Medeshi 21 Aug, 2008
When Aid Harms….
By Nicholas D. Kristof
Aid groups in general do an important job, and medical interventions have a better record than many other kinds — just think of vaccinations, or oral rehydration therapy. But one problem with medical aid groups is that they typically hire doctors and nurses and turn them into administrators — and in African countries with very few doctors, the result is even fewer people treating patients. The upshot is that the aid group may end up doing more harm than good.
When Aid Harms….
By Nicholas D. Kristof
Aid groups in general do an important job, and medical interventions have a better record than many other kinds — just think of vaccinations, or oral rehydration therapy. But one problem with medical aid groups is that they typically hire doctors and nurses and turn them into administrators — and in African countries with very few doctors, the result is even fewer people treating patients. The upshot is that the aid group may end up doing more harm than good.
( Photo: Nursing at Edna Hospital )
This problem has been long noted and discussed, without much being being done about it. Today I received an email from Edna Adan, a woman whom I hugely admire, who runs a maternity hospital in Somaliland. Naka Nathaniel and I did a video about her a couple of years ago, and she also figures into a book that my wife and I are writing about women in the developing world.
Here’s what Edna said:
I am writing to you in desperation because we have lost ten of our best qualified nurses and midwives to International NGOs who do not support us during the training but who snatch the best from us with salary offers that we cannot match. Somehow, we seem to have become victims of our success because our nurses are the best in the country. We train four times what our hospital needs but still cannot cover the demand for good and responsible nurses. My greatest need is for Nurse/Midwife trainers for the next couple of years so that I can get the current 70 students in training graduated. We would welcome Interns to teach English, basic Sciences, and if possible, Nursing subjects. We are also willing to pay a salary of $800 a month plus food and accommodation to qualified midwife trainers, as well as the air ticket.
One step to a solution must be much more pressure on NGO’s and UN agencies that hire away doctors and nurses in poor countries, particularly for administrative jobs. Another step has to be more training of doctors and nurses, perhaps producing people with degrees that do not easily transfer to other countries. Right now there are more Ethiopian doctors in the Washington DC area than in Ethiopia, and this brain drain amounts to a subsidy from poor countries to rich ones.
I’ve often recommended that young people go and live abroad for a time, the better to understand the world — and also the better to see their own country. Somaliland is a wonderful little country, and I can’t imagine a more remarkable experience than spending a year teaching at Edna’s hospital.
This problem has been long noted and discussed, without much being being done about it. Today I received an email from Edna Adan, a woman whom I hugely admire, who runs a maternity hospital in Somaliland. Naka Nathaniel and I did a video about her a couple of years ago, and she also figures into a book that my wife and I are writing about women in the developing world.
Here’s what Edna said:
I am writing to you in desperation because we have lost ten of our best qualified nurses and midwives to International NGOs who do not support us during the training but who snatch the best from us with salary offers that we cannot match. Somehow, we seem to have become victims of our success because our nurses are the best in the country. We train four times what our hospital needs but still cannot cover the demand for good and responsible nurses. My greatest need is for Nurse/Midwife trainers for the next couple of years so that I can get the current 70 students in training graduated. We would welcome Interns to teach English, basic Sciences, and if possible, Nursing subjects. We are also willing to pay a salary of $800 a month plus food and accommodation to qualified midwife trainers, as well as the air ticket.
One step to a solution must be much more pressure on NGO’s and UN agencies that hire away doctors and nurses in poor countries, particularly for administrative jobs. Another step has to be more training of doctors and nurses, perhaps producing people with degrees that do not easily transfer to other countries. Right now there are more Ethiopian doctors in the Washington DC area than in Ethiopia, and this brain drain amounts to a subsidy from poor countries to rich ones.
I’ve often recommended that young people go and live abroad for a time, the better to understand the world — and also the better to see their own country. Somaliland is a wonderful little country, and I can’t imagine a more remarkable experience than spending a year teaching at Edna’s hospital.
