So I’m challenged by articles like these: The Moral Hazards of Humanitarian Aid and In S. Africa’s Orphanages, Is Doing Good Really Bad?

A Japanese participant shares a meal with a local family during a homestay

I know some people are going to question what we do, and that’s okay. We need to have answers for them. We are constantly rethinking what we do and how to make it genuinely participatory and grounded in long term relationships. It’s not enough to use these words if we don’t live them out.

Now I think coining a term, voluntourism, and making it an automatic pejorative is misguided. Perhaps it comes from the need to blame someone. But as one commenter on the second article says, it’s “not a zero sum game.” There are many programs that help people experience the two thirds world in a life changing way beyond mere site seeing and play. These programs may be respectful, based in relationships, educational, and self-aware. Or they may be voyeuristic, exploitative, and blind to their negative impacts.

Visiting orphanages presents a pointed problem in itself. We have increasing evidence that orphanages are not ideal for children. They are, however, easier to initiate and fund than family and community based options. People who visit orphanages tend to come away with idealized images (and lots and lots of photos), but they tend to miss or ignore the deeper questions. I don’t want to cover all the problems with orphanages right now–I’ll do it another time. Suffice it to say that most of us, if we died, would not want our children to end up in an orphanage but in a loving family–and most “orphans” have one (or two!) living parents not to mention grandparents, uncles and aunts, etc.

The problem is that anything to do with humanitarian work–and especially orphanages–has tended to get a free pass on hard questions and accountability. But now critical books, articles, and studies are mounting up. Here in Cambodia, there will be a campaign starting soon to counter “orphanage tourism.” For years people on the field have known about problems with orphanages, but there’s a growing backlash that can’t be kept in the bag. I just hope people become better at discerning the kinds of partnerships and programs that really make positive differences and better at holding organizations and people accountable, rather than becoming withdrawn, unwilling to donate to anything, and cynical.

As for us, we emphasize long term relationships in our work. We are challenged to work with and alongside Cambodians rather than imposing our activities on people. It’s easy to come in with money and generate results quickly, but (as a friend said), things that happen quickly rarely last. Frankly, it’s much harder to work through relationships (and we’re learning as we go), but we trust the results will be worth it.

I’m very honest about the benefits our Japanese participants receive. I want them to be grateful and truly consider how in their future lives they might give back some of what they’ve received. Most participants in our programs return to Japan with changed perspectives. They see Cambodians as real people with great challenges and potential. They also see their own wealth and poverty in Japan. As one young women said, “In Japan we have so much stuff, but we also have emotional poverty and a poverty of relationships.”

I don’t mean to be defensive. We have a lot to learn. Read the articles above and join me in opening your eyes to the needs and pitfalls of  helping and caring.

During September we hosted a group from Japan who came through Project Friends. We had a great time with them, and they returned to Japan changed people (if they continue what they started here). We also welcomed our first intern. She’s out in Takeo Province now doing well. I’m sure she handled that welcoming party of lice by now…

After the water fight

I’ll be focused on language learning for the next few months, and I hope to do some of that with camera in hand. My camera, used with intention, is a good tool for engaging with people. I’m looking into potential projects and people I can work with on them.

The group from Japan had lots of energy. Once we went them into our local market to buy eggs, and a vendor was overheard saying, “Aren’t Japanese people supposed to be quiet?” Not always! Here is a video slide show of their experience here.

We’re going to further develop our work with Project Friends. Here is a video that we made to publicize Project Friends for potential participants. We made it in Japanese, but I’ve added subtitles to this version.

Let the adventures begin!

During the past 10 years we turned a corner. Cheap medications became widely available, and millions of people worldwide began receiving treatment. Before 2005, getting HIV was a death sentence for the majority worldwide, including more than 2 million children newly infected annually. Then there was hope. But will this hope be sustained, or are we turning a corner in the opposite direction?

…for most of Africa and scattered other countries like Haiti, Guyana and Cambodia, it seems inevitable that the 1990s will return: walking skeletons in the villages, stacks of bodies in morgues, mountains of newly turned earth in cemeteries.

What happened?

Simply put,  the number of newly infected people each year is exceeding the number we can treat. At the same time, funds for the fight are shrinking.  Besides the global economic crisis, donors have been redirecting funds to combat malaria and other preventable diseases that actually kill more people than HIV/AIDS.

It would be a terrible tragedy to return to the situation ten years ago when people were dying in such numbers and unimaginable conditions. I’ll be moving to Cambodia in two months, and I know children who are alive because they take ARV medications every day. When those programs started, promises were made that the plug would never be pulled.  You can’t give someone medicine and then take it away after a few years…can you?

The bitter truth is that we cannot save everyone. We’re slowly saving less and less. We must concentrate more on prevention, or the dam will break.

“You cannot mop the floor when the tap is still running on it,” said Dr. David Kihumuro Apuuli, director-general of the Uganda AIDS Commission.

There are no easy answers. Prevention versus treatment is more than just a debate to take sides in. Simply giving more money is not an answer. I recommend reading the full New York Times piece and Bill Easterly’s response for further perspective.

Living with HIV in Cambodia thanks to ARV medications provided by USAID funds

This is the gecko that was living in my room last time I time I was in Cambodia. He normally stays behind the dresser where you can see him during the daytime if you look. At night, when the lights are out, he comes out to eat.  I turned the lights out and waited, then I turned them on and took this shot (just after he ate a bug, but I blew that shot).

By the way, geckos come in different varieties. When traveling in Southeast Asia it’s very common to see small “geckos” running around on the walls. Most people don’t realize there are much larger geckos as well living inside most homes and rooms. The large varieties make a very loud “uh-oh” sound (kind of like “guh koh” from which they get their name).  They can grow quite large. This one is about 12 inches long, but he’s not a “big” one.

I’m not posting much recently. We’re in transition, so I’m not particularly inspired with new things to say. Today Hitomi is meeting with a few members of our Project Friends volunteer team to put the finishing touches on key processes. They will be working hard after we leave. One is handling the accounting. Another is processing applications (actually, we’ll pay her a bit for that). Another is organizing events for past and potential participants. Then there are others who will help coordinate and assist. I’m amazed at their willingness to serve.

Last night I taped together eight boxes that we’ll take to Cambodia (double width cardboard specially purchased). Today I hope to finish packing them and clean up most of our mess from my in-laws’ house. The kids will go with their grandmother to see the latest Doraimon movie.

Spotting a bug

Eating the bug (I didn’t focus on time)

That being said, and I mean it; I’m hoping for a future without orphanages. I don’t recommend starting an orphanage if you want to help orphans. I’d like to see orphaned kids being raised by their extended families, because the majority of “orphans” in the world have relatives who could take them in. Heck, a lot of them have at least one parent alive (the definition of “orphan” in Cambodia is that at least one parent has died). Often the relatives are very poor, so they think an orphanage would be better for the child, but a small subsidy would help them accept the responsibility. I don’t have it here, but I’ve read about a study showing that being raised by a dysfunctional family is better for a child than being raised in an institution.

I want to learn from an organization in Phnom Penh that has (I’ve heard) placed thousands of orphans in homes with either foster parents or extended family members. Someday I’ll post a report of my findings here.

In the meantime, read this excellent article from the New York Times which makes an excellent case for supporting families rather than starting more and more orphanages.