Call for Papers 2012: Articulate Journal

Alex B. Hill | October 29th, 2012 | No Comments

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From the Field: on Community Mapping

Yvette Efevbera | March 3rd, 2012 | No Comments

This past week, as part of my new program management responsibilities, I led a team of 4 in a community mapping exercise. As the name suggests, “community mapping” – a global health buzzword – is an activity used to understand and document resources that exist in a given locale. Although the process can be extremely technical, utilizing complicated computer software to generate detailed maps that clearly plot health facilities or key community resources, it can also be informal, resulting in a simple hand-sketched diagram or idea of community networks. My interesting experience was with the latter.

In preparation for a United Nations-funded project that would equip our community health workers with skills to work beyond health facilities and within actual communities, we wanted to understand what was already happening in regards to HIV and nutrition in our district of focus. What were NGOs and community members doing, and what gaps existed? What networks were already in place? We tried to do some background using government officials, health facilities, and of course the world wide web, but it was clear that we needed to investigate the on-the-ground reality.

Preparations began with a week of meetings and tool development (and some true insight to what it means to be a “program manager”), and then it was time to go into the field. After a 5 hour trip from the capital of Lilongwe, we spent our first day meeting government officials and interviewing NGO representatives. We devised a three-day plan for exploring existing community-based structures in a district of nearly 360,000 people, which involved meeting with rural health facility staff, identifying key community organization leaders, and interviewing members of local community-based organizations and support groups. On paper, it seemed like an easy plan – 2 to 3 hours transportation to and from, 3 interviews at 45 minutes to an hour each. In reality, it was another eye-opening experience involving hours and hours on the dusty roads traveling from village to village in search of these community structures (and getting creative when rains made certain pathways impossible to traverse across). Days started early and ended late, phone connections were challenging and at times unfeasible, but in spite of these challenges, communities were so open and willing to share their stories and experiences with us.

By the end of the week, we successfully conducted several interviews and focus group discussions and gained a much clearer understanding of existing community networks. I was so impressed by the work that members of the community had taken the initiative to do, supporting people living with HIV and addressing needs of their own communities. Now, with this preliminary knowledge of where gaps are and where communities want additional support, it’s back to the drawing board of proposal development!

Categories: Health in Africa

The Little Things: on “-isms” in International Development

Yvette Efevbera | February 14th, 2012 | 9 Comments

After six months “in the field,” I was beginning to feel like I had nothing new to share. The program evaluation I’ve been working on is still on-going. My days still consist of nine-and-a-half hours in the office. My personal life continues to be less-than-exciting, which is more pronounced than usual on this particular day. So naturally (in my view, anyway) I stopped writing.

The truth is that the last few months have given me unique opportunities to reflect, and perhaps these thoughts, these “little things” that have come to mind, are worth sharing. I’ve thought a lot about nutrition, as you may have noticed from past food-based posts, but even more on my own personal struggles to live a healthy life in this setting. I’ve thought a lot about different organizations – governmental, non-governmental, for-profit, multilateral – and how they all contribute to improving health and development in countries like Malawi. But perhaps more controversially, I’ve thought a lot about the role of race and foreign aid in development work, and how this allows, or prevents, people like me – coming from the outside – to truly make a positive impact on the lives we seek to help.

My first experience with this while in Malawi was within my first month, when a Malawian male acquaintance and I were looking for seating in a public venue. I came in with the cultural expectation (as much as I hate to admit it) that as a female – and a well-educated, slightly senior, and foreign one at that – I would be offered the one remaining seat. Every -ism came to mind when I watched him take the seat and wondered: Is this because he doesn’t like or respect me? Is this a gender issue in a patriarchal society? Is this because I’m black? It’s possible, perhaps likely, that the explanation was simpler; maybe it never occurred to him, or maybe he was never taught any differently. If I were to ask him about the incident today, he probably wouldn’t even remember that such an exchange had occurred. Regardless of intent, the result of the interaction I didn’t quite understand was a hyper-awareness of my foreignness in this culture, and an even more heightened awareness of myself.

I could go on and on with stories and instances that have left me questioning why I was treated one way when I’ve seen someone treated differently in the store, at the bus stop, when seeking community service activities outside of work. And while initially my instinct was to place the blame on myself (“I’m not being culturally-sensitive enough” or “I’m not being assertive enough”) and then on others (“They are purposely treating me different than they would treat someone else in my shoes.”), my thought has evolved.

I recently read an article on How Matters about “Race, power, and international aid,” where a white donor describes her experience of witnessing people in a development setting treated differently based on the color of their skin. And while I leave comments about the article itself aside, it validated my feelings that there may be some truth to how we look and act, and our role in any culture or society, particularly in the world of development. If I wore a suit and high heels every day, would people be more inclined to listen to the suggestions I have in health and development? Or if I always wore “Harvard alumni” gear, would that make what I have to say more valid? And since I will never be a man, and will never be able to change the color of my skin, will that continually push me towards the periphery of the change I hope to make?

My answer right now is that I don’t know. And just because we choose not to talk about it doesn’t mean that it doesn’t exist. So I’ll choose to believe, as the article describes, that if I push myself to ask “What can I do with you” instead of “What can I do for you,” whether in the international world or back home in the U.S., I can find my place in making the change I am driven to make.

I welcome any feedback, comments, and further discussion.

“Everyone’s Problem”

Brittany Griffin | February 9th, 2012 | (1) Comment

Unless you’ve been living under a rock, you’re probably well-aware of the ongoing world economic troubles currently known as the ‘Eurozone Crisis.’ Given its global implications, it’s completely warranted that the situation would receive the high-profile, worldwide coverage it has seen for months now.

Further substantiating the global relevance of Europe’s recent economic woes, IMF director Christine Lagarde, in a recent CNN interview at the World Economic Forum in Davos, succinctly characterized the situation in Europe as “everyone’s problem.”

While I completely agree with her assessment and wouldn’t argue the potentially devastating global effects of a Eurozone disaster, what I’m taking issue with is the lack of attention and urgency toward other potentially disastrous situations that I would also characterize as “everyone’s problem.” These include, but unfortunately are not limited to: the impending civil war in newly-independent South Sudan, the rocky transition to democracy in Egypt, the ongoing fighting in Libya, and the continued violence perpetrated by Somalian militants.

And that’s just Africa. I’d be remiss not to mention the violent repression in Syria, homophobic legislation in Russia, and tensions mounting daily between Israel and Iran over Iran’s nuclear program. These problems in faraway places (from an American perspective, that is) are also everyone’s problems, yet are being handled with markedly less global urgency than the Eurozone crisis.

As reprehensible as this dynamic is, however, it’s easy to see how it got this way: we pay attention to those areas where we think our national interests lie.

But what about our human interests? Unfortunately, those don’t acknowledge the imaginary lines we’ve drawn all over the globe; they tend to be urgent and everywhere. And if we don’t start tending to those, too, then achievements in pursuit of our national interests will do little to compensate for our moral deficiencies acquired in ignoring everyone’s ‘other’ problems.

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