Action for health. A community offers high-impact health care in the home, and it asks a commitment of moms to give back in a way that’s affordable: by donating time or food to a malnutrition support group, by helping to build the new community clinic, by enrolling a daughter in a community literacy program.
fresh off the royal air moroc 747, i started scrawling lists of ideas to design a mechanism -- systems of monitoring and tickets and possible actions. but. this ain't right. i started to feel disgusting-- it's actually pretty horrific.
a perverted power trip: bearers of donor-funded medicines brainstorming non-monetary hoops to be jumped through “because it’s good for people.”
How can such a small difference – whether it’s me or Soukheina at the blackboard writing up action fees, not just writing them but cooking 'em up -- determine whether a program is the community’s own mechanism to empower itself – or know-it-all foreigners pushing a program that attaches strings to health?
After talking to Caitlin and others, and relaxing into life in Sikoro, i can start to feel more humble and less creepy. The past couple days, I’ve approached this huge blank page as a mechanism that needs to be designed. that route is misplaced -- and, i'm seeing, it's not MHOP. Soukheina and the CHAG are powerful, opinionated, driven and definitely don’t take any sass. The ideas will come from them – and as long as they do, it’s their ship. I was confused that there could be such a hairline divide between such slap-in-the-face patronization, and a mutual commitment between a community and it’s families. But it’s not a hairline divide. It’s the grand canyon. I feel so relieved to have this more clear – dodging a bullet by realizing how tiny my role has to, and will, be.
Coffee Exchange
6 years ago
hi darling! it sounds like you're having quite an adventure right now! d'ya know what your new name means in bambara?
ReplyDeletehey hey, don't think of the system of action fees you're setting up as attaching strings to health. nothing in life is free, right? giving out handouts isn't sustainable (and people don't place as much value on what they get for nothing.) i think the process of setting up action fees-- if the CHAG, soukheina, and other local groups are driving their formulation-- is a remarkable system of making the best outta what they've got. is there any way to think of what you're doing as setting up a system to help malians hold themselves accountable for completing their action fees, and not as creepy paternalistic monitoring? i am sure you know WAY more about what you're doing than i do, but i think you're doing an amazing thing! and that you'll have the judgment and insight to figure out something that isn't so ethically murky. hearts! keep on rockin' out in sikoro, girl.
xx,
sophia
also, psychologically speaking, it has been shown (albeit in affluent Western countries) that requiring people to do task A in order to achieve a reward (e.g., get good grades to receive $100; in this case, do an "action fee" to receive health-care) makes them resent task A and become less likely to do task A. so I would be concerned that once the incentive of free health care was removed from the society (or had been fully received), the recipients would stop doing things like helping build clinics or sending children to school. (OF COURSE, this objection still supposes that such requirements are valid, thus that such imposition of cultural values is valid... so it is sort of in addition to your argument rather than in place of it)
ReplyDeletethen again, unfortunately the chasm between what people SHOULD do and what they CAN do continues to be enormous, and application of one principle often entails the rejection of other principles.
Obviously I cannot speak with ANY kind of authority about any of this situation because I know nothing about it... but that is (one reason) why you are in Mali, Coletteybuns, which is to learn more about the situation and country and culture so that you can brainstorm informed, fair, and equitable solutions!
I MISS YOUUU!!!