How would you make aid and development better?

This post is in response to a call out from AidSpeak, the blog of the Humanitarian Social Network known as AidSource. The guys recently asked writers to talk about how they would improve aid and development. Of course, this is by no means an exhaustive list (that would involve a word limit longer than Tolstoy’s War and Peace), but just a few key areas in which we might move aid and development forward.

Let’s make aid and development truly about “beneficiaries”, once and for all.

Aid and development, as it stands, involves a triangular relationship between the donor, the NGO and, for lack of a better word, beneficiaries. Although the word beneficiary sounds a little too passive for my liking, getting to the core of aid and development is about improving the lives of people in communities that are impoverished or vulnerable. However, too often, aid and development does not revolve around them.

The donor often determines what programs get funded and therefore what kind of development work gets done. The Millennium Development Goals (MDGs) announced in 2000, contain no specific mention of disability. Since then, there has been anecdotal evidence that some programs developed by disability NGOs, in consultation with communities, have been refused funding.

Some agencies and funding bodies refuse to fund programs that target people with disabilities simply because disability is not explicitly mentioned in the MDGs. For the 15% of the world who live with disabilities at least, rather than foster collective action, the MDGs have promoted inaction.

We need to create an environment where communities determine for themselves what issues need improvement. This in itself is complex, because simply asking communities often ignores those who are not already in positions of power. It is up to NGOs to reach those who are typically the least heard. Women, children, ethnic minorities, LGBT, migrants, and people with disabilities would help. Let’s get NGOs to do the listening, and then spend time and energy talking to donors about what communities really need.

Put more trust in poor people.

In Just Give Money to the Poor: The Development Revolution from the Global South, the authors take a step back from looking at what reduces poverty, and investigate our own attitudes towards poor people. They ask the question: “Who is to blame for poor people being poor: society as a whole, or poor people themselves?” The variation across countries is fascinating.

Who is to blame for poverty – poor people or society? Adapted from Just Give Money to the Poor.

The data shows that the majority of people in the United States tend to blame poor people for their level of poverty, rather than society. At the opposite end of the spectrum, only 13% of people in Germany blame poor people, with 87% blaming an unfair society. Our own attitudes about who is to blame for poverty are crucial in how we attack the problem.

If we continue to see poor people as the architects of their own predicament, then “poverty eradication” will continue to be done for them, not by them. Programs will continue to be paternalistic, and poor people themselves will have little to no agency in creating a better future for themselves.

Microcredit, or the giving of small loans to people in poverty has, at best, tenuous evidence in lifting people out of poverty across the board. As economist David Roodman says, “microfinance is rarely transformational”. Yet currently, microcredit is incredibly popular. This is despite strong evidence that suggests that unconditional cash transfers (just “giving money to the poor”) may be more effective in reducing poverty, particularly amongst vulnerable groups.

Why do we favour microcredit? One reason may be that behind all of this is the unspoken belief that poor people cannot be trusted. In fact, advocates of microfinance often point to loan repayment rates as a sign that microcredit is working. One of Grameen Bank’s greatest brags is that 97% of their loans are repaid.

However, this figure is only a distraction. Surely, the success of microcredit should be measured by the effect on reducing poverty, rather than the ability of people to pay loans back. People often baulk at the idea of giving money away with no strings attached, because they feel that poor people cannot be trusted. Yet the overwhelming body of evidence suggests that cash transfers work better than microcredit. In asking why we still prefer microcredit, we have to ask ourselves the simple question: “Do we trust poor people?”

Do more to reach the most vulnerable.

In his book, Due Diligence: An Impertinent Inquiry into Microfinance, David Roodman notes that while microcredit can change the lives of some people who are poor, there is one group that microcredit almost universally does not reach: the poorest of the poor.

To boil a very complex situation down to its simplest form, microcredit is run like a business, and the ability to reach the poorest in any community has a high opportunity cost associated with it. You may be able to reach the one ultra-poor family in the remote hills away from the village, but this will come at the expense of reaching four less poor families within the village.

Similarly, aid and development as it stands today does not do enough for people with disabilities, often the most poor and vulnerable within any community.

Poverty and disability are inextricably linked. The lack of access to decent employment, the higher costs of living, the opportunity costs of caring for those with disabilities – all of these factors combine to make families of people with disabilities multiply disadvantaged. Children with disabilities are far less likely to attend school than their non-disabled peers.

