Re-inventing the wheel

While academics work away, producing carefully crafted and thoroughly and systematically researched papers on current development issues, this work is failing to inform the practise of many NGOs and development projects. Overstretched and understaffed, many NGOs can be seen to operate reactively to challenges, rather than actively anticipating those challenges and taking preventative measures. However, even these reactive measures could be made more effective by drawing on the wealth of best practise knowledge available. By failing to systematically and regularly consult the advice, tools and support available, NGOs find themselves continually attacking time old, and arising issues from scratch. 

I found this broken sculpture in the office. I think of it as an apt visual representation of two NGOs doing exactly the same thing, failing to collaborate, and not even having the head to notice.

It is hard to identify the exact point of disconnect. Certainly, much academic work is inaccessible to implementers organisations. This can be literally so, when access requires expensive subscriptions to academic journals and portals. Time constraints and the need for clear,concise and to the point recommendations can also rule out the helpfullness of longer, more theoretical papers. Where to begin looking for information on a particular topic is a mindfield in iteself. Clusters of small, ill coordinated and patchily informed fora and "platforms" have mushroomed up to encourage information sharing and collaboration. However, in duplicating one another they run the risk of becoming part of the problem, rather than the solution. 

A quick google search identfied a Ugandan CSO forum here  http://www.civilsocietyforum.org/about-portal which offers a more inclusive directory of CSOs according to thematic areas. However, the listing itself is neither exhaustive nor particularly informative. Some clarity on what a Civil Society Organisation actually is might also help matters, and work to exclude currently included international NGOs (INGOs) like ActionAid (which work with CSOS rather than being one), from the list. Hello uganda fare better in providing contact numbers and a more comprehensive listing service http://hellouganda.com/listing/index.php?id=3 but have no provision for searching under thematic areas. As a source of best practise and recent information, Eldis http://www.eldis.org/ is a pretty good bet, allowing searches by country and by thematic area. However, the search tools are basic, and can't take one into specifics beyond a broad area such as '"health" or "HIV &AIDS." There is no provision for, example, specifically searching for information on the use of SMS technology among community health workers in HIV and AIDS. You just have to scroll through the recently added articles list to see if anything comes up.

There doesn't seem to be a one stop shop for NGOs or DPs seeking development  information  and technical case studies and info that could be used to inform their own current and future practise. It is not just  labyrinthine sources of information that foster this situation of  stubborn ignorence . NGOs themselves lack a culture of consultation and exchange with others. True collaboration often excludes the competitive and is therefore unpopular among NGOs who are continually fighting to maintain a competitive edge. In the quest for income, the business of development can be an unpleasant one. What is perhaps most frustrating is that while weak businesses are weeded out by market forces, NGOs are immune to these. Lack of vigorous monitoring and evaluation of real project impact, rather than just outputs, and weak accountability requirements that are directed towards donors, rather than those they claim to serve, can lead to a proliferation of ineffective organisations that continue unchallenged.

Fortunately, relevant research does trickle down into organisations which dont have a budget for a research team, or which have a budget for an eneffective research team. This tends to come through the working groups that have been established around particular areas like HIV&AIDS and in whose meetings really valuable information and research based changes in policy changes  is disseminated and shared. For those operating on the fringes of these networks howwever, or those that have no internal process for consulting, or responding to information shared, re-inventing the wheel is commonplace.

The house on the hill / LGBT in the house!

Saturday was moving day. Had a lie in, a leisurely breakfast, and some time to reflect on the news Brooke had told me the former evening; that she had been offered a job with  another agency, to do the research project I was developing with NACWOLA, but for Marie Stopes. (MSU) So, while I had been away on the field trip, discussing the research ideas that we had presented on the last day of the workshop (to do a situational analysis of the use of community health workers in Uganda, to identify opportunities for collaboration and strengthening of community systems), this agency had been thinking along similar lines. What baffled me was the apparent decison to duplicate this research without officially informing, or discussing this with the NACWOLA team. This was a confusion shared by Brooke. I was unsure whether to take my exclusion from this advancement and the possibility of funding to do the research as a personal slight, as a symptom of some kind of NGO rivalry, as a result of having so clearly aligned myself with NACWOLA through the course of the workshop. I hoped it was the latter.

