Author: Alanna Shaikh

On process

By Alanna Shaikh | | 2 Comments |

A friend of mine recently attended a meeting that was intended to develop a process to guide the preparatory meetings for the coordination meetings with the Ministry of Health. And the thing is, when you’re in the thick of it, these meetings make sense. You do need a unified message before you talk to your host government, and without some ground rules, the prep meetings to develop that message can get genuinely ugly.

All of this led me to think about process, and its sibling, bureaucracy. I’ve always had a pretty unpopular belief in the value of bureaucracy. Bureaucracy, to me, is the core of an organization. It’s what keeps an organization functioning when its staff changes. Without the forms and the regulations, you don’t have an organization. You have a cult. The structures are what makes it about more than just whoever works there at the moment. Bureaucracy puts the “organize” into organization.

That does not mean, however that bureaucracy should rule your work. It’s supposed to help the work get done. The work does not come second. And everyone accepts that. In fact, most non-me people hate bureaucracy.

Unfortunately, this is not the case with process. Plenty of people will sing the praises of “process.” Having a well-thought-out process means that you are Doing a Good Thing. If your intervention fails – the village women don’t feed their children more beans, or the Ministry of Education refuses to adopt your snazzy new curriculum – well, at least your process was good. Everyone benefits from being part of it.

I call shenanigans. Process is a jargon word that we use to obscure what’s going on. If your process is a series of meetings (and it almost always is), say so. And a good process is a process that achieves your goals. No more and no less. Nobody benefits from your stakeholder interviews if their input never turns into anything.

Lastly, some food for thought. A project I was connected to wanted to solve a problem they were seeing in a lot of rural clinics. The clinics would just use up all of their medicines, and then request more from the central supply. Since new drugs didn’t arrive instantly, there could be stock-out periods of a week or more while they waited for the new drugs to come.

To fix this, the project wanted to implement a pharmaceutical logistics system. They brought in a consultant from Europe, who worked with a group of clinic managers and Ministry of Health staff to estimate ongoing demand from different kinds of drugs. Based on these estimates, they then set re-order points for drugs. So, if you distributed, say, 10 IUDs a week, you would reorder IUDs when you were down to 15 of them, giving you a week and a half of time until the new ones came. The consultant turned these plans and estimates into a training system, and the project went around training rural clinics to use the new method.

Nobody ever did. Despite the training, and the eminent logic of the system, nobody ever did. Rather than try to determine why, the project wrote off the exercise as a failed pilot project and carried on. (My own suspicion is that clinics ordered their drugs when they knew that central supply had them, and were afraid that if they ordered according to some system, their orders would go unfilled.)

One of the project staff, when describing the whole fiasco to me, said something I’ve always remembered. “We paid thirty thousand dollars for the consultant, the curriculum, and the trainings,” he said. “If we’d given that thirty thousand to the government in return for a promise to improve their ordering system, every clinic in the country would be using it by now.”

(photo credit: markhillary)
Chosen because that’s exactly like many of the meetings I attend.

Anger, control, and finding the zone

By Alanna Shaikh | | 6 Comments |

I have, once again, given up substantial amounts of control over my life.

Living overseas does that to you. Part of it is the expatriate experience. The language barrier makes it hard to know what’s going on much of the time, and the cultural gap means that even when you’ve got the language skills, you’re still missing most of the nuance of everything that’s happening around you. You don’t get to customize your environment like you would in your home country – you accept whatever flavor of juices is offered to you, and you let them paint the walls any color your landlord likes. Doing anything else is an exhausting and unpleasant way to spend your time. People who can’t give up control should stay home.

The loss of control runs deeper than being an outsider, though. The fact is that poor people have less control over their lives. This is the damage done by poverty. They cannot easily change jobs or locations, they are less resilient in the face of crisis, and they are at the mercy of often autocratic governments.

And when you go to live in a poor country, you accept those same limitations. You get special treatment for being an expat, yes, but there are limits to this. The police officer will do what he wants regardless of the facts of the situation. There is no treatment for HIV. The government just repossessed your house and now it will be torn down. Women can be beaten for undercooking dinner. That is how it is and your foreign passport can’t fix it.

