Tag Archives: Children

Women breastfeed their babies in Cambodia. World Breastfeeding Week is from August 1 to 7. Photo by: Charles Pieters

Breastfeeding needs more aid

Dr. Arun Gupta is co-founder and central coordinator of the Breastfeeding Promotion Network of India, an affiliate of the International Baby Food Action Network for Asia. A member of the prime minister’s Council for India’s Nutrition Challenges, Gupta gave up his private practice to promote breastfeeding and bring this issue to the forefront of social and political discussions in India and abroad. 

Breastfeeding stands out as the single most effective intervention to save children’s lives, improve nutrition, by reducing diarrhea, pneumonia and newborn infections. Among the growing benefits are enhanced IQ, reduction in obesity and non-communicable diseases, which include diabetes and cardiovascular problems. Yet the rate of exclusive breastfeeding among children younger than six months is a dismal 37 percent globally, which means 92 million out of 136 million babies are not able to practice WHO-recommended exclusive breastfeeding for the first six months. And these indicators have been almost stagnant for two decades, despite World Health Organization plans to increase exclusive breastfeeding by 50 percent by 2025.

Women breastfeed their babies in Cambodia. World Breastfeeding Week is from August 1 to 7. Photo by: Charles Pieters
Women breastfeed their babies in Cambodia. World Breastfeeding Week is from August 1 to 7. Photo by: Charles Pieters

According to data from a new study carried out in 51 countries by the World Breastfeeding Trends Initiative, exclusive breastfeeding rate averages about 46 percent in 15 countries and initiation of breastfeeding within one hour of birth is about 51 percent. East Asia and the Pacific has shown a decline in breastfeeding mothers from 45 percent in 2006 to 29 percent in 2012, while the baby food market is set to grow by 31 percent over the next three years.

What most people perceive about breastfeeding is that women do it anyway. However, women need to be supported with several strategies, including protection from baby food companies, support at the workplace, support at the time of delivery and accurate information about optimal feeding practices. In spite of proven benefits and repeated emphasis, there has been very slow progress in developing specific programs. Governments, donors and international aid organizations have been focused on “promotion of breastfeeding,” which means nothing or different things to different people. When it comes to funding, it is hardly there for any of the three strategies mentioned above. International funding, for example has been largely driven by food aid for therapeutic food or micronutrient supplements. This is because of market-driven policies and programs.

So where should the donor money go?

First, to protecting breastfeeding from pernicious commercial influences, which is critical. WHO’s recent report on implementation of the 1981 International Code of Marketing of Breastmilk Substitutes shows that only 37 out of 199 countries have enacted a law that fully adheres to it. Does that send any message to our aid agencies or governments? Ending all inappropriate promotion of food for infants and young children needs more attention. If you invest in this strategy and promise to deliver on this standard by 2015 in all 199 countries, the world would be much kinder to women and children. Ambitious, yes, but it can be done, and requires both courage and cash.

Next is promotion. The most common reason for women to adopt artificial feeding is perceived insufficiency of their breastmilk for the baby. Breastfeeding is not like “food in” and “food out” — it’s all controlled by two hormones. These hormones depend on sucking by the baby and the state of mind of the mother. It’s all about building her confidence to increase her milk supply. Evidence shows that increasing exclusive breastfeeding rates is possible through individual or group counseling by an adequately trained worker. This again requires technical assistance and human resources. Only seven countries out of 51 have such a provision, and the gap is too large.

Third is support. Breastfeeding can’t succeed if mother and baby are away from each other. Improving maternity benefits and encouraging breastfeeding at work must be encouraged. Yet none of the 51 countries where we studied policies could score a perfect ten in this area. Asia is no exception, as very few countries provide a six-month maternity leave. To equally support women, innovative thinking is required. Wage compensation for women in the informal sector should be a top priority — at least $2 a day. The ILO convention could be revised to include a mandatory six-month leave for all women, working at home or not.

According to a recent study, the United States could save up to $13 billion in health care costs if 90 percent of women were able to breastfeed. You get your money back along with a range of public health benefits.

Finally, it should be viewed as women’s right. Breastfeeding is a public health priority requiring social, political, legal and financial interventions. Somehow, breastfeeding, though admittedly of great benefit, is always left out when it comes to resource allocations.

All countries, donors and development agencies should allocate at least ten percent of the child budget to strategies for increasing breastfeeding. Otherwise, the global community and the world at large will fail in supporting women. To spend this fund, countries could design a minimum essential programme of services within a legal framework according to the guidelines set by WHO’s Global Strategy for Infant and Young Child Feeding, and coordinated by a high level body within the government, like in Brazil, where this policy dramatically increased the country’s breastfeeding rates.

You have the power to invest in children. The choice is yours.

This post originally appeared on Devex.


Best in show? WhyDev wants you to vote for us

In the almost three years WhyDev has existed, the 1500 comments and nearly 100 contributors to the blog demonstrates we’ve been successful in promoting discussion around topics related to aid and development.

And the accolades keep pouring in! By which we mean that last year we were runners up for an ABBA from A View From The Cave.

But that has not been our only nomination for a random blogging award. Oh yes, there’s more.

Last month we were nominated in the Best Australian Blogs 2013 Competition. We’ve been nominated for an award in the Commentary category, and we’re also up for a People’s Choice Award.

To win the People’s Choice Award, we need people to vote for us. People just like you.image

Take thirty seconds of your time to go to page five of this site and vote for us.

A vote for us is a vote of acknowledgement that our contributors are awesome. It’s a vote for sunshine and puppies. It’s a vote for Madonna to get back to the music she was making in the ’80s and away from development.

