Greetings once again from the ZealWithKnowledge blog at the Health for All Nations. With this installment we address the issue of using strategies that identify the type of situation we will be encountering when working in another culture. In their best seller “When Helping Hurts,” Corbett and Fikkert rightfully highlight the importance of knowing what type of situation we are working within. Is it a relief effort, (post tsunami Indonesia or post-earthquake Haiti for example) a recovery effort (they actually use the term rehabilitation) or a development situation? This is important for several reasons. It will change the type of team member we ask to participate (an ER doc is going to be more useful than a radiologist) and there will be a difference in the type of meds we arrange to be made available. But the most important factor may be our strategy for how we do things. In a relief effort we are doing all we can to save as many as we can and we will likely find ourselves in positions of leadership that are more in line with just getting done what needs to get done. Whereas in a development situation our approach will be entirely different. So our Statement 8 reads:

We will differentiate between relief, recovery and development efforts

  • Disaster relief
    • Short-term
      • Providing free or minimal cost care
      • Caring for emergent medical needs
      • Those who are most capable of saving the most lives are in positions of leadership with the approval of local authorities.
  • Recovery phase:
    • Medium term
      • Begin shifting focus of leadership toward local trusted individuals/entities
      • ID those who were previously doing sustainable (or at least moving toward) development work and review with them there strategies. Give feedback and input when asked.
      • Assist those with no long term strategy for sustainability to ID means by which they can move in that direction.
      • Assess healthcare infrastructure (assets) and fill in the gaps where local means are not sufficient.
  • Development
    • Long-term
      • Building healthcare capacity
      • Education
      • Assist in implementing strategies likely to lead to self-sustainability – Encouraging Primary Care, maternal/child care and Community Health.

This is obviously not an exhaustive list of activities at each level but you get the picture. I think we are very good at the relief level and probably with the recovery phase, however when it comes to the more long term development phase we have a lot of trouble. This is where issues related to culture come into effect and we have not too well over the years along these lines. Western culture is more interested in short term results and giving glowing reports about #’s of people treated and lives saved. But when it comes to reports related to achievements in the long term we are much less patient. If done right long term reports on transformation will have much more to do with what our local partner is accomplishing for their own community rather than what we as outsiders are doing for them. As always we welcome feedback. Mike and the Health for All Nations team.

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