It’s a fine line between realistically facing limitations, and accepting the very conditions that you are there to change. If you’re working for an anti-corruption project, you need to stay angry at cops who require bribes. If you’re trying to improve health, you need to identify the obstacles to HIV treatment (generally lack of funds and inability to write decent Global Fund grant, coupled with provider inexperience) and find a way around them.

If you push too hard and get too angry, you burn out, fast. It hurts you and it doesn’t do much for your projects. It could get you kicked out of the country. But if you are too laid back and do too little, you’re just a waste of funding that could be used for something that matters. You have to find that sweet spot, somewhere in between, where you don’t mind a late plane but you do mind physicians who must be bribed to provide care.

Finding that mental space is hard. Staying in it is harder. But it’s one of the many things you have to manage if you want to do things well.

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(photo credit: Ko:(char *)hook)
Chosen because it’s a nice harmless photo of a control room – searching Flickr for “control” brings you freaky, freaky things.

Bill Easterly and the Culture of Nice

By Alanna Shaikh | | 18 Comments |

I was really excited to see that William Easterly has a blog now. And it’s not because I am a big fan of the man. I think many of his conclusions are just plain wrong, and he’s prone to ugly sweeping generalizations. He seems to assume from the get-go that other people are stupid and/or thoughtless. But he’s brilliant, and he’s not at all nice.

Development and aid work is mired in a culture of nice, and that culture keeps bad work from being eliminated and good work from getting better. We’re too nice to call a bad project a bad project. When we criticize, we criticize in abstractions. No one has any problem identifying bad products as bad – Vista, for example – but no one will ever call a bad program bad. If you look at my post on NGOs that do harm, you’ll only see anonymous comments about unnamed projects. We’re addicted to nice.

The charitable reason for this behavior is human decency. When good people are making a good faith effort to do work that matters, you feel like the worst kind of jerk calling them out for waste or incompetence. And every project benefits one or two people. Nobody wants to be the one to say that those one or two people were not worth the effort.

But there are a couple of people who like Vista, too. That doesn’t keep the rest of us from explaining exactly what’s wrong with it. After human decency, however, comes self-interest.

We change jobs a lot in this field. Project funding runs out, and you have to find your next gig, or your next donor. Most of us have worked for three or four different NGOs or companies, and perhaps a government agency. You don’t want to talk smack about a potential employer, and a potential employer could be just about anyone. And, of course, a potential employer doesn’t want an employee who criticized his last boss in public. So we all shut up, and organizations that everyone knows are sinkholes of mismanagement and despair just keep on getting grants and contracts.

I don’t really know how to fix this. I am not ready to tell you here on the world-wide-webs exactly which of my former employers sucked because I too would like to continue getting jobs. I started my “things I don’t believe in” series as one way to address the bad work no one wants to talk about, but I think it is still the kind of generality that doesn’t do enough good.

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photo credit: devillibrarian
Chosen because both smiley faces and cookies effectively represent the culture of nice.

A story I’m not proud of

By Alanna Shaikh | | 8 Comments |

When I first started at IMC, I was senior desk officer for East Africa and the Middle East. I had a solid Middle East background, but I had to do a lot of reading on East Africa. I’d been there a few weeks and was starting to realize I’d somehow become an aid worker and I loved it.

I was reading an article about a young mother in Mogadishu. She had a baby and wouldn’t leave her house during the fighting (this was the 2006 fighting, FYI). Finally she ran out of all food and had to leave the house. She took her 3-month old baby with her. She was killed in the cross-fire and NGO workers found her baby frantically trying to nuzzle at his mother’s dead breast.

My son was three months old when I read that. I was a breast-feeding mother. I sat at my desk and cried, for quite a while. And then I thought, “If I had a picture of that, I could fundraise a million dollars, easy.”

Your work saves lives. You can’t do the work without money. It’s very, very hard to keep chasing the money you need to do good, and stay good yourself.

I don’t want to be Kevin Carter.

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(image credit: Fiore S. Barbato)
Chosen because I am still too human to be able to search flickr for dead children

What makes a new NGO succeed?

By Alanna Shaikh | | 7 Comments |

1. Highly targeted mission. If you have the skill set to identify a very specific goal, you are likely to have the expertise to do your work well. And when I say very specific, I mean it. Something along the lines of “supply used lab equipment to labs around the world that request it” or “provide vaccines and health care providers to one small village.” In addition, a very specific goal gives you a solid fundraising angle. Community development for one small village is too general.

