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In Africa alone, 307 million people are malnourished. Forty-two nations receive aid from the World Food Programme and other Western powers pour billions, into ending global hunger. Just this past July, Obama pooled $20 billion from the world’s richest nations to be used for the reduction hunger in Africa. Yet, Ethiopia (one of the world’s largest recipients of aid) still has 6.2 million malnourished people in it’s country. Sudan, Somalia, Niger, and Chad, too receive plush amounts of aid, yet have devastating numbers of malnourished. Kenya, one of the most developed nations on the continent as well as a large receiver of aid, has 3.6 million malnourished people and that number is expected to rise. The problem is obviously not lack of money. The problem is misdirected use of money and an perpetuating intersection of poverty, drought, and corruption.

Poverty is the principle cause of  hunger – as well as a direct effect of hunger. Poverty and hunger are so entwined that neither can be solved individually. Without money, farmers lack the buying power to purchase seed, farming tools, and fertilizer. Without these necessities, they are unable to produce a sufficient food to turn a profit. The effect of this is two fold. The farmer’s poverty and hunger grows and the reduced supply of food to urban markets increases the prices, pulling urban poor who are unable to purchase the higher-priced food into malnourishment and hunger. Furthermore, drought exacerbates the problem.

The drought and subsequent famine of 1984 in Ethiopia claimed over a million lives. While some say that the drought never left, it is evident that the drought has returned with a full-fledged famine. There are currently 6.2 million people in Ethiopia who are malnourished and the famine is expected to raise that number to 14 million – in Ethiopia alone. In Kenya, the famine has severely threatened the lives of 3.6 million people. And Somalia has another 3.8 million people affected. In total, there are 23 million people in the Horn of Africa and Eastern Africa who have been affected. There is simply not enough water to produce a good harvest. And when rain does arrive, the sun-baked earth does not immediately absorb the water, rather causes flash floods and outbreaks of cholera. Farmers can’t grow enough food to even feed their family. They are forced to cultivate cash crops in hope of turning a minimum profit with which they can buy fertilizer that will hopefully provide a better harvest next season. “They are essentially going hungry so that they can feed the country.” But even those in urban settings do not walk away unscathed. They must compete for jobs in slums so that they can pay the inflated food prices. Furthermore, the hungry in cities are often overlooked while food aid and donors flock to the rural communities. Children in slums like Kibera, a shanty-slum of 600,000-1.2 million outside of Nairobi, Kenya, drop out of school to work or beg so that they to pay the 130% inflated price of maize (over one year’s time) and the ever-increasing prices of water. Regardless, there is hope.

“Drought does not need to mean hunger and destitution. If communities have irrigation for crops, grain stores, and wells to harvest rains then they can survive, despite what the elements throw at them.” Irrigation, grain stores, and wells require money, however,  and, once again, poverty stands in the way. Yet the same poverty that is preventing these people from building famine preventative infrastructure, was caused  by the previous poor harvest and famine. The cycle seems interminable – until someone steps in to provide the infrastructure these communities need. That someone is government.

“The urban crisis [and famine] is not just about poverty – it is about governance,” Oxfam reportedly said. Governments have the responsibility of providing fundamental social services to it’s citizens. In a country susceptible to drought, this includes irrigation infrastructure, grain stores, and rain water wells. However, very few governments have provided any of these resources to their people. In Somalia, there is no functional central government to provide these resources. In Kenya, the government is “paralyzed by infighting and political maneuvering.” And in Ethiopia, the government is, both, trying to maintain its good image from its successes in health care, education, and counter terrorism, and trying to undermine its citizens through corrupt, profit-driven deals. It’s desire for a positive image has led it to gloss over the famine by reporting (relatively) low numbers of people affected and making the definition of people at risk more exclusive. It has also tried to hide the severity of the famine through banning aid from reaching specific severely-affected regions. Backroom politics has highlighted the government’s lack of interest in curtailing the famine. Hundreds of bags of maize disappeared from the Ethiopian reserve and then reappeared in Sudan a month later, leading a lot of people to suspect that deals were made behind closed doors. Furthermore, the government has marketed Ethiopia in the new business of land-leasing, where large, rich foreign investors can rent vast plots of lands on 44-99 year contracts. The contracts have nearly no safeguards and foreign investors buy them purely for profit. The effectively take land away from local farmers, employ local residents under extremely brutal conditions, sell their crops to foreign nations for profit, and deplete the soil of nutrients. These are not the kinds of contracts a government interested in its people should be offering.

If it were not for corruption, the drought and the poverty could be (more-easily) resolved. But without the necessary functions of the state happening, the impact of both is increased and perpetuated. “Ethiopia’s famine today is a famine of food scarcity as much as it is a famine of democracy and good governance.” African governments must take responsibility and ownership for their states. I they want to become a respected global voice, they must end corruption and end their dependency on aid .

