Viewpoint

Development in Practice, Volume 9, Number 4, August 1999

Viewpoint ICVA’s near-death experience: temptation and redemption in the `Humanitarian International’ David Sogge

On 30 May 1997 the Executive Comm ittee of the International Council of Voluntary Agencies (ICVA) met in Geneva in a mood of crisis. The organisation’s m anagement was in turmoil. Its book s were deep in red ink. For those at the meeting there seemed only one way out: to wind up. That meant bringing one of the world’s oldest associations of NGOs to an ignom inious end. Given the historical mom ent, such a turn of events seems bizarre. After all, the bloc of organisations forming the `Hum anitarian International’, despite recent dents in reputations, still enjoyed record levels of government and public support. The collapse of such a forum was out of keeping with the tem per of the times. Indeed, it was too bad to be true. W ithin a year, ICVA had been redeem ed, saved from bankruptcy, put under new managem ent, re-organised, and re-centred on essentially the same mission with which it had begun 35 years earlierÐ promoting the interests of hum anitarian organisations. W hat could ICVA’s near-death experience signify? Organisational science specialists regard such dramas as `critical episodes’ offering rich material for research and theorising. For aid-industry watchers, crises can provide insight into what is push-

ing, pulling, and driving the Hum anitarian International. The story narrated here is about such a crisis. It is a tale of tem ptation and, for the tim e being, redem ption. In off-the-record interviews during February±March 1998 , persons in or previously associated with ICVA provided most of the background information used here. The aim is not to draw up a balance sheet on ICVA or its m embers. Rather, it is merely to tell the story of crisis that nearly overwhelmed them. The paper ends with some brief comparative observations from organisational science about the moving and shaking of promotional networks.

ICVA’s roots Concern for the plight of uprooted people in EuropeÐ refugees, migrantsÐ was the founding impulse behind ICVA. It was form ed in 1962 through the m erger of three NGO networks: the Conference of Nongovernmental Organisations Interested in Migration (founded 1922); the Standing Conference of Voluntary Organisations W orking for Refugees (1948); and the International Comm ittee for W orld Refugee Year (1959). All three had enjoyed the patronage of UN agencies, particularly UNHCR. As a network-of-networks, ICVA consolidated those relationships and their pivot in Geneva, the `humanitarian capital of the world’. It aim ed to promote private agency interests, including their eligibility for subsidies and contracts under the of®cial aid system. For its part, that of®cial aid system needed a body like ICVA. The UN High Comm issioner for Refugees term s private

ISSN 0961±4524 print/ISSN 1364±9213 online 040449±19 Ó 1999 Oxfam GB Carfax Publishing

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aid agencies òur right arm’. And indeed UNHCR, even when it faced cutbacks, has been am ong ICVA’s m ost im portant and loyal funders. Its other ®nancial backers have ranged from the Ford Foundation to the Canadian Government. In addition to of®cial aid bodies, m ember agencies furnish a large part of operating revenues. Funds to support, among other things, a secretariat in pricey Geneva, have com e from annual m embership dues: a sliding fee of up to about SFr22,000 (US$14,00 0) for agencies in Northern (OEC D) countries and SFr360 (US$230 ) for Southern NGOs. To run its ®eld projects, ICVA relied on outside funds. But at least nom inal m ember òw nership’ is supposed to be guaranteed by its structure: a General Assem bly every ®ve years, regular m eetings of an elected Executive Com mittee of m ember agency representatives, and various comm issions and task forces. There has been a pervasive culture of consultation, gatherings, and meetings. But since the role and style of the secretariat has always loomed largeÐ a fact of life in most federations or centralised networksÐ the question of who really drives and owns ICVA has no unambiguou s answer.

Branching out In its ®rst 20 years, ICVA led a quiet and respectable existence. But by the late 1970s some of its associates had begun to feel that it was far too quiet, and indeed almost com atose. Led by a new, activist secretariat, it had by the m id-1980s begun to regain some forward motion. The decade saw m embership nearly doubl e to about 90 organisationsÐ the result of a deliberate effort to recruit Southern NGOs. Hum anitarian crises in several corners of the world (e.g. the Thai±Cam bodia border or Namibia) prom pted special advocacy initiatives and co-ordinating task forces. Of these, the longest-lived and perhaps most effective concerned war and displaced people in Central America. 450

ICVA began to lobby harder in the humanitarian corridors of power. It used its consultative status with the UN’s Econom ic and Social Com mittee (ECOSO C) to m ake points. It successfully hamm ered UNHCR to pay programm atic attention to children. And it is said to have been instrum ental in setting up the UN Disaster Relief Organisation (UNDRO), an earlier incarnation of today’s Of®ce of the Emergency Relief Coordinator. Some of the activism stem med from pressures by both Southern NGOs and some Northern m ember agencies wishing to move beyond humanitarian relief to structural m atters of development and inequitable North±South relations. ICVA thus began to accum ulate new foci and functions. A few m embers began pushing it into politically touchy terrains such as the Bretton Woods institutions and the aid system itself. Under ICVA’s aegis, the ®rst NGO Working Group on the W orld Bank operated from 1984 until its 1995 m ove to Washington DC. That effort at policy dialogue has since been eclipsed by more assertive exercises such as the Structural Adjustm ent Policy Review International Network (SAPRIN). ICVA came under pressure to help nonpro®ts to professionalise, and to defend their interests vis-aÁ-vis m ore powerful players. In the latter half of the 1980s it served as host to the NGO Management Network, one of the ®rst broad initiatives helping popularise `capacity building’ in NGO and agency discourse and budgets. Earlier than m ost in the business, ICVA began paying attention to donor±grantee tensions, and to bungled or politicised humanitarianism. It drew attention to the need for rules in a de-regulated industry ¯ooded with new entrants. Its ow n answer was self-regulation. W ell before such things becam e a fashion, ICVA began generating standards and codes of conduct. These were about both internal managem ent and NGO relations with governm ent funders and Northern private aid agencies. W ith many more Southern NGOs under the sam e roof as the Northern agencies,


ICVA’s near-death experience

schism s appeared. Paralleling such divisions, organisations in the `development’ camp began to eclipse the `humanitarians’. To m anage these trends, ICVA reorganised. It set up two internal commissions: one on Hum anitarian Affairs catering chie¯y to Northern mem bers with vocations in relief and rehabilitation; and one on Sustainable Development in which Northern agencies, but especially Southern NGOs, could address North±South issues and NGO strategies. In the early 1990 s new crises, and accelerating competition am ong agencies, helped push the `hum anitarian’ camp again to the fore. The deÂbaÃcle in ex-Yugoslavia, echoing crises of an earlier Europe, led ICVA to take on coordination roles. In the face of what a Yugoslav com mentator once termed the ìdiocy’ of W estern relief agency conduct in his country, ICVA set up a coordination unit there. Am ong its useful regulatory functions was to serve as a referral point for the small-tim e hum anitarians then swarming in. As one observer puts it, `W hen a onem an-and-a-truck NGO showed up, the UNHCR could say, ªGo to ICVA!º’. There cam e m ass repatriations in postwar Mozam bique and Central America, and fresh upheavals in Som alia and the Great Lakes region of Africa. ICVA responded by setting up an of®ce in Nairobi, a coordination unit in Mozam bique, and so forth. Aid ¯ow s, boosted by crises and transitions, were then reaching their 1993 peak. The Hum anitarian International was boom ing. There was work and incom e not only for agencies old and new but also for private security ®rm s, consultants, transporters, provisioners, and for W estern military establishments with too few roles to justify their budgets in the post-Cold W ar world. Inevitably, pressures rose for both coordination services and for policy consensus around clearer rules in a wide open `market’ in hum anitarian action. ICVA played a m ajor role in UNHCR’s PARinAC (Partnership in Action) effort in 1993±94, a global exercise in rolling re-