Talking about the isse later, the CD agreed it made sense to collaborate, but I was unsure of how this collaboration would work if one party were getting paid to do it as a full time job, while the other was doing it on a voluntary basis, and alongside  other projects. I had already considered concedeing defeat and handing over my purpose for being in Ugandas to Brooke, as she had already secured the fubnding to do what I had planned to do. I felt pretty disheartened and confused by the conversation.  However, it later transpired of course, that I had put 2 and 2 together and gotten 20, envisioning that both research projects would evaluate the system nationally. In reality the respective projects, for NACWOLA and for MSU would be a first step towards this, by evaluating each NGO system respectively. Possibilities for collaboration and further research would perhaps arise after this first step. I had lept from stage 1 to stage 10 in my thinking, and so got my wires crossed unecessarily.

We packed up and at around 4, the country director of Marie Stopes came and picked us up. We have the good luck of being able to live there for the next 6 weeks or so as house sitters and dog feeders. On top of this, the CD was good enough to pick us up in the car, and to swing by the supermarket on the way home.  The supermarket was full of local produce that was impossible to find in Ghana and most of West africa-there was fresh milk, cheese, flavoured and plain yoghurt and west nile honey. The vegetables were good, varied and cheap.  The highly inflated costs of imported food like pasta and rice that I was used from Ghana (where you paid at least double what you would in the UK) were non existent here. There was even dairy milk chocolate! I got quite excited that I wasnt going to be reduced to a diet of beans and matooke on my shoestring budget. Brooke and I stocked up and clambered back into the car which chuffed around and up the very steep hill to the house. 

Cranking open the gate we were met by Bobo and daisy, the two guard dogs, who were clearly interested but unsure of us at first. As the CD had described, Bobo is a big baby who jumps at you and wants his tummy rubbed whereas Daisy is smarter but with yellow eyes and with a flash of wolf in her that snarls from time to time. They had a good sniff as we unpacked warily.We met the friendly guy who looks after the compound and does the gardening etc. He was pleasant, but for a marked body odour issue. The house was beautiful-like a bug Scandinavian summer house, but decked with rich teak floors; a veritable colonial palace. Brooke and I had a room each, and adjacent bathroom. Living here would be far from slumming it. and we were both delighted. We deposited our bags, the CD shackled the dogs up to their leads, and with one in each sturdy hand led the way for a walk around the hill.

Canine tryptich, part 1: tension mounts

 

Part 2: Bobo attempts to mount, tension is released

Part 3: all is calm

The path was rough, and the slope from the house down onto it even more precarious, the loose stones on the surface sliding underfoot like on a spree slope. We picked our way down gingerly, relieved that we weren’t the ones holding the dogs. The view was, like from the house, utterly brilliant, and as we walked round we could trace the humped backs of the surrounding hills gently undulating on the leafy horizon. The area was beautiful, serenely quiet, but pretty far from town; the Kampala equivalent of Chislehurst.  Transport, particularly at night, was going to be an issue.

We arrived home a bit sticky. Brooke and I set about making pesto and pasta, with fresh basil from the garden while the CD packed. Over dinner we discussed the logistics of the house, how to deal with inevitable water and power cuts, the location of the key, noisy neighbours, organisational politics and the trials and tribulations of being an expat. Later we headed out to a party I had been invited to nearby, arriving to find the LGBT community letting loose in the safety of the compound belonging to the self names "fag-hag of Kampala." A dapper guy in a tilted flat cap started a conversation with me about vaginal douching while his friend in a skin-tight wastecoat, flared jeans and stacked mules, puffed out his chest and danced /pranced circles around himself to lady gaga. He had been bold enough to leave the house dressed like that despite the homophobia here that recently made the headlines due to Uganda's proposed anti-homosexuality bill. If passed this would have criminalised homosexuality and made it punishable by death. Read more about it here: http://www.gayrightsuganda.org/ The guy finished the conversation with a "toodleoo, must dash dahling..."  , and accompanied jazz hands. Rather than asking for each others numbers (so last year), the question was always "what's your facebook?" Fabulous people, fantastic party.

Field trip to Iganga. Part 3: the reflective return.