As outsiders from the West, we must be cautious in our critique and support of African nations. Too often aid has been given in ways that only increase dependency, circumvent governments, and enable corruption. The West is not culpable for the existing corruption, but it has not given support that leads towards independent, sustainable nations. “Continued food and agricultural support, coupled with falling [crop] production, have led some to believe that aid might actually be the root of the problem.” Food handouts increase dependency through creating disincentives to produce and providing short-term fixes to problems that need long-term solutions. Africa does not need more food, it needs more ways to consistently cultivate its own food.

It’s extremely challenging and a great moral conundrum to critique food handouts when lives are at stake. And I, in no way, believe that food handouts should be stopped, rather they should be accompanied by long-term solutions. It is easy to ideologically critique these different forms of aid, but when the reality that this aid saves a person’s mother, father, son, or daughter from dying is realized the disadvantages of any aid seem inconsequential. So it is with great respect and appreciation that I say, there is a better way.

Handouts cannot be expected to prepare these countries for the next famine. The international community must begin to fund projects which build irrigation infrastructure, wells for rain water, teach efficient methods of cultivation, and inspire autonomy of communities . The calamities of hunger and drought in Africa are not our burden and we should not carry the weight. The international aid community acts out of compassion for Africa, not obligation. It would be immoral to cease all aid merely because we are not obligated. Aid and exchange should always be occurring. We should always be in a flux of giving and receiving (even in times of prosperity) – giving the skills and lessons we have learned from our culture and experience and receiving the skills and lessons of another. We should be working to create autonomy and sustainability in African nations, which is why funding needs to be given to projects that pursue these goals.

The international community would be equally flawed if it built the preventative infrastructure of irrigation, wells, and grain stores. Although we would be establishing preventative measures for the next drought, it would still be us establishing them. Africa needs to help Africa -and we need to help Africa help itself. Funding should be targeted towards local, African projects which are building sustainable preventative infrastructure. Only then, do we truly help establish an equal, autonomous, independent Africa.

Though the intertwinement of hunger with large socio-political problems exacerbates the issue and makes it appear hopeless, it is not. There is abounding hope that Africa will make it through this crisis and then through the next. It is hope that lies behind all forms of aid and it is hope that feeds the starving souls of those who can’t find enough to eat, providing them the determination to make it through another day and to another meal. I have hope that the international community, specifically the large aid donors, will recognize the cycle of dependence they are caught in and will begin to teach their recipients how to fish.

In an increasingly globalized world that allows people to connect to each other around the world in seconds, this is a problem. Earth is quickly becoming a singular planetary community rather than hundreds of smaller, national societies. As a result, understanding and education about places not currently understood is absolutely vital.

The United States has been and will likely continue to be involved in the situation in Israel and Pakistan largely for our own interests in the Middle East. Therefore, people need to know what’s going on there for as long as we’re implicated in the situation. Conversely, besides any minimal foreign aid the US sends to places like the DRC and Sierra Leone, we have little vested interests in those areas (excluding the diamond-rich Sierra Leone countryside) that would make the American public want to become educated on affairs in these places. The major interest in these areas is, of course, consumer-driven, since the DRC is very rich in Coltan, an ore used to make myriad electronics so vital to our everyday lives. Unfortunately, this western business interest that has the potential to better the lives of the inhabitants, mainly serves to fuel pre-existing problems in the region.
Many Americans are sadly and disturbingly under the impression that Africa is a mysterious place that just naturally and inherently produces conflict, and that there’s really just nothing we can do about it. This is wrong.

Africa is a beautiful place with a history of peace and conflict resolution much longer than ours. Still, because of the discourse produced by those in power over the course of our history, people simply don’t realize this and never will unless something changes in people’s attitudes regarding the world around them.

Furthermore, western media has little to no interest in reporting on Africa, be it good or bad news, due to the historical implications surrounding it. Much of the problems that have arisen in war-torn countries came from severe cultural, economic, and social oppression inflicted during colonialism. Similarly to here in the US, people would just rather forget that dark period in history and not recognize the seemingly irreparable damage it has done to innocent peoples’ lives.

Now, this entire ordeal might seem hopeless and anyone reading this might be under the impression that there is nothing they can do. Well I am pleased to tell you that you are mistaken. The best solution to this problem? Education. Education leads to understanding; understanding leads to tolerance and acceptance. The latter both lead to compassion and desire to help, which is where groups like SCOUT BANANA and other international philanthropic organizations that want to help those who need it help themselves come in.

