Vector Issue 2 - 2006

Aid: or does it?
She stood outside the clinic with her
arms crossed. Dust was settling from
where he had run across town.
“He’s wrecked our fucking ambulance,”
she said.
She was right. The man had thrown a
rock the size of a brick through the back
window of the ambulance. It had smashed
the satellite phone & hit some of the
equipment.
I stood next to her scratching my head.
I’d only been here a week, but this wasn’t
the first time I’d asked myself, “Does this
community really want a clinic?”
Be them missionaries, mercenaries or
misfits, whatever drives humanitarians is a
big mystery to most of us. And even if we
understood why, most of us wouldn’t do
it. But for those of us who do, there has
always been a reasonable assumption, at
least from the outset, that the benefits of
aid work outweigh the harms.
This was the assumption that I had
made, on making the decision to volunteer
in a clinic servicing a community which
was in desperate poverty.
The timing could not have been more
perfect. It was June, 2005. Millions were
attending Live 8 concerts, flaunting their
white wrist bands & trendy, altruistic hairdos.
The G8 leaders were about to meet in
the UK to discuss whether to increase aid
to the third world.
And the International Monetary Fund
(IMF), contrary to its official stance, published
two research papers with this unsettling
conclusion: there is little evidence
supporting the assumption that aid boosts
growth.
According to the United States Agency
for International Development, western
countries have spent more than one trillion
Lending a Hand: the Aid Issue
ISSUE 2
September 2006
1 Aid: or does it?
by Sally L
1-2 Lessons from a
frozen Capital
by Tonya Littlejohn
2-3 Interview with
Dr Mark Moore
by Andrew Perry
3 AMSA Conference
by Gail Cross
4 Upcoming Events
& Opportunities
4 Links & Resources
by Jacqui McDonnell
dollars in grants and loans to 70 countries
since the early 1950s to help reduce poverty.
So how is it that foreign aid has been
unable to pull the world’s poorest nations
up by the bootlaces & out of poverty?
The first reason is corruption. Take the
instance of when Australia donated aid to
Papua New Guinea - of great benefit to
PNG’s leaders as they licked the honey pot
clean. A Senior Fellow at the Centre for
Global Development in Washington, D.C.
says aid is least effective in countries such
as Somalia and Haiti, where governments
are especially weak, and in politically unstable
countries, like Iraq and Afghanistan.
The second is this: the amount of foreign
aid in many poor countries is very
large compared to the miniscule size of
their economies. The sheer size of the inflow
lifts the value of the local currency,
thereby making imports cheaper and exports
more expensive, reducing output in
other sectors of the economy.
The third is quite an overused piece of
rhetoric used here in Australia, often espoused
to prevent funds being diverted to
Indigenous Australians. It is that aid flow
becomes an alternative source of funds
that reduces the need for communities &
governments to become self-reliant. Less
effort is put into nourishing domestic
sources of growth, creating a good environment
for business, & spending money
where it will do most to reduce poverty. As
Michael Radew of The World Policy Institute
in New York says, “It encourages
all the wrong economic policies that made
those countries poor in the first place.”
When it comes to thinking about international
assistance, buzz words
such as ‘collaboration’, ‘sustainability’ and
‘empowerment’ spring to mind almost reflexively.
Yet despite the good intent, many
programs fall short of achieving positive
and sustainable outcomes. Political agendas,
competing interests and social factors
But the IMF economists who wrote
the offending report are the first to criticise
their findings. One criticism is their method
– their comparison of broad growth
figures across different countries is flawed,
and the findings could be overrepresented
rather than real effects. Secondly, the research
studied aid pre-1990 rather than
recent aid, since influenced by massive reforms.
For example, in the past five years,
most African countries grew at a faster rate
in per capita terms than Australia.
Nevertheless, the report highlights the
importance in the actual execution of providing
aid. The authors of the report admit
that the findings, which relate more to the
past than the present, do not imply that aid
cannot be beneficial in the future. “Overall,
we see our papers as urging care, prudence
and perhaps a little more creativity and experimentation
when aid is delivered.”
