Understanding Aid Work

"Decolonizing" the Aid Industry

More and more in the world of foreign aid we are seeing the trend to decolonize aid work. I had mentioned this in the previous instalment, but now I think it is time that we expand on this concept and dive deeper into its importance and how it can create a better future for the industry. We may think that going overseas to help foreign nations in times of medical, social, or political crises is part of our duty as a world “superpower,” or to show some international altruism. In the past, and even slightly to this day, our approach has been to travel to these areas, administer aid to the way that we see fit, without taking input from local communities. So, what is the common denominator here? “We.”

So, Who is “We?”

Well, I can tell you who “we” is not, and I am not alone. Last week we heard Matthew Thacker telling us about common hiring practices implemented by PSI overseas. Before this push for decolonization, “we” typically meant major western organizations – donors and NGOs—, rather than balanced collaboration with individuals and communities in which donor dollars support, and international NGOs work in. Matthew mentioned to us how, across PSI’s 40+ country offices, country-level nationals lead the efforts: working within their own communities, running offices, administering the actual aid, and taking up leadership positions. My take: “We” can go only so far without help from the people in the contexts in which we work. But how do we make this realization universal?


The first step to changing our realization about foreign aid is to change our perspectives. Many Americans were introduced to foreign aid in a time when a majority of countries were just gaining or had just gained their independence. These nations were now starting from the beginning and did not have the resources or funds to support certain development projects. But a lot can change in that time, and since then there has been an emerging middle class, something that can only exist in a well-functioning economy, as well as multiple billionaires in most of these countries. These economic factors, of a middle class and billionaires, prove that these countries are fully independent and functioning without us. These nations have worked hard to set themselves up autonomously, away from Western models and away from the dependency of Western intervention. They have decolonized and taken control of themselves. Our drive to help these nations should come from the fact that we have the ability to allocate resources in order for global development. Not because they need us to, but because we are in a position where we can. This is the basis of altruism, and that is how we should be framing our view of modern aid.

This is not to say that we do not need to help. In the past, when aid has come into a country, it has come in via the Western standard. This may work wonderfully for us, but for other nations this is not how things are run. With little breathing room, tensions can arise between communities and the organizations delivering aid. Working in security, I have seen examples of such attacks. One example of such a security incident occurred in early 2019, where the group Médecins Sans Frontieres (MSF) were attacked in multiple locations in the Democratic Republic of the Congo, not once, but over the course of multiple days. These attacks were attributed to community dissatisfaction with the way that Ebola treatment was being administered. These are tragic events that need to be taken as a lesson, and MSF did just that. In a statement in March, Dr. Joanne Liu, International President of MSF states that “we must ensure that we are looking from the patients’ perspective.”

That is exactly what Matthew explained to me in our discussion; that PSI takes the approach of putting consumers in charge of their own care. For PSI, that’s called consumer-powered (CPH) care. PSI’s CPH approach doesn’t seek to empower , a dated term that sounds neo-colonial and condescending. Through PSI’s CPH work, PSI works with and for consumers, health actors and diverse experts to pave pathways for consumers to be the drivers of their own life, all while strengthening health systems’ capacity to provide essential health services.

It can become personally tailored to their specific needs, much like any consumer specific market is. When the world wants a better camera in their smart phones, a tech giant should deliver; when a community in Kenya wants more control over their health care, foreign aid should deliver based on what the community says they want and need. This approach, as a consumer driven market, is something that most of the Western world can understand because it is how we operate on a day-to-day basis.

In the Hands of Consumers

To me, this is one of the best ways to begin to change the perspective of foreign aid. Across the world, but especially in the West, money talks. We shape many of our daily activities around finances and other nuanced market practices. We shop on certain days to obtain certain sales; we wait for gas prices to drop before filling our tank; we are already in a very consumer-driven mindset. If we, as a society, already think in a very consumer-driven way, then it is not a far stretch to apply this mindset to the industry of foreign aid. We can take advantage of a psychological concept called the framing effect, where presenting information in a certain way (or frame) can change how an individual processes that information. If we present foreign aid as a consumer driven process, then perhaps it can be easier for the general public to see the importance of putting care back in the hands of its recipients. This is critical, because a consumer wants to engage with a product, and the market has to be flexible to the demands of the consumer (unless, of course, we were talking about inelastic demand, but that does not apply here).

My Take

2020 has framed so many concepts in a new light, so we can push for positive change during some of the world’s most grim of times. Decolonizing aid work is one of these positive changes that has become more attainable in recent years. Do not be confused though, this is not a new concept. The removal of Western systems from certain countries have been desired for generations, we are just now finally listening. Foreign aid is a necessary industry. As children, we are taught to help our neighbors in times of need, and foreign aid is no different from this concept. If your neighbor needs help fixing something, it would be assumed that if you could, you would help. But you would wait for that neighbor to tell you just exactly how they need help, rather than barging in and assuming your way is best way. This is what it means to decolonize, to put the power back in the hands of the people asking for help. This is just one of many concepts I learned from speaking with Matthew and other members at PSI, and we’ll dive into some more as the weeks come; this is only one voice that we have heard regarding an issue that involves countless communities, and it is only right that we hear from them all!