Diarrhoea

I felt you coming

I thought you were a mere fart

You were so much more

DSC07474.jpg

(Heiku describing a shared experience. By an Anonymous Visitor)

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The Day I Fired a Poor Man

(Name, location, age, job title and gender may have been changed to protect identity)

“Your contract finishes in a month. I’m really sorry, but we’re not going to renew it. We’ll pay for your transport and your belongings to be relocated back home from the health center…”

He cried, right in front of me, head in hands on a blue plastic chair in our office. We sat in silence for what seemed like forever. I tried to say something to console him, but it was meaningless.

Opwonya, a health center cleaner worked for us for 4 years, and held the only steady source of income for his family of 5 children. 60 US dollars a month may seem like a pittance, but in Northern Uganda that’s enough to feed your family, and send all of your kids to the primary school at least. Steady jobs for unqualified people aren’t just rare here, they are a precious lifeline.

I can defend myself until the cows come home. Opwonya’s work ethic was poor. He didn’t up to work for days on end without telling anyone. We talked to him, sent warning letters. Less patients were coming to the health center as malaria levels plummeted, which meant not enough work for our staff, and less money coming in to the health center. The health center was functioning well, but was nearly out of money to pay staff. We we had to reduce staffing, just to keep the place above water. The local management agreed that he should go. My job is to provide sustainable, quality healthcare to rural citizens, and this was a hard but necessary decision.

But justification doesn’t make me feel better. The chances of him getting another job are close to zero. His kids may now sit at home and not go to school. His life will be full of new stress and problems.

Its not the first time I’ve made decision like this, and it won’t be the last. When you work with limited resources, trying to make a dent in seemingly bottomless poverty, situations like this will continue to arise. Juggling sentiment with practicality is an ongoing struggle, and with limited resources practicality usually wins. Is it fair that Opwonya lost his job just because he wasn’t a good worker? Perhaps. Is it fair that his life will now be an uphill struggle? No. If he had lost this job in New Zealand, the safety net would have kicked in, and at least provided enough for his family to live on. His kids could still go to school.

I may or may not have done the right thing. Regardless, it hurts. I consider my easy life, and overwhelming privilege. I ask for forgiveness.

Busy Day at Wii Anaka.JPG

 

 

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My African friends who agree with Trump

Call me old fashioned, but due to the sheer quantity of swearing required, from henceforth ‘shit’ shall be written as $#%

Straight after the famous $#%@hole comment, the internet flooded with response, my facebook wall included. Many nice, thoughtful responses were from Americans who apologised for their President. Of course the mega-rich, corrupt African leaders came out immediately, up in arms that Trump had said such a thing. How could he?

Response

A significant number of Africans however, agreed with Trump’s assessment. At least on some level. And its not just on facebook. Some of my friends here in Northern Uganda found his comment refreshing. One friend laughed when they heard it, and expressed that Trump was ‘very accurate, politicians don’t usually talk like that’.

Patrick Reacher

Patrick and Jairus are not just well educated, but are top young leaders in Liberia and Uganda. I got to know Patrick at a conference in Demnark, and I’ve never met anyone so passionate about changing women’s lives by improving access to family planning. Their responses are well thought through and fantastic.

Jairus

By agreeing with Trump they don’t think the Physical country, is $#%@hole, or that the regular people are $#%@hole. That’s obviously not true. Jairus and Patrick love the land, and the people of Liberia and Uganda. They are devoting their lives to improving it. They just realise that their ‘nation states’ and their institutions, are indeed $#%@hole. Many Westerners, especially in the mainstream news talk about countries like Uganda as if  they have governments and institutions that are trying do the right thing, but just have a lot of work to do. They are wrong. This is what I mean from a Ugandan perspective.

– The policeforce is so corrupt and evil they are probably worse than useless, it would probably be better if they weren’t there.
– In rural areas, when you complete primary school you still can’t speak English, the language you have apparently been taught in for the last 5 years.
– Your government health centers don’t have drugs half the time because of corrupt leaders and zero accountability.
– Even if you struggle through the system and get educated, jobs are hard to get. I had 80 people with university degrees apply for my assistant’s job 3 years ago which at the time was paid 200USD a month. That’s right, 200 a month.