Although this trend is starting to be reversed, too few mainstream development organisations and agencies include people with disabilities into their programs. I have personally met with many development NGOs who do great work across a wide range of areas. However, when asked specifically how they address the needs of people with disabilities (often 15% or more of their target group), I’m faced with blank stares.

How can we truly claim that we are working towards improving the lives of poor and vulnerable people, if we continue to ignore those at the most vulnerable end of the spectrum?

Often, organisations resist including people with disabilities because it is perceived as too difficult or intimidating. Fortunately though, there is a wealth of information available to help mainstream the specific needs of people with disabilities. Here is a fantastic guide, produced by the disability organisation CBM, to get the ball rolling.


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Weh Yeoh

Weh is a disability development worker currently based in Cambodia. He is a professionally trained physiotherapist who has completed a MA in Development Studies at the University of NSW. He has a diverse background, having spent years travelling through remote parts of Asia, volunteering in an orphanage and adult shelter for people with disabilities in Vietnam, interning in India, and studying Mandarin in Beijing. He has experience in the NGO sector both in Australia and internationally in China, through Handicap International. He is an obsessed barefoot runner, wearer of Lycra, and eats far too much for his body size. You can view his LinkedIn (www.linkedin.com/in/wmyeoh) and follow him on Twitter @wmyeoh.

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17 Comments to “How would you make aid and development better?”

  1. […] How would you make aid and development better? Weh Yeoh puts forward his views on WhyDev. […]

  2. [...] point illustrates the often yawning gap between what donors perceive will work and what communities themselves actually [...]

  3. [...] relationship between the donor, the NGO and, for lack of a better word, beneficiaries.” WhyDev, [...]

  4. AidSpeak says:

    [...] mate over at WhyDev.org and AidSource group facipulator, Weh Yeoh, has a really good post on the WhyDev blog. Rather than try to copy/paste the entire thing, we’ll leave you with his first and best [...]

  5. [...] How would you make aid and development better? Weh Yeoh puts forward his views on WhyDev. [...]

  6. Sam Byfield says:

    Good article, Weh Yeoh, and good to see growing recognition of disability in the mainstream development sector. AusAID and Australian NGOs are really leading the way in this area, though I still find myself sometimes having conversations that involve me having to answer the question – ‘this proposal/project isn’t about people with disabilities, why should we include them?’

    The point about the percentages (15% versus about 2%) is interesting. It’s important to remember that prevalence of disability is higher in developing countries than it is in developed countries. There are several reasons for this, including the absence of preventative health measures that we often take for granted, and the absence of basic services – for instance, while in Australia we take it for granted that if we have a vision impairment we are going to be able to get surgery (like a cataract operation), or a pair of spectacles , in much of the developing world this is still a pipe dream.

    It’s also important to keep in mind that with changes to the global burden of disease the types of disabilities, and the necessary preventative and rehabilitative measures, will continue to evolve. A good example of this is the ongoing emergence of non communicable diseases like cancers, diabetes, stroke and respiratory diseases. The WHO’s World Report on Disability estimates that NCDs already account for 66% of all years lived with a disability across the globe. With the common risk factors of these conditions – like smoking, dangerous use of alcohol, obesity and a lack of exercise – showing no signs of slowing down, there’s a real risk that over the coming decade we’ll see an explosion in levels of disability in the developing world. Mental illness and traffic accidents are two more major causes of disability which look likely to grow substantially in coming years.

    Accordingly, effective international development practices must have at their core a commitment to preventing disability, and where it’s not preventable, to ensuring that people with disabilities benefit from development and are able to access opportunities and basic human rights.

    • Thanks Sam for your brilliant comment. You make a good point about the direction in which disability is headed in lower income countries. It seems the smart countries/agencies/orgs are the ones who are getting on top of the issue early.

    • I completely agree about microcredit. But I think the folowing argument is wrong:

      “If we continue to see poor people as the architects of their own predicament, then “poverty eradication” will continue to be done for them, not by them. Programs will continue to be paternalistic, and poor people themselves will have little to no agency in creating a better future for themselves.”