Not convinced we’re worth your vote? Let us convince you by highlighting some of our favourite posts since the last time we boasted about the quality of our posts.


How services, not “innovation,” can change lives” by Weh Yeoh

This is a challenging post that has broad implications in an environment that is increasingly searching for The Answer to End Poverty. Where does this leave service provision and the needs of people, particularly people with disabilities? Who is deciding what those needs are? Are we listening? Weh challenges us to not get distracted by shiny things and bring it back to the people.

Where are the children? Orphanage voluntourism in Ghana” by Hanna Voekl

Finally, some evidence-based research about the efficacy and effects of orphanage voluntourism! There is a lot of chatter and general misgivings about: a) orphanages in general; b) how voluntourism is a negative practice particularly in orphanages. But, these misgivings are anecdotal. Hanna’s research is not.


Making the world better does not make you better” by J.

I’m generally not a fan of opinion pieces that border on rants, but there is something about the way that J. writes and thinks that is so compelling. This piece is a great example and taps into something really important about the distinction between what aid/development workers do, and how we are more broadly as human beings.

9 development phrases we hate (and suggestions for a new lexicon)” by WhyDev Team

“MT @Vanalli: In Laos “gender mainstreaming” translated as “man & woman together in the middle of the river”. Shows how silly NGO-speak is.” WhyDev Twitter account, 10th April, 2013. As tongue in cheek as this post is (creating an entire litany of useless buzzwords simply because you don’t like the previous lot), it does highlight the importance of saying what you mean. All the time.


Stop branding aid” by Josie Stewart

I come from a communications background where a central assumption is that branding is good. Josie strongly challenges this assumption, and argues that branding aid undermines aid effectiveness.

Teaching children journalism to strengthen democracy” by Jessica Carter

Children are so much brighter and more critical than we often realise. This piece powerfully demonstrates how kids in Bangladesh involved in a youth-centred development project are reporting on and critically assessing news in their country.

Did we convince you? Then vote for us. Voting closes Tuesday, April 30.



Good intentions are enough – to ‘nearly kill’ a local kid

By Anonymous

Given the nature of today’s anonymous post, WhyDev is unable to verify the details of the story below, but we believe it is valuable to publish given the ethical questions it raises. Names and identifying details have been changed to protect the privacy of individuals.

What does ’saving‘ a child really mean? Ask 10 people and you’re liable to get 20 different answers.

Here’s a situation where this question was implicitly asked but I’ll let you decide whether or not anyone was ’saved.’ As extremely discomfiting as this situation is for me, I’m putting it out to the wider development community with hopes of starting a conversation about how we can stop similar occurrences in the future.

I am currently affiliated with an NGO that works on health systems strengthening in East Africa. Pretty standard stuff – malnutrition, maternal mortality, village outreach, and the like. Recently, the founder turned the formerly-secular NGO into an explicitly-evangelical one, and with the shift came missionaries dedicated to ‘soul harvesting’ and ‘crusading.’

But ultimately, this is a story about an 11-year-old boy, Micah (not his real name). He was found by the side of the road one evening and was brought to the nearby health centre, where one of the missionaries happened to be working. We don’t know exactly how he ended up there, though the working hypothesis was that his mother tried to poison him and left him for dead. We’d later learn that this is almost certainly not true.

Whatever string of events led Micah to the side of the road, he was in rough shape and alone at the hospital. The missionary wanted to help, made phone calls to community members, and became involved in his case.

Micah required a higher level of care, so the missionary insisted that he go to a better-run private hospital, all expenses paid by the NGO. The missionary then had the police hastily write up a note giving our organisation the right to take the child, so he went into surgery and came out with one less appendix and one additional eight-inch incision on his abdomen.

As he recuperated, the conversation shifted to what was going to happen to him after he was discharged; a group of at least six members of the organisation, along with one community member, tasked themselves with deciding Micah’s next home – with no single person responsible for the decision or for his care. Relatives were unreachable and the paucity of available information meant that no good option seemed to exist; orphanages were discussed, but shot down for not being ‘right’ and for taking too long to accept him.

And so the missionaries decided that, while they attempted to sort out proper placement, he would stay with us. They wanted to save a child. Please do not misunderstand me – all of them are extremely kind, caring people who only had the absolute best of intentions.

But, that’s exactly the point – as we all know, and as this story will show, extraordinarily good intentions can be extraordinarily dangerous.

Before continuing, it’s instructive to note a few things. First, a police report was never filed in a case of what was assumed to be attempted filicide; while we now know that it wasn’t, at the time that was the working assumption. In some areas, it would be commonplace to forego police action; here it is not. The missionaries did receive a handwritten letter giving them the authority to take the child to the private hospital, but that was the extent of police involvement. A suitable post-discharge plan was discussed but not seriously considered by the group of seven; many orphanages were available, but never truly considered as an option.

So, Micah was taken from his community into an NGO home that is teeming with foreigners and bereft of other children. He was placed in the care of people who neither share his language nor his culture. While it’s a little facetious to say that he was ’kidnapped‘ (technically, the police did give consent; whether it was theirs to give is a separate, but important, question to ask), it is fair to ask whether this was truly in his best interest or if it was appropriate to do.

If this was the end of the story, it could probably serve as the start of a good discussion on the promise and the peril of good intentions and whether these actions are ethical or advisable.

But it’s not the end of the story.

Micah arrived in the late afternoon and walked into a room full of foreigners. For the next hour or so, a member of a nearby church translated as the missionaries explained what was going on and asked a number of questions about what had happened to him. It was clear that he was extremely uncomfortable, and understandably so.

