By Marc Hujer
It's the Tuesday after Easter, and the waiting room is so full that patients are lined up all the way into the courtyard -- some have to wait for hours before it is their turn. On this particular day, 120 patients have an appointment, which they made as far back as two weeks ago. They have returned, and that is the best proof that the Guguletu model is working.
Inside, the AIDS counselors of Guguletu sit and discuss their patients. The staff now numbers 24 men and women, who deal with over 2,000 HIV positive patients. Over 90 percent respect the guidelines and regularly take their drugs and come in for a blood test.
This program shows just how important public support remains despite a wide range of private initiatives. Private donors may be able to develop effective tools like vaccines and counseling models, but it takes the money and support of the state to extend these benefits well beyond a few initial test cases.
Reghana Taliep is on duty this morning. She is a young woman who tends to raise her voice when contradicted. Taliep likes to run a tight ship.
The Hope Offered by Millennium Villages
She is familiar with the problem cases and her counselors have visited nearly all the patients at home. But time and again, some patients fail to show up simply because they have failed to regularly take their medication or have suddenly stopped believing in the drugs. Sometimes a case of diarrhea is enough to make them stop the treatment.
The files for the problem cases are marked with red stickers, and Taliep reads the numbers aloud. "What about 1776?" she asks. "I see that 1776 missed his appointment at the clinic last week." A counselor informs her that 1776 died over Easter. Taliep nods, pushes the file aside, and picks up the next one. All morning long, they sit together, then they head out again to visit the houses and corrugated iron huts of Guguletu.
In western Kenya, near Lake Victoria, there is a project that aims to produce conclusive proof that development aid actually works -- to demonstrate that when the donating countries honor their pledges, poverty disappears.
The United Nations has established a Millennium Village here called Sauri, part of a project meant to show just what aid can achieve. There are 5,184 people living here, 64 percent of whom live below the poverty line, 24 percent are infected with HIV, 43 percent suffer from malaria, 42 percent of the children are malnourished.
An annual budget of $110 per person is purportedly enough to help the village rise out of poverty. Local government agencies and the village itself pay for $40 of the $110 per inhabitant, while the remaining $70 comes from external donations. These $70 correspond to the per capita sum that the industrialized nations promised Africa when they made 0.7 percent of GNP their target for future development aid.
Expectations Are High
The village residents are supposed to learn how to take responsibility for their own lives and work together. They have to establish committees for water, agriculture and local streets. In addition to deciding how the money should best be spent, they have to ensure that all members do their share, for instance, that they pay for the well technician's lunch or help prepare stones for the well.
Sauri is the first of 12 "Millennium Villages," located in Africa's "hot spots," where most people live below the poverty line of just a dollar a day. Expectations are high. Working from his office at Columbia University in New York, the project is being monitored by controversial economic and political analyst Jeffrey Sachs, who achieved notoriety for his strategy of shock-therapy privatization in Russia.
Sachs has been accumulating statistics, and he has figures for everything: the number of malaria cases inside and outside the Millennium Village, the harvest compared to previous years, the amount of donations to the school lunch program, and how many people place mosquito nets over their beds.
It is exactly those areas that the Millennium Project focuses on: technologies and incentives that have been scientifically proven. Aid workers distribute mosquito nets, donate lunches to schools to encourage children to attend classes, and provide fertilizer so farmers can increase their harvests and invest in more lucrative vegetable cultivation.
The Millennium Project has rented a villa on the shores of Lake Victoria, just under an hour's drive from the millennium village. This is where the numbers and statistics are evaluated, seminars are held and visitors are received. From here, researchers and journalists are driven to the Millennium Village like safari tourists. There have been quite a few important visitors here, including Bill Gate's wife, Melinda.
Looking for Signs of Progress
On the way to the village, the car rolls over dusty roads, past fields and villages, until there are no more paved roads. It's a journey through a veritable showcase of good deeds, where every new barber and company is celebrated as a great success -- a stand, for example, that sells not just soda and sugar, but also cards for mobile phones, a house that is completely screened against mosquitoes to protect its inhabitants against malaria. The aid workers are constantly on the lookout for signs of progress, collecting numbers and sending them to New York -- the idea is also to generate good PR.
The grain bank in Yala is the most convincing evidence that the project is working. For many years, the storehouses here went unused because nobody had anything to store, no grain, no beans, everything was immediately consumed. But now the storage facilities are suddenly full, rented by the residents of Sauri. Thanks to subsidized fertilizers, the locals have been able to more than triple their per capita grain production. The once-empty halls are now filled with 11,000 bags of grain. This is patent proof of their success.
But this success can only be achieved under certain conditions. The village needs to be connected to a road network, supplied with electricity, and given good teachers. Such progress requires state support. Each and every private project depends on a state that creates the right conditions, one that is neither corrupt nor bankrupt. Private aid can fill certain gaps, create incentives and develop new tools, but it cannot eliminate poverty.
The problems are so enormous that they cannot be tackled alone by a private project or a Millennium Village. Millions of children do not attend school in Africa today, and a free lunch like the one offered at the Sauri primary school is not enough to lure them there. It's important for the state to take action. In Kenya and neighboring Tanzania, millions of children were finally able to go to school when school fees were abolished.
A Role Model for her Continent
The state needs to create the necessary conditions for international aid and investment to make sense. It needs the help of the industrialized nations that forgive debts in countries like Tanzania on condition that the government invests this money in schools and the health care system. Economic development depends on a state that builds roads so the grain that is stored in the warehouse in Yala can be sold for a fair price.
Nobody is more aware of this than Monica Okega. She is the chairwoman of the coordinating committee in Sauri, and she knows how important it is to look beyond the confines of the village.
She lives in Sauri B, a district of the village where the huts are being replaced by houses and the corrugated iron by real walls. The aid workers at the Millennium Village call her their "champion farmer." She has always been one of the more privileged residents, but now she says that the others are better off as well. "The others no longer break into my home."
Last year, she harvested 36 bags of grain, twice as many as the year before. Since this bountiful harvest, she has even been able to afford to hire workers from outside. She has become economically independent.
She is a role model for her village -- and for her continent.
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