gional conferences to re-pro®le UNHCR’s sub-contracting relationships with hundreds of humanitarian NGOs. PA RinAC’s concluding mega-conference in June 1994 was to have set standards of coherence, professionalism, and order in the Hum anitarian International. In the event, it was overshadow ed by helter-skelter agency competition then unfolding in the aftermath of genocide in Rwanda. Thoug h it had gained a name for pragm atic coordinating action in trouble spots, ICVA could not shake off its less ¯attering image as an NGO talk-shop. 1 Moreover, by the early 1990 s ICVA was no longer the only agency show in town. Several other form al networks, such as EuroStep, were m aking the running , as were transnational agency alliances like those under the Save the Children Fund (SCF) banner. Agency m anagers, looking for valid information streams and points of leverage in places like Brussels, yet with dw indling travel and time budgets, had to choose which meetings their staffs should attend. More and more, the choice was not ICVA. A number of m ajor playersÐ Oxfam GB, Acord, SC F-UKÐ began pulling out. This was an om inous trend, since it began to sow doubt s am ong ICVA’s major bank-rollers in the of®cial aid system. In short, since the early 1980s, ICVA’s activities had become more diverse and m ore com plex. And its internal and external environm ents were marked by ®ssures and stress. Against this turbulent background , ICVA’s tenth General Assembly in March 1994 considered its options and decided ` ¼ to embrace them all’. It resolved to make a priority of just about everything then on everyone’s aid agenda: human rights, international law (including indigenous people), civil society and popular participation, econom ic growth with equity, the environment, NGOs in peacekeeping, con¯ict resolution and the promotion of cultural tolerance, institutional development of NGOs, coordination among NGOs, and, ®nally:


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the integration of humanitarian affairs and sustainable development w ith a particular emphasis on advocating new approa ches to emergency relief to try to ensure that such assistance is developm ental. Beyond these priorities, there followed another four for ICVA’s Commission on Hum anitarian Affairs and four m ore for its Sustainable Development Comm ission. Yet in these long lists of intentions, and amid the further resolutions about strategy, structure,2 and topical issues, there is no m ention whatever of an imperative to build bridges to the world of commerce and the m arket for humanitarian good s and services. In light of what was shortly to befall ICVA, this was a noteworthy om ission. In the year following the General Assem bly, ICVA came under new managem ent. Fresh from a US agency noted for its fund-raising prowess, SCF-USA,3 the new Executive Director assum ed control amid expectations that ICVA’s then anaem ic ®nancial condition would soon be restored to ruddy good health. In the event, it was to end in tears, as ICVA was brough t to the edge of ®nancial ruin. The precise sequence of decisions and non-decisions is still not clear to outsiders, and even to people close to the inner workings of the organisation at the tim e. But among comm on threads in som e accounts are: a closed m anagement style focused less on the network and its (extensive) priorities and more on the agenda of an entrepreneurial leadership marching to the beat of its ow n drumm er.

To market, to market The one leadership decision with the greatest consequences was also the one least likely to have been predictedÐ if one is to go by what ICVA’s mem bers had resolved in 1994 as their vision and intention. For ICVA’s new leadership the temptation was irresistible: a main priority was henceforth 452

to develop the Global Hum anitarian M arketplace and to catapult ICVA into the midst of it. W orldAid’96 was ICVA’s big splash. Held in Geneva’s main trade fair complex, it was `the ®rst and therefore the greatest humanitarian exhibition on earth’. Featuring exhibits by 267 ®rms and well over 100 aid agencies, it drew about 4,500 visitors over seven days in early October 1996 . On display were com modities ranging from tippers, tankers, and generators to high-protein biscuits and personal satellite phones. Beyond their self-prom otion as suppliers in this highly lucrative, US$3 billion-a-year m arket, some businesses pitched up also to suggest `that they can get assistance to the af¯icted m ore effectively and ef®ciently than their not-for-pro®t counterparts’. Unclear is whether ICVA’s leadership actually welcomed such chill winds (or bracing breezes, depending on your persuasion) of m arket com petition. There were opportunities for discussion in workshops mainly centred on technical and m anagement them es. Despite the undertone of com petition, the upbeat message beam ed to participants was the importance, indeed the inevitability, of the for-pro®ts and the non-pro®ts working together for m utual bene®t. Described as `controversial, bizarre, slightly macabre’, this was an event where `com merce and charity jostled som ewhat nervously together’. At issue, according to a collaborating journalist, was nothing less than a `battle for the soul of aid’, where `the nature of interests, the objectives as well as the very character of the participants themselves are evolving so quickly and fundam entally that uncertainty and shifting alliances seem to be the only conclusions so far’ (Kent 1997). Yet other conclusions in the afterm ath of W orldAid’96 began to emerge. One was that it had failed to involve m any people from the South; only about one exhibitor/ participant in ten came from the places whose humanitarian em ergencies justi®ed



the whole event. More sobering for the organisers was the conclusion that it had failed to satisfy m any business people. Com panies m ade it known that, in future, any such trade fairs would interest them only if their sales objectives were servedÐ especially contact with aid-agency staff tasked with procurement and contracting. But the m ost devastating conclusion for ICVA was that W orldAid’96 had been a ®nancial disaster. In dealing with its Sw iss and other business partners, ICVA’s leadership had incurred debts of about SFr350,000. W orse, these had been acquired allegedly without full Executive Comm ittee approval. The subsequent crisisÐ departure of the Executive Director, disputed ®ring of other staff who in turn threatened legal action, and so onÐ also exposed other sizeable liabilities, the apparent result of poor budgeting. Matters were so shadowy and com plex that mem bers sought a special investigation by forensic auditors. By October 1997, a year after WorldAid’96, ICVA faced debts totalling about SFr688,000 , or nearly half a million US dollars. Helping prom pt Comm ittee m embers’ decision in May 1997 to dissolve the organisation had been pure panic. Under Sw iss law, board m embers are personally liable for their organisation’s debts, whatever the extent of their knowledge or consent to how those debts were incurred. Closing down appeared to them to be the prudent way out. How ever, once the broader m embership learned of the decision to dissolve ICVA, an ad hoc group of mem bers pushed for a reversal. In a strongly-worded letter to all m ember agencies in July 1997 (citing widespread, but not unanim ous, mem ber sentim ent against closing down), the group asked for a m ajor review of ICVA’s strategies, an overhaul of its managem ent, and an im provem ent of governance, especially Executive Committee oversight of the secretariat. They were particularly disturbed at marginalisation of Southern organisationsÐ especially as monies earmarked for Southern m ember participation in Executive Com-

m ittee m eetings had not been used for that purpose in recent years. For som e, neglect of the Southern voice matched the short shrift given critical perspectives on globalisationÐ a topic that had never received anything like the attention ICVA’s leadership had lavished on the humanitarian marketplace.