Micah became the ’house boy,’ and as no one was specifically accountable for his health and wellbeing, no one was responsible for him. None of us are able to speak more than a few words of his language, so we got by with a few hand signals. He warmed up to us, watched television, and ate.

But not in that order. By the time someone noticed how much food he was eating – including things he probably had never digested before, like burgers and chips – it was clear something was wrong with him. Micah’s a skinny kid, but he looked six months pregnant; he was eating too much and it was all staying in his now-distended stomach. With no one accountable for his care, this was allowed to slip by for far too long.

A day later, Micah was in extreme pain, so the missionaries took him to the hospital – the same one he had been discharged from days earlier. The doctor put an emergency nasogastric tube through his nose to reduce the distension; after the tube was in, the doctor said that his stomach ’deflated like a balloon.’

He later said that Micah’s stomach was dangerously near rupture, and that he was, unequivocally and without exaggeration, ’near death’ and ‘nearly killed;’ his stomach could have perforated or his abdominal distension could have put too much pressure on his lungs.

Micah spent the week writhing in discomfort, as the nasogastric tube kept him from distending. After myriad tests and consultations, the surgeon said that the valve between the stomach and intestines was not opening; this could require surgery to fix. But ’could‘ does a lot of work there – the condition could also work itself out in time.

In other words, a decision had to be made, but the medical officer of the NGO was out of the country, and we could not get a hold of him. He’s from the country but not the region, and had not been involved in Micah’s case in any meaningful way. Ultimately, the surgeon had to leave for the airport, so Micah didn’t have surgery that day.

This was a remarkable stroke of good luck, as the doctors were able to take the nasogastric tube out, and Micah began to eat. Bit by bit, his strength – and his smile – returned, and he was discharged days later, no surgery necessary.

He is back in our home once more, but this time one person is responsible for his health. I’ve had more than a few conversations with that person about the need to find him a suitable home as soon as possible, and it seems to have had an effect. I’m hoping he gets better, and finds a new home, soon.

So, uncharitably, it could be said that a NGO – with the best of intentions – took a child from a hospital and was the proximate cause of his immediate readmission and ’near death‘ experience. But even the charitable version leaves much to be desired: an outside group took ownership of a local child, failed to understand the risks of doing so, failed to take care of him, and – most importantly – failed to keep him safe.

There’s no question that his life was in a precarious situation before the missionaries intervened; he was a sick child who desperately needed help. But did he need help from his own community, or from outsiders who felt they were doing the right thing by removing him from it?

It’s possible that Micah’s community would have allowed him to overeat, or would otherwise failed to provide him the appropriate atmosphere conducive to convalescing. With a pyloric valve issue, it’s possible that, eventually, he would have returned to the hospital.

But would he have nearly died? Would major decisions about his health have been made by outsiders?

Are such situations simply unlucky or avoidable? Is this a one-time, isolated case of hubris, or is it proof positive for the broader claim that outsiders – even with the absolute best of intentions – are fated to cause more harm than good?

What if the child would have recovered as normal – how does that change conceptions of right and wrong? What if my organisation would have done a better job of taking care of Micah – then would it have been OK?

I don’t have answers to those questions, and am grappling with them myself. I only know a few things: this situation leaves me deeply uncomfortable, deeply furious, and deeply ambivalent about my tangential relationship to it, and it seems to me that no child was saved.

In this case, good intentions were enough – to nearly kill a local kid.


Where are the children? Orphanage voluntourism in Ghana

By Hanna Tabea Voelkl 

As part of her Masters research on “Children, Youth, and International Development” at Brunel University, Hanna Tabea Voelkl conducted a qualitative case study in Ghana that focused specifically on the experiences of orphanage children with international volunteer tourists. Post-studies, she consciously decided not to work in development, but rather to work hands-on where she could “make a difference” without causing potential harm — back in her own country, Germany. She currently works as a social worker in a temporary institutional home for vulnerable and traumatised children. Contact her via e-mail: hanna.voelkl89@gmail.com.

Many development workers and blogs, including this one here and here, have discussed volunteer tourism and its possible negative implications, especially on host communities. In these debates, there seems to be a consensus that good intentions are not sufficient to “do good.”

While voluntourists who visit the children in orphanages genuinely want to make a difference to the children they engage with and more broadly the local communities they visit, where are the children’s voices in these often highly emotional discussions? When I sought the answer to this question I quickly realized that the perspective of the most affected group of the local community, children, has not been considered.

Considering children’s perspectives

So, let’s consider their perspective. The words “youth participation” and “empowerment,” are based on Article 12 of the United Nations Convention on the Rights of the Child (UNCRC), and bring to mind the concept of children as active social agents.

This treaty implies that children are the hope of the future as they build up the new generations that aspire to develop themselves, and their own country. If we agree with the norms and values embodied in the UNCRC, shouldn’t children be considered the primary stakeholders of volunteer projects in orphanages, child day care centres or on the street?

Following this logic, I decided to find out whether these values operated in practice. I went to Ghana and asked children living in an orphanage used as a volunteer tourism site about their experiences. What I learned intensified my concern about the unsustainable nature of voluntourism and confirmed fears about the harm volunteers can have on children’s emotional development.

You would probably think that no matter what, children enjoy the presence of volunteers – they are after all poor orphans. Indeed, they become very excited when new volunteers arrive. Who would not be excited when knowing that sweets, stationery items for school, shoes, clothing, colouring pens, fruit, photographs and temporary playmates are on their way? Being besieged with presents and having constant entertainment through the continuous flow of volunteers sure sounds like fun… or does it?

