why there is no doctor: harsh realities in zonkizizwe (part 2) (11)


(photo: Zonke Testing Day banner on the back of a van used to transport people to the clinics)

While working in Zonke, a fact that shocked me was that an HIV-positive person can only access ARV treatment [for free, otherwise it is very expensive] if their CD4 count is below 200. This is official South African government policy and numerous studies have shown that accessing treatment earlier has greater long-term health benefits as ARVs are meant to be taken life-long. A World Health Organization (WHO) study in 2008 outlined four clinical stages of HIV progression. The WHO recommends that when a patient hits stage three with a CD4 count below 350, life-long ARV treatment should be started. Starting patients earlier negates complications later. However, in South Africa once the CD4 count goes above 200 again, treatment is stopped, which allows for greater complications and the need for new strains of ARVs. This year a push to increase the CD4 count threshold for treatment was rejected by the National Health Council on the grounds of affordability (85).

Prof Robin Wood, director of the Desmond Tutu HIV Centre at the University of Cape Town, is among the clinicians who have been calling for the South African government to raise the standard of treatment set out in its guidelines. However, he pointed out that better guidelines would be meaningless without improving the quality of care and access to services (86).

Professor Wood brings everything back to perspective. Anyone can call for greater access and more treatment, but if there is no distribution system for health services and care then what is the point. It would be like having a big supply of pizzas and no delivery drivers. This is the problem in many former “homelands,” townships, and informal settlements. There are inadequate or non-existent delivery systems for health services and treatment and so in areas where the HIV/AIDS crisis is most critical, there is no system to address the problem.

Today was the 2nd half of Prevention in the HIV/AIDS course. The kids are incredibly receptive with questions, comments, and the desire to learn more. We will be covering Treatment and resources this Friday. Celumusa did a great job of translating and really getting the course lessons through to the kids. Later in the evening she talked with us – her passion and drive to get people tested and aware and knowledgeable is amazing and so admirable with all she has been through. She is so excited about a Zonke testing day, the HIV/AIDS class, working with the staff and community to make more people talk and not be afraid to talk. Today she told the kids that she was HIV positive and they all did not believe her at all – they asked her to cross her heart that she was not lying. I could tell from the first class that the kids were learning much more than they had before beyond what HIV and AIDS stands for (87).

Much of the work at the center and the work that needs to happen in Zonke is HIV testing. Once tested you can learn how to take care of yourself, your children, and your community. When I asked Celumusa why people don’t test she said that people don’t know that they can live with HIV. So many people are involved in risky behaviors, she said, they have family members die from HIV/AIDS, but don’t test themselves. She also noted that pregnant mothers are tested and are given tablets, but not told their status. Testing is critical and we began working on this by planning a Zonke Testing Day for July 31st.

As I began organizing for the Testing Day, I came into contact with more of the health services available in Zonke. There are a number of traditional doctors and surgeries in Zonke. I can only imagine that this is because there is such a lack of other health services. Celumusa and others have bad perceptions of traditional medicine: evil, it kills people, and the traditional healers are crazy people. I was still having no luck finding any doctors, until I finally caught a traditional doctor in his office. He ran a clinic that was more Western than others and was supposedly trained by the government in traditional healing, but his office was empty every time I visited – no patients (88). Why are there no doctors?

Across the road from his office was a private clinic run by a group of Indian doctors. I also had a difficult time finding them, as did many Zonke residents. I was able to visit the private clinic only when Celumusa had to schedule an appointment for her baby. The private clinic had become her last option that she was sure to see a doctor. This says a lot for the health care system in Zonke (and other overcrowded settlements and townships left over from apartheid era) that the poor will pay to see a private doctor because the government health services are unreliable. Celumusa said they always give injections at the private clinic. Yet again I wonder about the quality of care. The clinics give painkiller tablets and the private clinics give injections (antibiotics?). If care is inadequate and access to ARV medication is beyond the ability of most, then the extended scenes of cemeteries become less shocking.

In the past 2 weeks, 3 people have passed because of HIV and AIDS that we have been directly informed of because the Buthelezi family has been close to the deceased – a father, an aunt, and a neighbor. Living in an HIV positive community is so different when you can fully understand the impact of just one life (89).

