[2] According to the story, most people living in Eastern Africa (and many other developing regions) have traditionally obtained medical devices and equipment largely through donor-funded initiatives. These efforts may in fact do more harm than good. “The majority of the equipment is literally dumped into the African continent by suppliers who are funded through donor agencies. Indeed, close to 75% of medical equipment donated from industrialized nations are not in usable condition six months after arrival. Some 25% have major defects, another 50% fail progressively due to age or lack of proper maintenance.”
As bad as the short-term consequences of this type of development assistance can be, the long-term costs are even higher. By shifting the burden to relieve the problem out of the hands of the people affected, this current approach to development stifles the capacity for a country to meet their own needs independently of outside assistance.
“The dependence on donors to give equipment destroys any industry that happens to be present in the country.” This destruction of markets for local products “makes it even harder to think of creative ways of providing access of local products to the market.”
I’ve heard similar arguments from other development practitioners, and not just those in the healthcare field. A colleague from South Asia once told me, “what this country needs is more struggle and challenges, not less. People get used to having things done for them. Need a new road? No problem, just ask the Japanese. Need a new job program? Go ask the Dutch. Development aid creates a dependency mindset, a belief that someone else will always be there to solve your problems, so there’s no need to worry about them yourself.”
That’s one of the reasons I find the ‘development through enterprise’ model so appealing. It’s not just about creating the capacity to consume, but also the capacity to produce locally for local consumption. The approach generates jobs in the short term, and more importantly, engenders the ability to innovate and create new jobs in the long term.
KDNC is doing just that. The group has begun a new program for development of sustainable medical device manufacturing in Kenya. “The plant will serve the needs for local medical devices and equipments in the region; and serve as an outsourcing unit for medical device suppliers in the industrialized nations.”
Other initiatives with similar goals include Aavishkaar [2] and the Rural Innovations Network [2] in India, as well as Amy Smith’s work [2] at MIT on designing for the BOP. The success of such initiatives may portend a broader adoption of this developmental approach, one that creates empowerment and not dependency.