So next time you sit down to read the paper or watch the news on TV I’m presenting you with this challenge: for every story you read or watch about domestic affairs, read or watch at least one about Africa, or any other region of the world not typically covered on CNN, ABC, CBS, or in USA Today, The New York Times, The Washington Post, or any other major news source. You might be surprised how much you have to learn.

“Giving in its purest form expects nothing in return.” – Anonymous

There are a lot of confusing buzzwords being thrown around these days: ending charity, dead aid, patient capitalism, impatient optimists, and investment over aid. What does it all mean?

My initial thoughts on this subject were spurred by zyOyz founder Steve Jennings’ repost of an article titled: “Charity alone not the answer to tackling poverty”. Well I agreed with the article’s basic premise that just giving money is not the only solution or the best, I was troubled by the article’s absolute statements that business models and capitalism will save the world.

The article, reposted from the Financial Times, notes the work of the Acumen Fund founded by Jacqueline Novogratz, which invests in small businesses with a social impact termed as “patient capital.” It has become a highly successful model, however Novogratz is quoted as saying: “We need creative approaches to reinvigorate capitalism and make it more inclusive.” The most inclusive business model that I know, with high degrees of success, is the cooperative model based on needs of those involved, inclusion, and participation. Looking at history, capitalism has generated exclusion: great amounts of wealth for many people, but it has also perpetuated extremely flawed systems that create great degrees of poverty for many people. The evidence is in any major city where the consequences of capitalism lay bare the desperation of good people who are left with nothing.

At the root of the article, “Charity alone not the answer to tackling poverty,” is the long-running debate on whether investment is more effective than aid. Professor Bill Easterly made popular the fact (through his book, “White Man’s Burden”) that over $1 trillion in aid has been given to Africa over the last 50 years with limited positive results, Dambisa Moyo has termed this “dead aid” and calls for a complete end of aid to Africa. Others like Bill and Melinda Gates, who have given vast amounts of aid (which they often call “investment”) to Africa with their foundation, label themselves as “impatient optimists.” They are hopeful for the future and want more done at the present time.

However, there is a problem with their impatience that many have critiqued. Impatience tends to push solutions that are ineffective. Ian Wilhelm gets further into this topic in a blog about “irrational aid.” In the post he writes about Alanna Shaikh’s critique of ineffective aid, such as outdated pharmaceuticals and medical equipment that has no use in the field. This argument is countered by Isaac Holeman’s disagreement that well that aid may be irrational, it provides immediate personal stories of need to bring in more donors. I have to agree with Alanna in saying that this irrational, possibly impatient, aid does more harm and basically no good.

How have we now moved from decrying the failures of charity and aid to highlighting the benefits of business models and the capitalist system back again to smiling about greater benefits of monetary investment in people and ideas? Where is the line drawn between investment and aid? As far as I can tell it is mostly semantic. Isn’t aid when transparent, effective, and driven by best practices an investment? Giving an investment is essentially the same as giving aid or charity.

Investment is the buzzword used by social enterprises, microfinance, and has become the new fad in international development organizations. I think that it is important to make a distinction between what is effective and what is not. Aid can be very effective and investment can be very ineffective. The reverse is also true. Where does effective aid change from being a type of investment? When experts talk about the broken aid system do they forget that the broken aid system is merely a reflection of the broken financial system. The same interests and individuals who have run financial systems have run foreign aid systems.

The real issue in this debate need not be if businesses are better than charities or who’s money is better spent. What is most important needs to be the question of, “How?” The systems, structures, and practices that implement aid and drive investment need to be cooperative, inclusive, needs based, and people-centered – in one word: effective. If you are looking for a return on investment (ROI) or accolades for your donated or invested dollars, then maybe you should reconsider why you give?

Before you have anything else, you have your health. Hopefully if you have nothing else, at least you have your health. Unfortunately, for millions across the African continent this is not an absolute fact. Even more unfortunate is the fact that many Africans have no ability to change their health status. They are trapped in a system that is driven by Western market based, profit driven health care systems. As the failures of Western development practices come to light, alternatives to what has been are becoming increasingly visible. These alternatives will form a revolution in African health care delivery. This revolution will be fueled by health care delivery models that will give local communities agency in the provision of their own health care. Community-based models involving cooperative financing, proven para-professional training, new information technology, and social enterprise for the social good will drive the revolution in African health care. People will be able to determine for themselves, their level of health.

What does “Health” mean anyway?
This is a question often left to remain ambiguous. For the purposes of my writing I will provide a comprehensive view of “health” and all that is entailed in sustaining and maintaining health. “Health” in all instances will refer directly to the “basic needs” of a person in regards to health care.

