Goat loans reach the end of their tether

The following post is written by Diane Bennett and Dennis E. Bennett. “Yes, but is it scalable?” is a question often asked of development interventions. Sure your life-saving malaria net program works in one village, but will it work throughout the whole country? Yes, cash transfers worked in Mexico but will they work in Sierra Leone?

Everyone knows that development interventions should be scalable. But sometimes… everyone is wrong. In our experience working in South Sudan, very short-term, totally unscalable solutions may be just the thing to address specific short-term problems and avoid perpetuating aid dependency.

In 2003, communities displaced from their homes by decades of conflict  were trying to re-establish themselves in Upper Nile, but local leaders found their energies consumed by the demands of growing grain to feed their families. To maximize their efforts on community development, we wanted to improve the food supply and infuse capital into villages, while respecting local mores. For Dennis, a banker who helps multi-billion dollar institutions manage their risk, the problem was an unfamiliar one: how to infuse capital into a cashless society?

Our research found tribes in the area bartering with grain, gold, goats, chickens and cattle. The small amount of circulating bills barely survives local termites, which can devour a pile of cash in just a few hours. Grain is commonly used, but attracts rats, which in turn draw poisonous snakes. In addition, grain needs seed and time for cultivation, depends on unpredictable rainfall, requires storage for excess supplies, and is more vulnerable in times of war. Searching for a better cash-less solution, we found goats. Goats are portable, require relatively little care, and since tribes in the region universally trade goats, this solution doesn't exclude anyone.

We made three loans of three locally-sourced breeding goats each (one male, two females), for a total investment of $300.  The loans were two years, and “repayment” was a reciprocal set of goats (from the progeny), so there was no interest or expense. The loans went to three community leaders, chosen by the communities. Our intention was to reinvest the “repaid” goats back into the village, making the program self-perpetuating. But the villagers had other plans.

Of the three loans, only one was repaid to us, an abject failure in finance terms. Instead, goats were contributed to other villagers to start herds, “paying it forward” rather than paying us back. Instead of continuing with our program, borrowers assumed responsibility and perpetuated the project not just to feed their own families, but to help the whole village.

Five years later, these villages no longer need external food assistance, this program no longer exists, and we can say the Yamachoma (grilled goat) is delicious.

A Tale of Two Refrigerators

In 2001 in southern Sudan, it was a time of peace between wars. It was a time ripe for treating diseases that kill thousands of children every year. It was an opportune time for measles vaccination to halt outbreaks of one of the world’s most preventable diseases. The Measles Initiative, founded by the WHO, UNICEF, the CDC and the American Red Cross, was created to address this significant challenge. In the rural county where I ran an NGO, over 1,200 young children died of measles over four months in early 2001. The death toll was devastating to our school children and their families: local villagers did not have the resources to combat the outbreak except to bury the dead.

When we reported the outbreak to the WHO, the officials we corresponded with expressed shock and dismay that our communities had no access to a vaccination program to stop the spread. But the WHO was caught in a Catch-22 of their own devising: they were unwilling to allocate resources and send doctors unless they could be certain the outbreak was measles, but they couldn’t be certain it was measles without a clinical diagnosis by qualified medical personnel.

Our NGO shipped out videotape of the infected children to one of the Measles Initiative partners. A medical doctor and global measles expert said the video was some of the best footage of children with measles he’d ever seen, but unfortunately Sudan wasn’t on the list to have a measles eradication program that year and he couldn’t be certain without seeing the patients. Even with the clear video footage, a senior WHO official still wouldn’t attribute the children’s deaths to measles nor send an investigative team. So, as far as we know, the children who died in eastern Upper Nile state in 2001 were never counted in the WHO’s official measles statistics.

Worse yet, the WHO wouldn’t supply vaccines to inoculate children and stop the outbreak without a refrigerator to store them, and the remote communities where we worked had no refrigerator and no reliable power source. UNICEF, we were told, would provide a fridge if the number of diagnosed deaths from measles was significant. But with no qualified medical personnel to diagnose a “significant” number of deaths in our area, we didn’t qualify.

In cooperation with Save the Children (US) and funded by USAID, our NGO set up a medical clinic and put qualified African medical staff in place. Training on running a vaccination program was provided and record-keeping started. The communities waited impatiently for the vaccination program as more children died in subsequent outbreaks. There were hundreds more deaths diagnosed from measles each time. Our NGO was repeatedly told it was “near the top” of the waiting list, but years passed with no refrigerator and no vaccines.

Another outbreak of measles started in mid-2008. In desperation, our NGO raised private funds to purchase a refrigerator and fly it into the isolated area where we worked. Within a few months, our new refrigerator was in place and ready to hold the free vaccines that the Measles Initiative promised to qualified organizations. We have found that “free” is a relative term in Africa, however. We quickly learned that a small number of vaccines were available to us at a regional distribution center, a $5000 air charter flight away.

Just last week, a second refrigerator was delivered, this time courtesy of Save the Children (US), nearly seven years after the original request was made. According to locals, thousands of children have died of measles in the mean time, but the major aid agencies still cannot work together to provide truly free vaccines. Seven years later, this community has two empty refrigerators and still no means to keep their children dying from measles. The refrigerator excuse is gone but the vaccines are effectively out of reach.

Even a time between wars is not the best of times for the poor in rural Sudan. As it turned out, it has been a time of bureaucratic “defer and delay” from the UN aid agencies who failed to provide the vaccines needed to save vulnerable children dying from a preventable disease. After seven years, Save the Children (US) is making the most progress, which is disappointingly slow.

It makes me wonder if the 90% drop in measles infection rate between 2000 and 2006 claimed by the WHO is accurate, or if the children who are dying are just too much trouble for them to count.