Exit stage left

Apparently Amref are struggling to see through their exit strategy in northern Uganda; ‘volunteer’ health teams are refusing to work without the per diems to which they have become accustomed. Amref have countered with the usual response that the VHTs don’t work for them, but for the government. It would be nice if the Ugandan government could find the funds to continue supporting the VHTs, but we all know that is wishful thinking. Surely Amref cannot pretend they didn’t see this one coming?

Why is this happening? Well I don’t know any more than what the Guardian Katine blog is reporting, but we can make some educated guesses. Firstly Amref sourced a fixed length grant from a donor. The donor – anxious that they weren’t about to embark on an open-ended commitment – would have required Amref to describe their exit strategy, and Amref would have duly obliged with the usual bla bla. Both Amref and the donor are to blame; the donor for enforcing such requirements, Amref for meekly assenting, and the donor again for believing the b******t that Amref wrote.

If Amref were smart and truly dedicated to the project, they would have prepared well in advance for the impending cut in funding, and sourced alternative support from elsewhere. This is easier said than done, but large NGOs like Amref have the resources and plenty of options.

Maybe, in future, and after a gap of some a year or two, if the Katine project is judged a success, Amref will be back with a follow-up. Except that in the meantime they will have lost a lot of credibility as long term supporters of health care provision in northern Uganda. Now the problem of per diems will be twice as bad; the VHTs will know they can only get these payments for a few years, and so now is the time to capitalise. By showing their lack of serious commitment, Amref will have provided the worst kind of example to their ‘volunteers’.

All donors need exit strategies – that is both clear and understandable – but they need to be a lot more flexible and distant than is presently the case (try 10-20 years rather than 3-5 years). Meanwhile BINGOs should stop launching projects just because they can get the funds, and concentrate on providing lasting, sustainable benefits. Communities never just exit stage left; neither should those seeking to support them.

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