The morning after The outcom e can be brie¯y sum marised. Prom pted by a pledge of bridging funds from UNHCRÐ the agency with the most to lose if ICVA were to go underÐa number of mem ber agencies rallied. Prom inent am ong them were Scandinavian and Lutheran humanitarian bodies. But organisations rooted in the USA , notably InterAction and W orld Vision, stood at the forefront of the rescue. The rescuers conditioned their help, however, on a num ber of reforms in ICVA. The m ain ones were: a trim meddown secretariat with an Executive Director in a role of coordinator rather than that of an entrepreneur running his ow n NGO; decentralised ®eld operations under ICVA’s nam e but in practice managed by a m ember agency; and more com puter-based inform ation-sharing, thus fewer meetings. Strategic priorities are also being re-set. Som e attention to power and poverty rem ains possible. Issues of global apartheid m ay refuse to go quietly. But for the time beingÐ as shown by ICVA’s spearheading the follow-up trade fair W orldAid’98Ð the m ain thrust is that of the Hum anitarian International.

Some comparative and theoretical observations Sum marised, ICVA’s brush with extinction illustrates some of the risks arising where there is:

· a broad and loose set of aim s in a network, in part formulated in order to accomm odate mem ber agencies across a


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·

·

·

·

wide range of viewpoints, experiences and interests; a diverse set of mem bers with differing (and by no means tension-free) structural positions and relationships in a hierarchical system of aid; a `principal agent problem ’, arising where som eone is hired to do a job that cannot be perfectly monitored; weak m onitoring of a secretariat, and weak overall governance by supervisory organs; strong currents in the external and internal environm ents pressing on a humanitarian/em ancipatory developm ent network to adopt an open stance toward, and develop new alliances with, actors in the for-pro® t sector.

What could science tell us?

organisational

ICVA bears many characteristics of a classical `promotional network’. In them , three out of four preconditions for collaboration among organisations are usually present: a willingness to collaborate, a need for inform ation or expertise, and a need for ®nancial resources. A fourth precondition, `the need for speed, ¯exibility and adaptive ef®ciencies’ is rarely present, or needed, in prom otional networks. But at mom ents of localised hum anitarian crisis, sub-grouping s in ICVA have crossed that threshold, thereby vaulting into a m ore advanced kind of collaboration, nam ely joint ventures or `system ic production networks’ (Alter and Hage 1993:263). At m om ents like those, ICVA has seen some of its ®nest hours. As a promotional network, ICVA ®ts easily into the well-known category of trade association. As described by the organisation science specialists Aldrich and Staber, their publicly stated purpose is to defend and promote the interests of business ®rms. Their internal function is to integrate the often incongruent preferences 454

of their members, althoug h smaller ®rms’ preferences are usually subordinated to those of larger members ¼ Externally, their function is to propagate a collective interest vis-aÁ-vis interests outside their domain (Aldrich and Staber 1988:1 12) ¼ Research on trade associations reveals, unsurprisingly, that they do not live for ever. In the USA in the post-war period, for exam ple, more trade associations died (or were absorbed by others) than were born. As em pirical evidence of crisis and discontinuities in such networks mounts, a m odest theoretical literature is emerging. In remarks relevant to the case of ICVA, Aldrich and Staber note that: As interest associations, trade associations are subject to the collective rationality problem (Olson 1965). ¼ [T]heir survival depends not only on how well they represent membership interests but also on how effective they are in aggregating the parochial preferences of their members ¼ . The organisational problem is that, under certain circumstances, it may be rational for potential members to refrain from participation in association affairs. This implies that trade associations may not persist (or arise at all) despite favorable external conditions (Aldrich and Staber 1988:1 12). Tensions and crises in NGO networks are well known in anecdote but poorly known in organisation science. Yet a close scan of the thousand-odd publications touching on the careers of international non-pro® t associations 4 would probably turn up only a few stories of tension and discontinuity. Rather, the reader would mainly ®nd extended, if not always plausible, narrations of untroubled achievement. The building of coalitions, alliances, consortia and other kinds of networks is now accepted as crucial to civil society strategies. An understanding of networks, their care and



feeding, and the tensions that can af¯ict them is, therefore, gaining importance. The prom otional network, and its subtype, the trade association, may often be a useful and effective m eans of prom oting civil society actors. Certainly a number of such associations are purposefully active, South and North. M ost are oriented towards the state, and seek advantageous treatm ent, such as subsidies, contracts, and tax exemptions. M uch of what passes for private-aidagency advocacy is essentially in pursuit of such advantages. Prom otional networks may serve em ancipatory agendas, but they concern them selves m ainly with their m embers’ ow n institutional security. Can they prom ote emancipatory agendas, serving as effective witnesses, and points of leverage, on behalf of the poor and marginalised, in whose name they act? Available analytical work, such as on the homogenising and perhaps coercive effects of the `collective rationality problem ’, backed by case studies such as ICVA’s, would underscore the limitations rather than the potentials of non-pro®t prom otional networks for such purposes. Effective pursuit of an emancipatory agendas m ay therefore require something else. To overcom e widely differing structural positions in an aid system driven and strati®ed by power over resources, there m ust be a genuine basis for a comm on agenda. ICVA lacks that basis. It is composed of, on the one hand, fairly secure organisations that dispense resources and on the other, m uch less secure ones that constantly have to scram ble for resources. Research might also suggest the value of less hierarchy, more lateral alliances, and norm s of managem entÐ such as a low-pro®le catalyst whose success is measured by the strength and joint contribution of mem bers, not that of a semi-autonomous secretariatÐ m ore in keeping with em ancipatory aims. 5

Notes 1

Of the kind lampooned by Ayi Kwei

2

3

4

5

Armah in `Halfway to Nirvana’ in Chinweizu (1988:96±102). Om inously, but probably unremarked by most, there was buried in the Assem bly’s formal record of decisions a routine addition to ICVA’s statutes, concerning just about the last thing on anyone’s m ind: the power of the Executive Com mittee to dissolve the organisation. For a view of that organisation’s internal culture and performance, see Maren (1997). The Yearbook of International Organisations 1997 /8 lists 923 publications under the rubric ÌNGO Case Studies: on organisations’. As outlined in David Korten (1993 ) `Strategic networking: from comm unity projects to global transformation’, in Alders, Haverkort and van Veldhuisen (1993:25±34).