The negative impact of voluntourism on children

The act of giving and receiving is what children associate the most with volunteers. Significantly, the children develop certain expectations and strategies to convince volunteers to give them something or take them on a trip. Sadly, this relationship reflects the widening gap between wealthy “help-givers” and “needy” beneficiaries and reduces support to individual acts of charity.

From the children’s point of view, volunteers are white, mostly young, female students who enter their lives in order to distribute things and spend time with them. From the volunteers’ perspective the children are poor, but happy due to “lotto-logic” — in life some people get lucky, some simply don’t, and their engagement with children does not contribute to them gaining an understanding of the structural causes of poverty.

In theory, the children learn about other countries through engaging with volunteers, which ultimately widens their horizons. The children develop an extremely positive image of the volunteers and the “oh-so-wonderful ‘Western world’.” Children in the orphanage frequently drew flags of the volunteers’ countries portraying nice places with good-hearted people, cars and airplanes.

Further, they developed aspirations to travel to Europe in order to learn a “proper” profession. It was great to see them dreaming big, but raised the issue of “brain drain” when I realized that their dreams involved leaving their own country. With a country’s future resting on its future generations, wouldn’t it be better if children aspired to develop their own community and country and were proud to be beautiful and intelligent Africans with the potential to do great things?

Many advocates for voluntourism argue that intercultural exchange is promoted by volunteer tourism, but is it really? My research found that it predominantly produced stereotypical, overly positive images of the Western world in the children’s minds, which ultimately expanded the gap between the home communities of the host and of the volunteer.

What remains after volunteers leave?

For the volunteers, it was an experience between school and university, a way to explore another country and to develop themselves. For them, the experience was successful and has come to an end. But what about the children they leave behind?

The comings and goings of different cohorts of voluntourists results in the children experiencing constant instability and inconsistency in their emotional care. They are also left with empty promises, as many volunteers promise to return, but the majority do not keep in contact and are soon replaced by the next cohort of volunteers.

Volunteer tourism might create opportunities for temporary social interaction, but it does not broaden the social networks of the children or make information more accessible for them. Further, it does not appear to create sustainable bridges between the two communities. And finally, it does not provide the children with the emotional care and support they need in order to develop into healthy individuals with a bright future.

As a result of the usage of their orphanage as a volunteer tourism site, the children I spoke with are spoiled but poor. Is this the best outcome for the children and is it the best way to use the energy, motivation and good intentions of volunteers?

If you want to make a difference, think again before volunteering with children abroad. An extra hand of a motivated volunteer can make all the difference right on your own doorstep at home. There are soup kitchens, vulnerable and traumatised children, homeless shelters, summer camps and much more in our “oh-so-wonderful” Western world as well.

And if you want to “head out there” without causing harm and emotional damage, you can always go backpacking.

Do you think the negative effects of voluntourism on children in orphanages outweigh the benefits?

Screen Shot 2012-08-22 at 9.16.02 AM

Teaching children journalism to strengthen democracy and development

“A boy named Rana lived in a slum with his mother. When he was two years old his father had passed away and his mother earned very little working in a wealthy man’s estate. It was just enough to keep them alive. When Rana saw that his other friends went to school he wondered if he could do the same. He asked his mother but he knew that she could not afford to send him.”

Online edition of Angikaar

These are the words of Bithi and Lelin, two Bangladeshi children from the same district – Rayer Bazar in Dhaka – as their friend Rana. This story was published in Angikaar, a school newspaper that finds its way into the hands of hundreds of Bangladeshis every two months.

Angikaar (read online here), which means ‘commitment’ in Bengali, is the product of hard work and small voices. Founded in September last year by a group of entrepreneurial young Bangladeshis, it features stories written by the children of the JAAGO Foundation’s school in Rayer Bazar.

In Bangladesh, where education is barely a right and more of a privilege, a school in the middle of a slum is a rare sight. But in Dhaka’s sprawling Rayer Bazar, where life leaks onto the muddy alleyways in techni-coloured patterns, the JAAGO school provides free education for nearly 200 students, helping children to break the cycle of poverty through learning.

Bithi, Lelin and Rana are three of the students who attend the JAAGO school. They are also budding journalists who are able to write their stories for Angikaar to share with a society that often ignores them.

On my first day helping out with Angikaar, I was greeted by the news that a fire had swept through a large portion of homes in Rayer Bazar. Surrounded by a bunch of over-excited children, I was struck by the significance of their story and the fact that this was the first I’d heard of it, despite living in a neighbouring suburb. The next day, a hundred words in Bangladesh’s English newspaper, The Daily Star, announced the fire with unsettling objectivity and little detail. For me, this moment captured the reason behind Angikaar and the potential behind sharing those children’s stories. It was an idea that resonated with the newspaper’s tagline that we would later go on to create: “Rising voices, building a better Bangladesh.”

Strengthening democracy and development

The fourth-estate role of the media is taken for granted in much of the world. Resting on the notions of free speech and democracy, it expects journalists to hold the government to account through their reporting. Although Bangladesh is a democracy, its media are hardly free or able to play a genuine watchdog role – the Bangladeshi media are ranked at 136th out of 178 countries on the Reporters Without Borders Press Freedom Index, with first being most free.

To add to the political limitations on media freedom, only slightly more than half (56%, according to UNICEF) of Bangladeshis are literate, and those who are non-literate are unlikely to have access to the electricity needed to watch a television or listen to a radio.

The result is local media that lack the resources, skills and platforms to report effectively on the many challenges faced by the nation and the people of Bangladesh – corruption, poverty, poor governance, and degrading or non-existent infrastructure, to name but a few. And when these issues do successfully make the headlines, they lack the voices and stories of everyday people.

