The not-so-sexy world of development work

Today I realized that I don't want to spend the next decade or even 5 years of my life doing health development/monitoring and evaluation work. Yes, I get to travel a lot and no I can't bitch about the opportunity to sip white wine in a 5 star hotel while writing my latest blog post, but the blue collar/pragmatic part of me is just disgusted and disillusioned. I sat in a meeting with our local and international partners and realized, without speaking a word of Amharic, that the disconnect and gulf between the privileged universe of the world weary, highly educated, and Hilton/Sheraton staying health "experts"and folks who live and work at the field level (in whatever cultural context, be it Lesotho, Ethiopia, Cambodia or North Philly) is wider than the Grand Canyon. The lip service that international NGOs and other health service organizations pay to "meeting the needs" of local organizations and people is just depressing. Don't get me wrong, there are some programs that are working and development work, whether in health or any other area, does employ local people and redistribute some resources, but the hidden agendas and top down approach of international government and non-government organizations will never change. Local staff of these huge international organizations often do not understand the changing agendas and trends (the House of Chanel has nothing on the whims and fleeting desires of the development world) of first-world governments and non-governmental organizations and are incredibly frustrated by the "flying elites." The waste of money and the mindboggling amount (especially USAID) of red tape and budgetary restrictions make you realize that most of your job is just keeping expats and local elites in a job and providing a means to assuage the guilty western conscience that we are indeed doing something for these (and I quote here) "poor people." How can we discuss "research" when people are telling and showing me the real needs on the ground (i.e., food, shelter, employment, clean water, education, and access to basic health services)?? Okay, time for another glass or two of wine.