It was as if I had seen the walking dead. The prospect of death is so intertwined with life in Zonkizizwe that the author who wrote that South Africans attend more funerals than weddings was supported by my experiences this summer. The hardest hitting example was with the passing of the father of one of the families at the center. Three of the children attended the center. The oldest was 17 years old and was taking care of her frail father as he withered away, making sure her younger brother and sister were going to school, and attending school herself. This small family had already lost their mother to HIV/AIDS. The burden of disease was not met by the health care system or any the government response. The burden of disease rests completely on those who are affected and they do not have the resources to help themselves.

A critical aspect of combating the effects of HIV/AIDS in South Africa is education. As one of my goals over summer I developed an HIV/AIDS curriculum, based off of the Peace Corps Lifeskills curriculum, that the youth could share with the friends and families as peer educators. The spreading of knowledge is a powerful first step in giving people the resources they need to prevent HIV/AIDS. It is especially important when there exists no other means to access this information. The Zonkizizwe schools are under-funded and teachers are under-trained. This translates to the lack of a teacher for the Lifeskills curriculum and therefore the lack of knowledge on sexual health and HIV/AIDS. VVOCF is beginning to fulfill a service where the government is horribly failing.

All of our kids were tested, plus about 20 others. In all over 60 people tested. […] The community and guardian support was incredible. There were a few positives that we expected from already young mothers […] and unexpected bad news surprise […] Many good surprises came out of the day as we learned of many negative cases that were expected to confirm our worst nightmares (90).

Year – Number of HIV Tests (*from clinic 2)
2006 – 128
2007 – 246
2008 – 412

The success of solutions driven by citizens was best evidenced by the culmination of the HIV/AIDS peer education courses, health classes, and the death of a father in an area wide testing day. I had taken the lead in organizing the testing day with the clinics, MSU study abroad volunteers, and various local organizations. Because of the stigma attached and sensitivity of the issue I was a bit nervous when the day came. July 31st 2008, the first Zonke Testing Day was a day of success fueled by the youth at the center. And while the numbers of people testing have made steady increases, the reality remains that the majority of those who need treatment after testing will not have access. Many in the generation just older than these youth mocked or scoffed at the testing day, but our kids were set on it.

We really are building a new generation of freedom fighters – not afraid of stigma, talking about sex, ready to be tested, and not about to turn a blind to HIV/AIDS. These young people stood today with a powerful support base of each other evidenced by yesterday’s action and the larger community is taking notice. The youth continue to give me hope and pride in being allowed to take part in such a community action (91).

The realities of Zonkizizwe paint a vivid picture of the effects of apartheid on health care for the majority of the South African population. The health system operating in Zonke is the ground zero of the failures of post-apartheid government policy to address the far-reaching impact of HIV/AIDS.

Notes:
85. “South Africa: Funding shortfall threatens treatment programme.” IRIN/PlusNews. 2 April 2009. http://www.irinnews.org/report.aspx?ReportId=83762
86. Ibid.
87. Hill, Alex B. Journal Entry. 30 June 2008.
88. Ibid, 17 July 2008.
89. Ibid, 6 June 2008.
90. Ibid, 31 July 2008.
91. Ibid.

Coming next: Conclusion

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modernizing traditional remedies


(photo: Traditional surgery, not in the sense of cutting people open – just means it is a place of traditional medicine practice.)

6 June 2008
There hasn’t been much that I have cared to write on for the past few days. I am building an HIV/AIDS curriculum for peer education from the Peace Corps Life Skills curriculum. The Peace Corps program is very good with excellent activities and info. The classes were supposed to start today, but will be pushed back a week because kids didn’t show up on time – so it became freedom of expression day with singing, drawing, and poetry reading. But I am excited to start and contribute to youth leadership development in such a critical and controversial subject.

In the past 2 weeks, 3 people have passed because of HIV and AIDS that we have been directly informed of because the Buthelezi family has been close to the deceased – a father, an aunt, and a neighbor. Living in an HIV positive community is so different when you can fully understand the impact of just one life.


