Remarks by Dr Bill
Pigott, WHO
Representative in Nepal,
at the
Inauguration of tbNET
Conference on
Tuberculosis and NGOs,
12 February 1997
Honourable Minister of Health, Colleagues , friends,
I bring you greetings from the Director General of WHO, Dr H Nakajima and from the Regional Director for the South East Asian Region, and add my own personal welcome to Kathmandu.
There are three reasons why it is auspicious for us to be meeting here in Kathmandu on this day. Firstly, it is auspicious that we should start this meeting on the day of the Nepalese festival that honours the Goddess Saraswati, whose greatest blessings are bestowed on learning and education. Secondly today is recognised as the first day of spring in Nepal. The third auspiciousness is that we should meet here in Nepal, the place where it can be said that the NGO originated. The "Ghuthis" or traditional self help co-operatives have served the people of Nepal and enabled them to serve each other for centuries.
Sadly though, I observe that many of these community organisations are being allowed to wither and die. This may be because development projects, and possibly even outside NGOs, have made them unnecessary. As a result, like so many things that no longer serve their purpose or are not used, they atrophy, and fall into dis-use. When their energetic people are taken away, they lose their momentum and cease to attract the attention of those they served and those who served them.
I believe this highlights the importance of and the need for all of us to work with the people in a way that enables them to carry on, leaving them better able to achieve what they want to achieve. It points clearly to the importance of facilitating, of being a facilitator.
Soon after my return to Nepal 18 months ago, to take up my post as WHO Representative, having previously worked here for six years in the 1980's, I recorded some of my reactions to the experience. I observed that at least two changes are needed in the way we work, both within WHO, as well as at country level. They are;
- a change from seeing "money" as the answer to development problems, to making much more effective use of the resources that are already available
- a change from providing answers from the outside, to enabling people to realise how much they have within their own experience and setting..
It seemed to me at the time, that in much of development, unintentionally, people become dependent on outside resources and ideas. In their interactions with development agencies and people from outside, they begin to focus on how much they themselves lack. When they do this continuously, they lose their self-esteem and their self-confidence. This is particularly so with respect to the cultural traditions and traditional approaches, which indeed have enabled many communities to survive particularly difficult (if not impossible) conditions. These traditions and practices sometimes represent adaptations that have taken place over hundreds of years. They include adaptations in the ways in which communities relate with each other, make decisions and use available resources. These patterns have evolved in response to a particular context.
I had seen many examples of foreigners moving into someone else's country, bringing answers to problems that come from the outsiders' own cultural context, and which may well have been very effective in that context. Although effective outside, they may not work as well in another setting. A sad consequence is that people forsake the values that have sustained them, letting go the principles on which their communities are based.
Because we have stopped validating peoples' inner strengths, we have presented, like good advertising agencies, the idea that people should want something else. In our haste, we forget to invest the time needed to validate what they already have and to encourage their use of it to gain what they need.
What I am talking about is the need to be a FACILITATOR. This means enabling others to understand what it is that they are trying to achieve, rather than telling them what it is that they should be doing.
In the Intergovernment or International organisations, we often feel that the NGOs can do it more easily. However, at the same time I have noticed that it is harder for some to resist the urge to do the thing themselves rather than work with others, rather than enabling them to do it themselves, and so build the people's capacity.
Clearly we must work in partnership with others. Recent real success in Nepal with National Immunisation Days against Polio, have shown us how effective we can be when we work with others. It is a tribute to partnerships and effective leadership amongst people in Government, Non-Government, Service, Political, and Community organisations. We were shown by our own Minister of Health how important personal effort and leadership can be in motivating people at all levels to work with each other and get things done. IF WE CAN DO IT ON ONE DAY FOR POLIO, WE CAN DO IT ON OTHER DAYS FOR OTHER THINGS.
Concerning Tuberculosis, you all know much more about TB than I do, but I am concerned that frightening figures remain; with a third of the world's population infected, 90 million expected to become sick in next 10 years. Yet there are exciting prospects from the DOTS approach, with its guarantee of cure, and the prospect that its widespread use can reverse the epidemic.
But let us not forget that TB is a disease of the poor and undernourished. Let us use the success of DOTS to reach out and advocate for action in the areas that influence the spread and control of TB, nutrition, women's health, environmental health, HIV/AIDS, and the people's information about the need for proper treatment. This links with the need to promote literacy.
Let us also celebrate the co-operation and team work, between Government and NGOs, between organisations and the people, between countries, and between the rich countries and the poor countries.
Allow me to close by wishing you well for the next three days and quoting a wise man from our neighbour to the north, China, where Lao Tzu, in the 5th century BC said ;
"Imagine that you are a midwife: you are assisting at someone else's birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening ... When the baby is born, the mother will rightly say: "We did it ourselves".
from:
The Tao of Leadership by Lao Tzu (5th century B.C.)
adapted from the Chinese by John Heider (Bantam Books)