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How only small NGOs can address unmet needs

How only small NGOs can address unmet needs

Whether it is Daniel-san in Karate Kid, the Jamaican Bobsled team or Mel Gibson in a kilt, people love to support the underdog. Here’s a feel good story with a simple lesson – in international development, we should often do much of the same.

In Cambodia, it is estimated over 600,000 people with disabilities lack access to basic Speech Therapy services. These are people who have disabilities related to communication and swallowing. They may have had a stroke and cannot swallow food independently. They may have been born with cleft palate, and require surgery and therapy to eat and communicate. They may have Autism Spectrum Disorder, and require communication strategies to interact with their family, friends and community.

Despite this great need, there is a huge lack of services that exist for this population. There is a multitude of reasons for this, but this lack of services can be explained through this (grossly oversimplified) diagram.

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At the top of the diagram, there is no explicit mention of disability in the Millennium Development Goals, nor does the UN Convention on the Rights of People with Disabilities mention Speech Therapy services, or the needs of people with communication and swallowing disabilities.

When conventions, laws and policies are not inclusive, this creates the same problems in funding. This affects programs, which in turn affects services. As a result, although no disability organisations in Cambodia could claim to be flush with funding, some of the best funded focus on hearing and visual impairments.

One organization, however, was unable to ignore the needs of 600,000 people needing Speech Therapy services in Cambodia.

CABDICO, a small organisation with 11 Cambodian staff and an annual budget smaller than many UN salaries, went searching for funds to support a program that helped initiate sustainable in-country Speech Therapy services and education.*

Despite the huge need, almost a year of searching provided fruitless. The most common response was “I can see that you’ve raised something very important (for over 600,000 people), yet this area of disability is not our focus and we cannot help.”

When needs are unrecognised at the international level, but felt at the local level, what could CABDICO do?

Larger NGOs often pursue funds that are in the order of millions of dollars. These funds exist because they are in internationally recognised areas of need – education, HIV/AIDs, maternal health, for example. Yet, smaller NGOs like CABDICO, pursuing funds that were closer to $30,000, face tremendous challenges in finding resources.

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The little guy often displays more flexibility, which can be beneficial as demonstrated in this photo.

How do most NGOs respond when then cannot find funding? A good example can be seen through a large and relatively well-funded disability organisation in Cambodia, who, like CADBICO, also recognised the need for Speech Therapy a few years ago. However, due primarily to lack of motivation from funding bodies, they were unable to take steps towards addressing it. Concurrently, they started to develop programs in mother and child health. Why? Due to the availability of funds this area, as a focus of the Millenium Development Goals.

I am by no means suggesting that a focus in mother and child health is unwarranted, nor that this NGO’s work in this area is ineffective. However, the choice this organisation made to pursue available funding affected its ability to be flexible and responsive to the population it serves.

CABDICO, on the other hand, decided to start a funding campaign through the online platform StartSomeGood to offer community-based Speech Therapy services. With these funds, and later, having successfully secured funds through the Australian Embassy, CABDICO began to take steps to address this huge problem.

The first task was to gather everyone who had been doing bits and pieces of Speech Therapy, and those who should know about it, together in the one room. As simple as this sounds, CABDICO had never organised a workshop on a large scale before. It was a daunting task, yet with their can-do attitude, something that they embraced. They partnered with a government coordination body, the Disability Action Council, to help  get access to people from Ministries of Health, Education, Social Affairs and Labor, whom they would otherwise have difficulty reaching.

As a result, for the first time ever in Cambodia, people, international and national, governmental and non-governmental, came together to discuss the future of Speech Therapy in Cambodia.

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Secretary General of the Disability Action Council, HE Em Chan Makara, speaking about Speech Therapy on national news. Unprecedented.

Working groups were set up to address the problem. Buy in from government, so crucial towards success, has begun. Speech Therapy was explicitly mentioned in the strategic plan of the Disability Action Council, but as importantly, in the National Strategic Disability Plan. A Cambodian university that teaches Medicine, Nursing and other Allied Health disciplines has agreed to initiate a Speech Therapy course.

Although there is so much more to be done, the change that has already occurred has happened at breakneck speed, and CADBICO has shown that things can happen like this:

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Identifying an unmet need requires going to one place, listening and observing. Anybody can do that. But, often, only small organisations have the agility and capability to do something about what they hear.

In this underdog story, ordinary people generously helped to create change, because those in positions of power wouldn’t. CADBICO’s efforts, and those of countless other effective, small NGOs demonstrates that it doesn’t take millions of dollars to create change, just the belief of the little guy to dare think that things can change for the better.

 

Addendum: There is still a long, long way to go in this journey. If you would be interested in supporting, in any way, please contact CABDICO.

*I have worked as an external advisor to CABDICO since July 2012.

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Weh Yeoh

Co-Founder & Board Member at WhyDev
Weh Yeoh was born in Sydney, Australia, and has lived, volunteered and worked in Cambodia for the past 3 years. He is a professionally trained physiotherapist who has completed an MA in Development Studies. He has a diverse background, having travelled through remote parts of Asia, volunteered in an orphanage and adult shelter for people with disabilities in Vietnam, interned in India, and studied Mandarin in Beijing. He is an obsessed barefoot runner and connoisseur of durian.

