By Michaela Maynard, Global Health Issue Analyst

Nicholas Kristof coined the phrase in his article, published in the New York Times Magazine this past Sunday: “Do-It-Yourself” Foreign Aid; it’s a shift from the usual ‘wealthy country’ gives to ‘poor country’ to improve health and development. Mr. Kristof introduces readers to several of these D.I.Y. individuals: a woman working to manufacture sanitary pads in Rwanda, so that females will not have to miss work or school because they are menstruating; a 23-year old who developed a children’s shelter in Nepal, a mission that started with the $5,000 she had saved from babysitting jobs during high school.

The dedication and commitment that these and other D.I.Y. individuals demonstrate is inspiring. This kind of altruism reminds me that despite all the hardships in the world, there is hope. Today, the delivery of foreign aid does not depend on presidents, United Nations officials or even multi-millionaires. It is the workings of passionate but ordinary individuals with great ideas who are chipping away at huge global challenges. And, that’s the problem I guess, we are only chipping away at the issues.

The article made me question the long-term effects of foreign aid and the sustainability of these projects. If the goal is to make long-lasting changes, shouldn’t we be working towards more systematic development? Shouldn’t we be trying to help countries, economies, and governments help themselves? Don’t get me wrong; I’ve made donations to specific charities and I’ve spent time volunteering abroad. I know how wonderful it can be to witness the difference that you can make in the life of even one person. As a public health professional, I know that charity is not the solution to global health and I’m hesitant to think that foreign aid donations will solve the rest of the world’s troubles. Kristof is aware of this; he notes that these noble projects don’t always work out the way they are planned; sometimes even the best intentions aren’t successful.

While charity and individual or private donations may be helpful for organizations and countries that receive them, there can be implications for these ‘solutions’. In the area of public health, foreign aid is often directed at specific, short-term or numerical targets instead of long-term systemic changes in health infrastructure and design. Donors designing the projects tend to have specific requests about where the money is going and how it is being spent. Usually, ‘the poor’, the people for whom the intervention is being developed in the first place, have no say in the way the project is designed, managed or executed. How can something be sustainable if it is not well accepted by the local people – those who are actually in need of the service? I think we are forgetting that there are local individuals in every country who already understand the needs of their community, and who are finding ways to make improvements.

After reading Kristof’s article, I began to think about whether foreign aid projects- either by individuals or organizations- are really sustainable. What happens when the donations stop, funding runs out and the volunteers go home? Without safeguards in place it is likely that the problems will return. It seems as if we are using ‘Band-Aids’ to solve complex issues, but they only help to cover the wound, they don’t fix the problem. Perhaps, we need to assist governments in becoming accountable to their people. We also need to ensure that the assistance we are providing does not impede local efforts. Often, outside money, resources and volunteers take away from local opportunity and economic development.

Kristof’s article made me wonder about the best way to be socially responsible. As a country, I think we need to take a better look at how we can provide effective foreign assistance. Should we be donating money, goods and volunteers or should we be supporting better governance and responsibility. Perhaps, the solution is somewhere in between.