References Alders, C., B. Haverkort an d L. van Veldhu isen (eds.) (1993) Linking w ith Farmers: Netw orking for Low-External-Input and Sustainable Agriculture, London: IT Publications. H . Aldrich an d U. Staber (1988) Òrganising business interests: patterns of trade association foundings, transformations, and deaths’ in Caroll (1988). Alter, C. and J. H age (1993) Organisations W orking Together, Newbury Park: Sage Publications. Caroll, G. (ed.) (1988) Ecological M odels of Organisations, Cambridge, MA: Ballinger Publishing. Ch inweizu (ed.) (1988 ) Voices from Twentieth Century Africa, London : Faber and Faber. K ent R. C. (1997) `The battle for the soul of aid’, Crosslines Global Report special supplement for W orld Aid ’96. M aren, M . (1996) The Road to Hell: The Ravaging Effects of Foreign Aid and International Charity, New York: Free Press.


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Christine Kilalo and Deb Johnson

The author David Sogg e is an independent consultant based in The Netherlands and is a Fellow of the Transnational Institute in Am sterdam . He is editor of Compassion and Calculation: The Business of Private Foreign Aid (1996) and M ozambique: Perspectives on Aid and the Civil Sector (1997). Contact details: W illemsparkweg 194, 1071 HW Am sterdam , The Netherlands. E-m ail: , dsogge@ antenna.nl . .

Mission impossible? Creating partnerships among NGOs, governments, and donors Christine Kilalo and Deb Johnso n

Introduction This paper is one of a series of re¯ections on W orld Neighbors-East Africa’s (W NEA) collaboration with the Governm ent of Uganda (GoU ) and the UN Capital Development Fund (UNCDF) in the process of formulating the District Developm ent Project Pilot (DDP Pilot) Project Document (UNCDF and GoU 1997). The process of re¯ection, analysis, and writing these papers is meant to serve as a learning opportunity for the authors as well as for the reader. This Project offered a new and exciting venture for W N-EA. W N-EA has made good progress in prom oting and supporting com munity-based development, but has not been very involved in this level of national collaboration. W hen the opportunity to work with the Ugandan Ministry of Local Government (MoL G) and the UNCDF arose, W N-EA spent time thinking through the implications and assumptions of the partnership. The decision to becom e in456

volved in the DDP Pilot form ulation was based on two main objectives.

· The assumption that W N may be able to in¯uence the policy and procedures of the GoU and UNCDF through two avenuesÐ the integration of a comm unication strategy within the process of form ulating and im plem enting the programm e; and the use of participatory m ethodologies in both the formulation of the Project Document and in the implementation of the Project. · The hope that this would be a learning opportunity for W N-EA at the `macrolevel’ given that one of its weaknesses, along with m any other development NGOs, had been the lack of involvement, understanding, and im pact at this level. Much of W N-EA’s work was focused on mobilising comm unities to control their ow n developm ent, thoug h the organisation had com e to see that it had to play a m ore effective role in in¯uencing at the national and regional level as com munitybased development can be negatively affected by m acro-level policies and procedures. This partnership was therefore seen as a potential learning opportunity for W N as well as a way to translate micro-level experiences into macro-level changesÐ a new area of operation. These two objectives were based on the prem ise that W N-EA’s involvement would be considered a `partnership’ of m utual respect and exchange. This proved a naõÈve assum ption as there was no precedent either within the M oL G/GoU or UNCDF/UNDP, or am ong other NGOs, for this envisaged partnership. In addition, this remained an unexpressed assum ption on the part of W NEA. There was only lim ited discussion on the de®nition of the W N-EA’s `relationship’ with the M oLG and UNCDF, or even internally. Although it is dif®cult to capture all of the possible reasons why W N-EA did not engage in such discussions, three stand out.


Partnerships among NGOs, governments, and donors

1 Lack of examples. Since there were so few precedents of partnerships being created am ong governm ents, bilateral or multilateral agencies, and NGOs, it seem ed better to start out with a service contract arrangem ent in order to learn more about the Project as well as about working with governments and multilateral agencies. 2 Uncertain potential contributions. W NEA was still unsure about what it could offer to this type of project. Many smaller NGOs (both national and international) working at the comm unity level still feel intim idated and overwhelmed when attem pting to engage with governments and bilateral or m ultilateral agencies, as their ow n resources (human, ®nancial, etc.) seem so m uch more lim ited. 3 No w idely accepted de®nition of partnership. Closely linked with this is W NEA’s then-limited re¯ection about the de®nition of `partnerships’ at this level. WN-EA has had good experience with grassroots collaborations and partnerships, but its experience is more lim ited at a national and regional level. But the very concept of partnership, with a sense of equality and coming together as equals, was not clearly understood at the time by any of the actors involved. This paper re¯ects on som e of the insights and lessons about partnerships gained during W N-EA’s association with the DDP Pilot.

Background The DDP Pilot aim s to support efforts to eradicate poverty in rural areas by im proving the inclusiveness, effectiveness, and sustainability of the delivery of public goods and services. Technical and ®nancial resources are provided by UNCDF and the GoU to test participatory planning, allocation, and investment m anagement procedures for locally determ ined priorities. The project will provide ®eld-tested lessons from

experience, and so contribute to national policy and procedures (Porter 1996). These procedures are being applied in ®ve districts (Arua, Jinja, Kabale, Mukono, and Kotido) and the oversight responsibilities for the DDP lie with the Decentralisation Secretariat of the MoLG. Implementation responsibilities are vested in the corporate local government bodies in the Pilot districts (Porter and Onyach-Olaa 1997). The form ulation of the DDP Pilot attempts to go beyond the super®cial participation of people in the project development and writing process, where this is lim ited to giving information in a survey, to an interactive formulation process, where district stakeholders are involved in debating the different options for the project’s design. The DDP-Pilot form ulation process attempted to guarantee stakeholder involvem ent in the design of the Project Docum ent, which would form the basis for the agreem ent between the GoU and UNCDF. This process was uniqu e in two ways. Firstly, the level of comm itment by both the UNCDF and the M oL G to a slower, more intense form ulation process (despite pressure to m ove the process faster which created a tension which was both positive and negative). And secondly, in terms of the consultative m ethods for involving the stakeholders, varying levels of stakeholder involvement in the de®ning the Project. The implementation of the Project Docum ent will determine the effects of the form ulation process in the long term , but the ground work was laid for an inclusive implementation process.

De®ning partnerships Several authors have attempted to de®ne government±donor±private partnerships, bearing in mind that `private’ could m ean not-for-pro®t, voluntary organisations, or for-pro® t businesses. The de®nition that works best is a combination of two: à ªpublic±privateº partnership ¼ implies a dynamic interactive collaboration between


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sectors’ (Stephenson, quoted in Stacey 1997). `Partnerships are long-term relationships of mutual interdependence [involving] a reasonable equilibrium in the bene®ts (and risks) to both parties’ (Ferreira, quoted in Stacey 1997 ). By combining these two de®nitions, partnerships are here interpreted to be dynamic relationships where particular roles and responsibilities (in terms of activities and resource allocations) are decided upon collectively and delegated to each m ember of the partnership, with the recognition that each is dependent on and accountable to the other m embers. These partnerships should result in more equitable distribution of bene®ts and risks based on the level of inputs. This de®nition would be welcom ed by m any NGOs until they realised that there would be a mutual obligation for them to contribute in terms of hum an, information, m aterial, and ®nancial resources and to assume some of the risks associated with joint decisions. It is easy to criticise and condemn decisions and projects if the person(s) who do so are not accountable in terms of offering suggestions and working towards alternative solutions. T hat NG Os could and should be held accountable for their com m itm ents as an im portant feature of partnerships (im plied in the idea of m utual interdependence) is based on the understanding that they w ould also take on an equitable portion of the risks entailed in supporting the project. (If N GOs were to be involved in the type of partnership described, they would need to be corporate bodies. At present in Uganda, N GOs m ust register with the NGO Board and receive a certi®cate of registration, but they do not have to register as corporate bodies. Nor is there m uch incentive to do so as this would m ake them legally liable for their actions, but provide few, if any, noticeable bene®ts.) T his ensures their accountability and com m itm ent to the project in question, thereby opening their right to take an active part (not sim ply giving inform ation and input w hich is non-binding ) in 458

the decision-making concerning resources and plans.