(photo: Traditional doctor’s office, 2 years of formal training)

Celumusa told us today that all the health clinics do is give out painkiller tablets for everything. She often just goes to the chemist (pharmacist) to tell them what is wrong and to get something that will actually help. I inquired about the herbalist and surgeon – same building that we passed in Zone 3 – Celumusa is skeptical of the herbalist. Today she returned from Sandonga with a paper flyer for a “traditional” healer who claims to help with 65 diseases including HIV/AIDS. Supposedly the South African government gives witch doctors certificates in the hopes of finding a cure for HIV/AIDS. Yet another example of their [the government’s] absurdity. Mr. Ndaba told us that Mbeki and Zuma are supposedly coming to Zonke for the upcoming elections. That should be interesting.

Reflections 6 July 2009:
This is a very different picture of traditional medicine than what I saw and studied in Ghana. Here traditional medicinal practice is more associated with the spirits and evil (muti in isiZulu) as opposed to healing processes that are trusted to work, like I saw in Ghana. There were plenty of stories about the frightening things that might happen to small children who upset a Sangoma (“witch” doctor), etc. However, I did see some traditional medicinal practices being employed by the grandmother (Goko) and mother. One such traditional remedy turned modern was using a ball of toothpaste or soap (inserted into the anus) to cleanse the body. Nothing like a little soap to clean out your system of sickness. Regardless of the views I received from neighbors and community members about traditional medicine and doctors there were plenty of locations to visit the practitioners of traditional medicine.

definition of development (revisited): beauty in the palm of your hand

Last summer I wrote about the definition of development after having a conversation with an incredible Peace Corps volunteer in Ghana who was really making the most of his time and abilities. The conversation that we had really made me think about the term ‘development’ and what it really means. Before that conversation and since I have been working to create my own definition, or rather I have been working to make the term stand for what I believe development should be all about.

This is what I wrote from Ghana on 7 June 2007:

This discussion with Alex really made me think about ‘development’ as the word was thrown around a lot that night. Alex has said that he really likes the Peace Corps model because it deals with integration. A volunteer is placed in a village or area and works with the people to improve their situation. This as opposed to some large organization or institution just giving out money to big plans they believe will work. But, what is the definition of development? Who gets to determine what development is? Who is allowed to call one developed or developing or underdeveloped? Is development all based on a desire or push to become Western? Yes, I think in the very recent past it was and really still is to a degree, but for me development holds a different definition. Development for me mirrors positive progress in people’s lives. Development should be based on getting and giving people their basic needs (rights) for survival and life. Even in this regard the almighty ‘West’ needs development.

Now my development studies have become more involved and I will apply certain paradigms of thought and different theories of development from many different minds. Before I get into theory I want to begin by tackling the continuously difficult task of writing a definition of development.

Development is a loaded term and cannot be the way that we approach others in need. From President Truman’s “launch” (Wolfgang Sachs, 2) of the idea of development in 1949 during his inauguration speech in which he declared “underdeveloped areas,” the West began a long blinding road on which the US would always be number one with no need for ‘development.’ Development in this sense creates an inferior to superior relationship between those who need help and those who have the resources. This is where the idea of the ‘third world’ comes in. Two years ago I wrote on the idea of the ‘third world’ and how the term’s use perpetuates bad ideas in development. The notion of being better because of circumstance is an extreme detriment in development work. In actuality the West is developing just as much as those we deem ‘underdeveloped.’

We are developing the way we see the world and how we react or act to the different situations that various people face. We are developing our ability to care and show compassion, the most basic human action, to those who need our help. We need to start developing a process to assist those who most need our help. We need to develop our government’s actions to fit the size of its big words and statements. The world’s people need to recognize that we are not separated by very much anymore, except maybe our prejudices and false perceptions. We are not so distant as to claim we live in different worlds any longer. The distance is only in our minds.
From: new world discovered 3 September 2006

Development and its Uses

Truman called others ‘underdeveloped’ and what we have now seen is the disparity between rich and poor has grown exponentially. The ‘underdeveloped’ were not able to come closer to the ‘developed.’ We began calling some countries ‘developing’ as they adopted our ideas for governance, economy, liberalized markets, and modernity. This began the ‘era of development’ and Wolfgang Sachs provides us with an excellent quote:

“Like a towering lighthouse guiding sailors towards the coast, ‘development’ stood as the idea which oriented emerging nations in their journey through post-war history. No matter whether democracies or dictatorships, the countries of the South proclaimed development as their primary aspiration, after they had been freed from colonial subordination. Four decades later, governments and citizens alike still have their eyes fixed on this light flashing just as far away as ever: every effort and and every sacrifice is justified in reaching the goal, but the light keeps on receding into the dark.” (Thomas, Ch. 1)

