What am I doing here?

One of the questions that Matt and I least enjoyed answering before we left for Sierra Leone was, “What will you be doing there?” It was difficult to effectively respond to this question when we didn’t really know the answer.  We knew that we would be working for a local NGO and that I would be working on “budget monitoring” and Matt would be working on “women in governance” but what that meant exactly was rather unclear. We tended to fumble a half-hearted response and remind ourselves each time that “we should really come up with a better answer to that question!”Finally, after two weeks of “doing what I am doing” I can now (sort of) come clean about what I am up to.

The work I am doing is with a network of civil society organizations that monitors government activity in order to push for greater accountability in public service and development. My assignment is to support an investigation into health budgeting and expenditure as it relates to three main issues – 1) maternal health, 2) child health and 3) Malaria/TB/HIV/AIDS and other infectious disease.

Since 2004, many government responsibilities in Sierra Leone have been devolved to the district and municipal councils. Our report will be focusing on three districts and two municipalities which are the areas of operation for the network. Unfortunately, none of these districts is the one where I live.

Right now, my work consists mainly of gathering information and producing a literature review that will help guide the investigation. One of the biggest challenges to holding leaders accountable in SL is that it is often so unclear who is actually responsible for what. If we don’t know what someone is responsible for, then how can they be held accountable? In many cases, these issues have never been defined but even in instances where they are defined, it can be very difficult to get hold of the documentation that clarifies the matter.

That said, the situation of health services in Sierra Leone is so dire that there is a real sense of urgency in pushing leaders to do a better job. Sierra Leone is consistently at the bottom of the UN’s Human Development Index. A Sierra Leonean’s life expectancy is less than 50 and rates of maternal and child mortality are among the highest in the world. In Kailahun, where we are staying, the only hospital has no running water, restricted electricity and has limited, if any, regular supply of safe medications. Yet the district council recently purchased 12 satellite televisions for the hospital in order to “help patients feel better”. It is not hard to see that something is going wrong.

Another challenge to this work is that the network that I am working with, while passionate and serious about getting the job done, is lacking in resources and capacity. The work requires balancing the need to produce results while mentoring staff to be able to conduct this work on their own. Obviously this is even more difficult when I am not even in the same town as any of the staff and internet is completely unreliable if available at all. I definitely do not want to “do it for them” but time and resources to really make this a learning exercise are simply not available. I find myself in a rather uncomfortable situation of doing the work without passing on the skills. Hopefully this will improve in July when I am scheduled to meet with the team and begin travel to the districts.

  Updates on that are sure to come…..