I agree with Jairus and Patrick. That’s $#%@ hole. Its good to recognize the plain truth. If we get out of our privileged ivory towers and recognize just how messed up these nation states and their institutions are, we’d understand why Trump’s comments resonate with a surprising number of people here. And this will continue while Western Governments continue to prop up these nation states and institutions, and fund the militaries of countries like Uganda, all the while turning a blind eye to the violence, corruption and inequality inherent in the institutions they support .

There is huge irony that the US government, the institution which Trump himself heads is one of the most guilty parties in funding these evil governments and perpetuating the problem. He’s a little bit guilty himself for the whole $#%@hole situation.

 

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Blame the NGO, not Ed Sheeran

The Radiator Awards highlight the best and worst aid fundraising videos of the year. Yes, this blog is about the worst: the winner of the ‘Rusty Radiator.’ Comic Relief (an NGO) fronted by Ed Sheeran won the prize, and the judges quite rightly shredded them for their video.

I blame Comic Relief. They had Ed Sheeran, a megastar and they butchered it. I only like Ed Sheeran more after this video – the guy has heart. They take him to where homeless kids are sleeping in boats, and you can see him trying to deal with the horrible situation “I can’t process this… My natural instinct is to put them in the car, and just take them. Put them in a hotel until we can get them sorted… Can we do that?” When you’re a rich western pop star with no background in aid or NGO work, what are you supposed to do? Sit back objectively and comment on the socio-political situation? Start a project for homeless kids in Liberia? No, you care for the person in front of you.

That’s a great instinct. To love your neighbour, the neighbour in front of you, and do it now. Unfortunately his practical approach was a bad idea – to put the homeless kids in a hotel and figure it out from there, and I facepalm every time someone says “Doesn’t matter how much it costs” (it always matters). But he was trying to do what any decent, loving human being should do when thrust in that kind of situation with no context. Thumbs up Ed Sheeran. Maybe I should listen to his songs sometime.

Despite that, I think we should be deeply disturbed that these kinds of videos still exist, and I balk at the response of these large agencies, which was not to apologise but to dodge and justify. That’s what NGOs do best. Ed Sheeran on the 1 in a million chance you read this, ditch those big NGOs and come help us fundraise for our clinics. We’ll make a video that will win the Golden, not the Rusty Radiator.

P.S. If you haven’t seen it already, watch the original ‘radiad’  video ‘giving back’ to Norway. Hilarious. Also watch an amazing wee clip from Warchild Holland, the winner of the Golden Radiator award

 

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Dad and Uganda in The Press

Recently my parents had their second magical visit to Uganda. Mum taught kids full time, bringing amazing resources and reinvigorating our class. Dad got to know the locals, and wrote this unorthodox, yet insightful article which got published!

https://www.stuff.co.nz/travel/destinations/africa/96459900/north-uganda-the-destination-or-the-journey

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I’m a Doctor – give me a house, a car and 3 maids.

All Doctors in the Ugandan Public sector laid down their stethoscopes a week ago, and there is no end in sight. Their demands are off the charts.

“A senior consultant doctor or professor will be the highest paid health worker, with a gross salary of Shs 48 million, a five-bedroom house, 4000cc vehicle and three domestic workers.”

This seems insane. They are asking for 12x their current pay, and a whole lot of other perks. To locals here though, it makes some sense, and with just a bit of digging we get a great insight into 3 major issues. Inequality, cultural expectations and the ridiculous political situation in Uganda.


Inequality

Poverty is bad – inequality might be even worse. First the inequality between rich countries like New Zealand and Uganda. New Zealand’s GDP is over 60 times that of Uganda. Senior New Zealand doctors earn more than 10 times their Ugandan colleagues. Unfair right! Yes…… but not as unfair as the situation within Uganda itself.

Earning 1000 US dollars a month, senior Doctors in Uganda already earn 20 times more than the average Ugandan. In New Zealand, Senior doctors only earn 3 times the average person, which I think is brilliant. Senior Ugandan doctors are demanding a 1200% salary increase. $12,000 a month. $150,000 a year. Yes that’s right, they want 12 times their current salary. They would then earn more than a senior New Zealand doctor. Absurd! Should doctors in one of the poorest countries on earth, earn more than doctors in one of the richest?