Journalists and volunteers for the newspaper. Image credit: http://angikaar.com/home/inner-page/reporters.php

From this starting point, the benefits of giving more people the skills to tell their own stories seem obvious – more stories are told, people become better informed, voters make better decisions, accountable politicians do a better job. Of course, the reality is much messier, but this is the ideal driving a growing number of media development projects across the developing world, Angikaar included.

Empowering individuals

From my own observations over ten months of working with Angikaar, the greatest benefit was not simply that more people heard the children’s stories. Certainly, their words were read and appreciated. But, in a country of 150 million, a team of 15 student writers and 15 volunteer youth editors will need a lot more time to make their voices heard. Instead, the greatest achievement was what the children learnt about the complexity of news and the art of telling a story. In other words, it has increased their media literacy.

By increasing their exposure to different types of news sources and stories, the Angikaar team gradually became more confident in their ability to judge news and understand it. In a country where the quality of media is poor, being able to explain why and at least acknowledge that it could be better is invaluable.

In practice, this meant that the students could look at a news story and immediately ask how and why it was considered “newsworthy.” When Angikaar student journalist Siam read a story about underage marriage statistics, he decided to tell the story of a woman he knew who had been married at 15 and whose family had sold their land to pay for her dowry.

Importantly, Siam didn’t just tell her story, he finished by asking why it happened: “Why didn’t Amena receive any justice? Is it because she was poor, her family was poor, and there is no profit in helping other people?” To 12-year-old Siam, including this question for his readers was important, because he felt it was something rarely asked elsewhere – and there’s no doubt that the answer alludes to an even bigger story of injustice.

Consistency and stability

One of the key lessons I learnt was that consistency and stability are fundamental to the success of youth-centred media development projects. Whenever there was more than a week between our workshops, re-connecting with the students was difficult. Furthermore, the newspaper was bilingual – in Bangla and English – a feature which demanded that we work very frequently with students so that language issues wouldn’t become a barrier to their story.

Around the six-month mark, the Angikaar project started floundering a little. The team’s grand hope, that they would revolutionise views in Dhaka towards people from the Rayer Bazar slum, seemed impossible to attain. They’d dreamed that within a few busy months, the newspaper would create tangible change. Convincing them (and the school) that they could and should commit to a long-term vision for Angikaar was the biggest challenge faced, but ultimately it is what will make the difference between Angikaar being a short-term activity and a meaningful project.

I believe there is huge potential for the media and development fields to work hand-in-hand to strengthen civil society and communicate messages that bring about positive social change. For youth-centred media development projects to move from being introductions to media literacy, to projects with the genuine potential to produce young citizens with skills in producing media and accessing audiences, time is crucial.

It’s certainly not what anybody wants to hear as it would be much easier if a few capacity-building sessions could deliver the expertise and leave communities to create successful media projects immediately. The fruits of media development projects need patience as people acquire skills and audiences. Just like the traditional media brands needed time to forge a reputation, so do small-scale community media projects.

You can follow the Angikaar news team on Facebook here and read their online editions here.



A Rising Tide: The Invisible Grassroots “Movement” for Children in Africa

The author, with her great grandmother, in the U.S. state of Nebraska in 1977.

Growing up, my family life was not easy. My father drank and it weighed heavily on my mother, who did her best to maintain as much normalcy for me and my brothers as possible. Looking back, our home’s “culture of silence” was often the most difficult part for me to bear, more than the yelling or the financial stresses or the unpredictability of my father’s behaviour. As a child I had so many overwhelming feelings inside of me that simply had no place to go.

Since the 1990s, the crisis of millions of children infected and affected by HIV in sub-Saharan Africa became well documented. It was during this period that I traveled abroad to Zimbabwe at the age of 19, hoping to get as far away from home as possible. I then went on to become an aid worker, and it is no wonder that I was drawn to children’s programming in sub-Saharan Africa. Even though I was from middle America, from another culture and upbringing, I knew what it was to feel that loneliness, shame, burden, and vulnerability.

Both scholarly literature and policy papers told us at the time that the extended family – the traditional source of support for African children without parental care – was the primary safety net of care for children infected and affected by HIV. It was understood, at least by some observers, that most children were getting by not because of sweeping national-level policy protections or major international programs. Rather, those who survived and thrived did so because of the local efforts of people who organised their communities to keep children in school, mobilise and assist foster parents, and provide psychosocial support for children grieving or caring for ill parents.

Building on Tradition

Assistance to children and families affected by AIDS and poverty within their immediate communities builds on long-standing African traditions of community-level sharing of agricultural labour, assistance in times of drought and other calamities, and shared child care, much like the rural, farming area where I grew up. In fact, across Africa, the poorest and most vulnerable people set up indigenous, resilient, and often informal coping mechanisms such as self-help groups, church groups, burial associations, grain loan schemes, and rotating credit and loan clubs. Most of these community initiatives grow out of the concern of a few motivated individuals who work together to support vulnerable children. They spring from a sense of people’s obligation and desire to care for those in need.

I know intimately that it is this sense of obligation that can give children the care they need to become healthy and happy adults. My own family did not exist in isolation either. The proverb “it takes a village to raise a child” was no cliché, but my lived experience. Even when things were hard, I now realise how much that love, care and protection existed around me and strengthened me.