NGO roles Project documentation for the DDP Pilot states that it is committed to working both with NGOs and the private sector in ensuring service delivery, especially as a strategy for poverty reduction; but there is no real provision for them as decision-makers within the Project Document signed between the government and the UN. There is much talk of including NGOs and members of the private sector (largely for-pro®t businesses in this context) in decentralisation theory and in the practice of democracyÐ partially in response to a desire for better accountability and ef®ciency by donors, governments, and citizens; but also in response to a recognition that direct public service delivery by governments is under severe pressure in terms of both funding and capacity. Stacey (1997) notes that there are generally four major types of legal partnership options, listed in order of increasing responsibilities for non-governm ental agencies: service contracts, management contracts, lease contracts and concessions. The contracts for those NGOs and private-sector consultants involved in the DPP -Pilot form ulation process fell into the simplest form of partnershipÐ the service contract. In this, `[t]he public authority retains overall responsibility for the operation and m aintenance of the service delivery system, except for whatever speci®c and limited-scope services are contracted out or out-sourced’ (Stacey1997:17). In cases of the collection of m arket fees, for example, this is a highly effective contract for governm ents (especially local authorities) and the private sector. The roles and outputs expected from the service contractor are clearÐ to carry out a speci®c function using skills and resources which are frequently easier to ®nd in the private sector (MISR 1998). But, as we shall see, it may not be the m ost effective way to


Partnerships among NGOs, governments, and donors

generate a responsive, accountable, learning partnership. As with m any government and bilateral and multilateral projects, however, the DDP Pilot provides no legal basis within the system for the contribution of private agencies and lim ited, if any, negotiating power to m ake changes or assert them selves outside a public service contractor role. It could be argued that the Project is m eant to help design a workable system for devolving the capital development funds of the GoU , and to strengthen local authorities, so that private agencies were not of utmost im portance for the Project. But if NGOs and privatesector companies are to be seen as major actors in these systems, then it follows that their roles cannot be limited to service contracts alone. If universal service delivery is an end-goal, this hampers the ¯exibility of the system to learn and change to local conditions and needs because the private agencies do not share in the overall responsibility or authority or, perhaps m ore importantly, in the ow nership of the Project. W N was unclear about what it wanted from the proposed partnership as well as what it could contribute to it. Instead of entering a partnership, then, it negotiated a role as a private service contractor which it was hoped would become a learning opportunity and offer a chance to in¯uence the Project. As noted in the introduction, however, it now seems naõÈve to have assumed that a small NGO’s contribution (for the ®rst month, the contract was a 60/40 split in costs between UNCDF and W N-EA) would be seen as a credible basis for partnership.

NGO contributions Although the suggestion so far is that governments and donors should open the door to including NGOs as èqual’ partners, what do NGOs have to offer a private± government±dono r partnership? This is where much of the rhetoric breaks down in that m any NGOs are not willing to m ake the changes necessary for these types of part-

nerships. Many NGOs talk of transparency, yet they do not share or re¯ect their budgets willingly, if at all. M any NGOs talk of accountability, yet they are frequently not corporate bodies so they cannot be suedÐ they are m ore accountable to their donors than to the com munities with which they work. These obstacles aside, NGOs can m ake several positive and uniqu e contributions.

Grassroots orientation One of the still contested contributions that NGOs make to developm ent is their connection to the poor and marginalised. This is contested because of the uncertainty of the extent to which NGOs reach the poor or the `poorest of the poor’. Even NGO staff recognise that it is dif®cult to reach poor and marginalised people, much less try to speak and act on their behalf (which is also in contradiction with many NGOs’ wish to èmpower’ these groups).

Representation The DDP-Pilot formulation process was unconventional because it sought to create an atmosphere of exchange and learning am ong all stakeholders instead of dictating the project’s design param eters according to èxpert’ recomm endations. The process involved extensive consultation at all levels of local governm ent and a wide variety of other stakeholders including central governm ent, donors, NGOs, private contractors and service providers, and other comm unity groups. It was intended to build a sense of ow nership and better understanding am ong the project’s stakeholder groups so that they could ensure that their unique needs and concerns were re¯ected. Yet, despite a concerted effort to consult groups that should and will be affected by the project, the question remains as to how far the marginalised and poor com munity members had a signi®cant voice in its design.


459


Closely linked is the question of grassroots orientationÐ NGOs which are closely connected to and working with marginalised groups can and do try to represent their concerns and needs in policy and allocation debates that are currently beyond the reach of isolated minority groups. NGOs can assist comm unities to `translate’ their needs and concerns into `languages’ or `formats’ that are m ore readily accepted by policym akers, or to ensure that the policy-m aking system s work for the m arginalised groups they try to represent.

Information dissemination, education, and mobilisation NGOs offer an opportunity for wider inform ation dissemination, and for debate, that lead to a wider understanding of functions, roles, responsibilities and, very importantly, a knowledge of how to seek recourse if there is a problem and the support/selfcon®dence to pursue these issues even if that means going to higher authorities. NGOs help to organise comm unities, to direct them through the bureaucracy or to the right people, and to offer a sense of collectivism that motivates people to continue even in the face of direct confrontation.

Public guardian NGOs do encourage community mem bers to understand their rights and how to defend themselves, but they also play an important watchdog function in their own right by ensuring that com munity concerns and needs are heard and considered in decisions m ade about public and private plans and resources. As a passive participant in the project or a public-service contractor, this `watchdog ’ function is greatly hampered by a given NGO’s limited ability to make changes. It causes a split in the NGO’s loyalty between the generally powerless people for whom it professes to speak and to support, and the signi®cantly larger (in 460

term s of funds and connections which could be used to alienate the NGO) donor agency. The NGO effectively becom es a muzzled watchdog without teeth.

