A reader emails on his experience of aid in Africa

Following on from the discussion yesterday about aid, particularly in the South Pacific another reader emailed his experiences in the 1960s in Africa.

Hi Whaleoil Team,

The current debate in your blog on the moral ethics of what has now become the ‘Aid Industry’ reminds me of the fascinating (but probably valueless) years I spent giving ‘Aid’ in several third-world countries.

My rather ominous introduction came when we arrived at the headquarters of the aid organisation in Accra, Ghana in the days when the country was a bankrupt communist dictatorship under the regime of Kwame Nkumah.  The local head of the aid organisation I was to work for, a Scandinavian, asked us not to take photos of the headquarters campus as ‘People back home might not understand’. What he was referring to were the palatial houses the administrators (all Europeans or Americans) lived in.   The one long-serving couple, who actually lived in a tiny single-bedroom house which used to be servant’s quarters, told us they first lived in a mud-brick house and made their own furniture from the wood of their packing cases.  How things had changed!

I spent three years working up country and finished up very cynical about it all.  The hospital I worked at had two doctors and served about a quarter of a million people.  Our own figures indicated that probably 50% of the children born were dead by the age of 5 years. What killed them were the Big Three – Malaria – Measles – Malnutrition.  The annual measles epidemic early each year would kill between 100 and 150 children (that we knew about!) in our area.  Most of these children would arrive at the hospital dead or dying, generally from a combination of pneumonia and sickle-cell crisis triggering heart failure.  There was effectively nothing we could do.  We didn’t even have an oxygen supply.
Incidentally, the ‘official’ figures for infant mortality were much lower.  Of course these were derived only from recorded deaths in the major cities – Accra and Kumasi – and, since death registration was optional, probably under-reported even these.

Of course the local women would have possibly 10 to 15 pregnancies and most would result in live births.  The fact that they would only raise about half of these children was accepted as normal.
We offered – rather limited – birth control advice but, apart from a miniscule number of educated Ghanaians, it wasn’t used.  Cultural reasons – such as the fact that a man’s status in the community was raised by the number of children he fathered – ensured that women did nothing to prevent repeated pregnancy.  Polygamy was legal, though less common than you might think since bride-price meant getting wives was expensive.

As was pointed out in one of the comments in your blog, it was disaster trying to save these children unless matched by measures to limit the birthrate.  Starvation was a daily fact-of-life. ‘Kwashiorkor’, due to protein starvation in children getting adequate calories, was named after the Ghanaian word for the disease.  It, unfortunately, has irreversibly damaged the brain by the time it is diagnosed.  I saw many, many cases of it.    

We had a couple of revolutions while I was there.  The almost bloodless coup when the army took over from Nkrumah and the subsequent internal army revolt.  After that, since the communist CPP was no longer in charge, US aid started coming into the country.  The result was that you could buy in village shops sacks of rice, bags of dried milk and protein concentrate all clearly labelled ‘A Gift of the American People  Not for Sale’.  Of course the poor starving people couldn’t afford to buy this ‘free’ food – only the rich.
Likewise, suddenly Government official were driving round in their lovely new Landrovers and they didn’t even bother to paint over the ‘UNICEF’ logo on the door.

On a related topic.  I worked for a short time helping out two inexperienced Swiss aid doctors at a hospital virtually on the border of Burkina Faso (then called Upper Volta).  Seeing 350 – 400 patients a day in clinic was routine and roughly a dozen languages were used.
In that region, the government had effectively handed over to the dominant Muslim tribes.  While school attendance was nominally compulsory in Ghana, special dispensation had been granted up there so that young boys could attend what were called ‘Koran School’.
These consisted generally of a blackboard on which were written quotations from the Koran in Arabic (not a language spoken or generally understood in Ghana) which a group of one or two dozen young boys would be learning parrot-fashion.  Girls from Muslim families got no formal schooling.  It was also my first experience of FGM.  It is more hideous that you can imagine, particularly the awful complications that arise in childbirth.