Aid is not a cure-all solution for the
developing world’s problems but it has
undisputedly been effective in reducing
suffering and poverty. It has been vital in
improving the health of people in poorer
countries, contributing to better education
and advancing human rights. While
economic growth and international trade
are critical to the long term reduction of
poverty, continuing assistance is an essential
part of the solution. And the future
relies on greater efforts to crack down on
corruption, to open markets and reduce
subsidised competition to exports, ensuring
that in this new age of aid, help will go
to where it will do most good.
Lessons from a frozen Capital
Inside a Mongolian yurt
Photo courtesy of Sally L
by Sally L
serve as impediments to the delivery of
aid. When such obstacles are stemmed and
overcome however, aid has the potential to
bring enormous change and improvement
to the lives of those in greatest need.
Five years ago, I spent a year living and
working in Ulaanbataar, Mongolia, a beautiful,
desolate country sandwiched between
Russia and China. With up to eight
months of winter conditions and
temperatures that regularly drop to
minus forty degrees, life for many
Mongolians is a constant struggle
against the elements to meet basic
needs. Mongolians eat what the
land produces, so mutton is plentiful,
but vegetables are scarce. Life
expectancy and health status of the
population are poor. It is a country
undergoing huge socio-economic
transition where traditional
continued on page 24
Lending a Hand: the Aid Issue page 1

Lending a Hand: the Aid Issue
page 2
Article photo courtesy of Tonya Littlejohn
nomadic herding practices coexist with an
increasingly youthful population. The outcome
of these major structural changes is
that services do not always reach the most
vulnerable groups.
In my brief time there, I was involved
in work aimed at adolescent development
and well-being. Up to 55% of Mongolia’s
Dr Moore is a Plastics and Craniofacial
Surgeon in Adelaide, South Australia.
His medical school days were spent
at the University of Otago, New Zealand,
following which he came to Adelaide to
undertake his fellowship, having earlier
completed his training in Plastic and Reconstructive
Surgery.
He has a longstanding involvement in
developing world healthcare through his
involvement with the Overseas Specialist
Surgical Association of Australia (OS-
SAA)
Dr Moore, how did you first get
Q: involved in developing world
medicine?
A:
A few years ago I met a doctor from
the NT, Dr John Hargreaves, who
had set up the organization that was to become
OSSAA, which coordinated surgical
trips to locations in East Timor and Indonesia
that were extremely disadvantaged.
He convinced me to go along on one of
these visits for a fortnight to East Timor in
2000 immediately post-independence. After
going on that first trip I haven’t looked
back.
How often do you go overseas and
Q: what do you do?
We travel four to six times a year.
A:
Herders in Mongolia
Next week I am going to East
Timor which will be the nineteenth time I
have made that trip. What is done on these
trips varies according to the skill set of the
surgeons on that particular expedition. My
area is Plastics and Craniofacial surgery so
the main conditions that I deal with are
cleft lips and palates, and burns. I also
come across a variety of other conditions
such as other congenital abnormalities of
the head and neck as well as tumours involving
these regions.
Looking at the OSSAA mission
Q: statement it says that one of your
aims is to provide local training in services.
Lessons from a frozen Capital
3continued from page 1
population are under the age of 24, many
of which live remotely or outside traditional
care structures such as family or
community. It was in the midst of this
complex and dynamic situation that I discovered
that despite my desire to contribute
to broader social and political change,
ultimately it was the small scale, targeted
programs that proved most effective at
addressing the immediate needs of Mongolian
people. For instance, delivering life
skills training to abandoned teenage girls
and outreach services to women in isolation
fostered independence and had a sustained
and tangible impact.
Sustainable assistance also involves giving
a voice to the disempowered. In many
communities, the most vulnerable populations
often do not have a say in the decisions
that affect them the most. It is vital
to create avenues for collaboration and
Interview with: Dr Mark Moore
Moving towards local sustainability
A: and independence is one of the ultimate
goals of our organization. When
I first moved to Adelaide the hospital I
worked at had an arrangement with the
Malaysian government whereby we trained
many of their Plastics trainees. At that
time Malaysia had no home grown surgeons
in that area, so we helped them develop
that capacity. They are now at the
point where many of these surgeons are
conducting their own outreach services to
places in Malaysia that are less advantaged
like Sarawak. I consider that a real success
story.
Similarly whenever we operate in any
of these sites we try to get some of the local
staff, both doctor and nursing, involved
so that their skills are built up. We still
have a long way to go but are slowly getting
there. The signs though are so promising
that AusAid is starting to look at our
operation as a potential model to replicate
elsewhere in the region.
