Cheaters and other Criticism
Not everything goes smoothly with a humanitarian interventions. Being representations of a rich white western aid organisation certainly means that as an expat here there is a dollar sign halo ever present. This causes conflicts over pay for starters, and then other things like demands for blankets for the watchmen, gumboots of the logistics workers, and endless pens for the nurses. Most of the time it is not a problem but quite often conflicts occur. In Wamura I have been trying to use only contract staff (ongoing employemnt) with no daily workers (paid for the day). This enables trust and loyalty to develop with staff, and avoids some of the walking dollar sign feeling being an expat.
One of the other problems associated with being in control of seemingly unlimited resources while dealing with people with very little, is the 'cheaters'. Woman and babies who try, and succeed, in getting around and through the system twice or more times, picking up drugs and food on each round. While it can be depressing seeing the same person many times, or a tiny little baby being bought back time and again with different mothers, or the same mother with various different children (perhaps even her own), it is completely understandable, and an extension of the normal pattern of people trying to maximise return. We are only here for a short time and the locals feel the need to make the most of it.
Actually I blame the MSF protocol a lot for this situation, it is over complex and unclear even to us expats who have it written down in front of us. For local people with no medical knowlegde the application of an arm band colouring system, then weight and measures, then a 'z-score' off a sheet of paper can only be seen as white man's random magic. Transparency for the local population was not a requirement when coming up with the system and as a result I think cheating is greater here than it could be otherwise.
MSF seems to have quite a number of instituational drawbacks which have become more clear to me now after three missions. One is the highly individualistic application of the MSF standard operating setup, which while highly benifital in conflict situations, is generally unnessary and unhelpful in zero security risk situations like Wamura. This means there is little logisticial adaption of the mission to the envionment, little thought to how a particular requirement could be achevied in a lower impact way than building it from sratch as is more usually required. There are resulting negative impacts on the commnity, both evironmentally and socially.
The other critisim I can easily point to is the lack of planning for closing a mission. It would seem to me that the main decisions for closing a mission are left to upper coordination sides of the organisaton, and the local team and logistics just bumble along behind. Even in the Wamura situation it was at the beginning meant to be a three month program, yet after three months nobody wants to think about closing, so instead of even a formal decision to extend, the program just keeps going and going. This result is uncertainly in the staff, and poor decisions with respect to logistics stocks and construction work.
Having a plan, and changing it if needed is fair superior to not having any plan at all.
One of the other problems associated with being in control of seemingly unlimited resources while dealing with people with very little, is the 'cheaters'. Woman and babies who try, and succeed, in getting around and through the system twice or more times, picking up drugs and food on each round. While it can be depressing seeing the same person many times, or a tiny little baby being bought back time and again with different mothers, or the same mother with various different children (perhaps even her own), it is completely understandable, and an extension of the normal pattern of people trying to maximise return. We are only here for a short time and the locals feel the need to make the most of it.Actually I blame the MSF protocol a lot for this situation, it is over complex and unclear even to us expats who have it written down in front of us. For local people with no medical knowlegde the application of an arm band colouring system, then weight and measures, then a 'z-score' off a sheet of paper can only be seen as white man's random magic. Transparency for the local population was not a requirement when coming up with the system and as a result I think cheating is greater here than it could be otherwise.
MSF seems to have quite a number of instituational drawbacks which have become more clear to me now after three missions. One is the highly individualistic application of the MSF standard operating setup, which while highly benifital in conflict situations, is generally unnessary and unhelpful in zero security risk situations like Wamura. This means there is little logisticial adaption of the mission to the envionment, little thought to how a particular requirement could be achevied in a lower impact way than building it from sratch as is more usually required. There are resulting negative impacts on the commnity, both evironmentally and socially.The other critisim I can easily point to is the lack of planning for closing a mission. It would seem to me that the main decisions for closing a mission are left to upper coordination sides of the organisaton, and the local team and logistics just bumble along behind. Even in the Wamura situation it was at the beginning meant to be a three month program, yet after three months nobody wants to think about closing, so instead of even a formal decision to extend, the program just keeps going and going. This result is uncertainly in the staff, and poor decisions with respect to logistics stocks and construction work.
Having a plan, and changing it if needed is fair superior to not having any plan at all.
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