Giving the wrong way

Last year, I wrote about a US NGO that wanted to sent a humanitarian aid shipment to a hospital in a Chornobyl-affected area of Ukraine. Listening to a BBC podcast this evening about the so-called “humanitarian industry”, I felt compelled to share the rest of the story about this saga. The situation was difficult, confusing, frustrating and irritating from the very start, and frankly only got worse. I want to write about it now to highlight some problems with the system, as well as the hypocrisy of a specific organization, but I do it with hesitation. There are extremely important reasons to give to humanitarian aid organizations. They do valuable and critical work, and they are essential in conflict zones, disaster areas and other at-risk places around the globe. I don’t want the “take-away” of this post to be that you should never give to a humanitarian aid organization. You should! I do. And because of the story I am about to tell you, I do my homework. I give to reputable organizations who are well-established in the country where I want to help. So before I tell this particular horror story of giving the wrong way, I’ll give my 2 cents on how to give the right way.

It’s hard for everyday folks to know what organizations are reputable or not, where to give money and for what. Do a Google search for Peace Corps, United Nations or Doctors Without Borders Volunteers in a country or region you are interested in. They are living in the middle of the toughest, neediest places and situations on the planet and they have blogs and email. Ask them what are the local needs and who is best addressing them. Ask how long an organization has been working in that country, and how many local partners they have.  The group that just showed up yesterday in Haiti cannot help nearly as much or as effectively as the organization that has been working there for a decade. Don’t be turned off by “overhead”, administrative expenses or staff costs. You absolutely should give to organizations that have staff, especially local staff. They know what the hell is going on, where the need is and how to get the aid to the neediest. The biggest conundrum for NGOs is that donors want to give money for projects, but they don’t want their money to pay for people, places or things. You need people to implement projects. They need a place to work, and they need to pay rent for that office. They need computers and internet and telephones and paper and printers and ink and other supplies and equipment. The administrative aspects of any project are critical and have to be done right, and donors need to understand that some of their donation must be spent on the NGO’s infrastructure. They aren’t stealing your donation, they aren’t lining their pockets and getting rich. Most NGOs and aid workers are surviving on a shoestring budget and they want your donation to be as helpful as possible to the people in need. Sometimes your donation is best spent making phone calls to raise more funds. Sometimes your money is best spent paying a qualified accountant to keep clear and organized records so the NGO doesn’t do something wrong and get shut down (and who is helped by your donation then?). Sometimes your money is best spent so a person sitting in an office, at a computer, with internet connection, can write press releases so the world might hear about a genocide happening in Rwanda, or an ecological disaster in the Amazon rain forest, or an utter lack of security in the post-earthquake camps in Haiti leading to unprecedented rates of women being raped. Your small donation (which, let’s face it, is what most of us can give) is most effective when LOTS of people are giving small donations and the funds are used together, and raising awareness is an important aspect of raising funds. Donors need to help pay for people, places and things that are all part of the projects being implemented.

Yes, there are scammers. But I firmly believe the vast majority of people in the “humanitarian industry” are honest and sincere. Which is why if you want your money to be used as effectively as possible, you need to spend a few minutes learning about where you are sending your money. And you absolutely should be sending your donations to aid agencies, big and small, international and local.

OK, so now an example of how not to make a humanitarian aid donation. There are several organizations involved in this story. The US NGO that originated this project is a small organization of kind people who truly meant well and wanted to do something good for a community they’ve worked with for years. I will call them the Naive Do-Gooders, or NDGs. The evil culprit of this story is Hospital Sisters Mission Outreach, which claims to be “focused on the recovery and responsible redistribution of healthcare equipment and supplies to developing countries.”  They are the ones who got upset last year because the Korosten hospital listed “family planning” amongst the services they provide. But I won’t rant about that particular hypocrisy again; there’s plenty more of it in this story.

So, the container was filled with supplies from the Mission Outreach warehouse and shipped to Ukraine. The Naive Do-Gooders had a stressful moment when they were told by USAID, which was providing a grant to pay for the shipment costs, that no items with expiration dates of less than twelve months from the date of arrival in Ukraine could be included. The NDGs were upset, said they had to take a lot of perfectly good items out of the container that could have been used in the first months upon arrival in Ukraine. Igor and I were comforted by the fact that USAID had a clue that these kinds of shipments always take longer to process than expected, and that it was better to not include items that could potentially expire during a drawn-out intake procedure in Ukraine. My biggest fear of the shipment containing a lot of useless garbage was allayed – or it seemed. I now consider myself a Naive Do-Gooder, too.