Do you think that doctors in the
Q: developed world have an obligation
to assist those in the developing world?
A:
I think every doctor, and indeed
every person, if they choose to
can contribute to the health of those in
the developing world. This contribution
can be made in countless ways, many of
which don’t involve actually travelling to
these sites to practice medicine because
that is not always going to work for an
individual person. It could be through
fundraising, assistance with running organizations
like OSSAA or by covering the
clinical responsibilities of your colleagues
who do go overseas. Something that I am
against however is a phenomenon that I
call “medico-eco tourism” where doctors,
often the more junior ones, head to third
world countries on one-off visits and undertake
operations without adequate follow-up
and in some cases the necessary
Article photos courtesy of Dr Mark Moore
build meaningful partnerships between
marginalised populations and the Government.
In this spirit, the creation of a national
level young people’s forum gave the
country’s silent majority the opportunity to
articulate their own concerns to policymakers
and institutions. It has since become a
powerful medium for representation, giving
users the confidence to speak out and
decision-makers the choice to listen.
From such experiences in Mongolia
and elsewhere, I have observed the benefits
that aid and technical assistance can
accrue to the most vulnerable populations.
Certainly, the delivery of aid is a complex
and difficult undertaking. Nevertheless, in
places where the Government cannot, appropriately
targeted aid continues to provide
services and programs to those who
face the greatest burden of poverty and ill
health.
by Tonya Littlejohn
expertise. One of OSSAA’s principles is
to try and send the same surgeons back to
the same sites so that some degree of continuity
of care exists, along with the opportunity
to build an ongoing relationship
with the site which provides a whole range
of attendant benefits in terms of training
and ease of providing services.
I also think the medical schools should
play their part in this area as well, such as
through bilateral exchanges with medical
schools in developing countries. Organisations
such as your IHN are a good way of
starting and increasing this involvement.
A:
Is there a patient or experience that
Q: stands out for you?
If I had to choose one it is probably
the case of a young married
woman who was severely burned to the
face and chest while in her late teens. The
burns were such that she couldn’t close
her eyes and had difficulty putting food
continued on page 34

Interview with: Dr Mark Moore
3continued from page 2
in her severely scarred mouth. We have
done a number of staged operations for
her which have made an enormous change
to her quality of life. Her ability to deal
with these circumstances and get on with
life has amazed and inspired me – since
we first met she has gone on to have two
young children with her husband who has
also been extremely supportive.
You give up the opportunity to earn
Q: a large amount of money when you
go on these trips and stay in some fairly
primitive conditions. Why do you do it?
I don’t think anyone does this sort
A: of work for purely altruistic reasons.
It is not in human nature to do that. There
are rewards for everyone which varies ac-
cording to the person. For me it is the opportunity
to share experiences like the one
I mentioned before of the burns patient.
The other gratifying aspect is the true appreciation
your patients give you for your
time and skills. I have patients here in Australia
who will grumble if they have to wait
30 minutes in my waiting room, whereas in
East Timor some of my patients with significant
deformities will have been waiting
6 weeks for a scheduled operation which
we will have to cancel at the last minute
and post-pone to our next trip which will
be months away. And yet they still thank
you for even considering them.
Any advice for young starry eyed
Q: junior medicos who want to go
Crescent and Oxfam Australia shared their
success stories of emergency relief, empowerment
of local communities, microfinance
initiatives and many other excellent
projects. Between sessions, delegates mingled
with NGOs at their respective booths,
browsed through posters detailing what international
health groups had achieved or
simply lounged over the delicious lunches
to discuss the equally plentiful food for
thought.
Day three was geared at answering the
perennial question, “How I can do something
NOW?” We learned about student
volunteering opportunities, electives advice,
an internship at the UN, strategic
planning for international health groups
and how to get involved with indigenous
and refugee communities locally. This was
all topped off with a panel discussion with
a junior doctor, a nurse and a retired colonel
who answered questions and provided
advice on career planning.
This conference was a landmark event
for AMSA’s International Health Network,
a collaboration of all the university international
health groups. The IHN chair
presented their achievements including a
comprehensive website: www.ihealthnet.
net, Vector magazine, and much more. The
smooth running and quality of the conference
is a credit to its organisers, students
from UWA who did a great job with the
academic programme as well as cultured
entertainment and lavish food throughout.