Healing, like health, is obviously rooted in the social and cultural order. [...] To define dangerous behavior, and to define evil, is to define some causes of illness. As the definition of evil changes, so does the interpretation of illness. To understand change in healing, we must understand what it is that leads people to alter the definition of dangerous social behavior. It can easily be accepted that health and healing in Africa are shaped by broad social forces.

As Feierman and Janzen state, health (and healing for that matter) are directly linked to social forces. If a comprehensive understanding of health is to be understood, it must be studied in the context of politics, economics, and other societal structures.

Health is defined by the World Health Organization (WHO) as, “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The WHO and many other international organizations recognize that this broad and encompassing definition of health. Where this definition becomes ambiguous is what qualifiers meet, “a state of complete physical, mental, and social well-being.” In 1978 the WHO made primary health care its number one objective with the Declaration of Alma Ata. However, even this statement had no clear definition of health or its qualifiers.

Feierman and Janzen provide a more clear definition of the qualifiers of health in the preface to their volume: The Social Basis of Health and Healing in Africa,

[…] it [health] is maintained by a cushion of adequate nutrition, social support, water supply, housing, sanitation, and continued collective defense against contagious and degenerative disease. Such a view is necessary if we are to understand those contexts in today’s Africa where health levels deteriorate, and where they improve.

These authors provide a complete set of qualifiers, or “basic needs,” of health that can be researched further to understand where political, economic, and social structures interfere with sustaining and maintaining health and where health care is inadequate.

Health care should thus be understood as the system and structure that works to provide the above defined “basic needs” to each individual. Often this role falls to governments, but sometimes is taken up by communities and organizations when government’s fail to provide these basic needs.

This blog series will cover four key areas identified that will fuel this revolution in African health care: cooperative financing, para-professional training, information technology, and social enterprise. SCOUT BANANA works to tackle social medicine (social, economic, structures) while enabling others to provide medical services. Be sure to follow closely to learn more!

It all began with one individual, Fr. Joseph Birungi, who had the dream of providing access to basic health care in a remote area where he worked. His dream was transferred on to me through his stories of those who died because they did not have access to basic health care. At the time I was a 14 year-old who knew little of the world beyond Michigan’s borders, but I was inspired to do something. Just entering high school, I was full of naive optimism with a goal to figure out how I could make an impact in the world. Although I was youthful, naive, and optimistic I had an incredible mentor, my mother. She helped me form basic assumptions that laid the foundation for my understanding of "global health as everyone’s responsibility. "

One assumption that grew from my optimism was the belief that everyone had the potential to make a difference in the world. From Fr. Joseph to myself to my mother, the chain of individuals who embodied this grew to include hundreds of families, church congregations, school assemblies, and individuals from across the country working to fund an ambulance. These individuals, linked by a common cause, were able to raise over $67,000 in less than three months for the health center in Uganda.

It is easy for many people to take for granted the small things: clean water from a sink, medicine readily available in your cabinet, adequate food sources, etc. In the summer of 2002, I was able to traveled to Uganda. During my one-month stay I met and lived with the people who would benefit from the ambulance project. The people I met were so friendly and, even in their poverty, they wanted to share what little they had. I have seen that all people of the world share the same needs and wants. Everyone needs food, shelter, clean water, and necessary health care. We all want to know happiness, health and love. Parents everywhere want the best for their children and children want to learn and grow. But not everyone gets the same chance for success. And so keeping in mind the interdependent and similar nature of our world it is not so difficult to see "global health as everyone’s responsibility."

As I graduated from high school with my classmates so did SCOUT BANANA. My friends began expanding our work into Chapters at colleges and universities across the US and Canada. This allowed our outreach to grow along with our ability to support more local projects. We became seriously focused on community-based solutions and empowering young people in the US to take responsible action when "making a difference" in Africa. Just because you have the means to do something doesn’t necessarily mean that you should. With an expanding support base and the desire to empower young people and community leaders we decided to pursue 501c3 status in order to better serve as a resource. Utilizing privilege in the US to connect communities in Africa with inspired students, SCOUT BANANA has been able to raise almost $200,000 to date and engage over 50,000 young people in partnering with African projects to provide access to basic health care.

SCOUT BANANA believes that global health is everyone’s responsibility and that everyone has the potential to make a difference. We look at global health issues systematically and our solutions are focused on revolutionizing structures as well as shifting paradigms of development thinking in regards to education, power, and privilege. We seek to create lasting social change in African health care and believe that solutions come directly from communities in need. SCOUT BANANA is dedicated to empowering community solutions as well as young people who want to responsibly make a difference in Africa. By connecting communities in long-term cooperative partnerships, we will build a movement dedicated to fundamental social change in which global health is everyone’s responsibility and every individual’s human right.