2. A cool name. I only wish I was kidding. But groups with cool names like Nothing but Nets (which has as a bonus an obvious sports tie-in) or a rhyming name like Unite for Sight – which sound catchy and immediately explain the organization’s goal – are far more likely to find support. It’s easier to raise funds, hire good staff, get grants, and find high-profile supporters when everyone can easily remember who you are and what you do.

3. And, of course, the song I always sing – a funding model which does not involve getting government or foundation grants. To repeat, it is very hard to get government funding. USAID and the other government donors usually identify a problem and then give grants or contracts to solve that problem. Big grants. Generally over $500,000. They don’t have the time to manage the kind of $30K grant you probably need for start-up. And foundations like to work with partners who have a long track record; they are rarely interested in funding the new guys. So, if you want to succeed, have a fundraising plan. (Here’s a hint – a cool name and a highly specific goal will help.)

Edited to add: I forgot the thing which actually started this post in my head. I have a new job – I am the global health blogger for Change.org. I am very excited about this. Change.org is full of amazing people with big social entrepreneurship ideas. We’re seeing huge numbers of people on the site every month. But I suspect that an awful lot of our success is due to the fact that the name Change.org is easy to understand and sticks in your head with the tenacity of a Britney Spears song.

(Writing for Change.org does mean that I will be posting here less often. I only have so many words in me, and I’m putting all my health content over there. I do plan to continue posting here at least twice a week, though, so please don’t drop my RSS feed just yet.)

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(photo credit: Cambodia4kids)
Chosen because they have a pretty good name and a specific goal of providing school uniforms to Cambodian kids.

Looking backward, looking forward

By Alanna Shaikh | | 2 Comments |


My favorite posts from 2008:

1) Why health matters. My best friends’ daughter died, and in the terrible misery that followed, I did my best to take a lesson from it. My grieving friends liked the post, and people are still linking to it, so maybe it’s a useful lesson. I hope I never have to write a post again informed by such personal pain.

2) Things I believe in: Oral Rehydration Salts. I love talking about ORS. I think everyone needs to know about them.

3) Development 2.0 – more than jargon? This post is still being tossed about on Twitter. Thinking about Development 2.0, writing the post, and talking to others about the contents helped me to finally get a grip on the concept. It was a really valuable process for me; I hope the result is valuable to others.

4) When do non-profits do more harm than good? A reader favorite, this post got amazing comments that enlightened me.

5) Things that do damage. My screed against thoughtlessness and poor planning.

6) Why I hate the word sustainability. Another post that helped me think things through, this generated a whole dialogue that I was proud to be part of.

7) Keep your banana to yourself. I love that I finally wrote something with a snappy title, and I think I said something important about the difference between street-corner charity and development work. Also, it got the best comment ever “Good grief. Such control! That’s like potty-training your kids at gun point.”

8 ) Suffering does not make you special. Apparently I like to rant. This time, about how poverty doesn’t ennoble the human spirit, it grinds it down.

9) Ethics and International Development. Just a few more ways that doing good is very hard.

10) Humbling Hospitality Experiences. You can always find a way to give, if you want to.

Bonus Post: A semi-definite guide to my volunteer work and my consulting. I felt like a total jerk writing that post, but based on the feedback it has helped a lot of people set boundaries in their own lives. (And it got me a consulting gig. I’m listing it here just in case it gets me more.)

And here is my thought for 2009:

We’re all in this together. We’re not in this line of work because we want to help far-away strangers. We’re in it because, in the end, we’re one big blob of people on one scarred messy planet, and no one is truly healthy when others are bleeding. We are connected; there’s no way around it. It’s time to make that connectedness a source of strength.

Happy New Year!

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(photo credit: NASA/Goddard Space Center, via woodleywonderworks)

Jargon of the Day: NGO, CBO

By Alanna Shaikh | | 0 Comments |

Jargon: NGO, CBO

Translation: NGO stands for non-governmental organization. CBO stands for community-based organization. The difference between them is that NGOs are generally formally structured organizations, registered with the government. Community based organization is a catch-all for any group of people working together toward a common goal.