This was the same time as the Biafran wars divided Nigeria.  I had an American (black) doctor come and work with me at the hospital I was working at.  He told me how his 30 bed hospital in northern Nigeria had been overrun by Muslim militants who’d pulled all non-Muslim patients out of their beds and slit their throats there and then.  He was then advised to get out or suffer the same fate. I don’t know if Sam ever had the chance – or inclination – to return to his remote hospital.  I’m grateful to him for helping me improve my surgical skills.

All this was in the mid 1960s  I wonder how much has changed?  I finished up with some fascinating experiences, a feeling that what I’d been doing was basically futile and a very cynical view on the value of ‘aid’ to developing countries.  There are few charities that I would support these days.


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  • MAWG

    I did 6 months of volunteer work in Africa as well, but in a far more developed area. This experience has taught me much on the nature of charity.

    The parable of “Give a man a fish, teach a man to fish” is a vital one, and is not limited to aid to Africa, or other Third World countries. The giving of aid, as described above, does nothing to help render a country as viable. However, aid programmes, such as developing micro industries help economic growth. This growth is panned by the left for creating inequality, but this is exactly what is bringing the lives of the poor up to the middle class, particularly in Asia.

    This approach, of providing charity in such a way as the recipient will eventually no longer need it, is the right way to go, and it requires more effort and work from both the provider and recipient. Our welfare system needs the same approach, and this government appears to be leading the way. It was pleasing to see the Salvation Army withdrawing support for a family because that family refused to meet it’s obligations.

    There are donors who are happy to give without thought to the consequences, but until we start to see charity and welfare as a process leading to a conclusion, as opposed to a singular act, we doom the recipient to a life of dependance. This is as true of countries as it is of individuals.

    • Quinton Hogg

      I am a member of a service club.
      We provide assistance to various projects in Fiji, Tokelau, and one in Tanzania.
      We do not give money as that disappears. what we do support is schools and projects that provide wells and such like.
      I think our focus in future will be in our back yard and not Africa.

  • conwaycaptain

    The most powerful country in the world today, the USA, has been in existence since the early 1600’s and it has gone from zero to now in 400 years.
    Likewise nations like Canada, Aus, NZ, have been in existence for a lot less time and are now in the top 20 economies in the world or nearly so.
    Yet we have nations in Afica, the Middle East, Far East that have been in existence for a damn site longer and are really no better off than they were. Taking the ME all the wealth has been extracted from the ground using Western ingenuity, Western Capital. All the benefits they get from health education etc provided by their countries comes from this fact yet they want to cut the hand that feeds them.

    • Grizz30

      Disagree with you to some extent. Much of Africa was colonised and run as imperial play things by European monarchs. It was only in the 20th century that africa was organised into countries. Prior to that it was tribal and feudal and even now these habits are hard to break. Sadly should mineral wealth be discovered it is usually squandered to buy arms for a conflict rather than be put towards the economic development of a country.

      • J Subz

        Africa was divided into colonial administrations in the 19th century, and the borders of those administrations later became the borders of the African nations today.

        The white colonial governments left plenty of Western infrastructure when they left. This infrastructure has since fallen apart because of incompetent and greedy African governments that have no desire to further that country’s development. South Africa and Zimbabwe are two very good examples.

  • timemagazine

    I agree with this post, that charities are in general “feel good” institutions.

  • Doc45

    Good commentary on the situation. A major part of the problem in Africa is a lack of defined property rights and a lack of respect for and the sanctity of contract. Aid in the form of product is worse than useless but attempts to set the locals up with “fishing rods” is hard work, involving lots of teaching, lots of demonstrations, and a knowledge of how to deal with safeguarding property and contracts.

    • And then someone with an AK comes along and takes the fishing rod, kills the fisherman and the kids still starve.