SCOUT BANANA is a nonprofit organization that works to provide access to basic health care in Africa. Focusing on community-based solutions and empowering community leaders as well as young people who want to make a difference in Africa, SCOUT BANANA is supporting the innovation in African health care. The organization connects student Chapters with local health project in Africa.

Learn more about the Chapter network & apply to launch a Chapter at your school HERE!

Cross posted from Change.org’s Global Health Blog: HERE Published September 09, 2009 @ 05:00PM

Articulate: Undergraduate Research Applied to International Development is now accepting submissions for its Fall 2009 issue! The journal will be published in November, and we encourage all undergraduates and young people (under 30) who are interested and experienced in the areas of development, African studies, and/or health care to consider making a contribution. See the Call for Papers below for more information.

(photo credit: WDI University of Michigan)

Over the years SCOUT BANANA’s work has been termed “social entrepreneurship.” Unfortunately, the definition of the social enterprise has slowly become muddled and confused with other ideas. During a discussion last month a friend said that calling someone a social entrepreneur was like “cutting the balls off of a socialist.” He may not have been as far from the truth as I once thought. As the term becomes more prevalent within aid and development we must delve deeper into the history of social enterprise and decide what it really means for the work that we do.

Jeff Trexler wrote an excellent post on the history of social enterprise. He writes that a social enterprise is essentially “a venture with a social purpose.” As many wrongly believe the ideas of social enterprise did not come from capitalism or corporate business models at all.

“In socialist jurisprudence, social enterprise was a term designed to replace the capitalist notion of businesses dedicated to the pursuit of profit. The social enterprise generated revenue in excess of the costs of production, but profit-making was not the goal of socialist business–rather, its fundamental organizational purpose was to serve collective benefit. More over, in keeping with Marxist/Leninist ideology, the social enterprise was owned & controlled not by private shareholders–a hallmark of bourgeoise capitalism–but by workers themselves, from the workers immediately connected to the enterprise to society as a whole.”

Jeff continues to write that “social enterprise” migrated to Western minds and charities much the same way that “civil society” was reborn and co-opted. Meaning “citizen’s society,” the term was used to unite individuals against centralized government power. Now the term is best understood as a descriptor of anything “non-governmental.”

It seems that “social enterprise” has drifted just as far from its original conception. As a social venture that was meant to give power back to people and allow them ownership, much like a cooperative, “social enterprise” has best come to represent corporate philanthropy and cause marketing campaigns. Both of which are focused on turning profits and not helping people. Julia Moulden asks, “is making a difference only for the rich?” She easily gives examples that it is not, but is it? As far as the foreign aid/ international development arena it appears that social enterprise is geared towards engaging wealthy Western populations in feel good campaigns, like Product (RED), that are best defined as image marketing campaigns for corporations to try and look better as a way to bring in more customers. Lucy Bernholz has termed this business model “embedded giving” where “commerce is used to generate funds for a cause.” She writes:

“Embedded giving is just one more example of the blurring of sectors and roles between commerce, philanthropy, and public good. [...] Maybe today’s teens and kids who have seen so much embedded giving will grow up to expect that every product and every service comes with a charitable affiliation.”

SCOUT BANANA’s work was first called “social entrepreneurship” in 2004 when I was selected as one of Netaid’s Global Action Awardee and was asked to contribute to a discussion on SocialEdge about young people and making a difference. Then, I was not too sure what the term meant or why it might be significant. More recently Spotlight Michigan has highlighted our work and called us a “social enterprise.” They select “innovative” companies and organizations in Michigan to feature on their website. Their criteria breaks down into three categories: creativity, risk-taking and adaptability. In the true spirit of a social enterprise we are an organization built for adaptation because we operate by members involvement and input. We have always been called creative for our fundraising tactics, use of yellow and bananas, and our ability to connect people. The risk-taking is another story. We never faced any risk in our venture to make a difference. If we failed the only people who would potentially suffer were those relying on our support to access basic health care. Alanna Shaikh wrote an excellent piece on how “global health is not about altruism.” While our actions may have been seen as risk-taking, we really work to create accountable, long-term relationships with communities developing their own sustainable solutions.

Personally I define social entrepreneurship within its original conception; a socialist structure (for social good) that is meant to give power and agency back to people as well as present an alternative to ineffective governments. Civil society still exists because honestly the government can’t do it all and often are not very good at meeting the needs of people. SCOUT BANANA sees the world’s problems as a simple equation of connecting communities; linking the necessary social capital (people and ideas) to social problems. We embrace the idea of “social enterprise” by focusing on presenting an alternative to government aid schemes and other big philanthropy and development programs that go for the quick-fix, band-aid solutions without being people-focused to produce long-term social change.