      On the contrary, If you think poor people is responsable for their own poverty you will try to make them change their attitude and do something about it. If you think society is to be blamed and not the poor, you will be most likely inclined to do something FOR THEM as a reapairment.

      In response to the question in the title I will cite 2 statements. One from a documentary about an indian women in Argentina called Geronima who died because of the help she received: “I don´t want you to give me a hand. I want you to take your hands off me.”
      The other from a María Elena Walsh song: “First I produce poverty and sickness, then I present the hospital”.

      Aid is a big industry.

  7. Ivan says:

    Like your post. Points you’ve made about making aid and development better should be taken into account.

    I surely agree that poverty and disability are linked to tight. Disability definitely means less opportunity, especially in developing world (here in Serbia and in Balkan for sure). Less opportunity leads to exclusion (no/bad education, no/bad job, low social capital…) and unfortunately it usually means that person with disability gets poverty package.

    Thanks for the CBM guide, looks useful.

    cheers

    @sociosolidarity

  8. Luc Lapointe says:

    Not quite sure how to respond to this because the numbers also show a lot of contradictions. I am not an American Citizen but based on the number that you are using, we would think that this is where there would be more apathy towards development. In a recent study published by the Hudson Institute, Americans are leading as the major source of Private Development Assistance. How could it be that the numbers differ so much when it comes to perception and actual aid!?

    Micro-credit is still sexy for donors because of the numbers that are published by organizations on the ground. The discourse is around repayment rates, not so much about how many individuals remained in business after they repaid their loans. There is a casino near my place at the Ontario and Quebec border. They report that the “One-arm-bandit” payback at a rate of 98% – that would leave you to believe that dropping money in these machines is a good investment. At a recent event on Social Impact Bonds, the message was “Let’s not do the same that we did with micro-credit” — dropping $20 billion just to keep it afloat. The problem is what data really tells you at the end of the day.

    Imagine if we had the real numbers – health conditions, success, etc! Let’s call it transparency for the lack of a better word!??! Some people would argue that…well this is better than nothing, that there are successes but I could also show that in a great majority of plane crashes, there would be survivors. Yes that is a good story but should we send more planes to the ground!?

    We still measure poverty with the same $2 a day!?! (thought I would just drop this in…since that $2 is what we use to measure absolute poverty)

    So what would make aid and development better!? The recent trend in the “mea culpa” or “oooops we’re sorry” or “admitting failure” shows (for me) the lack of seriousness that some organizations have towards development or aid delivery. Should we tell the “poor” ..”the bottom of the pyramid” that this is just an experiment” We are here until we run out of money…we are not sure this will work but don’t worry, we will admit failure somewhere back home…maybe get published for this. We would not accept that of our health system, of our road engineers, or other professionals.

    We had more good news today about the aid sector. In a recent report published on ODI, it looks that by 2025 the world will have dealt with absolute poverty (wherever we want to draw the line it seems).

    What are the buzz words this year? Needs-based development! Ownership! Innovation! but nothing has really changed. The aid sector still works in silos and silos within silos – health is about the number of people treated…not the number that have received clean water or better food. At an event in Central America last year…some communities basically said – stop building hospitals – housing, nutrition, education, water, and employment is about health even though they fall in other silos.

    What would make aid and development better? Good data…the ability for organizations to share data and collaborate. Maybe more honesty about the expected outcomes?!? Maybe communities would opt out if they knew that they are part of an experiment.

    I am sure we would all change doctors if s/he would tell us that s/he drops 50% of the babies during delivery.

    I remain positive about meaningful changes but maybe it’s time to trade the car in!

    • I would hazard a guess that the numbers don’t tell the whole story. Even though Americans give a great deal, that doesn’t really tell us about the manner in which they give. If we believe that poor people are the agents of their own predicament, the type of aid given will be paternalistic and top down.

      I’m pretty much in agreement with the entire rest of your comment. Thanks for sharing!

  9. A says:

    Good post. Interesting. I agree that microfinance is often assessed too uncritically and its success should be measured in terms of reducing poverty, not in the rate of paying back the loans. I would like to make two points about other issues in the post though.