Conclusion Although few NGOs can com pete ®nancially in arrangements made between governments and donors, NGOs and the private sector can make some signi®cant contributions beyond the provision of services on a contractual basis. In fact, limiting their contribution to service delivery without including them as part of a `partnership’ lim its their effectiveness and their accountability by sidelining them from decisionm aking processes. M ission im possible? It seem s that the go al of creating N GO ±do nor±go vernm ent partnerships is still elusive as the key actors are far from creating a com m on de®nition of partnership. In the case of the D DP Pilot, W N-EA entered into a contractual arrangem ent that allowed it an opportunity to learn m uch m ore about cultivating and strengthening relationships with go vernm ents and donors. It has learned m ore about the potential role, strengths, and challenges of N GO ±do nor±go vernm ent partnerships, and m ade inroads in in¯uencing som e of the decisions of the D DP Project, but it has not successfully nego tiated a true partnership with it. It follows that these types of partnerships require NG Os, such as W N -EA , to be proactively involved in de®ning their roles and contributions du ring the con ceptualisation of the project and beyond. Realistically, given that m ost N GO s have a relatively sm all resource base, it requires the N G O (and private) sector to organise itself suf®ciently: to de®ne its po tential contributions; and to determ ine those project risks it is willing and able to take, individually and collectively, before it will be taken seriously in discussions about partnerships.


Community development in the Third World

References M akerere Institute for Social Research (M ISR) (1998) `What Makes Markets Tick? Local Governance and Service Delivery in Uganda’, Research Programme on Decentralized Governance (UNDP/MIT). Porter, D. (1996 ) `November 1996 W orkshop Notes’, unpubl ished report, UNCDF and Government of Uganda. Porter, D. and M . Onyach-Olaa (1997) `Project Sum maryÐ District Development ProjectÐ Pilot’, unpubli shed report, UNCDF and Government of Uganda. Stacey, S. (1997) New Capacities for Old? Prospects for Public±Private Partnerships in Service Delivery in South Africa, Angola and M ozambique, Research Report No 61, Governance Series, Ottawa: International Development Resource Centre. UNCDF and Governm ent of Uganda (1997 ) `Technical Annex VII: Comm unication Fram ework’, Project Docum ent: District Developm ent Project Pilot, 1997 .

The authors Christine S. Kilalo is Area Representative of W orld Neighbors, a sm all international NGO. The paper is based on the experiences of W N-East Africa of®ce based in Nairobi and working in Kenya, Tanzania, and Uganda. Contact details: W orld NeighborsEast Africa, PO Box 14728 , Nairobi, Kenya. E-mail: , [email protected] . . Deb Johnson is Director of Sikiliza International, which provides various services to governmental, non-go vernmental, and private sector organisations struggling with issues such as basic human rights, equity, poverty eradication, and good governance. The nam e Sikiliza com es from the kiSw ahili word for `listen’ and underscores the value system which sustains the organisation. Contact details: Sikiliza International, PO Box 31618 , Kampala, Uganda. E-m ail: , djohnson@ im ul.com . .

Community development in the Third WorldÐwalking a ®ne line Dympna Casey

Introduction Using a `bottom up’ approach, comm unity developm ent (CD) aim s to assist people to identify both their ow n needs and also the m eans to address these. Primary health care (PHC) is an essential ingredient within this area, and may be de®ned as èssential health care ¼ m ade universally accessible to individuals and families in the comm unity through their full participation ¼ in the spirit of self reliance and self determination’ (W HO/UNICE F 1980). Prim ary health care focuses on bo th individual and com m un ity involvem ent in health projects. T his involves m otivating peop le tow ards self-help through their ow n initiatives as op posed to a top-down approach whereby the com m unity is dictated to by outside pow ers. A CD approach focuses on giving peop le a choice, central tenets of w hich are em pow erm ent and w orking in partnership with people, the aim being to assist them ` ¼ in articulating w hat their needs are and dem anding they be m et’ (M im ica and Stubbs 19 96:283± 28 4). Empowerment plays a pivotal role in CD. At its core is the notion of power, or the àbility to control the factors that determ ine one’s life (Robertston and M inkler 1994:3 00). Com munity em powerment proposes that individuals obtain control in their ow n lives in the context of participating with others to change the political and social environm ents (Rappaport 1987 ; Zimmerman and Rappaport 1988). Em powerment therefore is a `continuous process that enables people to understand, upgrade and use their


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capacity to better control and gain power over their ow n lives’ (Schuftan 1996:2 60).

Community development A ltho ug h rapidly becom ing a fam iliar con cept in First W orld coun tries (such as the H ealthy Cities M ovem ent), CD initiatives m ay be m ore w idely associated w ith developing or T hird W orld cou ntries w here they m ainly invo lve a CD w orker, generally from a developed coun try, working in villages to help peop le to identify their needs. Sup po rted by ®nancial aid from the developed w orld, the C D w orker then helps the local com m unities m eet these needs. Increasingly, CD projects in Third W orld countries are undertaken by NGOs (Mufune, M wansa and Siamwiza 1996). A key factor in their success may be attributed to their highly motivated mem bers who tend to apply m ore effort and dedication than other public/private agencies (Bratton 1990). NGOs that adhere to the principles of CD are primarily concerned with `facilitating learning in individuals and groups and about creating an environm ent in which people can take risks grow and develop’ (Heyns 1997:3 3). Fieldwork is where CD takes place, and is where CD workers attempt to put theory into practice. However, this is a dif®cult process, particularly for the novice. This Viewpoint describes the writer’s ow n experience as a `®rst time’ CD worker.

Angola In April 1990 I joined a Third W orld relief and developm ent NGO and, together with three other volunteers, went to Angola. Our brief was to establish a PHC programm e in Negage, a sm all village in the province of Uige. The prim ary aim was to reduce infant child and maternal m ortality through adopting a CD approach. Each m ember of the PH C team was a registered general nurse with hospital-based 462

nursing experience. W e had all received various pre-departure training which included accounts of what CD involved, inform ation on tropical diseases, how to care for our ow n health and welfare, and some background material on our designated country. Despite this, we all felt relatively unprepared for what lay ahead. The stories of aid workers stricken with cerebral malaria and the suspected prevalence of AIDS encouraged us to be m ore vigilant but also heightened the anxiety. Some NGOs work furiously to get a team into a country, with the result that as Heyns (1997) suggests, aid workers ®nd themselves in the ®eld with m inimal training. Having curtailed the pre-departure training, we arrived in Angola to discover that no accom modation had been arranged for us so that we had to spend four weeks in the intense Luanda heat before we ¯ew to Negage. In addition, our quick departure also m eant that we did not all have time to receive training in Portuguese, the dominant language in Angola. This was to m ake life extra dif®cult. It was later revealed that the reasons for our hurried departure were that funding had come through at short notice and the dono r was anxious to have workers in the ®eld. The population of Negage was approxim ately 30,000 . M ost of the buildings had been destroyed and the town lacked electricity or water. As in other areas of Angola, most people had been without basic healthcare since 1992. Prior to our arrival, the local governm ent of®cials and the NGO had selected three villages where we would be working: Quindinga (population of 3,000); Cangund o (population of 14,700 ); and M banza Quinguanga (population of 3,700). During colonial tim es, each of these villages had had its ow n health clinic. How ever, extensive repairs were needed to make them operational. This was the priority of our logistical coordinator. The priority for the PHC team was to ®nd staff to work in the clinics. Our ®rst major hurdle.