Amongst all I heard and learnt at DWC,
it was the sweet, sad, and often hilarious
anecdotes from people on the field that I
cherish. I am so grateful to have experienced
the camaraderie of all present with
out and heal the
world?
[Laughs] Go
A: in with your
eyes wide open –
for some doctors,
travelling to these
places isn’t going
to work out. For
those of you who
do get involved,
the rewards are
enormous – it
makes you a better
doctor and a better
person.
AMSA Developing World Conference 2006
Delegates gather in the main lecture theatre
War. Injustice. Poverty. Natural disasters.
In an age where turning on the
evening news can lead to instant despair, it’s
hard to find the inspiration to believe that
things can change for the better. For me,
AMSA’s second Developing World Conference
did exactly that and more. Over
three days almost three hundred students,
medicos and gurus of international public
health and development gathered on the
lush grounds of UWA, Perth, for “Talking
Truths: Global Perspectives on Health”.
The conference was
much more than a dry
information session on
statistics of death, disease
and devastation. Keynote
speaker Prof Dev Bhasa
urged us to think about
the concept of “truth” – is
it state sponsored knowledge
we subscribe to or do we truly understand
the needs of the people we are trying
to help? Then there was the fantastic, cerebral
debate on Neoliberal economics and
its impact on health. Prof Komesaroff ’s
discussion on how aid can disempower
rather than foster existing capacity within
developing communities made me realise
how ignorant and naïve I still was. Other
speakers discussed the crucial topics of
fair trade laws, the powerhouses’ abysmal
foreign aid commitment, war and its toll
on health, doctor poaching and more.
But it was not all doom and gloom.
Representatives from NGOs such as Opportunity
International, Red Cross/Red
“Not only is another world possible,
she is on her way. On a quiet day, I
can hear her breathing.”
- Arundhati Roy
by Andrew
Perry
Yasinta Black
their infectious enthusiasm and dedication.
I am certainly looking forward to more
learning and a reunion of these ideals at
Developing World Conference 2007, to be
held in Adelaide. Until then, I’ll put my
best foot forward and have faith that that
better world is one step closer.
Students gather on the grassy common of UWA
Formation of the new IHN committee
Varga, Ruth, Fred Alok and Sneha
by Gail Cross
page 3
Article photos courtesy of Sneha Parghi Article photos courtesy of Dr Mark Moore
Lending a Hand: the Aid Issue

Aid comes in many forms – from
small grass roots projects by
non-government organisations
through to huge infrastructure or
government reform programs by
the World Bank. One of the main
goals of aid and development
organisations is to reduce poverty.
This can mean increasing the monetary
incomes of people or it can mean
helping to ensure that people have
access to the basic physical and
social needs for their survival and
development. An ultimate aim of aid is
to make itself redundant – for people
to be able to support themselves or
their own community. This paper looks
at how effective aid has been in reducing
the many forms of poverty and
improving communities’ self reliance.
In discussions about international development, the question of whether overseas aid is effective in reducing poverty is
never far from people’s thoughts.
This is not surprising given that after over fifty years of aid there are still frequent and terrible stories in the media about
people suffering from hunger and treatable diseases, and non-government aid agencies like World Vision are still writing
asking people to help children who are suffering in the developing world.
This paper takes a look at the evidence on aid and finds that, while it is not perfect, aid has had remarkable successes and
has helped to make the world a much better place. The paper concludes with some suggestions to maximise the effectiveness
of Australia’s aid program.
Lending a Hand: the Aid Issue
Upcoming events and Opportunities
Are you a budding
photographer?
Photo competition...
If
you have been to an elective /
selective / volunteered or worked
in a Community in Need (overseas or
remote Australia) and have photographs
of these experiences, enter them into
IGNITE’s “Communities in
Need” photographic exhibition.
Check out the gallery:
www.mccullochgallery.com.au
To enter the competition,
download the entry form from www.
ignitehealth.org.au, under
photographic exhibition.
Photos courtesy of Vanessa Fitzgerald
To be held on one night only on the
15th of October in McCulloch
Gallery, 8 Rankins Lane (just off
Little Bourke St, Melbourne CBD) you
stand a chance to win best photo on the
night. If you happen to be in Melbourne
on the night, come along to see some
great photos, meet like minded people
and enjoy the fine food, a few drinks and
groovy music.