Here is where we can draw on a theme of ‘development of the mind.’ This idea has been grown on the backs of the very people that ‘development’ seeks to assist. Born of colonization which promoted a certain nihilism of colonized populations and modernization as a result of capitalist systems imposed on those populations, the development of the mind made people think that they weren’t good enough and that they did not have the capacity to do for themselves. This is also a mentality that can be found within the slave and Black populations of the US. When a people is subjugated it takes a long time to redevelop the thinking that is not rooted in subordination. Everything was made simple and efficient for the imperial masters to control and capitalise on stolen wealth. Esteva importantly notes that for people to embrace ‘development’ they have to first perceive themselves to be ‘underdeveloped.’ (7) In this sense development negates the very person seeking to improve their life through ‘development’ because, “it undermines confidence in oneself and one’s own culture.” (Esteva, 8) The nature of ‘development’ almost always forgets about history and culture. Economists come at development with the idea of a level playing field that just needs to be built upon, but that is never the case. Histories of colonization which spurred war and violent conflict cannot be sliced out of development work. Colonized populations often had their histories and cultures re-written. In the case of Rwanda a homogeneous people were divided and pitted against one another. In South Africa culture was bound by ‘bantustans.’ In every corner of the globe a system focusing on mass production and the attainment of ‘wealth’ was imposed on traditional ways of life, cultures were and are altered as a result – sometimes even discarded. The “standardization of desires and dreams” (Wolfgang Sachs, 4) resulted and now we have ‘development.’

What we also can look back and see is the use of ‘development’ as a “weapon in the competition between political system.” (Wolfgang Sachs, 2) The Cold War led to a widespread allocation of ‘rogue aid,’ that is aid that is given without restriction and without being tied to a government or ‘development’ agency. This ‘rogue aid’ was given to win over world leaders to the side of the US or Soviet Union. Development as a weapon has created long-term effects that can still be seen as countries fell to dictators and authoritarian regimes fueled by ‘rogue aid’ and their militarization by Cold War powers. The ‘era of development can also be called the ‘era of the Cold War.’ (Wolfgang Sachs, 4) Our privilege and ‘wealth’ does not give us a free ticket to ‘develop’ the rest of the world or tell them that they are living poorly. If the world was to be ‘developed’ entirely we, as a global society, would be reduced to a dead population living on top of each other on a barren planet devoid of all nature because we exploited both ourselves and our habitat. In some areas of ‘development’ I would even say that the West has taken irrational steps backwards.

Paradigms

There are three non-distinct paradigms or theories of development. The first is what we have seen for the past four decades since Truman’s statement on underdevelopment. Development as Modernization puts forth the idea that the “modern money economy should and would overcome the traditional subsistence economy.” (Ruonavaara, 2000) This is where ‘development’ has acted as a “Westernization of the world” (Wolfgang Sachs, 4) and the beginnings of a failed system that does not serve people’s needs.

In the 1980s Alternative Development came into fashion to deal with the failure of Development as Modernization. The problem here was a misuse of privilege. Scientific knowledge was favored over all as professionals and experts came in as ‘facilitators.’ The positive of Alternative Development was the greater focus on people and ‘including the excluded.’ Women, minority groups, and the actual people being ‘developed’ were engaged in their own development. The failure of this paradigm was the hierarchical structure of facilitator and underdeveloped community, the lack of agency given in development, and the focus on modern and scientific knowledge as the only way to go.

Now there is the paradigm of Alternatives to Development or what some call Post-Development. This is an absolute “rejection and the replacement of the Development as Modernization model.” (Ruonavaara) Alternatives to Development employs re-membering people into society, a step further than ‘including the excluded,’ participatory and cooperative practices, as well as allowing “professionals and non-professionals to talk about development in new ways.” (Ruonavaara)

I say these paradigms are non-distinct because it is often difficult to specifically define approaches to development in reality as one paradigm or the other. Often it is easy to place certain development practices within the paradigms, but not the actions of an entire agency or organization.

Definitions

Alan Thomas tells us that the term ‘development’ is used in three main ways:

1. as a vision, description or measure of the state of being of a desirable society;
2. as an historical process of social change in which societies are transformed over long periods;
3. as consisting of deliberate efforts aimed at improvement on the part of various agencies, including governments, all kinds of organizations and social movements.

