[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]
[afro-nets] Removing user fees for primary care (3)
- Subject: [afro-nets] Removing user fees for primary care (3)
- From: Peter Burgess <Profitinafrica@aol.com>
- Date: Tue, 17 Aug 2004 12:21:28 EDT
Removing user fees for primary care (3)
The expectation that "government" or "donors" or "philanthro-
pists (like Bill Gates)" will fund everything the poor needs is
a big problem. Certainly people have "rights", but rights can
only have any meaning when there is a functional economy.
In the past thirty years or more, the economy of the SOUTH has
become more and more disfunctional and there are no useful re-
sources for the poor, and the governments are essentially bank-
rupt. This is a terrible state of affairs and leadership in both
the NORTH and in the SOUTH is largely to blame. But also so are
we all. We are following (blindly it seems) easy words that can-
not end up doing any good.
Who is going to pay the nurses and doctors and other health care
Who is going to pay for the drugs and medical supplies that are
needed to give decent care?
Money does NOT grow on trees... and valuable money cannot be
Someone has got to figure out how poor communities can become a
little richer through better use of what is available. People
have got to embrace the idea of "surplus production" and an eco-
nomic framework that facilitates productivity improvement and
improvement in the local quality of life. With a surplus, a com-
munity can choose to do what will be best. If the community
chooses it can pay medical staff and it can buy medical sup-
plies, but it can only do this if there is a surplus available.
For the past thirty years almost all the resource flows have
been into government... and at the end of the day we have bank-
rupt government, poor people and a disfunctional economy. It is
time to change something... I suggest it is time to focus on the
possibilities and potentials of communities. Let the community
priorities be the ones that drive resource allocation for devel-
opment, rather than the Washington view, or the London view...
or Paris, Stockholm, Moscow or Tokyo.
I have spent a lot of time in (only visiting) African communi-
ties over the past 20 odd years, and one thing that is clear is
that almost nothing that I designed in New York was the best
that was possible after having dialog with the local community
people. Yet we still seem to want to drive development from a
distance. I think this has to change.
This is part of the rationale for getting information about com-
munities and community organizations "on the record". If we have
to plan at a distance in order to mobilize resources, then lets
have "management information" about communities available so
that they can be put into the funding loop.
in New York