Is SCOUT BANANA a social enterprise? Yes and no, it depends how you define the term. If you are thinking of an organization cooperatively owned and operated by its members, focused on providing an alternative to what hasn’t worked, and supporting community-based solutions that do work – then, and only then are we definitely a “social enterprise.” In her Spotlight Michigan article I think Caitlin Blair put it best: “A society of entrepreneurs and innovators simply could not exist without social entrepreneurs because where business entrepreneurs typically work to enhance markets, social entrepreneurs completely transform the necessary infrastructure and attitudes of a society.”

See our features on Spotlight Michigan:
profile
article
photo essay

(photo credit: WHO)

From the UN Declaration to Amnesty International, between Paul Farmer and William Easterly it seems that everyone has a different understanding of what constitutes a basic human right and the cause of its absence. Michael Keizner has been building the discussion on health and human rights on Change.org’s Global Health blog while NYU Professor, William Easterly has recently entered the debate as a response to Amnesty International’s position on poverty related to human rights. This fueled a response from Amnesty International, which stated that Easterly was “pretty off base.” Easterly followed his Amnesty International response with an end to his “human rights trilogy” by asking Paul Farmer who should be held responsible for satisfying the right to health care?

The World Health Organization (WHO) states health as a human right as:

“the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…”

It seems that Easterly’s human rights criteria is trapped in an old international law paradigm where there must be someone at fault or someone to blame. He also forgets that health is directly linked to food. You cannot have good health and not have food. Effective aid, not seen in today’s aid schemes, based in sustainable practices (not just buzzword reporting) that supports an individual’s right to develop themselves should look comprehensively towards the needs of a community of individuals. The ideas of human rights, foreign aid, and development should be less focused on international systems and more focused on building strong communities that meet their own human needs: health care, food, water, etc.

Within this debate of health and human rights, where does SCOUT BANANA fit. As an organization that makes and stands behind the statement that:

“global health is everyone’s responsibility and every individual’s human right”

Paul Farmer has the right idea, as Easterly quotes from his Tanner Lecture in 2005:

“only a social movement involving millions, most of us living far from these difficult settings, could allow us to change the course of history….troves of attention are required to reconfigure existing arrangements if we are to slow the steady movement of resources from poor to rich—transfers that have always been associated… with violence and epidemic disease… whether or not we can say “never again” with any conviction—will depend on our collective courage to examine and understand the roots of modern violence and the violation of a broad array of rights, including social and economic rights”

This is exactly similar to SCOUT BANANA’s understanding of health as a human right and a responsibility. It is a right where we do not attempt to place blame or hold the past accountable because those become frivolous exercises that produce no results. When we delve deeper into the root causes of issues, for example the driving forces of slavery, we must focus on a responsibility to not repeat the past and make ourselves accountable in the future.

There is no way that the entire European population and its descendants can be held accountable for the evils of the slave trade. While the same ideas of human rights did not exist in the time period of slavery, it is similarly difficult to place blame on systems (and populations) that drive the causes of poverty and lack of access to health care. Many people that I work with on development projects feel guilty that they are so privileged and wealthy compared to the communities that they work with that are so poor. SCOUT BANANA teaches its members to not feel guilty, but instead to feel responsible. Understanding personal privilege related to the oppression of certain populations within societal structures can assist in creating positive impacts. Human rights don’t necessarily have to be about placing blame, but rather developing an understanding of responsibility.

So Professor Easterly when you ask who is responsible for satisfying human rights: it is you, it is me, it is all those who dream of making a difference, and it is also those who lack the very human rights that we hold dear. Placing blame is not a concrete step forward, learning from history and recognizing where our privilege fits can be a first step towards effective actions. I too see Paul Farmer’s vision of a movement of millions, near and far, taking actions to shape a better future where human rights are everyone’s responsibility and every individual’s human right.

From the Article 25 of the Universal Declaration on Human Rights:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

Four modern-day explorers in Expedition Africa (from History Channel)

Reminiscent of the 1800s, a new History Channel show describes a team of explorers, dressed in their colonial khaki, set out to discover the perils of the African continent.

Four modern-day explorers retrace the most famous search in history through 970 miles of hell. They face countless dangers from predators and insects to disease and nature’s own fury. Check out the television event of the summer!

Miles of hell in Africa, oh my! Don’t forget the natural danger!

Between Zanzibar and Ujiji, there are 970 miles of high seas, steep hillsides, scorching plains, fast-moving rivers and mud-filled swamps. Danger lurks around every corner, and any step could be their last.
(Expedition Africa, History Channel)

The webpage for the expedition show describes how the explorers will be following in the footsteps of the great explorers, “heroes” to some of these ‘modern-day’ explorers, Sir Henry Morton Stanley and Dr. David Livingstone.