Chambers (1997, from Thomas, Ch. 2) defined development as just ‘good change.’ Thomas breaks this down excellently in his second chapter and the important concept to note is the ambiguity of ‘development.’ People have different ideas of what change is, of what progress entails, and especially of how we should get to that good change from where we are now. The nature of the defining is how ‘development’ happens in reality.

Cowen and Shenton write, “The burden of development was to compensate for the negative propensities of capitalism through the reconstruction of social order. To develop, the, was to ameliorate the social misery which arose out of an immanent process of capitalist growth.” (Thomas, Ch. 2) If capitalism is to be a working system of self-regulating markets then everything must become a commodity. The problem here is that everything cannot be a commodity: life, mind, dignity, equality – these cannot be bought, sold, and produced or regulated by any market.

Jeffrey Sachs talks about development (economic) in relation to a ladder, (Sachs, 18) where once you reach the first rung you are set on your path to development. This falls in line with the Development as Modernization approach. The problem with Sachs’ definition is that he creates a linear model that does not work in reality, people are often moving up and down the ladder – or not even on it because development can not focus solely on the economic. The political, social, and cultural must also be taken into account. Sachs’ other problem arrives when he defines poverty as a trap. This definition takes out all history and accountability in relation to one’s poverty. It discounts how one got into poverty in the first place or how a country or community lives in poverty.

Wolfgang Sachs defines development as, “an amoeba-like concept, shapeless but ineradicable. Its contours are so blurred that it denoted nothing – while it spreads everywhere because it connotes the best of intentions. The term is hailed by the IMF and Vatican alike, by revolutionaries carrying their guns as well as field experts carrying their Samsonites. Though development has no content, it does possess one function: it allows any intervention to be sanctified in the name of a higher goal.”(4)

Responsible Development– My definition:

Therefore all past implementations of development as intervention, as hegemonic control, as a political weapon, as a ladder, as Westernization, as capitalist, and as modernization have led to a more underdeveloped world where people are not valued and all that matters is the production and perpetuation of the current system for those are the forefront. Wolfgang Sachs says, “The idea of development stands like a ruin in the intellectual landscape” and “its time to dismantle this mental structure.” (Thomas, Ch. 1) I already wrote about the idea of development of the mind and so now how does someone from the West who wants to help those in need around the world engage in ‘development’ that will actually produce the desired results for people?

My definition of development falls along the lines of the ‘alternatives to development’ paradigm. I believe very strongly in people-centered development that is needs based. Where there is a focus on individuals as part of the whole and not on just numbers of people assisted, growth of GDP, or increase in production. I want to see development that uses what works and not just what looks good. Development that strengthens local communities and connects them to others, that evaluates itself often, that doesn’t ‘other,’ that spreads a cooperative mentality of interdependence, that believes in the co-evolution of people with nature, that does not feel guilty, but responsible, that uses unsustainable development to adopt sustainable practices. Development should be a resource for people who have historically and systematically been subjugated and oppressed so that they may have agency and actualize their own development. I am a strong believer in a communal and cooperative living style, this is a ‘modern’ idea based in practices of traditional societies. My definition of development is not an ideology, but rather it draws on wisdom from historical experience.

Development should be a vision that is defined by the community as a whole. I believe strongly in empowerment where the ‘developer’ does not act as an overseer or facilitator, but a resource and a support. This is where development needs to become a redistribution of power and resources that will transform the way institutions have worked. Along with empowerment comes the idea of participation. Both the ‘developer’ and those to ‘develop’ need to be participants on equal footing in the development process. In this way communities are able to develop themselves and take into account their social and cultural practices without being controlled by an outsider. Development as we have seen pushed for a conformity of global society – development should instead embrace diversity and equality in difference.

My economics mirrors the ideas of E.F. Schumacher where he focuses on economics as if people mattered. Schumacher uses Buddhism as an example of people and nature centered development practice. He writes:

“Simplicity and non-violence are obviously closely related. The optimal pattern of consumption, producing a high degree of human satisfaction by means of a relatively low rate of consumption, allows people to live without great pressure and strain and to fulfill the primary injunction of Buddhist teaching: ‘Cease to do evil; try to do good.'” (62)

He also writes about production at the local level for the local level and how that lessens human consumption as a “rational way of economic life.” Schumacher notes that now (1973, even more now) the human population lives parasitically on the earth, the market is an institution of individualism and severs all responsibility. (46) Development needs to be about wellbeing of both the individual and the world around them.