Communities ARE “Turning the Tide”

According to a 2004 survey by the University of Kwazulu-Natal, there are at least 50,000 community-based organisations (CBOs) in the South African non-profit sector alone, which contradicts the dominant image in the aid and philanthropic sectors that services are mainly provided by formal and professionally-run NGOs. In Malawi, a CBO mapping exercise identified over 1,800 CBOs focused on orphans and child protection. A Ugandan study for the Joint Learning Initiative on Children in AIDS in 2007 revealed that the prevalence of community-level initiatives for children affected by HIV was one per 1,300 people. Most were independent groups or linked to local churches, schools, or clinics. While these figures may vary in other countries, there is evidence that many CBOs are assisting children needing protection by extending emotional support and social services into areas and communities that are often not sufficiently reached by government or international agencies.

Today with the support and love of family members, friends, and trained professionals, my family has done a lot of healing and I am so grateful for it. In its ten years since its founding, REPSSI has worked with over 100 non-profit organisations and government agencies in almost 2,000 projects across southern and east Africa so that every child has this same chance. There are 5 million children and their families and communities who I know are also grateful.

REPSSI (The Regional Psychosocial Support Initiative) will be celebrating its 10th anniversary throughout Africa this year and at the XIX International AIDS Conference in Washington D.C. on July 21st.  The theme this year is “Turning the Tide Together.”  To enhance the social and emotional well-being of children in southern and eastern Africa, REPSSI develops easy-to-use and culturally appropriate capacity training, tools, and technical advice, including a distance-learning Certificate Course in Community-Based Work with Children and Youth©. An African-initiated and -led organisation, REPSSI works to place psychosocial support firmly on national and international social development agendas.

This is a cross-post here with REPSSI’s blog.


Literacy in Development: the flaws with using literacy rates to inform development policy (part 3)

Parts one and two recap: Literacy is not a universal skill gained through schooling with culture and home practices as irrelevant, especially in a minority language community. Nor is literacy an automatic catalyst for economic development. But a lot of development policy assumes so. This is a particularly complicated (but interesting) concern in China.

This week, the world’s first World Literacy Summit is being held at Oxford, and making a convincing economic argument for investment in literacy is high on the agenda. However, what may not be on is how we measure literacy and design appropriate interventions. Literacy rates are one such measurement, but do they tell us what we think they tell us?

Do literacy rates measure what we think they do?

Literacy measures often use school attendance as a proxy, i.e. they measure things like how many community members completed primary school. This is because reading and writing at a grade 6 level (for example) is seen as “being literate”. This misses what sociolinguists call “subaltern literacies”, which are those ways of engaging with text that happen outside the classroom. These often go very much under the radar because the people involved are the poorest of the poor and the most excluded. In particular, these “illiterates” are excluded from Culture with a capital “C”: they don’t glow with learning and literature and refinement. They speak dialects, they do manual work, they are adults without much education. So what these people do with text isn’t valuable to those deciding on the standards and collecting the data. In fact, schooling measurements don’t acknowledge that these Others engage with text at all.

Nevertheless, in many countries, many people like this are actually more literate than their “betters” assume. They are the “literate poor”, but if they are not visible in measurements, development policies are unlikely to be directed to them.

Schooling-centred monitoring also fails to explain the shared practices between literate and illiterate community members which determine when literacy skills will be made available to others. Such monitoring is therefore deficient as a basis for designing programs to harness literacy’s instrumentality, because the data doesn’t clearly reveal all those for whom literacy is an instrument. And such monitoring fails to tap into home and community practices and attitudes which might stymie children’s acquisition of schooled literacy: does everyone completing primary school have the same literacy? And why are some communities’ children less likely than others to even get to that point?

How can you maximise the use of literacy for development if you don’t actually understand how it is used by people together?

There is discussion amongst scholars – some of whom are also practitioners – about how improving the understanding and measuring of literacy could improve economists’ policies for development. It’s an interesting strand within broader debates about the quantification of development. (I know many whydev readers have an interest in those debates; please share your thoughts below.)

Here’s the difficulty: how can we get the quantitative data development agencies want if we accept that we have to start looking outside the neat boundaries of formal schooling to harness important literacy practices? Bryan Maddox, of the University of East Anglia, suggests moving to a statistical methodology using a transparent, multiple thresholds in a “set of valued literacy functionings”, which would  index the varied literacies in a person’s life to his or her development.  This thresholds approach sits more comfortably with Sen’s influential Capabilities Approach to development, which

“argues that illiteracy is a ‘focal feature’ of capability deprivation and human insecurity. Illiteracy is viewed as a pervasive feature of capability deprivation and inequality, and literacy (particularly women’s literacy) as a source of agency, autonomy and socio-economic mobility” (Bryan Maddox and Lucio Esposito)

That is, it provides a more nuanced measure of the range of deprivation but also agency one person can have in different parts of their life.

However, for the moment, the bulk of monitoring still treads lead-footed through governments’ literacy/illiteracy rates, themselves built upon the outdated ideas of autonomous skills and school attendance. One example of this is UNESCO’s monitoring of whether we reach the Millennium Development Goal of halving adult illiteracy by 2015. This happens because evaluating situated literacy is more complicated, but this approach loses a lot by prioritising simplicity.

Literacy t-shirt
And does anyone care if your parent can?

Anna Robinson-Pant, also of the University of East Anglia, suggests this approach to monitoring leads to perceptions that literacy and schooling are the same, and therefore that adult literacy should be about acquiring the formal literacy missed through lack of childhood school opportunities, without giving weight to many other important literacy practices in adults’ lives. She suggests this results in smaller development grants for adult literacy programs. To me, that brings home a problematic, real-world outcome of the datedness of the literacy thinking which informs development policy.

More nuanced views on literacy, and more nuanced data, require effort.  Monitoring methodology can be seen as the dull, back-office side of development work. But the room for methodological improvement is real, just as real as the changes such improvements could precipitate in the world beyond the stats.

