The Development Set

There’s a wonderful poem at the beginning of Lords of Poverty which starts:
The Development Set is bright and noble,
Our thoughts are deep and our vision global;
Although we move with the better classes,
Our thoughts are always with the masses.

In Sheraton hotels in scattered nations,
We damn multinational corporations;
Injustice seems so easy to protest,
In such seething hotbeds of social rest.

Last week I received a letter from my friend. She wrote that it felt like I was in a parallel universe and how on Tuesdays we used to sit after our International Institutions lecture having a very un-nutritious lunch of a caramel square talking of those people who work in deprived areas of Africa, and now how it seems I’ve temporarily become one. It’s as if the ‘big dream’ is being carried out, and yet it doesn’t in the least bit feel like that.

A few days ago I was at a rural hospital, and while I was waiting for the keys to the storeroom so I could check up on WFP food I was sitting in the NRU chatting to the homecraft worker. As I was there it began pouring with rain, with the wind pushing the rain into our open concrete square and through the windowless window frames. A woman walked in with her 13 month-old grand-daughter who had been referred to the NRU from their local health centre. The grandmother had walked for 4 hours with the girl, as the mother was at home with her 1 month old baby. The little girl had 3plus oedema, the symptom of quash. In malnourishment terms there are two illnesses we see, quashiokor and marasmus. Marasmus is what you see on tv, the stick like arms, alien looking head and general wasting which comes from starvation. Quash presents itself in fluid retention, so the child has swollen feet, arms and a moon-like head, often with very fair hair. Unlike most of sub-Saharan Africa here in Malawi quash is the most common form malnutrition takes, and it’s the hardest to cure. The girl who showed up with her grandmother at Alinafe in Nkhotakota district was a typical example. Her mother had initially taken her to the traditional healer, because a chubby looking child doesn’t equate with malnourishment for these rural women. The traditional healer gave the mother some medicine for the child, believing that she has either been cursed or that the husband was cheating. That medicine made the child’s legs purple. So the mother waited 4 days before taking the child to the health centre, who refered her to Alinafe. It’s not good enough that the child will probably recover, providing that there are no complications. The damage has been done to the child’s cognitive and physical development. She’s not unique by any stretch of the imagination, so when you consider that thousands of children suffer from malnutrition and what this does to their cognitive capacity, is it any wonder that countries develop at different rates? And think about all those children with quash who aren’t taken to the health centre, or who aren’t picked up by the HSAs – the outreach health surveillance assistance on their insane 50km bicycle catchment areas.

So what are the developments? I admit, WFP is not a development agency. It is a humanitarian aid agency which primarily works in emergencies, with a few development programmes such as school feeding. And yes, by looking at the facts in my programme alone we are proving food to 96 NRUs, 250 supplementary feeding centres every month, which equals about 30 children per NRU and 350 per supplementary centre, and this is half the size of the school feeding programme. In NRUs we also provide fortified foods to the caretakers to reduce the abscondee rate, and support nutrition education and low-input gardens to provide the caretakers with information about how malnutrition can be prevented. But is any of it working. The malnutrition rate is decreaing so far this year when compared with last year, but surely that’s only because the emergency is ending and the crop stores are better? Sometimes, when I’m in the office filling out a procurement form for ink and ink pads for the stamps the health centres need to complete their waybills I really wonder if this is it: hospitals which need signs on every wall saying not to wean babies onto Fanta or tea, and hospital workers who can’t keep a food storeroom clean and don’t seem to understand that the food we send should be treated like medicine, and not left to be eaten by rats or ruined by piling it up against damp walls. So I suppose what I’m trying to say is does any of this make a difference?

What I fear becoming is one of those development people who complain all the time and outside work only talk about where to buy such and such. I see myself doing it a lot. Conversation often revolves around the latest import of really fantastic cheese, or whether or not there’s the nice yoghurt this week. This isn’t what it should be about, but I suppose in an effort to blank out the work shallow-ness comes to the surface. It’s so easy to walk through an NRU and not take in what is actually there, and most of the time that’s what happens – it just looks so normal now.

In order to keep sane things are done in baby steps, one person by one person, one drop of water to make up the ocean, and all those other analogies. But ultimately what good is it doing? As the poem ends:

Enough of these verses -- on with the mission!
Our task is as broad as the human condition!
Just parry to God the biblical promise is true:
The poor ye shall always have with you...