The examples of subsistence and traditional communities are excellent, ‘small’ examples of how development should work.

“A world of ‘humanized’ production, based on a small scale but modern and scientific technology, a world of co-operation in villages and small towns, a world of enriched social relationships growing out of a process of production and exchange that is under human control rather than ‘alienated’. . .” (Kitching, 1982, p.179 from Thomas, 35)

There are many examples of this and even now practices within the ‘developed’ world are moving towards subsistence and small scale, cooperative and local. Within the ‘developed’ world there is a growing number of local farmer’s markets, organic growers, and alternative organizations focused on serving people’s needs. Even Barbara Kingslover’s latest book, Animal, Vegetable, Miracle is based on locally grown, locally purchased food as a way to develop a more environment friendly and people friendly society. This local food movement is growing fast.

Some may try and say that it is just a phenomena as food and fuel prices soar, but really it is a long held style of living rooted in historic, traditional knowledge which we are finally returning to: a method of living that is more holistic and accounts for the co-evolution of humans and nature. Evidence of these traditional practices is still seen today. There have been attempts to return to a historically sustainable way of life through movements like Kibbutz in Israel, Ujamaa in Tanzania, Revolutionary Inter-Communalism within the Black Panther Party of the US, as well as implementations of communes, cooperatives and collectives in the Western world – some that begin as far as 200 years ago. There are distinct reasons why these models have failed to achieve widespread results, but the most detrimental effect brings us back to the idea of ‘development of the mind.’People are too often trapped in a system’s way of thinking and living that it is too difficult to cut out un-necessary desire or it creates an inability to see beyond the current status quo and way of life.

One example of a community that was self-sufficient, sustainable, and at peace with others and its environment was the Ladakh in northern most point of India next to Kashmir. The Ladakh were a traditional indigenous community that operated on communal living. They lived with no strain on the natural environment. There was no pollution, excessive noise, or a lack of resources. People worked on their own time and used what would be called ‘primitive technology.’As soon as modernity and ‘development’ entered the scene the sustainable way of life of the Ladakh disappeared. Modern society claimed to understand and control the natural order, with energy and capital intensive, consumptive, and environmentally unfriendly practices. The elderly no longer had a role in the community with the creation of Western schools and business because of this young people did not learn tolerance and responsibility at an early age. Modern society broke down family and community ties. Agriculture was no longer an acceptable business, pollution grew, the status of women fell as men felt more and more insecure in the ‘modern world.’ A community where there were no constraints, no stresses, no violence, no capital or pollution was turned into what we now see on a worldwide scale with the propagation of capitalism. Polluted environments, where everyone is in a rush, and once you can no longer produce you have no place in society. We now live as parasites on the earth as opposed to co-evolving partners with the earth. We now value products and productivity above people. There are many related examples across the globe of communities like the Ladakh. Now the Ladakh Development Foundation exists to empower the community to improve itself.

It seems with all this understanding of history, ‘development’ should become a simplifying of life. We should re-learn traditional values of these communities and apply them to our own lives. Living non-hierarchically, with community consensus, subsistence, and holistically. There are too many broken people, we need to reverse our practices and rewrite our theories. There are many efforts now developing across the globe to spur a “green economy,” one that attempts to place the environment at the core of our societal progression. It has had mixed results, but the majority good. Where gardens are established on roofs (green roofs), community parks take the place of abandoned factories, and bringing people out of poverty is the norm. The Green for All organization is working to build an inclusive “green” economy that will assist and benefit everyone.

Green For All believes a shift to a clean, green economy can improve the health and well-being of low-income people, who suffer disproportionately from cancer, asthma and other respiratory ailments in our current pollution-based economy. Such a shift can also create and expand entrepreneurial, wealth-building opportunities for American workers who need new avenues of economic advance. In other words: we believe that the national effort to curb global warming and oil dependence can simultaneously create well-paid green-collar jobs, safer streets and healthier communities.