Stanley a Welsh journalist, who spent a number of years of his life in the US, is best known for finding Dr. Livingstone after he was thought lost in the African bush. Regarded as one of the premier African explorers, a little known fact about Stanley’s African exploration is that he laid the foundation, through his exploration, for the takeover of the Congo (now DRC) by King Leopold II of Belgium. The King was interested in spreading Western civilization and religion to the region as well as claim land. This has led to a still destabilized region where some of the longest running African conflicts are located. Allegedly his expeditions were marked by violence and brutality. He is quoted, “the savage only respects force, power, boldness, and decision.” On a health related note for the central African region, the spread of trypanosomiasis is attributed to the movements of Stanley’s enormous baggage train.

Livingstone’s African exploratory era was marked by the greatest European penetration of the continent. He began his African explorations as a Protestant missionary, but supposedly did not force his preaching on unwilling ears as his main interest was exploring. He was known to travel lightly and was able to negotiate with local chiefs. Livingstone was a man in love with the continent and popularized the search for the source of the Nile. After being ‘found’ by Stanley he refused to return without completing his mission. Just 50 years after his death, colonialism exploded across the continent and was able to penetrate further into the interior due to his work. However, this also allowed missionaries to provide education and health care services to more central Africans. Livingstone was also a staunch abolitionist and made many friends among the African chiefs and populations.

Both men are examples of the Western colonial mindset scarring the African continent. While Livingstone was perhaps a step forward in Western engagement of Africans, Stanley is far from a figure to emulate. The History Channel fails to take note of the important contributions these men made to the destruction of the continent. Instead they focus on the meeting of the two in a popular media tale of discovery in the African wilderness.

Four Westerners with varying experience with the African continent will be followed on their journey that will pit them against the harsh natural environments of Africa. But, this show isn’t about Africa, learning about African peoples, remembering African history or highlighting the difficulties faced in Africa. The show makes generalizations about the continent and perpetuates the myths of Africa as primarily a place of danger. It focuses on Africa as “the unknown, the interior of Tanzania.” If I’m not mistaken people have been living on the African continent longer than any other place on earth. It may be a dangerous, unknown hell full of nature to outsiders, but it is far from a mystery to those who live there. The show seems to be all about these four privileged individuals and the story of their personal journeys. The explorers are worried about mosquitos, disease, death, and surviving. Rightly so in some regards, but what if the story included the people that actually live there?

When will Africa cease to be represented solely by its nature, its dangers and its forgotten history?

Nyala, Kalma camp, South Darfur - March 2007 (MSF Photo Blog)

The impact of conflict on the environment and then the subsequent, direct effect on human health cannot be overlooked. This internally displaced peoples (IDP) camp in Sudan shows the seriousness of that impact.

Your Old Cell Phone Can Make a Difference in Global Health

Everyone in the global health sector is writing about the incredible reach of SMS technologies working for health in developing countries, and rightly so. Hope Phones has partnered with FrontlineSMS to provide old cell phones to communities in need through SMSmedic partner organizations.
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Your Old Phone Can Change the World

TeleMed
A service that I just recently came across is one that is not being as widely talked about. TeleMed is different from FrontlineSMS: Medic because it connects local health care workers directly to patients in need via SMS technology. SMS: Medic is focused on health infrastructure. TeleMed does not have a website up yet, but is definitely one to watch:

Paul Farmer and the US Government?

The other big talk within global health is whether Paul Farmer will take a job within the US government. Some have expressed great hope for potential reform others voice their plea with him to continue his incredible community based work outside the bureaucracies. My opinion is that Partners in Health has developed into a strong organization and does not depend on Paul Farmer to further their work. If he wants to take on the inefficiencies and inadequacies of the US government and global health, then all the more power to him.

Southern Africa: Global Financial Crisis Leads to HIV Budget Cuts

Broken promises abound as the economic crisis deepens and the right to health falters, but activists are coming together to ensure that funding for health and HIV are not cut. International donors are expected to slash budgets for health due to the economic crisis and health experts fear that this will lead to, “less food security and quality of nutrition, which will in turn put more stress on already weak health systems.” Paula Akugizibwe, regional treatment literacy and advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia demanded, “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.” Tanzania was the first sub-Saharan country to announce a 25 percent cut of its annual HIV/AIDS budget.
Other budget cut impacts:
Guinea: Medicines Running Out

Zambian High Court to Hear Groundbreaking HIV Case

On Wednesday, the Livingstone High Court was supposed to hear a ground breaking case about whether mandatory testing for HIV and discrimination solely on the basis of HIV status is constitutional in Zambia. Unfortunately two days later news came that the trial was postponed until mid-July. Be sure to keep watching this story.
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Trial postponed until 15 July

