Leprosy Mailing List Blog: (LML) Socio-economic rehabilitation: habitat for people affected by leprosy

Thursday, July 30, 2015

(LML) Socio-economic rehabilitation: habitat for people affected by leprosy

Leprosy Mailing List – July 30, 2015

Ref.: (LML) Socio-economic rehabilitation: habitat for people affected by leprosy

From: Matthias Wittrock, Bregenz, Austria

Dear Dr. Schreuder

First, let me express my sincere appreciation for the good intention, and for the good work of Dr Harun.

As no full-fledged project proposal was sent, it is hard to comment on the planned intervention. Still, I do feel skeptical about it. I see charity, but I do not see clear intervention logic/a theory of change. This is not only due to the anti-leprosy component, but to the general approach of the project.

I appreciate Dr. Kawuma’s comments on the leprosy work. In addition to Dr. Kawuma’s remarks, and to the ILEP documents http://www.ilep.org.uk/technical-advice/ , I suggest to check for classic project evaluation documents http://www.oecd.org/dac/evaluation/daccriteriaforevaluatingdevelopmentassistance.htm: Is the approach (1) effective, (2) efficient, (3) sustainable, (4) impact oriented (5)… ? Actually I doubt it.

Dr. Kawuma directed our attention to some WHO standards concerning community based rehabilitation (CBR). I am not aware if any ILEP member was contracted with intimate knowledge of anti-lepory work in Indonesia http://www.ilep.org.uk/ilep-co-ordination/leprosy-around-the-world/asia/bangladesh/ilep-co-ordination.

This project proposal certainly touches a nerve. This is because I strongly believe that a “superb Habitat for People with Leprosy!” (quote – your mail ) in effect amounts to “superb segregation”. I understand that this is a strong argument. However, relevant for our work is the Alma Ata declaration, and anti-leprosy work is best when it is following a sustainable, rights-based approach that seeks to make a system change. Please allow me to quote Pope Francis: “Changing structures without generating new convictions and attitudes will only ensure that those same structures will become, sooner or later, corrupt, oppressive and ineffectual.” (EG).

One does not need to be catholic to acknowledge the problematic relation of (Western) funding mechanisms driven by “charity”, and a certain project type in the global South (“direct support”). Everybody will be happy to “receive a simple small house” – but what are the selection criteria? What will the person across the street without a house (may be affected by diabetes?) be told? All of us have seen to many orthopedic workshops for people affected by leprosy who turn away patients with diabetes feet, or leishmaniosis.

Since many years our anti-leprosy work all too often falls short of overcoming old attitudes. Why is that so? Because, unfortunately, the type of project that is suggested will create unintended negative impact – but it will not fail to attract a certain type of Western donors who long for visible, “direct” help.

However, it is our obligation to facilitate new ways of thinking. If we seek to doing so, there will be a need of discussing old and new approaches.

Therefore, I am looking forward to an intense + enriching debate on this subject in this mailing list.

Again, let me assure my highest appreciation of Dr Harun’s genuine concern for people affected by leprosy. It is a bit unfortunate that I am travelling, so that I do not have as much time as I would like to have to comment on the project proposal in greater detail. Dr. Harun, please feel free to approach me via skype in order to engage in a personal conversation.

Yours sincerely,

Matthias Wittrock

Mag. Matthias Wittrock | Geschäftsführer/Managing Director

Aussätzigen-Hilfswerk Österreich | Austrian Leprosy Relief Association

Belruptstraße 21 |A-6900 Bregenz | Austria | phone: +43-(0)5574-62388-12 | fax: +43-(0)5574-62388-4