The country director invited us for a late lunch; a kind offer that was much appreciated by all. Arriving at a restaurant we agreed after some time to each order a plate of chicken stew with the standard collection of carbohydrates. We made polite conversation until the food came: plain boiled chicken, plain boiled rice, plain boiled sweet potato and matooke (a type of savoury banana/plantain that is steamed for hours in leaves). As I have discovered, Ugandan food is often a neutral palette of cream, beige, mustard yellow and off white, occasionally brightened by a splash of miscellaneous "greens", and tomato. Flavours are equally neutral, with Ugandans tending to eschew any use of spices and seasoning beyond salt, in favour of  unadulterated blandness. The waiter brought us each a small bowl of salty vegetable broth of the type my great grand mother used to prepare. "Is this chicken stew?" I asked, wanting to know so I could avoid ordering it again. The driver laughed, and said she was happy because she didn't like stew anyway-too spicy. The CD was back to business of one of his three mobile phones (It is not uncommon to have multiple phones here, with a sim for a different network in each phone to reduce call charges) . We finished up and travelled to the district health office to try and gather some more information on infection rates in the area.

I asked the CD if the information was collected centrally by a demographic health survey (DHS) and accessible from Kampala. He explained that invariably one would be passed from office to office on a wild goose chase and that the breakdown per district would not be available. He noted that the last DHS had been conducted in 2005, and at last I understood his eagerness to get at least an idea of what the current infection rate stood at. As the others disappeared into an office to hunt for numbers, I stayed outside, and introduced myself to the team from JSI who had just pulled up. JSI are NACWOLAs donors on the STAR EC project-strengthening HIV&AIDS and TB response in central/eastern Uganda. JSI themselves received funding from USAID and then subcontracted the actual implementation to local partners like NACWOLA. Ideally NACWOLA should be able to attract large grants directly, but they currently lack the M&E systems and management capacity to make this happen. I introduced the possibility of working with NACWOLA to develop an M&E strategy, and the specialist from JSI said he would be glad to offer technical assistance to the process.

I relaxed a few moments on the step, in the sun, before the others emerged and we set of back to Kampala at around 4.30pm. We tucked into the bananas given to us by the psychosocial support group leader. Irene made the (subconscious) connection between our visit and that of politicians, saying that when she travelled as a journalist on a political campaign, villagers would present far more than they could possibly afford to politicians in the hope of increased support. The politicians would return to Kampala with goats, chickens and great sacks of maize, only to deliver nothing. We all agreed that a bunch of bananas was probably acceptable, but that when people offered more, clever ways of turning the offer down without out rightly refusing needed to be exercised. Suggestions for such excuses included being unable to strap the goat to a bicycle that you intend to travel part of the way home on. 

We passed the time in the traffic home, discussing the universal challenge of encouraging men to access health care services in general, and not just for HIV&AIDS. Irene spoke of how you could treat woman for a sexually transmitted infected but that unless her male partner was treated too, she would repeatedly reinfect herself and return for services indefinitely.  We identified the need to reach out to more men, and to target men more with sensitisation. We discussed the big cultural ceremonies at which community sensitisation, for men in particular, could be conducted. Irene talked of the male circumsision season in western uganda, where almost everyday you could see small boys getting their foreskins "chopped"  in full view of the audience gathered. Sensitisation and HIV education activities had at least already increased the use of a fresh blade for each boys procedure. We spoke of the silent HIV epidemic in Iganga, and the practises among most at risk populations, including plantation workers, long distance drivers, sex workers, men who have sex with men.

We talked about the problems of polygamy for HIV prevention, and how the taboo nature of talking about sex that makes discussion of HIV&AIDS transmission& prevention and family planning an extra sensitive issue. We talked about the possibility of streamlining family planning into the information and support  provided by community support agents.  We talked of better partnerships between organisations working with community health workers and village health teams, and the serious need to identify opportunities for collaboration, to reduce overlap, and to fill in gaps. Irene and I discussed that I  (NACWOLA) and possiibly Marie Stopes could at least look at the other organisations and government involved in Iganga district. We saw a great need for these organisations to partner up, to try and streamline activities and resources, and to provide better, fully co-ordinated outreach services to the poor. A national strategy for the use of community health workers loomed as a gaping gap that we began discussing how best to fill. 

We dropped the CD at home with a big thankyou and a vigorous wave. It was brilliant that he had come, and that he was genuinely interested in engaging more with the realities of what was going on at the community level. His interest and genuine offer of support will no doubt be of great help to NACWOLA in the coming months. As we wound up and down and across the hills of Kampala, to the other side of  town, the dusk quickly tuurned to darkness. Each black mound was sporadically illuminated with the warm glow of houses and the snaking lights of heavy traffic. The driver dropped us at the hotel, Irene drove home, and I settled happily onto the veranda of the hotel with Brooke, the fellow anthropologist, and a beer.