By Ana Maria Poveda Garces
During three days while driving around Mbola in Tanzania, Columbia University MDP students measure in many ways the return on investments of specifically targeted social interventions.
HEALTH CLINICS – SOLAR ENERGY
As narrated by locals, before the Millennium Villages Project (MVP) started, women traditionally gave birth at home — while many of these women or new-borns actually died during labor — endemic diseases prayed on undernourished children and adults, immunizations were rarely seen, and under-five mortality prevailed. The only local clinic was not fully functional 24/7 — both because of a lack of human capacity as well as for its breaking infrastructure — and emergencies were never managed systematically. The luck of having medical care to survive polio, TB or malaria in the village, was almost as likely as having a snowstorm in mid-July.
MVP came, and with an average investment of less than $40 per person per year, put together a package that systematically resolves life/death obstacles: built clinics equidistantly distributed, all connected by a referral system that strategically allows households to approach the closest location at a walking distant anytime during an emergency, or if necessary, be transferred in a new ambulance to a more specialized medical attention. Alternatively, the community health workers (CHWs) whom MVP has additionally helped training visit locals with properly equipped supplies when households face transportation barriers in getting to the clinics. Immunizations are regularly conducted. Not surprisingly, medical records show a reduction of cases due to endemic diseases and a significant improvement of maternal and under-fives’ health.
Finally, these clinics are operating with solar energy, which in the long-term proves to be cheaper than coal and emit no greenhouse gases.
17 schools provisioned with trained teachers, adequate books and materials, latrines as recommended by the WHO ratios, kitchens supporting school-meal programs, and periodic immunization and de-worming campaigns, are preparing the future generation of this village of roughly 44,000 people today, to achieve a higher socio-economic standing than that of their parents.
According to the head teacher of Ulimakafu, the top school in the village as measured by pupils’ achievement, these interventions have: dramatically increased the levels of attendance, from less than 50% to around 75%; improved the quality of students performance; and the overall health and well-being of the student body keeps motivating both teachers and students. Other teachers in other primary schools we visited answered with these same three indicators.
Nevertheless, ‘changamotos’ still remain. Main challenges all schools discussed with us were: the prevailing difficulty in collecting water, many times at inconsistent rates and varying locations; the still prevailing lack of attendance of children who belong to nomadic/pastoralists families (in Ulimakafu roughly the remaining 25% attendance missing), and who are consistently changing locations in the pursuit of grass and water to feed their livestock, in one of the driest areas in Sub-Saharan Africa. To a lesser extent, some schools mentioned the difficulty in collecting parents’ contributions to the school-meal program.
Other successful intervention we saw, is the group constituted by the women of UPENDO. With remarkable entrepreneurship and resourcefulness, and the limited support of loaned inputs from MVP, these farmers are increasing their agricultural output and diversifying their business opportunities. New income generation activities include poultry farming and solar lanterns sales. We visited their farm in a joyful day, as they have recently finished building a new warehouse needed to store their now increased number of chickens. A remaining challenge they all emphasized is finding an input-loan system that could continue to support them for an extra couple of years — in my view, equally important, the opposite side of the same challenge is finding the input-loan system that provides strong economic incentives to achieve a culture of re-payment, the financial capacity to re-pay, in order to ultimately achieve a high rate of re-payment.
None of the above has come easy, nor achieving their continuity and sustainability will be easy tasks.
Yet it must be said that in such complex organizational contexts in which each of these interventions is taking place, the results described above are remarkably valuable. Challenges remain, undoubtedly. Yet as initial interventions, these are designs that are incredibly good first approximations. The work has been started with the help of MVP; now the job is to continue, and this job involves leaders from the local village, national and regional governments, and development practitioners, among others. When we asked the Upendo women what aspiration motivated their efforts and work, they answered “kumaliza umaskini”. Two words that in English mean, “end poverty”.