Sometimes, I must sheepishly admit, I sneak a glance at LinkedIn. It is a minor addiction. Similar, but not quite on par with the people who cannot look away from a motorway pile-up.
For the uninitiated, LinkedIn is the platform where the world’s most accomplished, visionary, battle-hardened professionals, all blessed with exceptional leadership qualities and a passion for driving impact, tirelessly advance their careers by informing humanity which celebrity they happened to run into while going about their daily business.
One recent post from UNICEF Uganda caught my eye: “Big Boost for Children in Uganda.” The US Government had provided USD 5.2 million through the East and Southern Africa Humanitarian Fund (ESAHF), managed by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), to strengthen efforts against child malnutrition in Karamoja.
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| UNICEF RD in Karamoja |
Under the sub-coordination of the UN Resident Coordinator, UNICEF, World Food Programme, and United Nations High Commissioner for Refugees were hard at work sustaining essential services for vulnerable children. Screening had begun using MUAC tapes. The UNICEF Regional Director had visited to personally feed therapeutic food to a child. All presented in the familiar humanitarian dialect that no longer causes my pulse to quicken.
What stopped me mid-scroll, however, was a comment from our friend Roger Pearson, who mentioned that he had coordinated a similar campaign in the same Karamoja forty years ago. Back then, they managed to avert famine.
Forty years later, Uganda has better roads, greater market access, more infrastructure, more trading centres, smartphones and vastly more trained health personnel. Yet here we are again: emergency malnutrition screenings, therapeutic feeding, donor appeals, and international agencies parachuting in with measuring tapes as though history had stood still.
A quick search online showed that UNICEF has been conducting emergency malnutrition screenings in Karamoja repeatedly over the years, including in 2022. For decades, UNICEF has received funding for nutrition and emergency interventions. My mind drifted back twenty years, when I counted ninety-five (!) separate UNICEF projects operating simultaneously in Uganda.
The latest UNICEF country programme allocates 54 percent of its Regular Resources, roughly USD 39 million, to “Programme Effectiveness,” which is about twice the amount allocated to Health and Nutrition. Previous years’ expenditure figures themselves are difficult to untangle, as the UNICEF Transparency Portal has become remarkably opaque. Even figures appearing on the same page seem not to agree with one another.
But the story becomes even harder to reconcile.
Uganda has received roughly USD 2 billion in aid annually for well over a decade. Every donor, agency, coordinator, planner and workshop facilitator solemnly assures us that the focus is always on “the most vulnerable.” Yet after forty years of interventions, reforms, appeals, capacity-building exercises, strategic frameworks and PowerPoint presentations, it remains necessary for foreign agencies to instruct Ugandan health workers to begin screening children in Karamoja for malnutrition.
Something in this long story of crisis, development, aid, and perpetual reform simply does not add up.
Einstein is often credited with saying that insanity is doing the same thing repeatedly while expecting different results. Whether or not he actually said it, donors seem to be noticing as well.
Two more points:
ReplyDelete1. Both the Karamojong and Yoweri Museveni are cattle farmers or herders. Museveni describes himself as rich, while Karamojong children survive from plumpy nuts handed to them by the foreign aid industry.
2. According to its 2025 annual report, UNICEF Uganda continues to lobby the government to spend one million US dollars annually on therapeutic food. Is it possible that the presence of aid organizations undermines the government's accountability to prevent Ugandan children from dying of malnutrition?
My dear friend Detlef, WE (UNICEF) are the vulnerable ones, we need the support every year to attempt to remain relevant, or just remain!!!
ReplyDeleteBrilliant. Like the UNRCO annual report and UNINFO (UNRC version of our RAM) - I have always failed to grasp who is the audience for LINKEDIN? Maybe my tone deaf sense of reporting and self promotion is why I rose so slowly ( I call it early plateauing). I was once visited by UNICEF Uganda staff under direction of the RD to help us nail down our district focus in Tanzania. I was told that direct funding of districts solved all DCT problems and had more impact. That was around 23 years ago? We then did the evaluation of our own district program- only to find no difference between places we funded and did not fund- as far as outcomes for children. Could it be I wasted 32 years of my life pounding my brain to measure impact? When I could have been on LinkedIn living the life?
ReplyDeleteSomething is disturbing about the rhythm. Forty years ago: an emergency in Karamoja, humanitarian mobilisation, famine narrowly averted. Today, after countless billions in aid: therapeutic feeding, donor appeals, and a new round of urgency, accompanied, of course, by dramatic photos and captions.
ReplyDeleteProgress, it seems, has stood still. One begins to wonder whether the system is designed to solve the problem or to manage its continued existence.
