A resource-constrained environment

March 16, from the student team

KCBHCP’s Katosi health center, which operates without electricity or running water (March 2011)

We visited Katosi Health Clinic, one of the two clinics run by our host organization. We were warned that the catchment area for Katosi is extremely poor. The majority of the population in the area is fishermen and thinks that their lives are always at stake when they go on the boat, which leads to risk-taking behavior.

What we found once on site was a small house converted into a clinic. The garage was used as the antenatal room, decorated with “posters” highlighting sanitary behaviors, and hallway with the stairs leading to the second floor was used as the doctor’s office. And to make the whole situation even more challenging, there was no running water or electricity in the clinic. When asked how they cope with it, the staff answered that they bring water in containers, and ensure that they make copies of all paper forms required before coming to the clinic (and they charge their mobile phones at the store in the village center).

Any technology-driven efficiency enhancing tools will be useless in this set-up. This is the part of the world that will definitely not become flat. No access to computers is one thing, but lack of electricity (or unreliable supply of) means that any system relying on technology is not sustainable.

What is amazing is that people are committed to serving in this area despite the resource constraints, and that they have been doing so already for an extended period of time. The reality of development work sets in, very much in my face challenging me.

Thoughts on donors

March 17, 2011, from the student team

The MIT student team visits a household in Katosi for an interview–and draws a crowd! (March 2011)

Today we talked with our host about the organization’s strategic planning and target setting process. What we essentially found out is that there is little room for the organization to have its own strategy and long-term plan. While it certainly is helpful to have its own plan, so much depends on the donor organization’s strategy and targets and what the donor organization wants to achieve. For example, the water and sanitation program does not have any funding because the funding provided was one-time only. In a more general term, the organization is originally a community-based healthcare program; however, most of its activities now focus on HIV/AIDS, because that is the area where much of the funding lies (and also all the HIV funding is from a single donor organization).

So, in the context of our project, there is no surprise that so much reporting is required by the HIV donor, even though that put so much burden on the ground. At the same time, the discussion reminded the importance of general funding that is not tied to any specific program, which will enable organizations to continue operations even when funding from specific donors are shifted. If not, how is one different from being an operational arm of the donor organization?