One of the buzzwords one hears very frequently when working in development is the idea of "sustainability." It's been pretty interesting being here seeing just what that means on the ground. I have heard over and over again in conversations with health care workers "Oh yes, this organization (some large US public or private aid org) came in and helped us run this program (usually something very good and important - like counseling, follow up, laboratory testing, data management), but then they left and we didn't have the money (always) or expertise (sometimes) to run it anymore." I think there is a vague idea in a lot of organizations that if you start a good program and get it on its feet, it will keep running by itself. The sad fact is that money is so tight in the health sector, when you take funding away from programs, they die. Sometimes they continue for a while, but usually only by exploiting volunteers.
One health center we visited had a volunteer counselor who did all counseling for HIV+ patients and received $25/month while the center was supported by aid. Now that the aid partner is gone and she is not receiving money, she has continued to come on time every day the clinic is open for six months. Most stipended volunteers are not able or willing to do the same.
The amount of money that has gone into starting programs that can't possibly last after the money leaves is staggering and sad. I think the two models of aid I most admire given this state of affairs are 1) Stay (ie PIH- once they open up shop in an area, they are committed to it) and 2) Work with an organization that will be there forever (ie CHAI working with the Ministries of Health of the countries we work in). Even with these models, it's important to make sure the plans and programs we undertake are not ones that the running organization (PIH or MoH) will have to give up - we have to think about how to make something a permanent fixture in the health system, rather than one that does good for a few months or years and then just leaves disappointment behind.
Because I think every post should have a photo, here is the cow hanging out outside my office....
One health center we visited had a volunteer counselor who did all counseling for HIV+ patients and received $25/month while the center was supported by aid. Now that the aid partner is gone and she is not receiving money, she has continued to come on time every day the clinic is open for six months. Most stipended volunteers are not able or willing to do the same.
The amount of money that has gone into starting programs that can't possibly last after the money leaves is staggering and sad. I think the two models of aid I most admire given this state of affairs are 1) Stay (ie PIH- once they open up shop in an area, they are committed to it) and 2) Work with an organization that will be there forever (ie CHAI working with the Ministries of Health of the countries we work in). Even with these models, it's important to make sure the plans and programs we undertake are not ones that the running organization (PIH or MoH) will have to give up - we have to think about how to make something a permanent fixture in the health system, rather than one that does good for a few months or years and then just leaves disappointment behind.
Because I think every post should have a photo, here is the cow hanging out outside my office....
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