Fact: If you are a Tanzanian citizen who has a child with a disability, the chances that your income is below $40 per month is significantly more likely than if your child was born without a disability.
“It’s all about poverty….stupid”
Years ago, a similar phrase was used during the Clinton presidency when a reporter asked about the health of the country … the answer was, “It’s all about the economy stupid.” It was right then, and it still is in Tanzania and other developing countries around the world.
Having worked in Tanzania periodically over the last four years, I felt that I had some sense of the culture, political environment, and economic status of the people of Moshi, Tanzania. That was before I was “living here.” There is a vast difference between swooping in on KLM, the nightly connector out of Amsterdam, and landing at Kilimanjaro International Airport for 10-14 days of consulting, and when I arrived in January and said, “OK, this is where I’m living for the next few months.” How naive I was … I may relive that sense of naivety again and again over the next few months or years. Barb and I have a commitment to stay and support the BCC program any way we can during the next three winters. I hope our final blog entry in 2013 will reminisce about the good times and the bad times with the good far outweighing the bad.
Let’s get back to “It’s all about poverty stupid.” We know, for example, that the average Tanzanian earns about $40 per month. You may say, “but that goes a lot further than it does in the United States.” Yes, that may be if your only source of nourishment is rice and you wish to live in under the stars. So how do people survive? Honestly I don’t know … a coffee at a restaurant in downtown Moshi costs about 75 cents and a 1/2 liter of water is $1.15. You do the math … few average Tanzanians buy coffee at a restaurant; fewer still eat at restaurants, and even fewer have safe drinking water or adequate sanitation. You hear this and assume that wages must be higher in a city the size of Moshi (est. urban and rural population of 256,000). Sure, but even if you increase the average income by 20%, it is still only $60 per month. So you don’t drink bottled water, you don’t eat in restaurants, and you hope that if you find work, your employer will provide some sort of meal during the day. I entered a business the other day, and when lunch time came for the 60 or so employees, the employer provided each with two slices of bread and a cup of tea. Not one person said, “Oh, I’ll pass on that and just go down the street for lunch.”
Life is hard for these families, and we, as guests who observe and advise our partners at BCC, cannot fathom the day-to-day challenges. With most people not having access to safe water to drink or water in which to bath, I often wonder about the effort it takes just to get ready for the day. After finding wood, a fire must be built to heat water, to bathe, make porridge for the family, help get the children ready for school and complete other household chores. Barb and I get up, turn on the shower to the desired temperature, put on clean clothes, drink refrigerated juice and fresh brewed coffee, and eat from a selection of food that we have. Then we drive the car to our respective work destinations of the day. We can stay in touch with each other and our Tanzanian colleagues with our cell phones.
So why am I recounting all of this and what motivates me to think about these things? Clearly, one reason is that it is necessary to understand these factors because they are directly related to the outcomes we expect from our partners. Our expectations are often those we bring from the “developed world.” We visit a BCC day center and observe physical conditions that don’t resonate well with us. For example, the space may grubby looking, staff and children are engaged in activities which fade as the day progresses. We may ask ourselves why the program sometimes doesn’t look just like the one that we and the center staff designed together. For starters – the Kilimanjaro region is close to completing a year that is the driest in recent years. Dust is in everything …your food, clothing, computer, your eyes and your living quarters. Power outages hit every day, often 8-12 hours at a time. Local officials are predicting crop failures, and prices for all commodities are rising at an alarming rate. Mangoes are in season and people collect them as they fall from trees, eat them, make juice, or sell them. Mangoes are healthy, but need to be combined with other sources of nourishment. Contrasting that to the fact that “ex-pats” get frustrated when the coffee machines can’t produce their morning cappuccino, one wonders how we can ever find common ground to pursue our work.
Hospital administrators tell us that if the medical assistance laws are actually implemented (there is a law that says that children under 5 years of age and other vulnerable populations are entitled to free health care), they will simply stop providing certain services because they will be unable to meet the demand and still balance their budgets. So we try to “sneak” a few children into the system, one at a time, hoping that no one notices.
We appear to have a system in place in the Kilimanjaro region to access adaptive equipment, but with scarce funding, lack of electricity to operate welders, lathes and other equipment, production falls a way short of demand. So again, we fall back and say, “Well, back home we can just go purchase a special wheelchair, walker or other device. Why can’t they do the same here?” If I’ve learned one thing here in Tanzania, throwing money at a problem is not the solution.
In short, almost everything we take for granted is a huge deal here. So is it, “it is poverty stupid,” or are the methods to support the 240 children in the BCC program possible if we measured them against our norms; I believe not. The solutions here must come from our partners … they will be slow in coming, they may not look like what we judge as appropriate, but they will be their solutions. They must also be sustainable solutions, ones that can live and flourish within the “scarcity mentality” we observe. We must avoid importing methods and expectations that are not achievable and could result in failure.
More than anything we have to remember as a major funder and programmatic consultant is that they are reluctant to challenge almost anything we recommend. In addition, there is often a strong sense of fatalism. If something bad happens, it is often just accepted as the cycle of life. (Death is one example, but it takes far too much time to cover that subject in this blog.)
As a friend here told me, “the first and foremost goal of our partners is to maintain our relationship.” So if what we hear sometimes does not sound like the truth. I now believe no one is purposefully lying about a certain situation, but rather they are struggling to find a way to express the reality of the situation while maintaining their self-esteem as measured against our view of the world. When we ask, why we did not see a high level of activity in a center between 2:00 and 4:30, the reason is way too complicated to explain to someone who can’t understand why they can’t have ice in their soda!
You might sense that I am skeptical about the outcomes we see, or that my frustration will get in the way of moving forward. That is truly not the case, As we said when we started this blog last fall in Romania, this work isn’t easy … but compared to the challenges faced by our partners in both countries, our lives here are good. We will continue to learn and I believe that our dreams for a better life for the families and children BCC supports will only get better over time. Our burden is to learn to support their solutions while finding windows of opportunities where we can be of “real” help.
You may agree with this piece or not. Please submit comments or observations.