Tag Archives: NGO policy

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
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When Helping is Hard (Part 3): Score One For Policy

[Follow these links for Part 1 and Part 2 of this story]

After we left Sommai’s village it was a long and bumpy car ride back to Luang Prabang. As I braced myself against the potholes I stared at the dozens of white cotton strings swathing my wrists – remnants of the blessings that had been bestowed upon all of us earlier in the day. The national staff who had traveled out with us all had strings around their wrists too, I noticed, but not nearly as many as I did, or Mike. It seemed a fitting metaphor for the day, for our entire life here: Upon those who are already well blessed will be bestowed the lion’s share of any blessings that are going around.

“You know,” Mike said suddenly sometime around hour four, long after I’d been jostled into an dazed and aching sort of exhausted. “I think they have the policy wrong.”

“Who?” I asked. “What policy?”

“Edena and the child sponsorship team,” Mike said. “The policy about how much Sommai’s family should be paying. They told me the family was responsible for a quarter of the medical expenses, but I don’t think that’s right. I think this family falls into the extremely poor category, which I think means they should be responsible for a hundred thousand kip (about $13) and the organization should pay the rest.”

“If that’s true,” I said, “then forget about us trying to figure out ways to save the water buffalo. The most important thing you can do is to go into the office on Monday, find that policy, and make sure it’s followed.”

When Mike came home on Monday night he had good news and bad news.

The bad news was that Sommai’s family had already sold their buffalo. They’d sold it almost three months earlier when Sommai first got sick.

“But I thought Edena said they were going to sell it,” I said, confused.

Mike was well used to these sorts of misunderstandings. He just shrugged.

“English,” he said. “It’s a slippery language.”

The good news though, was very good. Mike had been right about the policy. It turned out that Sommai’s family was only responsible for $13. The organization would pay the rest of Sommai’s medical expenses.

“Yay for good policy!” I said.

Mike laughed, for he knows how ambivalent I am about some of the policies and practices of many NGOs (non-governmental organizations).

Some of the policies that I am most conflicted about have to do with financial accountability.

Donors who give to NGOs understandably wish to know that their money is not ending up in the pockets of those in power and is being put to good use in ways that help people.

This puts pressure on NGOs to be able to demonstrate exactly how donated money is being used.

Up to a certain point, I think that this pressure to be financially transparent is a good thing. It opens international NGOs up to some scrutiny of their decision-making. It gives rise to anti-corruption policies and safeguards. It forces organizations to pay attention to how much of their money is utilized in target communities in demonstrable ways.

However, donor expectations related to financial transparency and accountability have also helped create an environment where the merest hint of scandal (or even heated debate) about how an NGO has used funds can spark a significant drop in public giving – and most NGOs rely on public giving to stay in business.

This feeds into the drive to keep overhead costs as low as humanely possible (and often lower than is sensible to adequately equip and care for the staff of the organization). It can also lead the managers, auditors, and finance people of humanitarian organizations to be hyper-vigilant about the merest possibility of bad press related to corruption, theft, or the misappropriation of donor money. This, in turn, can lead NGOs to go to extreme lengths to document every detail of every expenditure – in essence spending ten dollars to account for five.

About a month after we arrived in Laos, Mike came home with a form detailing the bottles of water (each worth about fifty cents) that were given out to volunteer development workers during a meeting in a village.

Everyone from the village who received a bottle of water at this meeting had to fill in a variety of information – date, time, village, and name (twice, for some reason). Right after the space for the 2nd printed name was a space for a signature.

Here was the problem with that, though: the Lao script has no cursive. There is no such thing as a signature in Lao.

So how had some auditor, somewhere, decided to deal with this problem of missing signatures?

Thumbprint everyone who received a bottle of water.

 

“No!” I said, horrified, when I saw this.

“Lisa, Lisa,” Mike said, playing devil’s advocate and trying unsuccessfully not to laugh. “How else are we to make sure people are who they say they are, and that no bottles of water go missing? How else are we to explain to the donors that we are using every single cent of their money in field activities and exactly where it went?”

“How are you supposed to explain to the donors that you are spending a significant amount in staff time, paper, and ink pads, to account for 50 cent bottles of water?” I asked. “Or why you’re thumb-printing beneficiaries like criminals?”

“Yes, well,” Mike said, sighing. “Those are good questions, too. But they don’t get asked nearly as often or as loudly, you see.”

No, I am not always a fan of the policies and practices that result from that fertile tension between donor expectations and desires, and the specific needs, opportunities, and contextual realities on the ground. I do not think it serves anyone well to prioritize financial accountability at the significant expense of operational achievement.

In Sommai’s case, however, policy has helped save the day. It has taken Mike several hours of discussions and coaching to straighten out the teams’ understanding of how to apply the policies related to emergency medical care for sponsored children, but Sommai’s story has a relatively happy ending.

The family might be minus one water buffalo, but they are now also minus a significant debt to the village that they would have found virtually impossible to repay. And they are plus one Sommai.

[Next time, in Part IV of this story, Money, it’s complicated, we revisit little orphan girl]

  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

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