NGO's

I am sorry to post what amounts to a 'rant' but it's been that kind of week. NGO's (Non Governmental Organisations) often get a bad press for reasons ranging from disorganisation to culturally inappropriate interventions that have little long-term impact. However, as a rule I would be quick to congratulate most NGO's for the undoubted good work that they do, in fact I am currently employed by an NGO although I work in a public sector role.

This weeks however I have seen first hand the negative impact that well meaning interventions can have. An NGO has moved into our area in an attempt to improve one of the patient services (I would rather not identify them on the internet so have omitted the exact details). That is a great idea and we are keen to form a partnership with them to improve these vital services. We even presented their job opportunities to our own staff and encouraged them to interview. The NGO is paying triple the wages that we can pay and are working in the same field so there should be no problem. However, the NGO has not been organised enough to actually find any work for the new staff to do. The result is that they are sitting around being bored while earning triple their old salary. Of course they are still friends with our current staff who, not surpisingly, now all want to go and work for an NGO. So at a stroke they have spent a great deal of money, they have reduced the quality of care for the patients by recruiting our staff who now do no work and they have managed to demotivate all of our remaining staff- thanks alot. Even worse if they don't get their act together and produce results soon their own funding will be withdrawn and all their staff will be out of work- great.

My own view is that the world has enough NGO's now. I think that anyone wishing to found a new NGO should think very carefully about their own motives as I'm convinced that a talented motivated individual could have a much bigger impact on the world by re-organising an existing organisations than going to the trouble of setting up a brand new one.

Milestone

At the risk of patting ourselves on the back we are pleased to announce that we put our 1000th patient on ARV's last month. There was some debate, or perhaps arguement, about which exact patient was the thousandth, at least three people were told that it was them. Perhaps it is like being the one billionth person in India or China, it's best just to pick someone at about the right time and go with it. As my personal contribution was small compared to the collective effort I think I can say that it was pretty fantastic to get there. There has never been a waiting list to start so it represents everyone in the area who is tested for HIV, who needs the drugs and most importantly has committed to take them lifelong.

One thing that struck me the other day was the strengh of the link you have with the patient. If as a doctor you spend your life handing out pills for high blood pressure you have to treat quite a few people for quite a long time to prevent one of them having a heart attack. That means that you never actually know which of the patients is still alive as a result. With HIV medication it is different, when I talk to a guy who had 'full blown AIDS' 2 years ago but now leads a normal life I can be as certain as a doctor ever can be that he is alive because of the drugs. Many branches of medicine can say the same of course, any surgeon who removes a malignant cancer at an early stage for example, but it is not something I have experienced that often and it's a good feeling.