  • Edward_L

    Current ‘development’ ethos centres around not interfering with cultures and ‘partnering’.
    This falls down because there are no defined outcomes, no planned successful end.
    What does work, is adopting place and training people up to modern standards of practice, reporting and review. And we will only hand over money if you turn up and finish the job and anyone of the parent teacher group in that village will now send a text or email if something is wrong.
    Despite that, corruption is still huge, almost part of daily life. I have experienced all of the above and it’s not like you can call in the debt collectors or take someone to court. The legal framework is usuàlly poor and people in a non electronic cash economy just disapear.

  • Bob D

    By far the most effective advances I’ve seen in the third world relate to two basic things: clean running water and electricity. Once a community has access to these two things, they begin the long journey to a better life.

    However, in Africa the politicians are seldom interested in building up the infrastructure to enable this for all their people. Rather, they steal whatever they can to put in their own pockets.

    • conwaycaptain

      I believe that in Kenya the MPs are known as Wa Benzi. People of the Benz (Mercedes). They are paid a HUGE salary in this country and then rip the place off

  • ozbob68

    Question: FGM = Female Genital Mutilation? (Aka female circumcision?)

    • jude

      That is what I took it to mean ,yes.

    • mommadog


  • YoungA

    It really does perplex me how people can support charities at all. I know some people may view me as “anti-people” but I really don’t care less – I’ve never had a favourable opinion of charities and don’t hide it either.

    Another massive con is “Fair Trade”, a la what The Body Shop does. They pay above market prices for coconut shea, and what happens? Farmers in developing countries think “oh, maybe I can get more money from producing coconuts!” – and what happens? They produce these coconuts, but obviously The Body Shop already has selected suppliers, and these farmers are now left in limbo. Not only with these useless coconuts, but because they spent all their time producing coconuts, they now have no food! And people starve! Go figure.

    You send the wrong signals to the market, and this is what happens – bad outcomes.

  • CheesyEarWax

    Very enlightening, thank you for sharing your experience.

  • Mark

    As long as the Muslims & Catholics are fighting a numbers game (sadly probably required) Africa will continue to be unable too feed itself.
    As long as their are Aid camps people will not move to areas that can sustain them,if there are any left?
    The numbers have become truly frightening & depressing,people should not be abandoned to die,but I do not see palatable solutions.

    • J Subz

      When Africa was colonially governed, this did not happen. Zimbabwe used to be the breadbasket of Africa, but as soon as they started to govern themselves the nation became overrun with greed, corruption, and selfish leaders. Africa has the potential to feed it’s population many times over, but a culture of ignorance, self-centredredness and greed prevents this potential from being realised.

  • kaykaybee

    I have supported a child from Uganda for many years. To this date I have had 3 boys, all from the same family the first two being deceased. My first boy had epilepsy and passed away at 18 from an episode. The aid agency then gave me his 9 year old brother to sponsor. The ink was hardly dry on my letter of condolence for brother #1 and I was informed of the death of brother #2. I was shocked to find my second boy had died from sickle cell anemia complications, and was informed by an Uncle that the family had never even known he had it. I’m not a medical professional but was horrified to think that in a small community being actively supported for at least 15 years simple tests were not carried out as routine for this serious disease that affects 1 in 5 in Uganda.

    As for the problem of aid in Africa, this is a huge subject and thanks to the writer above telling of his/her situation.

    Can I suggest that anyone interested might like to read Robert Guest’s “The Shackled Continent”. Although written a good few years ago now it addresses (in layman’s language) the impact tribalism and all forms of aid have had on the continent.
    This excellent book presents the extent of Africa’s political and economic quandaries and offers solutions leaders should take if they are serious about improving the lot of their people.

    For anyone visiting or interested in Africa this should be required reading. It’s the antithesis of the usual leftist twaddle peddled by African Studies and Politics departments whose graduates currently make our billion dollar AID decisions.

  • botti

    The scary thing is that with the lack of birth control the sub-saharan population is going to double by 2050, to around 2 billion. That’s going to be unsustainable given the current levels of poverty in the region.