Helpful Or Harmful?

I have always had a humanitarian conscience. I am by no means a saint, but in my school days I would organise fundraising events by getting the college bands to play in the name of a good cause, or I would cause controversy by handing out AIDS awareness leaflets in a Catholic school. After several independent missions I wanted to take a more permanent role in an organisation with some structure and clout in the aid arena. It was only natural that I veered towards MSF, an inspirational organisation known for being the best in the world at what it does, emergency medical care.

My scepticism has grown. I now worry at what damage an organisation with such power can do. Pakistan is an atypical context for MSF whose talents lie in rural Africa where there are limited medical facilities and qualified staff. Pakistan is not short on either. However we are active here with many consequences. Inflation caused by the presence of NGOs is not unheard of. Rent prices escalate as Western aid agencies infiltrate the towns, and pharmacies can often be put out of business as we import all of our drugs from Europe to follow pharmaceutical protocols that could be upheld locally. Japanese 4x4s cruise the town in between the rickshaws while doctors are poached from their jobs in the public sector. I acknowledge that not all we do is bad, but we should be aware of the impact we can have on a place. I cannot help reverting back to my capitalistic ethos that "trade equals aid".

Another worry I have is the real motive for us being here. Afghanistan is presently the jewel in the crown of NGOs, especially those of a mindset like MSF who wish to be the first actor in place in any emergency. Some team members have hinted that our proximity to the Afghani borders could be the reason for our presence in Pakistan. We are one of only two organisations acting neutrally, and this fact is hindering our progress in the country. Refusing to adhere to government enforced security rules has meant that we cannot provide care to many IDPs who are without basic needs. It would be wrong to compromise our charter of neutrality, but it is tough to sit back watch the disadvantaged and needy go without help. Aside from the war zones in Warziristan and other parts of FATA, where we are unable to assist, Pakistan cannot be considered to be in a true state of emergency. A huge network of hospitals exist for treating blast victims, even if their quality could be questioned. During our meetings we have many a discussion on the type of interventions we should follow, and more often than not the real needs are overlooked as they aren't glamourous enough to attract media attention and consequently donors. I fear that we are not here for the right reasons, and in that case weighing up our positive impact could mean that we are not right in being here. At what price do our interventions come at? Some international actors can certainly be suspected of being here purely for the reason of publicity because Pakistan is a hot spot right now. The public perception of NGOs here in Pakistan is one of suspicion, many locals say that we are not welcome as we have an ulterior motive, thus we do more harm than good. Perhaps there is some substance to this claim. My point of view is that one cannot do everything. But what one does should be done correctly.