A Small-Scale Foreign Aid Strategy

Abstract

Donor nations send billions of dollars of aid to developing countries with little evidence for lasting positive effects ([1][1]). It is clear that more effective aid programs must be conceived that will have an enduring impact in spite of the difficult conditions prevailing in recipient nations ([2][2], [3][3]). Small-scale efforts can make contributions to the global aid effort. I wish to share my experiences with one small organization that has achieved remarkable success with limited financial resources and a structure that demands only a modest commitment from the individual participants. “Cooperation Geneve-Yaounde” (CGY) is an alliance between the medical faculties of the Universities of Geneva, Switzerland, and Yaounde, Cameroon, whose primary goal is to improve the training of Cameroonian medical doctors. Two guiding principles of the CGY are that raising the standards of medical practice will have an immediate impact on the health of a population and that aid provided in the form of educational training is relatively immune to misappropriation and corruption. Volunteers from Swiss medical faculties actively collaborate in the teaching and evaluation of medical students at the University of Yaounde. Although each Swiss participant devotes only a period of 2 to 3 weeks of teaching per year, the students and local staff members also benefit greatly from the opportunities to interact informally with the foreign medical professionals. The CGY organizes residency training in Swiss hospitals for young Cameroonian doctors committed to returning into active practice in their native regions. A major challenge facing programs that train healthcare workers in developing countries is the drain of graduates to countries offering higher salaries and a vastly superior work environment ([4][4]). The CGY has been fortunate in that all but one of the over 60 Cameroonian doctors selected for residency training in Geneva subsequently returned to work in their native country. This success rate reflects the requirement that candidates must have already completed an internship in Cameroon, as doctors trained entirely in our medical system will find it extremely difficult to adapt to working in African hospitals. The medical faculty in Cameroon hosts 10 medical students from Geneva every year for a 2-month rotation in tropical medicine and community health. Apart from providing a unique opportunity to experience a different culture and its distinctive attitudes to health and disease, firsthand exposure to the daily frustrations encountered in African hospitals sensitizes these future Western doctors to our humanitarian obligations in the developing world. I believe that this conceptually straightforward program can serve as a useful model for universities with an interest in contributing to education in poorer nations. 1. 1.[↵][5] “How to make Africa smile. A survey of sub-Saharan Africa,” Economist , 17 Jan. 2004, pp. 1–16. 2. 2.[↵][6] 1. E. M. Einterz , Lancet 357, 1524 (2001). [OpenUrl][7][CrossRef][8][PubMed][9][Web of Science][10] 3. 3.[↵][11] 1. R. Klitgaard , Tropical Gangsters (Basic Books, New York, 1990). 4. 4.[↵][12] 1. C. Schubert , Nature Med. 9, 979 (2003). [OpenUrl][13][CrossRef][14][PubMed][15][Web of Science][16] [1]: #ref-1 [2]: #ref-2 [3]: #ref-3 [4]: #ref-4 [5]: #xref-ref-1-1 View reference 1. in text [6]: #xref-ref-2-1 View reference 2. in text [7]: {openurl}?query=rft.jtitle%253DLancet%26rft.stitle%253DLancet%26rft.aulast%253DEinterz%26rft.auinit1%253DE.%2BM.%26rft.volume%253D357%26rft.issue%253D9267%26rft.spage%253D1524%26rft.epage%253D1525%26rft.atitle%253DInternational%2Baid%2Band%2Bmedical%2Bpractice%2Bin%2Bthe%2Bless-developed%2Bworld%253A%2Bdoing%2Bit%2Bright.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252800%252904640-7%26rft_id%253Dinfo%253Apmid%252F11377628%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/external-ref?access_num=10.1016/S0140-6736(00)04640-7&link_type=DOI [9]: /lookup/external-ref?access_num=11377628&link_type=MED&atom=%2Fsci%2F307%2F5714%2F1410.1.atom [10]: /lookup/external-ref?access_num=000168614300039&link_type=ISI [11]: #xref-ref-3-1 View reference 3. in text [12]: #xref-ref-4-1 View reference 4. in text [13]: {openurl}?query=rft.jtitle%253DNature%2Bmedicine%26rft.stitle%253DNat%2BMed%26rft.aulast%253DSchubert%26rft.auinit1%253DC.%26rft.volume%253D9%26rft.issue%253D8%26rft.spage%253D979%26rft.epage%253D979%26rft.atitle%253DNurses%2Bdisappearing%2Bfrom%2Bdeveloping%2Bnations.%26rft_id%253Dinfo%253Adoi%252F10.1038%252Fnm0803-979%26rft_id%253Dinfo%253Apmid%252F12894140%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [14]: /lookup/external-ref?access_num=10.1038/nm0803-979&link_type=DOI [15]: /lookup/external-ref?access_num=12894140&link_type=MED&atom=%2Fsci%2F307%2F5714%2F1410.1.atom [16]: /lookup/external-ref?access_num=000184484900002&link_type=ISI