“Teach a Man to Fish”: The Sustainability Doctrine and Its Social Consequences

Abstract

This paper analyzes the social impacts of the commitment to “sustainability” in donor-funded AIDS programs. Using survey, interview, and ethnographic data from rural Malawi, we examine how efforts to mobilize and empower local communities affect three strata of Malawian society: the villagers these programs are meant to help, the insecure local elites whose efforts directly link programs to their intended beneficiaries, and, more briefly, national elites who implement AIDS policies and programs. We describe indirect effects of sustainability on the experiences, identities, and aspirations of Malawians—effects that are much broader and deeper than the direct impacts of funding.

Examining health-care volunteerism in a food- and financially-insecure world

“…A handful of anthropologists and sociologists have recently gathered information about the lives' of community volunteers upon whose labour so many HIV/AIDS programmes in sub-Saharan Africa depend. 8 The work of these scholars has gone some way towards dispelling the myth of the volunteer spirit by talking with volunteers and recording their discontent: unemployment (or landlessness in rural areas), lack of remuneration, low social status, inability to meet household needs 9 and, in the case of home-based care, being unable to help patients who receive drugs but are not able to afford adequate food. 10 Even with occasional remuneration in kind, training and per diems, these volunteers lack the certainty of remuneration that comes with regular wage payments.…”

From brothel to boardroom: Prospects for community leadership of HIV interventions in the context of global funding practices

“…sex workers without such experience). Through the globalisation of 'new managerialism', institutional logics of bureaucracy and performance management, have gained a 'global' familiarity for a limited audience -for policymakers and managers from Bangkok to Seattle or Lilongwe -but remain obscure and inaccessible to grassroots workers in these same cities (Townsend, Porter & Mawdsley, 2002;Swidler & Watkins, 2009). …”

“…The ostensible environment of an 6 HIV prevention project comprises the local settings in which risk behaviours are practiced and shaped, such as brothels and local political or policing practices (Nhamo, Campbell & Gregson, 2010). However, a second environment is equally crucial, namely the funding environment, in particular, the representations among global funders of what a successful project should be (Aveling, 2010;Swidler & Watkins, 2009). …”

Towards Promotion of Community rewards to Volunteer Community Health Workers? Lessons from Experiences of Village Health Teams in Luwero, Uganda

“…It was unsurprising that these failed promises were linked to bad response to the VHT led sensitization campaign. It is logical that VHTs' delivery on urgent needs might increase their social prestige and augment their reputation, better positioning them to deliver, equally important but less urgent, preventive health messages (Swidler & Watkins, 2009). The dichotomy of preventive and curative interventions may be easily seen as an oversimplification but they undoubtedly shape community's appreciation of any interventions and certainly those through their peers-the volunteer…”