than he himself could. But what if Nurse Baldock could meet John Evans as her equal?  What if she could try, instead of helping him by force, to engage with him? In this light, might the shadow finally begin to fade?

Theodore Dalrymple’s article (The Welsh Chekhov) can be accessed here.
Nurse Baldock is reincarnated as Lucymemsahib in our fellow panelist, Samia Altaf’s book (So Much Aid, So Little Development: Stories from Pakistan) forthcoming from the Johns Hopkins University Press in May 2011.
For more on foreign aid on this blog, see:
Should Pakistan Receive More Foreign Aid?

How to Aid the Health Sector in Pakistan
Remaking Public School Education in Pakistan

 

 

How to Aid the Health Sector in Pakistan

August 1, 2010

By Samia Altaf and Anjum Altaf

This op-ed appeared in Dawn, Karachi, on July 30, 2010. It was intended to initiate a discussion on the possible approaches to sector reform and is being reproduced here with permission of the authors to provide a forum for discussion and feedback.

We must state at the outset that we have been wary of, if not actually opposed to, the prospect of further economic assistance to Pakistan because of the callous misuse and abuse of aid that has marked the past across all elected and non-elected regimes. We are convinced that such aid, driven by political imperatives and deliberately blind to the well recognized holes in the system, has been a disservice to the Pakistani people by destroying all incentives for self-reliance, good governance, and accountability to either the ultimate donors or recipients. (more…)

Pakistan Picaresque

January 9, 2008

A chat over tea at a government office in Islamabad reveals why billions in aid have done so little for Pakistan’s poor… 

By Samia Altaf

Not enough nurses. Not enough jobs. Nurses working as “doctors.” Trained nurses being encouraged to leave the country. Untrained and uncertified “nurses” being recruited in sheer desperation by private hospitals. What a strange and paradoxical situation! Yet there is no discussion of these crucial issues. And new training programs are being developed, because there is pressure from international organizations to include more women, supposedly to meet the human resource ­shortage.

My companion sat shaking her head. Mrs. S. was starting to look restless. She signaled to the attendant for tea. In a government office, a tea break can become a project unto ­itself.

“The problem with women,” Mrs. S. volunteered conversationally, again adjusting the dupatta delicately on her hair as the tea service was laid out, “is that they all want to get married.” Quite a problem, and one the world over. “So eventually they must leave the profession to take care of their husbands and children.”

We let this pass, and raised another possible solution to the “problem” with women: training more male nurses. As the primary wage earners, they would not be compelled to leave once they married, and they could tend to the male patients, making it easier to attract women to the ­profession.

“Not a good idea,” according to Mrs. S. And why ­not?

“Because men are very unreliable. As students, they will agitate the girls,” she continued in the same conversational mode, oblivious to the effect of her remark on her audience. “If they are in classes together, they will induce them to strike on petty matters.”

“But the girls are under no obligation to do their bidding,” Lucymemsahib ­said.

“Yes, but the poor girls have no choice but to follow the boys. It is natural for them to do so. By themselves, girls never cause any problems. They quietly do what they are told or get married and go away.” Mrs. S. warmed to her subject. “Look what is happening in Liaquat National Hospital, Karachi.” Liaquat hospital is a major training institution for nurses, one of the few in the country that prepare male nurses. About a third of each entering class was male (as is still the case today). During the weeks before our visit to Mrs. S., the nursing students at Liaquat had gone on strike, demanding better living conditions, apparently at the instigation of male ­students.

“All because of these boys!” Mrs. S. continued. “So many headaches these boys are causing us.” She struck her forehead with the palm of her right hand in the traditional gesture of frustration, causing the dupatta to flop off her hair. She hastily retrieved it. “And the girls are not listening to us either. They are naturally listening to the boys. Stupid things!” She shook her head in ­indignation.

Lucymemsahib looked at Mrs. S. as if she had come from another planet. Thankfully, the tea arrived at this point, and we fell to it with gusto, under Mr. Jinnah’s enigmatic smile from his perch on the wall. Mrs. S. very generously ordered her attendant to run out for some mint chutney to go with the samosas, which were really out of this ­world.

[The complete article can be accessed at the Wilson Quarterly (Winter 2008) here.] 

Samia Altaf was the 2007-2008 Pakistan Scholar at the Woodrow Wilson International Center for Scholars in Washington, DC. Her book (So Much Aid, So Little Development: Stories from Pakistan) was published by the Johns Hopkins University Press in 2011).

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