Friday, July 17, 2009

Good Intentions Gone Efficient


Sitting in the front seat of a white government issued SUV, I felt sick to my stomach. Two of my teammates sat behind me joking with Dr. H, a well connected health official, as we rumbled between two South Indian villages. It felt like something out of a movie – foreigners wearing sunglasses arriving to a host of curious looks. I tried hard to put aside the misgivings I had for the time being. At each stop we were graciously accommodated - bodies whirling around us preparing tea as doctors dropped everything to answer our questions. Yet, it felt far from traditional Indian hospitality.

Maybe it was the looks in their eyes, or the urgency with which they moved, but it quickly became clear that the staff was afraid of something. Behind us our host barked orders, apparently using our visit as an opportunity for an inspection of the facility. I bit my tongue as the janitor hung his head- presumably being told in Kannada that the floor was not clean enough. Eventually we received news that a baby had been delivered earlier that morning and Dr. H shepherded us into a makeshift recovery room.

The new mother laid with her child as her family watched us from neighboring beds. Dr. H paced around asking questions and noting the quality of the room. Our eyes drifted to the squirming hours old baby. My heart sank when our curiosity was noted and we were prompted to touch the newborn. Here we were on what should be one of the new family’s proudest and happiest days – strangers barging in and being asked to treat their child like a hands-on experiment. My discomfort was visible, but our host insisted. I eventually touched the poor thing’s head and hustled out of the room. Dr. H teased me and we moved on with our day.

I couldn’t put the experience behind me. Images of the day kept flashing through my head- the vacant looks on the faces of patients in the crowded waiting room as the doctor left his post to meet us, the embarrassment of another clinic’s staff when Dr. H pointed out a error in their tabulation of the month’s deliveries, and my silence throughout the whole ordeal. I had come to India to help people, but had I really spent the day doing the opposite?

That feeling stuck with me for longer than I expected. While the three of us had spent the day with Dr. H, one of our team members stayed back in Hubli to troubleshoot our technology and do other some other work. Over the past week our team had researched something called Samastha, a HIV/AIDS program funded by USAID and an organization called KHPT that our NGO was responsible for implementing in Dharwad District. Eager to gain a perspective on the finer details and goals of the program we decided to email two contacts listed on a PDF document we had found online. The responsibility of writing the email fell to Jon as we toured the clinics.

The email read:

Hi Ms. Shankar and Mr. Gurnani,

My name is Jonathan Goldford and I am part of a team from the University of Southern California. As a group of four we are working with the Desphande Foundation to improve the efficiency and effectiveness of the Samastha project at BCT in Dharwad. To do this, we are implementing a simple SMS-based healthcare communications network using software called FrontlineSMS.

Once we have completed the project we hope to be able to scale it to each of the other NGO's in the Samastha project. It would be great if we could set up a phone call with you to discuss our project and the potential to work with the other NGOs in the future. Thank you and I look forward to hearing from you both.

As we later found out, the message was a textbook error for several reasons. First, we had unintentionally reached out to two very high up officials. Despite the relative ease of obtaining their contact information we were later told, “People don’t just email them.” The best description of communication in India I have heard since is that in this country things are “well stratified, well channelized”. The status of the two individuals made the informal tone and greeting of “Hi” unacceptable. Worst of all, we had used the terms “efficiency and effectiveness” – two words thrown around American business communication that had been misunderstood in this instance to mean we were calling their program inefficient and ineffective.

The message would later prove to be a bold, but brash gesture. The introduction we were trying to make for ourselves was independently made by a Deshpande Foundation program officer the very next day. When he received a call later that afternoon he assumed it was in response to his request for a meeting, but instead it was to admonish him for our communication. It quickly became clear that we had made a mistake that jeopardized not only our project, but our relationships with the Foundation and our partner NGO as well.

The next day the possible consequences were presented as such by our mentor, Rahul Brown:

• You will be spending the remainder of your vacation in America
• You will be reassigned to another project
• You may be able to salvage your project with another NGO, but you will need to work 12 hours a day, 7 days a week.

Oh, and we were told that it was more than likely that our partner NGO would lose its funding from the organization we had contacted. Our emotions at the time were many – disbelief that a harmless email could cause such damage, frustration that we ourselves were unable to do anything to rectify our actions (we were put on “communications lockdown” and referred to as “grounded”), and fear that the friendly staff we had grown to know would be out of the job.

Yet, today our project continues. We enjoy a healthy relationship with administrators at KHPT (the organization we emailed). In fact, we met with one administrator today to make an introduction to EXPAND our project in the future and another requested a PowerPoint of ours yesterday to take to a meeting in Bangalore. So how did we get from the dire straits described above to where we are now? The short answer is, I don’t know. The apologies we showered on the affected parties were laughed off, administrators whose relationships we had supposedly strained behaved like old friends, and after a long lay-off our project emerged stronger with important people supporting it. The full story involving exactly who reacted and in what way, and other critical details have not been shared with us and likely never will.

I still think about the incident amidst our now demanding project's activities. New information emerges every day and with it new theories – for instance, that our affiliation with a US university combined with the American government’s funding had led some to believe we were contracted to evaluate their program without their knowledge or consent. Most read the text of the email and can’t believe our stories – a high-up staff member at Deshpande even told me recently that he thought it was a good email. Most often I think about the ubiquitous Samastha program banners. In small print beneath the USAID logo it says, “From the American People.” Wasn’t that our intention as well? Where had I gone wrong? Where had we all gone wrong?

In the end, I've given up explanations in favor of something Gandhi says in his autobiography:

“Numerous examples have convinced me that God ultimately saves him whose motive is pure.”

- Dan

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