Education still a long way off for children with disabilities in poverty

It’s a great idea for a movie. A political drama. George Clooney or Matt Damon as male lead, and there’s a young, feisty, female journalist who gets caught up in it all. The opening scene spans a meeting room high up in skyscraper land, with a marble round table, iced water jugs and leaders of a big global development Bank.

Disability is not the only battle for kids like this. © 2011 CBM Australia, Photo: Christoph Ziegenhardt.

“Gentlemen, you should be proud,” says the silver fox, “This policy forges the path to education for the poorest of the poor.”

Clapping and shaking hands all around.

Cut to the brilliant green and brown of a remote village high up in Indonesia’s mountains. Children, gorgeous and laughing, walk kilometers of terrain to a tiny, one-teacher school. The camera pans back to the village, where a little girl stares wistfully after them. The shot widens to show that she has clubfoot; her feet twisted inwards. As opening credits scroll on, we know there is no way she could walk to school…

I haven’t worked out the complete script yet, but there are plenty of true stories to draw from. One billion people in the world have disabilities, and around 80% of them live in developing countries like Indonesia. In fact, in the world’s poorest places over one in five people have disabilities.  These people live with much more than just physical or mental impairments. As my “little Indonesian girl” character would portray, people with disabilities experience huge barriers in participating in education, employment and community life.

Barriers exist for people with disabilities in all societies, but are steepest in poorer communities where access to these activities is often limited anyway. A child born with clubfoot in Australia will generally get treatment at birth to straighten and strengthen her legs, and still go to school, socialise and work with her peers. The little Indonesian girl, however, presents the reality in many developing countries.

In these places, children born with clubfoot will never receive treatment for this. Walking, if possible, will always be painful, and she could never travel far. In many communities her impairment would also be seen as a curse. She would likely face a lifetime of stigma and exclusion from her community, who assume that because she has a disability, she has no potential.

If there was a movie, this little girl’s story would show us how poverty and disability create a vicious cycle: being poor generally limits access to health care, good nutrition and safe conditions – which increases the likelihood of acquiring a disability.  And having a disability generally limits access to education, employment and community – which increases the likelihood of being trapped in poverty.

Clearly this movie is a drama. It’s a dramatic fact that children with disabilities make up one-third of all children in developing countries who should be in school but are not. What isn’t so clear is how this dire situation can be developed into a Hollywood ending.

Cue for us to cut to the silver fox in the skyscraper.

Some of the big players in development are coming to recognise that people with disabilities are extremely vulnerable and excluded from their projects. How this recognition gets the little girl with clubfoot to school is more complicated. RESULTS International (Australia) recently released a report examining how the World Bank, Asian Development Bank and AusAID include girls and children with disabilities in education programs they fund in Papua New Guinea, Indonesia and the Philippines. The report finds that while all three agencies consider disability in their high-level development policies, “on the ground” many children with disabilities are still not getting to school.  Some progress has been made—particularly by AusAID–but children with disabilities continue to be profoundly excluded from education. And so the scene is set for the tale of the silver fox and the little village girl.

To be honest, I don’t think I’d like the movie. It would have a twee love plot and some expendable character I fancied would die. Then there would be the inevitable contrast between the skyscraper and village, reinforcing unhelpful paradigms of “us” and “them”, “benefactor” and “beneficiary”, “problem” and “solution”.

But I would still probably go to see it. Because when millions of the world’s children are facing such extreme discrimination and exclusion, you need to take what you can to get the message out there.

Which is why I’m asking you to think about this: Would you have gone to see the film? Would you get teary at the injustice that the little girl endures? Would you spend the trip home ranting about the laudable development banks writing toothless policies from their air-conditioned skyscrapers? Would you Google some combination of “disability poverty Indonesia education” when procrastinating at work the next day?

Or, even if you think the movie sounds like the worst thing since the Titanic, are you horrified by the fact that 70% of children with disabilities in Indonesia do not go to school?

If so, don’t let this storyline just be an overlooked opportunity for Matt Damon to get an Oscar. Movie or not, there are still millions of children in the world being denied their rights because they have a disability. So get teary, rant, Google, find out more about ending the cycle of poverty and disability.

Their stories may not make it to the big screen, but these children still deserve the chance to write their own happy ending.


This article first appeared in the Angry Cripple column of The Punch.

To find out more about the cycle of poverty and disability and what you can do about this, visit End the Cycle.


Disability in China and Australia: hardly worlds apart.

Preface: TADNSW is an Australian charity providing personalised equipment, modified bikes, refurbished computers and advice to children and adults with disabilities and their carers. I am a former employee of TADNSW who now works as a rehabilitation advisor with Handicap International, a Belgian- based international NGO that focuses on supporting people with disabilities who are living in poverty. My views in no way reflect those of my employers, past or present.


I have to admit that when I left TADNSW to work with Handicap International in China, it was with a mixture of excitement and trepidation. Sure, we faced difficulties working in the disabilities sector back home all the time, but here I was going to a country that I had no experience working in, with language skills that I would rate as barely passable, and in a disabilities sector that I was very unfamiliar with.

Apart from studying a Masters in International Development, I worked for 3 years with TADNSW as a physiotherapist alongside the current physio, Brendan Worne. Here in China, my role is similar, but instead of concentrating on the provision of assistive devices to people with disabilities, my input is more on the systems that Handicap International is helping the Chinese government to build and strengthen.