Ugandan GDP vs doctor salary

This would mean a Ugandan doctor would earn 250 times the current Ugandan GDP. Effectively this means that 250 poor farmers would earn the same as only one doctor. Isn’t that horrific! Unfortunately this is the trend around the world. Salaries increase while the poor aren’t much better off.

Cultural expectations of Big People

In Uganda, even more than in western countries ‘Big people’ are expected to display their status through lavish living and big things. There are a lot of expectations on ‘big people’ here, and this helps makes sense of the obscene extras demanded “…a five-bedroom house, 4000cc vehicle and three domestic workers.”

Big job = Huge house (5 bedrooms!)
If you’re a Big Senior Doctor in Uganda, you’ll need a 5 bedroom house. First so everyone can see you have the biggest house in the neighbourhood, and second so you can support all 20 your family members who expect to live with you for free because you’re a doctor.

Big job = Huge car (4000cc)
Google image search “4000cc vehicle” and see the huge 4WD cars that every big doctor clearly needs. A doctor isn’t a real doctor until they look down on you from the windscreen of their Range Rover! Status and heirachy are the name of the game, illustrated by the biggest doctors (senior ones) getting a 4000cc 4WD, while ‘medium’ doctors get a more modest, 2500cc car. Perhaps a corolla?

This cultural norm makes me quite sad, as environmental concerns become irrelevant, and good health goes out the door as soon as you earn decent money. You’ll never see anyone with a high salaried job here on a bicycle, even if work is just down the road. Its culturally inappropriate just not the done thing. Junior doctors riding the public buses complain to me that other passengers deride them. “Get out of the bus. Why aren’t you driving your own car? You’re a doctor!”

Big job = 3 domestic workers
(Women running around doing everything for you)
It may seem unfathomable that one person should ask for 3 domestic workers. Remember though that the workers aren’t just to look after them, but also their 20 family members who will insist on living in their huge house. Nothing demonstrates  status and opulence like having a gardener carefully prune every bush, one maid cooking and the third washing your clothes.

Ridiculous Political Situation

President Museveni has been the big boss boy for longer than I’ve been alive. Nearly 32 years. The huge issue at the moment is him becoming Mr. President-For-Life, by scrapping the presidential age limit (75 years). As much as many people don’t like Donald Trump, at least the longest he can be there is 8 years! To help secure this life presidency, Museveni handed out an official bribe of 8000 US dollars so that every one of the 431 Ugandan MPs to hold “consultative meetings” in their district.

Many people, including the health minister herself believe this official bribe triggered the strike. Maybe a salary of 200,000 dollars a year is fair enough, when MPs already earn about that much. Many people are asking the question. Why should a poorly educated MP who is driving their country into the abyss, earn more than a highly qualified doctor who is saving lives?

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6 Million Dollar Red Cross Heist

Have you given to the Red Cross recently? Your money was stolen. Nearly 6 million US dollars of it. Stolen by rich, well connected thieves – hundreds of Red Cross staff. How do you feel about that?

First, I deeply respect Red Cross for both investigating and apologising. Recently I haven’t given to Red Cross (as they seemed like a big, inefficient NGO), but this humble and honest announcement has made me reconsider. Uncovering “overpriced supplies, salaries for non-existent aid workers and fake customs bills” is not easy, nor is admitting this kind of painful situation to the world. What happened to them, happens to every NGO operating in tough contexts. The only difference is that Red Cross talked about it.

Second, the five million discovered will only be the tip of the iceberg. If they found evidence for 6 million stolen (5% of the 120 million donated), the actual loss will be much higher. Perhaps 20 million, maybe more. They only found the sloppy thievery. Corruption done well is untraceable.

3 Lessons from the Red Cross Heist

1) Most NGOs hide theft. Red cross didn’t. One survey showed that 3 out of 4 fraud cases in large NGOs don’t get reported to the public. A year ago Israel accused a World Vision Staff member of stealing millions of dollars to give to ‘terrorist group’ Hamas. Although this particular allegation is unproven, theft Is guaranteed in an NGO working on a huge scale, in a difficult unstable region like Palestine. Even if World Vision are doing an great job, there will still be theft. World Vision leadership told the world that they didn’t think there was corruption going on in that project. “Our own ongoing audit has not uncovered any diversion of funds” they said. A zero theft scenario isn’t possible. World Vision are either hopelessly naïve or lying through their teeth. Either way, World Vision are hiding theft. Red Cross made the unusual decision to both investigate properly, and not to hide it. Well done. One report estimated that around 2 billion dollars was lost by NGOs to fraud in the UK alone in 2016. Did we hear about it?