    Firstly with regard to disability: the 15% you quote from WHO refers to people that have ‘some form of disability’. Depending on what is defined as constituting some form of disability, this number is very flexible. The 15% includes people with such disabilities as ‘back pain’ and ‘depression’. (Not that I want to trivialise the seriousness of those conditions; just that most people might not include them when simply presented with the word ‘disability’). If the definition of ‘disabled’ is narrowed to “people who have significant difficulties in functioning” – perhaps closer to the common understanding of the word – the rate is only 2.14%.

    Of course there is no rule about the precise definition of ‘disability’ but I think selecting a relatively loose definition in order to show a high percentage is not necessarily helpful. It is likely to reduce, not increase, the chances of donors acknowledging the specific needs of people with disabilities. If it’s 15% of the population then they will be beneficiaries of the aid just like the other 85%. A lower percentage is more likely to highlight the need for special attention.

    My other point is related to letting “communities determine for themselves what issues need improvement”. This is an admirable principle but a problem with it is that “communities” are not always rational entities in the way that individual people are. It can be hard or impossible for a “community” to decide what it needs most and then articulate that goal. For example, at a community meeting being held to determine what issues most need improvement, one self-righteous individual might say ‘the mosque needs a new roof’. It immediately becomes almost impossible for anyone to say that other issues deserve more priority – even if everyone knows that getting a safe water source, for instance, is more important to the wellbeing of the community. The intervention of an outside agency at this point is critical, in that it provides an escape route from the dogmatic restrictions of local politics/religion/culture.

    Our fear of being seen as paternalistic can limit the effectiveness of the work we do. Of course we should avoid paternalism but we should not be afraid to recognise that we have knowledge and expertise that the people in this community don’t have. We know that if the people wash their hands after going to the toilet there will be less diarrhoea in the community. This is a fact; it’s not dependant on cultural perspectives or anything else. If we see that there is a high rate of diarrhoea in a community and the people are not washing their hands after going to the toilet, then we have a responsibility to address this issue, even if it the community itself has not identified it as a problem. It’s fine to let “the communities determine for themselves what issues need improvement” but the reality is that, for a variety of reasons, they might not identify the ‘correct’ issues. And there are indeed ‘correct’ issues. Implementing a hygiene improvement program in this community will do more good for the people in it than fixing the hole in the mosque roof. We must not allow our distaste for paternalism to prevent us from seeing things like this.

    Again, good post, very interesting and well written. Sorry for such a long comment, thanks for reading it.

    A

    • Thanks A and no worries about the long comment!

      I agree wholeheartedly with your comment about not being too fearful that we are being paternalistic, at times. And you’re right, communities are complex, we need to get to the heart of what the real issue is that affects those that are most vulnerable. Which is why I believe that if we can deliberately aim to reach those whose voices are most silent, we should be getting close to what is truly needed.

      In regards to the point about disability, can I ask where you got the stat about 2.14% of people having a disability? I’ve not come across it before. Also, while there is no agreed definition of disability, “those who have significant difficulties in functioning” is not really adequate, using our current understanding of disability. What you are referring to harps back to the medical model of disability, and under the current (social) model of disability, refers to “impairment”. Disability these days is about the barriers that society erects to make impairments affect people’s lives. So in other words, it isn’t the fact that someone cannot see that makes them disabled, it is the fact that no Braille exists in textbooks. It puts the onus on society to change, but it also puts the definition of disability on the person who feels the barriers to entry.

      This is why the definition of disability is loose. It’s not up to the WHO or you or I to determine who has a disability, it’s up to them.

      • Aengus says:

        Thanks for that thoughtful response. And sorry for my anonymity earlier; this morning I felt ill-equipped to deal with the potential for an onslaught of outraged indignation at my views. :-) Not that I expected it from you or either of the other posters here, but I have found myself on the receiving end of it on occasion.

        As you say, “if we can deliberately aim to reach those whose voices are most silent, we should be getting close to what is truly needed”. Yes, that is true and important. We’re all familiar with reports of “the community said…” actually meaning: “the loudmouth guy who turns up at every assessment visit said…” What I would add is that in addition to the voices of the most silent, we must also acknowledge the need to include our own expertise. While I respect the opinion of Nora Lester Murad, below, we in the developed world must have been getting some things right. Witness our life expectancy and rates of infant mortality, for example, as compared to the equivalent values in developing countries. Yes we must create an environment where communities determine for themselves what issues need improvement, but I think we must also use our knowledge to assist them with the decision-making process.