This had already been discussed by the NGO with the local village chiefs (sobas) and health of®cials. Two individuals who were deemed to be quali®ed nurses had been identi®ed to work in each clinic. Under norm al circumstances it is custom ary to seek copies of a nurse’s certi®cation or other documentation to support such claim s. How ever, this was a war-torn country, most people had lost all their possessions as they were constantly on the move to avoid being conscripted or shot. Quali®cations were therefore dif®cult to assess. W e were thus faced with two problems. First, individuals claiming to be nurses who may not have been trained. Second, as these workers had been accepted before we arrived, in the interests of harm ony and good relations we could not now dism iss them even if they proved unsuitable. It soon became apparent that these were not quali®ed nurses in the W estern sense. The so-called nursing staff in fact tended to be individuals who had taken part in UNICEF’s vaccination cam paigns who either had fam ily connections or to whom the local of®cials were obliged. In short, the m ost knowledge these people had about nursing/healthcare was either basic ®rst aid skills, or involvement in m obilising villages to attend vaccination programm es. Eventually this knowledge proved bene®cial in identifying and encouraging families to attend the clinics and in conducting health prom otion initiatives, but in the ®rst few m onths these skills were of little value.

levels. This analysis revealed that the nurse responsible for dressings did not require extensive reading and writing abilities, whereas the consulting nurse required a higher level of literacy skills. In addition, while a few of the staff had som e knowledge, others would require extensive instruction. W orking together we were able to identify appropriate positions in the clinics for each member of staff. The next issue involved setting up a training programme. It was decided that step-bystep on-the-job demonstrations would be the m ost appropriate teaching method. This was a painstaking process as each staff m ember received individual instruction on such topics as how to undertake dressings, consult patients, and com plete health records. In practice, this meant that only 15±20 people per day could receive treatment. This slow work pace also meant that the m ost acute cases were attended to immediately, while others who were less sick had to wait until m uch later, although they had arrived early. This was unpopu lar and indeed there was m any a fracas outside the clinics with people jostling to be seen. However, the fact that the nurses lived in the villages had an unforeseen bene®t. First, they could inform the villagers about their training, and stress that this would eventually lead to better care. Second, they explained that in tim e they would become m ore experienced and attend to people more rapidlyÐ something that happened relatively soon.

Clinical skills training A training-needs analysis w as und ertaken. H ere our lack of ¯uency in Portugu ese w as a m ajor barrier. S ince there w ere no translators from Portuguese to E nglish available, w e had to com m unicate via pidgin P ortugu ese. W e also had a F rench translator w ho un derstood som e E ng lish but had lim ited Portugu ese. E ventually, by observing and asking questions, w e w ere able to assess clinical skills and know ledg e

Skills for community development Nurses undertaking a CD role need to ` ¼ have well developed collaborative skills and ¼ (be able to) truly work in partnership with the comm unity (Chalm ers and Bram adat 1996). Many factors in¯uence a nurse’s competence to do this, including her/his ow n understanding of the principles of CD, em powerm ent, and the organisational structures in which nurses traditionally practise


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(ibid.). Community developm ent requires power-sharing, m aking joint decisions, and entering into a partnership with clients. How ever, it is dif®cult to give up professional control especially when this is an unfam iliar role. This dif®culty is accentuated when language barriers are included. In Negage there were occasions where CD workers failed to work in partnership with the people but rather `took over’ because they felt frustrated with the slow progress, and underestimated the local nurses’ ability to understand and to teach. Other factors included the desire to treat as m any people as possible, to `get the work done’, and to m eet programm e objectives within a reasonable tim eframe. These CD workers required a lot of support and encouragem ent. It is dif®cult for nurses who have failed to experience empowerm ent and participation in their ow n nursing training and subsequent working environment to take on an em powering role (Lask, Smith, and M asterson 1994 ; Schultz 1991). Regardless of the setting, nurses need to learn to become accustom ed to increased autono m y for them selves and their colleagues and learn to share power with their clients. This requires an understanding and ®rm comm itment to CD principles.

Lessons learnt It soon becam e evident that two nurses per clinic were inadequate to cope with the large num ber of patients. More nurses would be needed, but this time the selection approach would be different. The situation we had inherited was not a good exam ple of com munity development. By working with the sobas and local health of®cials we had in fact failed to work with people at the grassroots. Hence we had received workers who did not belong to the communities, people who were favourably predisposed to the sobas, or who had family connections. In brief, individuals who were not the most suitable for the tasks in hand, but with whom we had to work. 464

This tim e the trainees themselves were asked for their opinions since they were in a better position to select people who would give the best care to their ow n communities and had ®rst-hand experience of what the job entailed. How ever, this too posed various dif®culties. First, whites or branchas are perceived to be the om niscient èxperts’. Second, these experts had in the past always dictated the term s and controlled what occurred, with the local people having little input or control. Having their opinions solicited aroused suspicionÐ why were their views im portant? W hy weren’t the branchas just telling them what to do and how to do it? Indeed, it would have been far easier for everyone to have done so. Eventually, when they realised that we earnestly wished to hear their views and to incorporate them in the program me, they gradually began to participate. Slowly at ®rst, but by the tim e I left the program me, they were freely voicing their opinion s. W ithin a short period of asking them to identify and seek out individuals whom they believed would deliver them appropriate and good care, they m anaged to ®nd people who had actually received som e form al nurse training education. W ithin three months, these people were working in the clinics attending to some 70±100 people per day.

Formal training Having concentrated on clinical skills requirements, the focus now m oved to increasing basic nursing and medical knowledge with an emphasis on health prom otion. W ith this aim in mind, a more form al educational system was established. Prior to developing a curriculum, the clinic nurses were asked to identify the areas they wished to learn more about, keeping in mind what would be most pertinent for their patients. W orking with them in a spirit of partnership as a CD approach would imply, a basic nurse teaching package was devised. Health promotion was a



primary elem ent of this program me and included such topics as basic house and personal hygiene, and the use and building of latrines. Other topics were the diagnosis and treatm ent of com mon illnesses such as m alaria, anaem ia, tuberculosis, dehydration, diarrhoea, and malnutrition. Central to CD is the notion of ow nership: that the comm unities involved should maintain ow nership and control over their ow n destinies. It was vital therefore that any interventions should, as far as possible, be controlled from within the comm unity. In line with this, the nurses were frequently asked for their opinions and contribution in attempting to provide healthcare. In furtherance of this, and in order to instil and build con®dence within these com munities, it was decided that having one of their ow n colleagues do the teaching would be a m ost appropriate solution. How ever, the selection process would take som e time. Eventually, one of the better nurses was unanim ously selected to become their teacher. At this stage there were ®ve clinics in operation so a plan was devised whereby this nurse was taught the material, and he in turn, under supervision, passed this on to the others. For the next three months, every afternoon when the clinic closed, the nurses received form al nurse/health training in com mon illnesses and diseases.