2) Many (if not most) NGO workers steal money in corrupt countries. Its not just 1 or 2 bad eggs. There was theft in all 3 countries, through a variety of mechanisms. Hundreds, if not thousands of workers were involved. Unfortunately stealing money from the most vulnerable is part of NGO culture. Here in Northern Uganda even good people will steal if they feel there’s a decent chance they won’t get caught. I’ve seen it in my local church, higher church leadership, individual health centers I manage, NGOs, local government, central government, everywhere. I’m not saying people here are bad people. Stealing money where you can is just the behavioural norm. Good people steal. Only the best people don’t.

2) Don’t automatically trust NGO leadership. In western countries, we have this idea that aid workers, or people working for NGOs are usually virtuous and want to help people. In developing countries, NGOs are like any other institution. NGO jobs are often the most lucrative jobs and everyone knows there is ripe opportunity for extra “allowances” or just straight up theft. In Ugandan Institutions (and I’m sure in many developing countries), the best way to rise in an organisation, is to keep quiet when money is stolen, and buy patronage (paying people around you to keep them happy and quiet). If a superior steals money in Uganda, if you speak out you are gone, and other NGOs won’t hire you. Workers higher in the organisation are MORE likely to steal money than people lower down. First they have more opportunity, and second that may be they got to the high position in the first place. Trust needs to be earned, slowly and carefully.

4 Things Red Cross (and other NGOS) can do better next time

1. Be honest with the public about corruption in our organisation. Red cross have made a great start with this announcement. Its like giving up alcohol or cigarettes – you have to acknowledge you have a problem before you can do anything about it. Most NGOs don’t. Add a “loss to corruption” line in your budget. Report all theft to the public. Address the problem, don’t ignore i

2. Lock up the thieves. There needs to be a disincentive to steal. Right now there isn’t. In Northern Uganda, NGO workers caught stealing only get sacked. Often the rest of their contract gets paid out too, which is madness. In my organisation, we’re not allowed to take thieves to court – only fire them. In the last few years I’ve heard of at least 50 rich NGO workers caught red handed stealing money intended for the poor and vulnerable, and no one has gone to jail. NGOs need policies that anyone caught stealing WILL be taken to court with no exception. Yes the corrupt police and court system makes this difficult, but try your best. Its great that Red Cross say they will “hold their workers to account”, but I doubt any will end up in prison.

3. Play hardball with corrupt Governments. NGOs are slow to learn this lesson, and often bow to the will of corrupt, mega-rich government officials. You’ve got power, use it. As corrupt as NGOs can be, government officials are much, much worse. Why are the Red Cross paying customs duty on anything? They are there to help the country out of an Ebola epidemic, a crisis. The Red Cross and other NGOs should insist on their donations and equipment being exempt from government fees like customs duty in a crisis. If there are no customs bills, there can be no fake customs bills.

4. Pay locally appropriate salaries. I’ve said this before, and this stuck record will continue. As soon as staff have an inflated salary (especially in short term jobs), they see the job less as a real job, and more as an opportunity to grab as much money as possible before the magical money fountain stops flowing. They are blinded by dollar signs in their eyes. Paradoxically, your workers will steal less, be more satisfied and get better work done on a fair salary than a bloated one.

5. Put foreigners in charge of the money. I don’t mean white people, I mean foreigners. Keep control of the money outside of the corrupt local systems. It’s an Ebola Epidemic. You are not there to grow local capacity, you’re there to save lives. If qualified and experienced Nigerians and Kenyans managed this money, there would have been much less corruption. Foreigners don’t have the local connections to leverage with government officials. They don’t have the family pressure to feed out money. They have the incentive of ongoing work in the organisation if they do well. Keep the control of your millions outside of the corrupt in-country systems.

I hope this fantastic announcement by Red cross continues the growing awareness around the world of the real situation. We need Red Cross to continue saving lives in crisis situations, with all the dollars we gave them, every last million.

Red cross cracked.gif

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