Tag Archives: charity

We, the beneficiaries of admin costs, thank you

I am sitting in Bangkok airport in a recliner. Yes, recliner – Bangkok airport has a bank of them right near gate C2, surrounded by pots of orchids.

Mike is stretched out next to me, dozing. It’s 10:30 in the morning and we’re both yawning our heads off. We’ve done an awful lot of sitting around this week, so I feel a bit silly about being quite so tired. But, then again, even the best hospitals are not entirely relaxing places to hang out.

We may not have gotten quite as much sleep as we’d like this week, but we did get good medical care. Mike has another week’s worth of antibiotic tablets to take three times daily, but so far everything points to him being well mended – for which we are very grateful.

I read an article this week by Nicholas Kristof called The D.I.Y Foreign Aid Revolution. It was an interesting, challenging piece primarily focused on the stories of three women who are passionately committed to making a difference in the lives of the poor.

“It’s not only presidents and United Nations officials who chip away at global challenges,” Kristof writes. “Passionate individuals with great ideas can do the same, especially in the age of the Internet and social media.”

Driven by “some combustible mix of indignation and vision” these women have accomplished extraordinary things.

They have also sacrificed greatly. One has depleted her life savings and is now close to homeless. Another one of these young women in rural Nepal recently had an infected tooth extracted by pliers…with no anesthetic.

This last story stands in stark contrast to our experience this week. For me, it’s enormously reassuring to have seen our emergency medical insurance company in action.

When Mike rang them in Singapore last Monday to talk to the on-call doctor, they could easily have told us to monitor the situation and wait it out for another 24 to 48 hours, but they didn’t.

Within hours they had transferred Mike’s case to their Bangkok branch and organized flights for both of us. On the other end they had pre-arranged someone to meet us at the gate, shepherd us through customs, and lead us straight to a waiting taxi. They had also contacted the hospital in advance, lined up a doctor to see us upon admission, and put us in a single room with a couch. They will cover the tab for this week’s little adventure completely. The only thing they won’t pay for is my air ticket and on-ground expenses.

This is one of the hidden benefits of working for a large NGO rather than on your own. Yes, the bureaucracy of large organizations can be frustrating at times. But the flip side of that coin, in this case, was that when something went wrong there was a safety net in place – a safety net paid for by funds that would normally be labeled “admin”.

“Administrative costs” is a bit of a hot-button topic for humanitarian organizations. NGOs love to be able to tell people they keep admin costs low. However, a hell-for-leather drive to keep admin costs low can mean more than just the vast majority of your dollar is going straight to building wells (or whatever you’ve donated to). It can mean that the organization is not investing in their staff and building their skills. It can mean that they’re not providing staff with emergency medical coverage, or resources (such as laptops in decent working order) that they need to do their work well and efficiently. It can mean that they’re not paying their staff well enough to stay long – which means high turnover and all that costs in terms of organizational knowledge, program continuity, and the recruitment and training of new staff.

So by all means look at the portion of a charity’s money that goes to admin costs when you donate, but don’t let it be your only yardstick. It is not a yardstick that does a complex situation justice. Mike’s office, for example, has a relatively high ratio of admin costs associated with it. This is partly due to the fact that (in accordance with government policy) program staff are not allowed to visit the project sites without being accompanied by government officials. Also according to government policy, the organization must pay these government officials a per diem for their time.

The relatively higher admin costs of this office are also partly due to Mike himself being here. In many other countries, a local would fill Mike’s position. But in this “strong state” it can be virtually impossible for the local staff to stand up to the demands of their government counterparts – demands that local staff hand over the money for the projects to the government, or work in non-target communities, or focus only on building infrastructure (such as schools) and neglect commensurate capacity building (such as teacher training). Part of Mike’s role here is to help shield these local staff by saying no to government when no needs to be said – to buffer local nationals enough to enable them to get on and do their vital work.

Here in Bangkok we must quit these recliners now – they are calling boarding. On the other end of this flight, Mike will head straight to the office from the airport and they will drop me at the house along the way. After a week on the couch with a small blanket I’m particularly looking forward to our bed, and I’m glad we’re going “home” to Laos today. But I must admit that I’m also very glad to know that we have good medical insurance (and, failing that, some savings of our own) and that I will not necessarily have to face a local dentist with a pair of pliers anytime soon.

When Helping is Hard (Part 4): Money, It’s Complicated

It was about a month after we returned from Viengkham that Mike received his first phone call about the case of Lahela, little orphan girl. You can read the start of this story in the post titled: What price a child’s life?

