Global Health Intentions - good or bad?

As part of my global public health certificate requirements, I have to attend several seminar discussion series. (These used to be the "Dinner Discussion Series" but as budgets were cut, so were our free pizzas.) Tonight I attended my first seminar of the semester and we talked about

Global Public Health Ethics. The discussion was led by Jim Thomas, a professor in the SPH.

Jim started out the evening by reading exerts from Ivan Illich's "To Hell with Good Intentions". (http://www.swaraj.org/illich_hell.htm) Illich, from Mexico, urges American "dogooders" to go home because their "aid" is harming and not helping. Illich says, "You, like the values you carry, are the products of an American society of achievers and consumers, with its two-party system, its universal schooling, and its family-car affluence. You are ultimately-consciously or unconsciously - "salesmen" for a delusive ballet in the ideas of democracy, equal opportunity and free enterprise among people who haven't the possibility of profiting from these."

Ouch! Obviously Thomas wanted a reaction out of us and invited us to join him in a discussion of global public health principles and ethics. What was the most important principle to keep in mind if we are going to go to a "developing" "community" and "help", he asked? Of course we threw out those public health buzz words - sustainability, transparency, collaboration.

This discussion got me thinking about my own work. In order to really do it right, you have to do so much planning and management from the get-go. You have to know your partners, know your communities and be able to work together seamlessly, ensuring ownership by those you are "aiding". You have to consistently and accurately track money and deliverables, all while addressing the needs of your clients and satisfying the demands of your donors. You have to use the right language to document your activities and appropriately disseminate, sometimes thru speeches, other times in journal articles. You have to constantly be planning for the next step while so precisely carrying out your current work, and oh, everything was due yesterday. The point is, there are so many opportunities for things for veer off course and you risk all of the efforts of your "aid" and "good intent" backfiring. It can turn the most optimistic "dogooder" into a pessimist running for the corporate world.

Well you don't scare me Illich. You speak of things that we all need to hear once in a while to light that fire under our belts and push us to succeed in the work we are doing with developing countries to improve the lives of those who live there. I side with the Nicholas Kristof, Jeffery Sachs and Paul Farmers of this world. I have hope and optimism that we, the developed world, have a responsibility and genuine good will to raise up the developing world. I bet the millions of people whose lives have been saved and improved by donor, foundation, and missionary assistance would agree with me.