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14 thoughts on “How only small NGOs can address unmet needs

  1. […] yet, I saw some of the best work I had ever seen, colleagues who really understand from a holistic point of view what a child with a […]

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  3. Faaria Volinski

    Hi Weh, thank you for your article. I think you share a lot of thoughts that are key for funding institutions, governments, and NGOs large and small. I’d like to weigh in here and suggest that rather than focusing on the determinant of size, we bring attention to the approach and design of programs large and small in order to reflect the second chart you included: Needs → Programs → Funding → Conventions, laws, policies. In my experience working with Reboot, I’ve seen big, multilateral institutions step forward beyond the competing incentives that often accompany their funding to support needs at the most local levels. They’re surviving and championing new methodologies, even though it is no doubt challenging. While easier for some than others, an organization of any size has the capability to infuse their programs with an empathy- and context-driven base from which to design programs that are built for people’s true needs. By saying that only small NGOs can meet unmet needs, we run the risk of turning our back on the overarching systemic issues—laws, policies, associated funding incentives, and misfit programs and services that often result. It is no doubt a huge mandate to attempt to change these systemic issues, but it’s worth doing to infuse more empathetic program design amongst both the large and small players.

    1. Hi Faaria,

      Thanks for this thoughtful comment. Please don’t be too distracted with the title – a little hyperbolic perhaps in retrospect. I think you make a good point about overarching systemic issues, and it’s definitely worth keeping in mind. In this particular example, the issue is being highlighted by the small NGO so that hopefully in the future systemic changes can be made as well, by the bigger players. However, you’re right, it is all about getting the bigger and smaller players to work together in tandem. You’ve made me reflect a little more, so thank you!

  4. Weh, a good constructive article. I’ve been assisting a small NGO in Cambodia (a school) for 9 years and have always considered this small-scale operation – the sort you describe – to be a much more efficient means of assisting Cambodians in need than big top-down driven organisations. Working at a niche level enables a more sensitive response to local needs, and it also enables the NGO to be locally managed whereas a huge UN-style operation almost always gets governed by foreigners, which is not a great recipe for independence.

    Another facet of your article, besides that of scale, is the practice of working with other entities – including Government. I think a few years ago local NGOs tended to run as jealously guarded fiefdoms – protective perhaps of their income streams and lines of influence. These days I see a lot more co-operation whereby NGOs are sharing their experiences and helping each other. Similarly, the Government – while criticised heavily at the highest level for corruption – is showing, at the middle level, a supportive attitude to NGOs.

    Your story about CADBICO shows what can be achieved through lowering the barriers. Perhaps that’s a trait of smaller NGOs. We’re all little boats on the same big ocean of need – co-operation is going to be more successful and efficient as a strategy.

  5. […] International NGO always focus on medication, HIV, education, poverty work. Yes, it is important to work on these. But, how a country will be if lots of family problems exit, you can imagine. How is this country going to help themselves, and to be less dependent on overseas NGO? There are always more to work on than you can imagine for a developing country. Maybe it is not the most urgent area to work on, maybe it doesn’t draw attention in the developed countries, but it doesn’t mean that there is no value to work on it. There is another good blog to share: How only small NGOs can address unmet needs […]

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  7. Darryl Barrett

    Great story, thanks for sharing. It’s often through incremental processes like this, raising the profile of speech and communication problems and the need for related therapy services, that momentum is built, more funding allocated, and lives are improved.

    1. wmyeoh

      Thanks Darryl. What I’ve learnt from this story is that it doesn’t matter how many times people tell you that they cannot help, simply following the lines of least resistance and going for those areas that are already identified, doesn’t change things for those whose needs are unmet. I’m hoping that through the example this tiny NGO has set, the bigger players who can have more of an impact on a larger scale will also recognise the need. Small steps by small steps, for sure. Thanks again for your comment.

  8. […] In international development, we should supper the underdog. How one small NGO is making significant inroads to address an unmet need in Cambodia.  […]

  9. Interesting piece. Your second diagram: needs–>programmes–>funding–>conventions reminded me of my issue with the “There is no field” piece by J. that you posted recently. For me, it sums up why, while it might be the current practice that policies and therefore strategies/funding are developed from “above” (ie not in the field) it should not always be that way.

    1. wmyeoh

      Ah yes! A good linkage as well. It often seems like there is never any flow from bottom to top, but this story indicates that sometimes, there is. Thanks for the comment.

  10. Gerry Ryan

    Great narrative Weh, and it does highlight the flexibility that many smaller NGOs enjoy that can make them more responsive to underrecognized problems and “unmet needs”. Like any business, government, theatre troupe, sports club, or organization you care to name: the fewer heads that need to nod, the less bureaucratic mire to wade through, the faster and easier it is to try new things or move in new directions, and often the lower the overheads for doing so.

    But I take issue with the definitive “only” small groups can do this. Larger groups have often more restricted or specified purview, but there is nothing *per se* that prevents a given group from addressing novel, small, or underrecognized issues that don’t meet some large funding pool. This might be best achieved at the scale of a local office or project, rather than from a big national or supra-national programme, but who knows – it is then much faster to scale-up if you’ve already go an existing framework to do so!

    1. wmyeoh

      Interesting comment Gerry. My only thought, and I’m by no means clear on this, is that larger NGOs would not want to spend their time chasing grants that are in the vicinity of 30 to 50K, as these don’t ensure their survival as much as the ones in the millions of dollars. After all, survival is key, right? What do you think?

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