After eight days in the hospital in Vientiane, no one seemed to be all that much closer to figuring out for sure what might be wrong with eleven-year-old Lahela. All the tests had come back negative, but the doctors had now circled back around to thinking that she might have Japanese encephalitis, after all.

All that the medication she’d been given in Luang Prabang before being flown south may have clouded the test results. Either that, they said, or she had a chronic neurological condition and would continue to suffer from acute episodes of paralysis in the future.

The good news was that Lahela no longer appeared to be in imminent danger. She was eating again, although she still needed help even to sit up in bed.

Mindful of the fact that the medical emergency fund was set up to assist families with emergencies, not chronic medical conditions, Mike and the child sponsorship staff judged that Lahela needed to be transported back to her village so that she could continue to recover there.

Mike instructed the staff in Vientiane to make sure that Lahela knew she would be leaving the hospital in a couple of days and to encourage her fourteen year old sister (who the organization had arranged to accompany Lahela to Vientiane) to continue to learn the rehabilitation exercises so that she could help her sister complete them back in the village. The staff were to put together instructions for rehabilitation in Khmu, pay the hospital bills, organize bus tickets and paperwork, and (as Lahela could not yet walk) accompany Lahela and her sister on the ten-hour bus trip back to Luang Prabang.

With the exception of the bus breaking down in the middle of the night during their long journey home, all of this went fairly smoothly and Lahela and her sister were returned to the care of their elderly grandmother in their village. National staff up here were tasked with checking in on them regularly and doing what they could to help Lahela in her rehabilitation.

Two weeks ago, a month after Lahela arrived home, Mike had to visit a village nearby to conduct a construction inspection for a half-completed school. While he was in the area, he decided he would drop in and see Lahela.

“It was depressing,” Mike told me later, after he’d gotten home tired and dirty from his three-day field trip. “The child sponsorship guy was there, helping her, and he says she’s getting better. But she’s very thin, and still can’t move her right arm or leg much without help. It’s a tough situation.”

“What’s happened with the paperwork for this case?” I asked, sitting on the bed while Mike unpacked.

“All the bills have been paid for the organization,” Mike said, “Everything is taken care of except for one hundred thousand kip ($12) they owe as family contribution and three hundred thousand ($36) they borrowed from the village development bank when she first got sick.”

“How are they planning on paying that back?” I asked.

“Iokina says they’ll sell rice from this harvest,” Mike said. “But that’ll leave them short during the hungry months.”

“Can we pay it using Matt’s and Hilary’s money?” I asked.

“I’ve already asked the national staff to look into that possibility,” Mike said. “They’re a bit wary. They say that if word gets around that the organization paid back someone’s loan from the village development bank, then no one else will pay back their loans.”

“But the money’s not coming from the organization,” I said.

“We know that,” Mike said. “It won’t look that way to the people in the village. Let’s see what the staff suggest.”

When Mike came home a week later he was grinning and shaking his head.

“OK,” he said, as we were walking into town for dinner. “Here’s the plan the staff have made. They’re going to take the money for the village development loan from me in cash and give it to a local government official they trust, and the government official is going to give it to the family, and then the family can give it to the village development bank. That way no one will know it came from us.”

“OK,” I said, a bit dubious. “That’s fine. I don’t know how they’re planning on explaining why the government had decided to help out, but as long as the loan gets repaid, that’s fine.”

“I printed out a picture of Hilary and Matt from Facebook and gave it to the team so that if the plan unravels and people start asking questions they can show them who gave the money and reiterate that it wasn’t the organization.”

I laughed. “Nice touch. So, score one for the Matt and Hilary fund?”

“Yeah,” Mike said. “Score one for the Matt and Hilary fund. Now Lahela’s family won’t have to sell any rice this season. So if their harvest is good this year, they’ll have enough rice to make it through three or four of the hungry months instead of being hungry for all six.”

“That’s good,” I said uncertainly.

“Yeah,” Mike said, and sighed.

We walked along the Khan River in silence. I presume Mike was contemplating the difference between our lives and Lahela’s. I sure was.

“OK,” I said after we’d been quiet for a while, when we were only a minute or two from the main road lined with market stalls, and tourists, and restaurants.

“Where you want to eat dinner tonight?”

  1. When Helping is Hard (Part 1): That sort of decision
  2. When Helping is Hard (Part 2): In the village
  3. When Helping is Hard (Part 3): Score one for policy
  4. When Helping is Hard (Part 4): Money, it’s complicated