Aid frustrations: A Doctor's View Into Humanitarian Aid

Guest Poster: J Chan. She captures quite nicely the frustrations of development work:

I'm back in Mozambique again, now in the 2nd largest city in the country- Beira. It's nice to be back in Mozambique and the 30hr plane rides are getting more monotonous. I hope to spend a little bit more time checking out the towns along the way while I'm working.

I'm here for the 2nd phase of another project. We were able to get the lay of the land of the flood situation back in May and now we are back to perform a more rigorous assessment of the water and sanitation activities in the resettlement camps (like refugee camps in some ways) by the Zambezi River. We will try to link this information with the risk for cholera outbreaks to help the project guide their future programming in the region.

Consulting for a large international NGO such xxx has been rewarding this year, but also a bit frustrating because it has provided the window to much of the disorganization in the humanitarian world. The interplay between government interests, NGOs strapped by funders as well as their own disorganization and at times lack of skills, create a challenging atmosphere for providing services to communities such as those affected by the floods in Mozambique. Services are being provided to some degree, but not often in a timely manner and often without the greatest leadership.

This work is so different from working in the ER in Boston, where flow, efficiency, and quick, accurate decision-making are the keys to making a shift work well. Accountability is also another element of providing medical care in the ED (as with most of medicine in the US), but now being an attending physician I feel that and see that in a whole new light.

In this post emergency phase in Mozambique I wonder who is responsible and even accountable for the fact that many people still are living without homes, little sustainable water and from what we know so far still living in high risk areas of poor sanitation. Is it the NGOs who are in the field, some of whom lack leadership to make decisions and provide water sources, or is it the local government who lack human capacity and support that they themselves don't provide services either... But in the end the communities who live by the Zambezi river are returning to their lives with or without the help of govt and aid workers--as they do this every few years when the Zambezi rivers flood.... It the resilience of these communities and the savvy coping mechanisms they create to withstand these multiple shocks that are most powerful in my mind..

Its a great balance to have both types of work (ER and Humanitarian work) fill my days, and I can't complain at all for these opportunities.