If you were going on a trip to a new country, how would you gain information about the sights you were going to see, the foods you were going to taste, and the places you wanted to visit? Would you be adventurous and try something new without any recommendations or cautions? Would you use your smartphone to produce a list of local attractions? Would you ask the locals to define the experience of their home by guiding you to specific spots? These attempts at making the most of a travel experience can also be applied to the attempts of many health organizations at making the most of international aid.
By making the most of international aid, I’m referring to the amount of patients treated with reference to the amount of aid given, measured in the allocation of products, time, and the number of hands on the ground. In the travel analogy, simply attempting to allocate aid without any research would be absurd. Of course, in emergency situations, such as after a devastating natural disaster, sometimes just getting boots on the ground is the best first step in order to start combating the issue. This travel analogy though, is more fitting for the other two attempts at maximizing the effectiveness of aid.
Using your smartphone in the traveling analogy would be similar to using health reports to distinguish what areas of the world are in need of the most help, and how that help should be actualized depending on the specific health burdens of the area. In the last decade, the production of up-to-date health reports for specific countries has dramatically improved with the pioneering work of Dr. Chris Murray and Dr. Alan Lopez in the Global Burden of Disease Study in 2010. By producing a comprehensive database of the realistic health problems of hundreds of countries around the globe, the study allowed every country-specific report to be normalized for comparison. For the first time, an organization could compare the quality of life for millions of people over thousands of miles away. Even more, the study accounted for stronger statistics in each report in order to make up for differences between the United Nations’ reports and those of the World Health Organization, which were found to be dramatically different and somewhat illogical at the time. By using reports like these, health organizations can at least gain a little perspective as to who needs what, where, and when in regards to everyone else. Yet, although these reports can pinpoint what specific health problems affect which areas, they cannot provide an in-depth analysis of what step is needed to take next. However, these reports have completely revolutionized how health aid is distributed, focusing more on the who, what, when, where, and why questions rather than the how in regards to treatment.
Using the widely accepted belief that “locals know best” may be an influential strategy for both traveling and health aid distribution. The reality that international aid is in fact international, makes it easy for there to be a discrepancy on how the aid is intended to be used by the health organization and how it actually is used on the ground. By just using health reports as mentioned before, the other determinants of how effective aid can be tend to fall ignored. For example, a mother suffering from AIDS could face the difficult choice of traveling miles a day to receive her antiretroviral drugs for treatment. Upon first glance, a several mile walk may seem like a simple inconvenience that is unavoidable. Yet, perhaps this walk also means choosing to leave her children in her home without care, or facing the difficult task of traveling with them just in order to receive weekly or monthly treatment. Faced with all of the other everyday tasks that she may have to complete such as cleaning clothes, working to provide for her children, or simply caring for them, it is no wonder why many AIDS patients fail to regularly abide by their treatment plan. Yet, these types of realities and barriers to treatment are very hard to understand or even imagine by health aid organizations because they are usually relying on “outsider” information regarding the everyday lives of locals. To combat this misunderstanding or even simple lack of information, many aid organizations have chosen to educate locals to provide their own health care force on the ground by working as a team. (Check out Josephine Najjuma’s article titled “The Village Health Teams (VHTs) in Uganda: how funders address their challenges!” to see an example of locals providing their own healthcare with the use of aid.) By respecting the fact that all patients are also all people, with their own worries and lifestyles and cultures, we can recognize that global health is a comprehensive field that relies on the hard sciences just as much as it does on sociology and anthropology. Perhaps the global health community can then begin to rethink the way we predict the effectiveness of aid to help determine what the ever-important next step should be.
Smith, Jeremy N. Epic Measures: One Doctor, Seven Billion Patients. New York: Harper Wave, 2015. Print.
Until No Child Has AIDS. YouTube. Elizabeth Glaser Pediatric AIDS Foundation, 21 Mar. 2014.
Web. 19 July 2015. <https://www.youtube.com/watch?v=yxRH-1PWLc0>.
Photo credits: http://n.pr/1DuYEik
– Caitlin Pollard, an undergraduate passionate about Global Health studying at the College of the Holy Cross