Wednesday, September 15, 2010

On Maternalism and Advocacy

So, I'm in Bangladesh right now, fighting what is apparently the mother of all eye infections (I know, I was totally blindsided--har har har), eating bananas and drinking a lot of tea. I'm also supposed to be working on my internship research, but as half my vision is out of commission and I made the staff doctor recoil in horror this morning, I've been spending all my time online screwing around instead, "resting".

Imagine my interest and delight, then, when I noticed via Twitter that Save The Children UK has sent three "mommy bloggers" from the UK to Bangladesh. The bloggers, writing from the perspective of being mothers, write about their experiences with other people's children--malnourished, fighting tuberculosis and diarrheal diseases in un-pretty, government-run hospitals. They stories are touching, heartbreaking, and real--one woman writes about a mother who begs her to take her malnourished, sick baby back to the UK with her, so the baby will live. These are not superficial or rare problems, and as heart-rending as they may be, they aren't journalistic sensationalism. These women write from the heart, and have been really effective at raising awareness about some of the problems in child health in Bangladesh. You can read their posts at nixdminx.com, mummy-tips.com, and sleepisfortheweak.org.uk.

In reading their blogs, though, I noticed that there seems to be a lot of talk about how lucky we all are to live in the Western world instead of this barren country. Although I understand that these are the echoes of people trying to come to terms with a completely different world (as I currently am doing the same), they may not be interpreted as such by the people reading these blogs.

In the comments section, I found no mention of how the mothers' counterparts in Bangladesh must feel, seeing their children sick and being unable to help them. In the discussions, there was only a contrast between how wonderful and rich the UK is, and how difficult it must be to live in Bangladesh--indeed, how difficult it must have been for the UK mothers to even see such things. Although this may be true to a certain extent, it doesn't engender a spirit of teamwork--it rather "others" the group that needs help. This makes it is more like charity, which doesn't make sense to me. Bangladesh is a country, with citizens, rules, and a culture. It has newspapers, police officers, and a national budget (which is not as large as the US budget, but still). As a state, it has a duty to be involved in the health of its citizens. Why are the rest of us in the Western world acting as if we're doing them a pure favor? Why can't we both work together towards the same goal?

The same thing occurred to me when I read the New York Times article about the battle over the intellectual rights to Plumpy'nut, a high-calorie tool in the fight against global severe malnutrition. The main point of the article is in itself fascinating and perhaps something for a different blog post. But what struck me most was the attitude taken towards Plumpy'nut at a fundraiser:

As volunteers sold raffle tickets for a Dior handbag, Salem delivered a practiced speech. Earnest and attractive, with wide brown eyes, she told the audience that her father, a member of an Indian merchant family, grew up in Tanzania. “There are over a billion people in our world that are malnourished,” Salem said. “It’s a shocking statistic. The good news is there’s a very simple solution.” And that, she said, was Plumpy’nut. “It’s really revolutionary, because it doesn’t need to be mixed with water or refrigerated,” Salem continued. “And the most miraculous part is, it will transform a child from literally skin and bones to certain survival in just four to six weeks.” This transformation, seen in before-and-after photos — on one side a sick and wasted child, on the other, a chubby, smiling one — was the promise that captured imaginations far beyond the technocratic community of specialists that originally developed Plumpy’nut. “People love a silver bullet,” says the prominent nutritionist Steve Collins...After Salem spoke, she began squeezing dabs of Plumpy’nut onto plates and passing them around, assuring the partygoers that the brownish goo was surprisingly tasty, with the consistency and sweetness of a cookie filling. Everyone ate it right up.

There is, of course, nothing wrong with trying to convince those with money and power to use it for public health programs like Plumpy'nut. But the danger, again, is that this type of advocacy encourages a spirit of charity, rather than teamwork.

You might be asking yourself at this point, why I should write about any of this? Why am I judging people who want to help but can't devote their lives or livelihoods to such causes? Why am I pretending that developing countries don't need help?

The idea of teamwork rather than charity is important for several reasons, the most important being that "teamwork" is more sustainable. From an organizational point of view, simply throwing money at a problem will do nothing except waste money--whereas continued communication with programs in-country encourages the strengthening of the in-country system, allowing it to eventually function on its own. And from a donor point of view, I'd argue that teamwork is more rewarding to those who are giving to the cause. By being aware of where the money is going and who it is helping, and receiving feedback, donors have an opportunity to personally connect with those they are helping. Rather than just a Dior bag, those people will have stories to tell about people like them who just happen to live elsewhere. In the long term, this kind of communication will be useful in building relationships between people and countries. This promotes public heath on so many levels besides just increasing the budgets of programs.

These posts are meant to foster discussion and debate; if you are stopping by and disagree with me, please let me know. I'd love to hear your point of view!