Posted by: zdy1 | 26 June, 2009

What helps the best?

Over the last year I have heard many discussions around the topic of foreign aid and the growing concern that it actually does more harm than good. The main arguments being is that it causes dependency, has strings attached that may not focus on the overall picture and does not allow for people to seek to develop in their own creative ways.

Following what I have gained from these discussions, I am starting my work here with a resolution to try and work with the resources that are here rather than be a direct provider of new things – yet I am very conscious of my newness to this situation and the risk of idealism – as with all things round here, it is going to be a steep learning curve.

Today I was involved in a meeting by three visitors from the Western World (who were visiting the hospital for one day) who asked for a shopping list of what equipment would need to be provided for the specific need of wound and lymphodema care. The impression was what was asked for would be provided. My head spun at this point. Where do you start and stop? Yes we could ask for pressure mattresses and walking aids but the real issues are multiple and varied – the lack of space, patients waiting too long for operations because the theatre has run out of oxygen, patients being discharged too early (for many different reasons), staff not having time to teach patients and relatives. I don’t want to knock the work that these visitors are doing, I am fully aware that I new myself both to the hospital and this culture and expect that I am making lots of mistakes and misjudgements, however I can’t see the provision of this equipment making the difference that is hoped for.

I sat in a very different meeting last week, led by the Ugandan head of the physio department, she asked the question “what are the things we need to change?” and then “how do we go about them, starting from here?”, the changes suggested by the team involve upskilling both ourselves and other hospital staff, improving information to patients and seeking to gather evidence to request more staff – if this takes place then the knock on effect will improve, among other things, lymphodema care for patients. Its a long haul but I am grateful that I have colleagues with this mindset and I feel I sit much happier on this side of the fence!

Watch this space… I’m sure my thinking on this issue will develop and change!

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