Do you have photos you’d like
exhibited?
We want your photos!
Digital photos and entry forms can
be sent to: ignite.photos@gmail.
com.
Entering a photo is free of cost. Entry
to the exhibition is by gold coin donation.
Love to see your photos and love to
see you there!
Gail Brenda Cross
IGNITE
Monash University
crossgailb@hotmail.com
page 4
Links and Resources by Jacqui McDonnell
Movies...
An Inconvenient Truth
If you have an innate sense of
hate for the fence sitting mumblings
of many politicians, and purposefully
avoid any contact with their facades, this
documentary by Al Gore will change your
mind forever. I am in absolute awe of
the impassioned way Al Gore was able to
simplify the connection between global
warming, drought, malnutrition and
disease in developing nations. I guarantee
that every muscle car fanatic will leave the
cinema wanting to buy an alternative fuel
hatchback. Out 14th September through
Greater Union, but if your study schedule
has you under house arrest, check out
the website and start making a difference
today. http://www.climatecrisis.net/
If you only have time for one movie
this year, this is it! ooooo
The Constant Gardener
Based on the novel by John Le Carre
Not the sort of movie that will leave you
feeling all warm and fuzzy on the inside
but instead gives you food for thought
on large scale pharmaceutical testing.
Available from the new release section
of your local Blockbuster http://www.
blockbuster.com.au/The_Constant_
Gardener.htm
Great suspense! oooo
Books...
Race Against Time
By Stephen Lewis
I was inspired to
buy this book after
listening to Stephen
Lewis’s keynote
speech at the
6th annual UCSF
Women’s Global
Health Imperative
day. This speech and
others are available at
http://www.wghi.org/events.htm
I have found Stephen Lewis to be
an emotive speaker, but this does not
seem to translate well to the written word
especially when he is off on one of his
many tangents. That said, this book is a
great insight on the workings of the UN
and the Millennium Development Goals.
Keynote Speech: moved me to tears!
ooooo
Book: lots of UN backstabbing.
ooo
Next Issue: The Cost of War
Web links...
The Australian Development Gateway
For information about humanitarian
aid work, go no further than the
Australian Aid Resource & Training Guide
at http://www.developmentgateway.
com.au/jahia/Jahia/pid/171
This booklet will point you in the
right direction for anything from aid and
international health courses available in
Australia to international contacts for
work in aid-related fields.
I cannot recommend this booklet
enough! ooooo
World Vision
Poverty Reports
Does aid work? You
decide.
http://www.
worldvision.
com.au/aboutus/
povertyreports/files/
DoesAidWork_2006_
hi.pdf
Poverty, lack of infrastructure, widespread corruption and civil
unrest are both cause and consequences of war. But how is our
global community addressing the problems? And what can we do,
now? We speak to MSF Head of Communications about the current
crisis in DR Congo and more next issue...
Credits...
Editor
Kathryn Loon
vectormag@gmail.com
Design & Layout
Vanessa Fitzgerald
orangebutterflyness@hotmail.com
DOES AID WORK?
DOES AID WORK?
What is AID?
Does AID WORK?
“Empowering medical students in creating
sustainable health improvements in
developing communities”
[ ihn@amsa.org.au ]

© Antonin Kratochvil / VII
Médecins Sans Frontières (MSF) Australia presents
DEMOCRATIC REPUBLIC OF CONGO:
FORGOTTEN WAR
“Offers a glimpse of hope through the people’s
resilience and the hand of humanitarian assistance.
We’re compelled to bear witness...”
New York Downtown Express
“Will send you back out into the world with a changed
perspective. A rare and powerful insight into ongoing
human disaster.”
Brisbane News
A unique photo exhibition from VII photo agency, New York, now on its Australian tour 2006-2007
· Brisbane 12 July-6 August
· Townsville 15-27 August
· Melbourne 26 September-15 October
· Canberra 23 October-5 November
· Adelaide 11-28 November
· Hobart 7-18 December
· Sydney 6-28 January
· Perth 9-25 February
· Shepparton 8-18 March
Principal Sponsor Artistic Partner Transport Partner
For more information go to www.msf.org.au
Entry is free