The notion of a growing or strong nation or country by way of its GDP or economic output does not give a comprehensive definition of the development of a country when people are a means to an end. And so ‘development’ at national and state levels is irrelevant when there are people who still live without their basic necessities at the small-scale, local and community level.

young people are the key drivers of social change

Harry S. Truman Scholarship Policy Proposal by: Alex B. Hill

Problem Statement
International development is a vast and complex issue. With over 18 million people dying each year from the lack of development assistance in health infrastructure something new needs to be done. Within the US there is a trend that foreign aid dollars are coming more from private NGOs and nonprofits as opposed to official government agencies. For so many years international development was tackled in simplified single-issue campaigns, which only created any effect in the short-term. This can be attributed to the fact that most Americans have a limited worldview. Most Americans have not traveled internationally, especially to developing countries. Therefore international development issues remain remote and abstract to most Americans. International development is a long-term issue. It is inherently complex and difficult to understand. There is no single enemy, and outcomes are rarely clear-cut or translatable through numbers. Faced with this challenge, some countries have opted to undertake broad-based efforts to build increased public understanding of development issues.4 There are a number of programs that promote volunteering and global engagement, such as the Peace Corps and Volunteers for Prosperity, through USA Freedom Corps. While these programs offer opportunities for highly educated and skilled Americans there exists a great void for those who are inspired and motivated, but may not have the degree or skills to qualify for these programs. The way to bring about increased political will on development issues in the US will lie in the creation of a long-term cultural and social movement, spurred by young people, to change the way in which many Americans think about international development. If this movement is to achieve change, it will be vital to increase the knowledge and understanding of development issues among the public.

Proposed Solution
Young people are the key drivers of social change. Considering this fact, there needs to be a policy focused on engaging young people in order to build a domestic constituency for international development that will create lasting connections. The policies on education and participation related to international development need to change. Young people have grown up with internet, global popular culture, and easier communications and travel, which has made the world smaller, more connected, and more accessible. Young people, specifically college students, have the opportunities to study abroad and are almost constantly encouraged to participate in global exchanges. Young people are left out of the equation when they exist as the greatest asset to making change in the development sector. If the problem is to be remedied then there needs to be a two-step plan. The first step needs to be increased support for a development curriculum in middle and high schools. This is where the US has fallen far behind Europe. European education efforts have focused their resources on offering learning initiatives for young people. Focusing on youth has been a key strategy of both European NGOs and government for many years. Countries that have embraced a long-term vision of youth-focused development education have the highest public awareness and support for development. According to the OECD the US spends less per capita on development education than any other OECD country. The second step needs to combine the learning activities of the school curriculum with action opportunities. The traditional classroom will not be enough to keep the engagement necessary to build an active constituency for change. Having action programs for youth will be a great method of measuring the success of the educational component. Pivotal to both steps will be increased support for a collaborative body dedicated to promoting development education. The US Development Education Alliance has been largely ineffective because it lacks support from both NGOs and the government agencies. This body needs to be coordinated at the national level and networked internationally so that efforts can be combined for maximum effect.

Major Obstacles/ Implementation Challenges
The major challenge facing this policy proposal is the US education system. In the US is largely determined locally, as opposed to Europe, where national governments set education policy standards. This will be the greatest difficulty in implementing a development-oriented curriculum. The next challenge will be government support. Having a coherent government platform to support development education will lend recognition and incredible support to the effort. Without a government backing, the policy will likely fail. Likewise, the US Development Education Alliance will need greater support from NGOs and government agencies, such as the USA Freedom Corps, Peace Corps, and USAID, in order to push for a change in policy.

Check out the Development Education Association, based out of the UK, it is a network of all development education organizations.

definition of development

7 October 2008 Update:
Read a more comprehensive analysis of the definition of development in a more recent post here:
definition of development (revisited): beauty in the palm of your hand.

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After lecture, and another drum lesson from master drummer Chris, on Monday I gathered a group of people interested in visiting the Peace Corps offices. Six of us worked to get taxis outside of the University with a certain degree of difficulty – probably because no driver knew where it was located. It seems that our group is very good at choosing destinations of which no one has heard. All we knew was that the office was located at 26 W. Cantonments Road – nothing more.

After a great deal of roundabout driving, a couple stops for directions, and some backwards driving (as in driving backwards) we found the offices located on Switchback Road near the house of the Ambassador of Cote D’Ivoire. It turns out with all our driving that we arrived right at closing time for the day with no appointment – I guess that helps. There happened to be a few volunteers at the check-in guard house and thankfully just as we were about to be turned away one of the volunteers claimed that he had gone to school with one of us and he just wanted to show us around.