Examinations After a few weeks, the nurses requested some type of exam ination whereby they could dem onstrate their knowledge and receive a certi®cate or award (not to m ention a ®nancial reward). This was to lead to other problems. First, m any of the nurses had only lim ited writing skills. Second, the examiner would need to be reasonably ¯uent in Portuguese. Third, the request to give ®nancial rewards to successful participants could lead to discontent. Finally, salary increases were dictated by the head of®ce in Luanda, and

budget constraints could prevent ®nancial rewards. In fact, the head of®ce agreed that nurses who successfully completed the course would receive a reward. But what was m eant by `successful’ was left to the discretion of the local NGO team . It was decided that the nurses would receive a reward for attending courses as opposed to passing any formal examination. However, candidates who successfully passed the exam ination would receive both a ®nancial reward and a certi®cate. The next concern was to devise an exam ination through which to assess knowledge that did not require great writing skills or call for extensive Portuguese on behalf of the course assessor. A 35-question multiple choice form at was found to m eet these requirements, and greatly facilitated the exam ination process. At the end of three months 15 nurse/health workers successfully completed the examination. All received a mark of 65 per cent or above, and so received both a ®nancial reward and a certi®cate.

Summary A commitment to PH CÐ which outlines that health services should be appropriate, effective, affordable, and acceptable to the comm unitiesÐ is a vital com ponent of comm unity development. This involves working in partnership with individuals from within the com munity, encouraging self-help m easures, assisting people in identifying their needs, and helping them establish the m ost acceptable and suitable ways to meet these needs. NGOs, which many writers identify as the m ost suitable kind of organisation to undertake such initiatives, frequently undertake CD initiatives in Third W orld countries. However, putting a CD approach into practice can be fraught with dif®culties, in particular the CD workers’ unfamiliarity with the concept and the slow progress of work. To be effective, CD program mes must be fully integrated into their surroundings,


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based on a knowledge of and familiarity with the political, econom ic, and social system s affecting the comm unity. The choice of clinic staff m eant that we had initially (and unwittingly) worked with the local eÂlites rather than with the grassroots since our NGO was as yet unfamiliar with the workings of the local comm unities. W ith some experience and knowledge of working in the com munity, the PHC team was able to work better with the local comm unities and to ®nd more appropriate staff. Allowing the nurses to select their ow n teaching topics and to identify their ow n teacher endorsed our com mitm ent to CD by supporting their decisions, and contributed to the overall success of both the examinations and the entire programm e. The gap between theory and practice is a concern for CD workers. The need to let people take control of their ow n destinies, to stand by and grit one’s teeth as they take a less appropriate m ethod to secure their aim s, requires a ®rm com mitm ent to the principles of CD. The desire to rush in and dictate solutions is dif®cult to curb. Furthermore, donors who may not fully appreciate the dif®culties involved in implementing CD control the purse-strings and set the criteria for aid organisations. This places pressure on NGOs to attain goals and secure their objectives within speci®c tim eframes.

Conclusion I returned home in July 1997 leaving behind seven clinics m anaged by local staff, with the NGO team acting in a supervisory capacity. W orking with the local staff, respecting and supporting them in their decisions while sim ultaneously attempting to instil new knowledge and new approaches to old illnesses, though at times dif®cult and frustrating, generated a high level of job satisfaction. Seeing individuals who had previously lacked con®dence, knowledge, and skills develop into con®dent m embers of the comm unity, caring for their ow n people, was a delight to witness. 466

Acknowledgements I would like to acknowledge the help and support of my colleagues Adeline Cooney and Kathy Murphy for their assistance in reviewing this article.

References Bratton, M . (1990 ) `NGOs in Africa: can they in¯uence public policy? Development and Change 21(1):87±118. Ch alm ers, K. and I. Bram adat (1996) `Com munity developm ent: theoretical and practical issues for comm unity health nursing in Canada’, Journal of Advanced Nursing 24:719 ±726. H eyns, S. (1997 ) Òrganisational capacitybuilding, and the ªquick and dirtyº consultant’, Development in Practice 7(3):54±57. Lask, S., P. Sm ith an d A. M asterson (1994) À curricular review of the pre- and post-registration education programm es for nurses, m idwives and health visitors in relation to the integration of a philosophy of health: Developing a model for evaluation’, Research Abstracts, London : ENB. M im ica, J. an d P. Stubbs (1996) `Between relief and developm ent: Theories, practice and evaluation of psycho-social projects in Croatia’, Community Development Journal 31(4):281±290. M ufune, P., R. M wansa and R. Siam wiza (1996) `Motivation integrity, performance and accountability in NGOs: The case of NGOCC in Zam bia’, Community Development Journal 31(1):20±31. Rappapo rt, J. (1987) `Terms of empowerm ent, examples of prevention: Tow ard a theory for comm unity psychology’, American Journal of Community Psychology 15(2):121±148. Robertston, A. and M . M inkler (1994) `New Health prom otion m ovem ent: A critical examination’, Health Education Quarterly 21(3):295±312. Schuftan, C. (1996) `The com munity devel-



opment dilem ma: W hat is really em powering’, Community Development Journal 31(3):260±264. Schultz, P. (1988 ) `W hat is health prom otion?’ Health Education 19(5):14±18. W HO /UNICEF (1980) Primary Health Care: Report of the International Conference on Primary Health CareÐ Alma Ata Declaration, Geneva: W HO. Zim m erm an , M . A. and J. Rap paport (1988 ) `Citizen participation, perceived control and psychological empowerm ent’, American Journal of Community Psychology 16(5):725±750.

The author Dym pna Casey is a registered general nurse (RGN) with academ ic quali®cations in comm unications and health promotion. She recently worked as a volunteer with a relief and developm ent NGO in Angola, where she was responsible for devising and im plem enting an educational curriculum for local health workers. She is now a lecturer in nursing studies. Contact details: Centre for Nursing Studies, National University of Ireland, Galway, Ireland. Fax: 1 353 91 75 0537 .

N ew Political Econom y E D ITO RS Anthon y P ayne (M anaging Editor), A n drew G am ble, An k ie H oogvelt, M ichael D ietric h and M ich ael K en n y, all at the U niversity of Sheffiel d, U K Su p ported b y an In tern ational A d visory B oar d The past decade has seen the em ergenc e of a new w orld order - a new stage in the develop m ent of the world econo m ic and political syste m . Understa nding it will require new m odes of analysis and new theories, and a readiness to tear dow n intellectual barriers, br inging together m any appr oaches, m ethods, and disciplines which f or too long have been separated. In short, w hat is needed is a new political econo m y, which com bines the breadth of vision which char acterised the c lassical political econo m y of the nineteenth century with the analytical advance s of tw entieth century social science. N ew Political E con om y cr e ates a foru m for work w hich seeks to bridg e past em pirical and conceptual divides. T he em phasis is upon explora tory and innovative work w hich draws on different disciplines and which address es core issues in the m ain constituent elem ents of its r esearch agenda : nam ely, com parative political econom y, the political econo m y of the environm ent, the political econo m y of develop m ent, and interna tional political econo m y. S U BS C R IP T IO N R ATE S 1999 - Volume 4 (3 issues) IS SN 1356-34 67 Institutional rate: £140.00; North Am erica US $198.0 0 Persona l rate: £33.00; N orth A m erica US $54.0 0 http ://ww w.carfax.co.uk /np e-ad .h tm

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