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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As much at home writing editorials as being the subject of them, Cam has won awards, including the Canon Media Award for his work on the Len Brown/Bevan Chuang story. When he’s not creating the news, he tends to be in it, with protagonists using the courts, media and social media to deliver financial as well as death threats.

They say that news is something that someone, somewhere, wants kept quiet. Cam Slater doesn’t do quiet and, as a result, he is a polarising, controversial but highly effective journalist who takes no prisoners.

He is fearless in his pursuit of a story.

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