        The 2.14% statistic: the first bullet point in the WHO website that you’ve provided a link to in your post says that about 15% of the world’s population have some form of disability. The second bullet point says “between 110 million and 190 million have significant difficulties in functioning”. I just took the median value, 150 million, and expressed it as a percentage. My figure of 2.14% is too precise for the information given and therefore misleading; I should have said “around 2%” or something like that. But the point still stands: according to the WHO, 15% of the world’s population have “some form of disability” while around 2% have “significant difficulties in functioning”. I think this illustrates a need for some kind of definition of the term ‘disabled’ every time we say that x% of people are disabled.

        According to the Australian Bureau of Statistics, 18.5% of Australians had “a disability” in 2009, but only 2.9% were “people who always need help or supervision with their mobility, communication and/or self care”. Again, the definition is crucial. I suspect this might be at least partially responsible for the blank looks you get from development NGOs when you tell them that 15% of their target groups are people with disabilities. Here in Bangladesh I probably looked pretty blank when the local government authorities told me that 20% of the target population were people with disabilities – until I realised that they were including such categories as ‘pregnant women’ in their definition. Somehow, rightly or wrongly, I hadn’t thought of pregnant women as being disabled.

        I agree that disability should not be thought of as just a medical condition but rather “the interaction between individuals with a health condition and personal and environmental factors such as negative attitudes …and limited social supports”. (I’m not so enthusiastic about the expression “the barriers society erects”, though. In the case of your example, Braille not existing in textbooks, I think it might be better expressed as ‘the barriers society has failed to remove’). Saying that “it’s not up to the WHO or you or I to determine who has a disability, it’s up to them” is good and well but it doesn’t sit comfortably with the assertion that “15% of the population are people with disabilities”.

        None of this takes from the validity of your post. You’ve provided three insightful and intelligent suggestions for improving aid and development. More people should be thinking like this. I enjoyed reading it.

        Keep up the good work,

        Aengus Ryan (A) :-)

  10. Justine says:

    Great Post! I think a lot of the arguments that you pointed out can also be applied to the way in which (international) donors work with local/southern NGOs. From my research in Indonesia there is a definite lack of trust between the two parties and two different systems of operation between the two groups which makes partnership difficult. As Nora pointed out this concept of its ‘our money to give’ leaves receiving NGOs in a position where they are indebted to their giver, obliged to reciprocated the gift which they have received.

    • Thanks Justine. We need to be mindful of the way in which INGOs work with local NGOs for sure, and tipping the power balance in favour of the latter is great. Do you think that giving money no strings attached can help to break down suspicion between the two groups?

      • Justine says:

        No not really because transparency is important and people (those who donate) want to know how money is being used and money alone does not end poverty. We have see from the past that throwing money at the poor can create dependence not empowerment so why would it be different for a local NGO? For one, I think long term partnership is necessary, none of this 1-5 year commitment business. If NGOs are going to work together to end poverty local NGOs need to know that they will have committed partners who will stand by and work with them and not just provide funding for one or two projects. Perhaps i’ll have a better response to this questions in a few months when my thesis on the issue is completed.

  11. The problem I have with the idea of “giving money to the poor” is that it validates the (wrong) assumption that the money is “ours” to give. In other words, if “we” (whoever that is) “give” money to the poor, then it must be ours to give not theirs. But anyone who knows history and economics can see that many of the resources that the first world controls have, to a great extent, been stolen from the developing world. This happened over centuries and continues today. So, I think we don’t need to “give” money to the poor as much as to return what rightfully belongs to them. It might sound like a subtle difference, but in that subtle difference is the concept of dignity and justice.

    • That is a really interesting point Nora. I guess when I (or in fact the authors of the book) used the word “give” we are talking more about giving, rather than loaning. It’s an act that doesn’t require any reciprocating. However, do you think it is fair to say that because (potentially hundreds of years ago) people in some countries stole from people in others, we cannot say it is our money to give? I’m just wondering whether that idea is too abstract for some people and whether it could alienate some from the concept of giving.

      • Justine says:

        But all gifts require some element of reciprocation… there have been many theoretical and practical studies which have show that there is no such thing as a free or disinterested gift (see Mauss 1927, Godlier 1999, specifically Stirat and Henkel 1995 who discuss the issue of reciprocity in the development world)