HIV Prevention and Behavior Change

Mara Gordon writes on Change.org’s Global Health Blog about a direct campaign in Tanzania discussing behavior change. “This campaign is partially paid for by the President’s Emergency Plan for AIDS Relief, U.S. government money to fight HIV that’s notoriously had lots of conservative strings attached. Had I seen this ad a year ago, I probably would have dismissed it as unrealistic abstinence-only propaganda. But behavior change works. Behavior change – in combination with access to condoms, comprehensive sexual education, open discussion about HIV and sexually transmitted infections in general, all that good liberal stuff.”
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Changing Human Behaviors: Sexual and Social
During a course on Africa’s environmental history I wrote about the need for changing human behavior in both the sexual and social arena to make a real impact in HIV prevalence. The major social change is the response from Western institutions and organizations in how they talk about HIV/AIDS and Africa while seeking to change sexual behavior.
Lesotho: Cultural Beliefs Threaten Prevention of Mother-Child HIV Transmission
Health workers note an encouraging response to the PMTCT program. The number of facilities providing PMTCT has risen from nine in 2004 to 166 by the end of 2008. The number of women who received PMTCT and subsequent antiretroviral (ARV) treatment increased from 421 in 2004 to about 5,000 by end of last year, according to 2009 National AIDS Council statistics. “The primary health care coordinator at St. James Mantsonyane Mission Hospital, Khanyane Mabitso, says stigma and cultural beliefs make it difficult for medical personnel to follow up on HIV-positive mothers and their babies.”

Progress on health-related MDGs mixed

Many advances have been made in health. Some argue that these advances have been dwarfed by the HIV/AIDS epidemic, the economic crisis, or the failures of African governments. The WHO report shows that the only statistic with concrete results was the number of children dying before the age of five. Is this a solid example of the failure of big plans and blanket goals for development?

Sierra Leone: ACC Recommends Reform At Health Ministry

The Anti-Corruption Committee report provides a number of recommendations for reform all focused on improving the health care delivery services in Sierra Leone and eliminating the risk of corrupt practices in the health services across the country.
More on health service scale-up:
Chad: Paving the Way for Better Obstetric Care
Government meetings with UNICEF to help scale-up of health services for better obstetric care across the country.

Ten Things You Can Do to Fight World Hunger

The Nation provides an interesting set of things you can do in your everyday life to fight world hunger. They properly focus on how food, a basic human need, has been commodified in our global capitalist structure. “Our planet produces enough food to feed its more than 960 million undernourished people. The basic cause of global hunger is not underproduction; it is a production and distribution system that treats food as a commodity rather than a human right.” When in February I wrote that agricultural experts had said the food crisis of the last year was over evidence from this past week point to the contrary.
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Tanzania: Food Shortage Unnecessary
“Tanzania has since independence sang the song of ‘Agriculture is the backbone of the economy’, but little has gone into strategizing and implementing viable actions towards surplus food production.”
Kenya: UN Agency Makes First Local Food Purchase from Small Scale Farmers
The United Nations World Food Programme (WFP) has for the first time bought food from small-scale farmers in Kenya under a new initiative aimed at boosting agriculture by connecting farmers to markets.
Zimbabwe: Another Year Without Much Food
Rwanda: Nearly Half the Country’s Children Are Malnourished
Kenya: Over Three Million Face Food Shortages

Africa: High Level Engagement with Continent Has Started

Speaking at a gala reception in Washington marking the beginning of “Africa Week,” Carson said: “Most of the Obama administration’s Africa team is in place, and we are gearing up. We will continue to build on and strengthen the strong bipartisan consensus in Congress and among the people of America that has motivated U.S. policy towards Africa. Over the next four years, we will be focusing our efforts on strengthening democracy, promoting sustainable development, resolving or mitigating conflict, and dealing with transnational issues such as climate change and agriculture,” he pledged. While Obama has built a great team, the White House has yet to announce any Africa Policy, greater control and influence for the Bureau of African Affairs, or take any serious (or effective) action for the continent.
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Tanzania: Obama, Kikwete Meet in Oval Office on Africa’s Conflicts

World Bank Resumes Zimbabwe Aid

Zimbabwe owes the World Bank and the African Development Bank more than $1bn, how much potential does renewed aid really hold for the country. If the debt is not forgiven there will be no way the country will be able to rebuild necessary infrastructures for health, water, etc. There are countless case studies to show this historical fact. It must also be noted that Western sanctions were a huge detriment to a country in need, maybe this marks a turnaround?