Alex showed us around the compound and answered any and all questions we had about the Peace Corps. He also shared with us his experience. He is near completing his second year and is located in a very remote farming village in the north of the country. Originally from Nebraska, he was selected for the agriculture and natural resources area. His village is on the cliffs of the north where a ten year war has just ended between neighboring clans. He has started a cashew cooperative with 13 area villages, teaches at a secondary school, works in a hospital, started an HIV/AIDS club, and is attempting to work towards reconciliation between the former warring clans. The Ghana country coordinator had at first called Alex’s assignment ‘hell,’ but he is really enjoying himself and is working very hard to make the most difference that he can. After hours of talking we accompanied Alex to dinner, since we had made him late for a previous dinner engagement – it was ok he said, “they were just high schoolers.” It was really great talking to Alex and hearing his experiences and it really solidifies my plans to join the Peace Corps after college.

This discussion with Alex really made me think about ‘development’ as the word was thrown around a lot that night. Alex has said that he really likes the Peace Corps model because it deals with integration. A volunteer is placed in a village or area and works with the people to improve their situation. This as opposed to some large organization or institution just giving out money to big plans they believe will work. But, what is the definition of development? Who gets to determine what development is? Who is allowed to call one developed or developing or underdeveloped? Is development all based on a desire or push to become Western? Yes, I think in the very recent past it was and really still is to a degree, but for me development holds a different definition. Development for me mirrors positive progress in people’s lives. Development should be based on getting and giving people their basic needs (rights) for survival and life. Even in this regard the almighty ‘West’ needs development.

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Read a more comprehensive analysis of the definition of development in a more recent post here:
definition of development (revisited): beauty in the palm of your hand.

Index of blog post series on Ghana.

what, are you serious?

I was going to be done for the year with the annual report, but recent events do not allow me to leave this year with something unsaid.

Today I had a dentist appointment. My teeth were first checked out and cleaned by the dentist’s assistant and as you all know, while they have those metal tools and the nifty little mirror in your mouth, they ask you questions and try to hold a conversation with you. You, the one with everything in your mouth. It started out normally – I was wearing my Michigan State University sweatshirt so I was first asked about college, how it was going, and then my major – International Relations and Global Area Studies: Africa specializing in International Development. Well now that changes the conversation to Africa. “Wow Africa, so what do you plan to do with that degree after college?” I said I was planning on doing the Peace Corps for two years and then whatever comes after. (most likely the Master International Program with the Peace Corps)

The assistant then told me some very interesting stories about people she knew who did related work in Africa. She talked about a co-worker who was a photographer and was about to go on safari in Africa to take pictures of wildlife, ‘wouldn’t that be fun?’ Then she noted with a degree of disdain in her voice that she would never go to such a dirty, sticky, tropical place with a bunch of mosquitoes and stuff. All I could think was ‘you have got to be kidding me!’ Is this still how most people think of Africa? I could not say much because of the tools occupying my mouth. Then she said something to the effect of ‘well whatever you want to do.’ To be honest I could not believe it and I was slightly taken aback by her perceptions of Africa. Thanks so much American mass media! That is a topic for another time, but this event has given me a sense that more people need to travel to Africa and see first hand the wonder and beauty and people. More people need to understand that actual people like you and me live in Africa everyday – they may not have as much ‘stuff’ as we do, but nevertheless they live incredible lives in that dirty, sticky, mosquito filled tropical wonder land that I have come to love.

On a more up-beat note, UN personnel arrived in the Darfur region of Sudan to support the African Union force, which is attempting to keep the peace as government backed militias spread destruction and terror with ‘rebel’ groups battling to keep the people safe. This is a large step towards a much debated hybrid UN force, backed by UN Secretary General Kofi Annan, being sent to the region to keep the peace. The African Union troops are under equipped and understaffed in this conflict. With the UN personnel also came equipment, including night vision goggles and armored personnel carriers. The goal is to eventually move to a hybrid UN-AU force of roughly 20,000 personnel. I believe that a positive step has been made here and it gives me hope for a future resolution of the Darfur conflict and the lives of those affected.

Have a Happy New Year everyone!