You might think that working in Sydney, Australia, and Guangxi, Southern China, are so far away from each other that it’s almost like being on a different planet. That is true in many (important!) respects. Good coffee in Guangxi is extraordinarily hard to find, and you don’t need to take out a small business loan every time you want to buy a bunch of bananas (they cost about Aussie 60c a kilo here).

But even though I am regularly stared at for my outlandish height (which, at 6 foot, is nothing to write home about by Australian standards), there are many similarities between the disability sectors here and back home. The same underlying problems that we face in Australia are here, often just amplified.

At the base of many of the issues that people with disabilities face in Australia is a lack of dignity. There is no dignity in living a life that doesn’t allow full participation in society, that involves sitting on the sideline and observing play as it carries on. As many people would know, this can involve not having the correct pieces of equipment to enable the people with disabilities to participate. Often the gap between what is needed and what is available in the market place is huge, which is a good justification for TADNSW’s existence.

TADNSW - helping through innovation.

Assistive devices is a big buzz phrase here in Guangxi as well, although the rationale and logic is a little different. While we spent much time trying to keep the cost of equipment down in Australia, to make it affordable for everyone, equipment that is provided here is very much given value according to the price tag. In other words, low cost assistive devices are always going to run second rate to expensive, complex and often unsuitable devices. As such, the common practice is to ignore low cost assistive devices that would provide the children with much benefit, in favour of stuff that is factory made and expensive.

Financial support is another area that is highly topical in the disability world, with the National Disability Insurance Scheme (NDIS) hopefully being a step forward in the right direction. Just as you see very few rich families with children with disabilities in NSW, poverty only amplifies the problems associated with disability in China. In my first week here, a visiting professor from Beijing said something that really struck a chord with me. He worked in the agriculture sector and had visited Australia before. He said that in Australia, the cities are less developed than those in China, with less infrastructure. Those who regularly complain about Sydney’s public transport would be interested to know that using Beijing’s subway is a dream by comparison, and riding bicycles in most Chinese cities is almost always a safer, and more enjoyable experience. Yet, in the countryside, the gap between Australian and China is enormous. As tough as farmers are doing it in Australia, they face nowhere near the amount of poverty that rural China faces.

As a result, children with disabilities do not often have access to education in rural areas. The closest school that is able to take them may be too far away, and their parents do not have the ability, time or money to get the children out there. Compounding this is often a lack of funding for equipment and rehabilitation that will assist the child to maximise his or her potential, so that being able to get into the classroom and participate is just a distant dream.

Without access to education and participation, the cycle of poverty continues, with the barriers that exist to prevent children with disabilities getting involved only exacerbating it.

Handicap International - giving children with disabilities the chance to participate fully.

In Guangxi, China, Handicap International works at various levels to promote the independence and participation of children with disabilities. We work not only to support inclusive education, but to get back to what the true definition of disability is – the barriers that society builds. For example, are there physical barriers in the environment that need to be addressed? Are there attitudinal barriers amongst the child’s peers or teacher? Is the child able to receive rehabilitation to improve his or her abilities, and can assistive devices help to overcome any of these barriers?

At the very heart of all these problems is the level of poverty in rural parts of Southern China. Just as lack of financial support is a huge problem here, the very same problem amplifies disability in Australia. Which makes me often think that the two settings are not as far apart from each other as you would initially guess.


You can follow this author on Twitter here.

If you were President of Ghana…

“Ghana has finally discovered oil. Discuss ways that you will use the oil revenue to develop the country if you were President of Ghana”

CitiFM, a radio station in Ghana, is asking children to address this hypothetical in its annual ‘Write Away’ contest. Extraction of Ghana’s oil reserves, estimated to reach 5 billion barrels in five years, began in December 2010 by Tullow Oil PLC. This company single-handedly propelled Ghana’s Stock Exchange to the 3rd-largest on the continent when it went public on 27th July this year. This is an incredible opportunity for the future of Ghana’s environmental, economic and human development.

Do children hold the key?

There are a number of aspects of this competition that are appealing. The prizes should encourage participation, if nothing else – a one week educational trip to one of three destinations, including South Africa, Namibia or London. It is also a great opportunity to foster children’s creativity, writing and critical thinking skills. Early childhood development is a challenge for many Low- and Middle-Income Countries. A healthy, caring and educative first 6 years are pivotal in shaping a child’s long-term well being. A 2011 World Bank report from China found that:

“Prenatal care and the quality of life experienced in the early years from birth to the first six years affect physical and brain development of children, and lay the foundation for cognitive and socio-emotional development in subsequent stages of their lives. Investing in early childhood development and education yields high economic returns, is the most cost-effective strategy to break the inter-generational transmission of poverty, and improves productivity and social cohesion in the long run”

The findings from China reinforce those found in studies from the U.S, Kenya, Jamaica, India & Peru. There are long-term economic and well being payoffs for children, communities and countries. This competition also highlights another key aspect of current thinking of development: democracy. It fosters a sense of inclusive democracy. Sure, their answers will not affect high-level policy decisions. Some children will let their imaginations run wild (as they should) and probably include a fund for attracting top quality footballers currently playing in Europe. However, getting children to think about their future, and the future of their country, is powerful a starting point for fostering long-term democratic participation, citizenship and critical thinking. Children need to, and can, be challenged with such questions.

And I’m sure their answers will surprise us in their clarity and sensibleness.


Postscript 16th August 2011

Researchers at the Center for Global Development (CGD) argue that the Ugandan government should distribute expected oil revenue to citizens through direct cash transfers and tax the stipend. See the full story here.

And, wouldn’t you know it, Todd Moss and Lauren Young of the CGD have also argued for direct cash distribution of oil revenue in Ghana. See the report here.