Of late, the enlightened in the aid community often draw a distinction: development aid may be complicated and often disappointing, but in emergencies, this is where its value is beyond question. If the same “emergency” recurs across decades, at what point does it cease to be an emergency and become something else, something structural, something political, something perhaps inconvenient to the prevailing aid model?
When the aid community steps in to prevent the worst outcomes, they save lives. But they may also relieve domestic pressure on governments. Compassion can dilute accountability.
Meanwhile, we were told by The Economist that recent reductions in aid flows to Africa may not have been the catastrophe many predicted, a view supported by several African economists. In some cases, countries appear to be adjusting, finding internal efficiencies and making harder choices.
This is not to dismiss the individual emergency aid workers on the ground who are often capable and dedicated and operate within the logic of a system they did not design and perhaps do not fully understand. But systems matter, and this one has produced situations that never quite resolve and interventions that never quite conclude.
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Delete😔 so true
DeleteI had so many typos from doing this on my phone I wanted a re-do: Thanks Thomas - those who work in emergency response or development- or like UNICEF- along the continuum- keep flogging this over and over. It could be akin to the boy who cried wolf? I was working in the Tanzania southern highlands in mid 2000s- the sacred birthplace of Urban Johnson's work on nutrition model - yet less than 30 years later hardly a trace that any of it sunk in the daily routines or choices of parents and local leaders? It is not encouraging.
DeleteLudo, thanks Detlef and friends, while I didn’t want to comment, hastily, the mentioning of dear Urban triggers a souvenir. 45 years back - with the backing of Charles Egger and Richard Reid, I decided to take-up my new assignment in Nigeria by traveling by road from Abidjan to Lagos via Ouagadougou and Niamey to say goodbye - after 5 years - to colleagues from - at that time - the UNICEF « Area Office » for six countries, with three program officers, each « covering » 2 countries, based in Abidjan, and mobile ( smile )... [ two P4s and me P3. ]. Different personalities, same purpose, same method: (indeed) with our sustained advocacy, let decentralized governance - however imperfect - assume their roles and define child-priorities themselves. Yes, UNICEF would do some fundraising for pilots where promising, but I don’t recall any « instructions « from Hqs. « Country-specificity was the goal. ok, Alma Ata was in 1978, Mini Health delegations were sent, and THEY told us how to translate into programming-by-objectives what was relevant for them. Liberia and Dahomey were slightly different,… (…) Urban’s nutrition model ( for example )was used and refined in their schools of Public Health, Watsan was internalized as a priority by them,etc…
ReplyDeleteWere we then living in a strangely for-ever gone world ? Yes. Karamoja and the Nimba Mountains had different « Situation Analyses « ,… Our grandchildren use them now for their PhDs. And are stunned by how - since - language has become « removed « from reality, on the one hand, with still some sterile repetitivity of terms on the other… At the same time, they wonder why - for the UN system as a whole - every people in the world loves inclusive development, and how suddenly all became resilient and determined to embrace the wisdom of our jargon. Social change? revolutions? Coups d’Etats? « Ruptures »? Warmongers? No, these are excluded from our reports… and not debated any more in our Executive (?) Boards… Detlef, thanks for sharing! Ludo Welffens, see you soon!
I mention Urban's name not in vein - but to demonstrate that all the good work that was done - did not ultimately sink in. I was working in the exact same districts where the nutition model was born as was human rights approach to programming - in Iringa - great stuff in the late 1980s and 90s - and with massive inputs and effort we made a difference - but then POOF - a mere 15 years later - and go to SAME districts and all forms of malnutrition are up, school enrollment is down, literacy is up, access to water is down. waterborne diseases are up. If those great things we did were so great (and they were groundbreaking) - why are so many communities not better off these days - why has development achievement plateaued or declined? We have to ask hard questions?
DeleteWithout sustained economic growth, which was absent in most countries where UNICEF worked, many of these interventions became a low priority within an environment of competition for resources once external funding ceased.
DeleteA very thought-provoking reflection. The question is no longer how many interventions have been implemented, but why communities remain trapped in recurring cycles of vulnerability after decades of aid and programming. Sustainable systems, local ownership, and long-term resilience must become the true measure of impact.
ReplyDeleteCould it be that whatever good stuff UNICEF promoted and piloted was never taken on board by our counterparts?? Or they did it just to be nice - and then after a few years we stopped noticing and moved on to other things and so did the leaders - like it never happened? It is rather sad. I heard the Karamoja most of my career in UNICEF - and anecdotal stories of the miracles performed nearby in child survival - and yet here we are?
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