Iatrogenic Violence? Lived Experiences of Recipients of Aid that Targets Vulnerable Children in Makete, Tanzania

Abstract

Humanitarian aid does not always achieve its intended outcomes but may have unintended side-effects which harm rather than help recipient communities in the long run. In the context of aid, iatrogenic violence refers to circumstances where aid intended to benefit recipients instead causes social disruption. The relations between donor and recipient contribute significantly to the outcomes of aid. This article aims to explore the recipient side of donor -recipient relationships in humanitarian aid targeting children affected by HIV/AIDS in Makete, Tanzania. Specific objectives include exploring (i) the lived experiences of the children who are targeted by the aid, (ii) the lived experiences of related caregivers and community members and (iii) the responses of local leaders, both nongovernmental organisation (NGO) officers and local government leaders. Fortyone orphaned children aged 9 -18 were involved in 3 one-hour-long participatory activities. From these, 12 were selected for in-depth interviews. Four caregivers of orphaned children and 15 key informants (community leaders and NGO officers) were interviewed. Findings show that the type of aid and method of distribution are determined by the donors and do not fit well with local conditions. Examples of iatrogenic violence include conflict and division between those in the community who receive aid and those who do not, increasing dependency with a corresponding reduction in self-reliance, criteria that exclude the most vulnerable children from aid and passivity and nonparticipation. Donor-controlled humanitarian aid is causing unintended harm in the recipient communities.

Exploring the roots of antagony in the safe male circumcision partnership in Botswana

“…Also, the highest leadership of the country was criticised for not supporting the program as its “face.” Therapeutic domination by donors gives ambiguous roles to the local partner, calling them “owners” of the program, but treating them as less-able recipients who should follow rather than lead [ 25 , 44 , 45 ]. This domination leaves the recipient countries unsure of their status in the partnership [ 30 ]. Critics argue that the fancy leadership/ownership phrases given the recipient countries are just a facade to cover the continuous exercise of power by the international financial agencies [ 46 ].…”

“…The DPs complained that the DHMTs were not prioritising SMC and were only dependent on the MOVE teams to do all the work. The creation of dependency and stripping local people of their agency is a form of iatrogenic violence [ 30 ]. Secondly, the abrupt pulling away of donors’ resource and implementation support caused operational disruption, “the pain” and the “violence.” One officer explained that whereas DP2 had been downsizing support slowly, with minimal effects, DP1’s pulling away its massive resources was sudden, within a month’s notice.…”

“…Usually health intervention programs are declared successful, but long term consequences are only borne by the recipient after the international partners have left, a successful surgery yet a dead patient [ 25 ]. Daniel [ 30 ] adds that the donor is rather ‘arrogant’ in assuming his solution is the best solution for the recipient, that his solution works, but if it does not, the blame is on the recipient.…”

The Impact of Organizational Structure and Funding Sources on the Work and Health of Employed Caregivers in Children’s Homes in Ghana

“…Cultural norms of child upbringing in this context emphasize practices such as corporal punishment and strict parental control -practices that clash with some of the provisions in the UNCRC (Kyei-Gyamfi 2011;Twum-Danso 2012). Funder insistence on the use of these laws therefore often generates tensions between child rights-centered programmes (especially foreign-funded ones) and local folk (see Darkwah et al 2018) Thus similar to arguments raised by Daniel (2014) concerning how humanitarian aid may help or harm recipient communities, funders' expectations and requirements of care institutions for CWPC may exert influences that may help or stress those employed as caregivers. Further, Hearle and Ruwanpura (2009b) observe that government grant systems for orphan care institutions in South Africa posed severe challenges to caregivers by way of bureaucratic application procedures and corruption among government officers.…”