There is no shortage of organizations of all persuasions that are conscientious about making meaningful contributions to developing countries, and the “playing field” is constantly changing with fluctuations in the world economy, ongoing realignment of nations and political changes within a given country. In times of an austere economy, such as has existed over the past several years, resources become difficult to amass and the activities of PVOs may be greatly diminished. Unfortunately, this comes at a time when the needs of developing countries are at an all time high, especially in sub-Saharan Africa (SSA) because of the permutations of famine and drought, HIV/AIDS, tuberculosis, malaria, lack of public health resources, high unemployment and fiscal constraints. Most PVOs that are derivatives of the smaller “faith-based” sponsors as well as strictly private humanitarian efforts by a handful of dedicated volunteers do not fare well in such an environment because they are limited in their ability to establish a permanent presence on the continent and therefore monitor continuity of their programs. This, in turn, makes it difficult to produce data and quantify productivity. On a larger scale, it has greatly impeded the ability to achieve a standard of excellence that insures recognition and, ultimately, funding by governmental agencies, international aid agencies and foundations.
Many people in America are aware of private citizens who conduct projects on their own across SSA, be it volunteering to do surgery in selected countries or “permanent citizens” who regularly return to their country of origin to deliver medical goods and supplies, conduct educational seminars, introduce or upgrade staff/patient safety initiatives and provide limited direct patient care. Some physicians make an effort to advance technology by securing equipment to perform laparoscopic surgery, colonoscopy and upper GI endoscopy in remote district hospitals. Although these acts of benevolence certainly benefit patients who are directly affected, it is difficult to document how these interactions affect the greater community as a whole, over time, if these initiatives cannot be sustained. The question then becomes one of deciding whether a repeat performance next year is worthwhile and how can it be improved or expanded with sustainable and quantifiable clarity. levothyroxine medication