The shipment arrived in the port city of Odesa in October 2009, and about a week later arrived by truck in Korosten, where it was stored in a secure facility pending import and customs procedures. Everyone was excited, congratulatory emails flying back and forth about a job well done. There was talk of having a big press conference when the container would be opened, maybe even someone from the US Embassy could be there to represent the NDGs. Do I need to say that we all jumped the gun, counted our chickens before they hatched, put the cart before the horse?

The items were in storage for about a month, and then the hospital was required to submit one example from each type of non-furniture item in the shipment (ie, one set of gloves, one catheter of each type, etc) to the Institute of Ecology and Hygiene in Kyiv, the place that inspects samples from medical shipments to Ukraine. They confirm that items are approved for use in Ukraine, sterile, not expired, etc. A hospital representative and customs agent opened the shipment in Korosten, removed the requested items and sent them to Kyiv for inspection. A few days later, the Institute informed the hospital that the items were expired and the shipment was rejected. Ihor and I asked to meet with the inspector and see the sample items ourselves, which we were permitted to do.

The inspector showed us about 40 or 50 items. About half of them had no date whatsoever, about 25% had an expired date and about 25% were not yet expired (although a few of these had expiration dates in early 2010, which contradicted what we had been told about all items expiring before October 2010 being removed from the shipment). We took photos of many of the items. The inspectors had lots of questions. Thed didn’t know what some items were (and neither did we – no labelling at all on several items), some had brands or labels that were unknown to them. The inspector repeatedly said that there are international standards for labeling items and that many of the items in this shipment did not meet those international standards – namely, no expiration date. A couple items I think showed manufacture date (MFG), which confused them, but that accounts for just a few things. So, many of the items were indeed expired and it was questionable if the Institute would release the unexpired items even. They hinted around about holding up the entire shipment because so much of it was expired or had no date indicated, and it would take too much time to inspect everything, since there are doubts about how much was still good, etc. They also made quite a show of disgust, told me how insulting it was for foreigners to send this kind of junk to Ukrainains. I was mortified, and felt they were absolutely justified in being digusted and insulted.

I reported all this to the NDGs and sent them my photos. They were shocked, to put it mildly. They immediately contacted Mission Outreach, who accepted full responsibility for the fact that some of their products are expired.  They claimed to be very embarassed for not catching this before. The reason it happened, they claimed, is that as boxes come in from their “partner” hospitals, a volunteer is supposed to sort the items in each box, but if a box is labeled, for example, “foley catheters”, the volunteer just pokes through the top to see if they are indeed catheters, without focusing on the expiration dates of all the same items in that box.  The box then gets sealed and stored, and shipped, as in this case, without further review.  Apparently they worked off an inventory list when pulling items before shipment, and did not inspect the items themselves. And apparently their record-keeping is quite crappy and no one really pays much attention to expiration dates, so the inventory list was very, very incomplete. Their other excuse for the non-labelled items was that there is no requirement they know of that non-degradable, non-pharmaceutical items must have an expiration or “use by” date. Perhaps there is not a requirement in the US, or no international standard like that. But apparently there is such a requirement in Ukraine, which is exactly why it is critical to work with organizations who are well-established in a country and know the local laws and regulations!

So, my worst fear was realized – Mission Outreach sent a container of TRASH to Ukraine. The NDGs asked about paying fines or bribes, or doing something, anything, to get the shipment released. The head doctor at the Korosten Hospital informed us that he didn’t care what we or NDG might do, but there was no way he was going to use these supplies for his patients, no matter how much the hospital needed them; there was no way he would put his patients at risk. I admire him immensely. Would the NDGs accept these supplies for their loved ones in a US hospital? Would you?

After much soul-searching, Ihor and I decided we could no longer be a part of this project. The NDGs had enough local contacts to continue on their own, and the hospital was willing to follow up themselves about the unexpired items that could potentially be approved and used. We informed the NDGs in December of our decision. Last I heard, they were still negotiating with the inspectors to get some valid items released. Thank goodness we didn’t have that press conference!

But I want you to know that Mission Outreach is sending this garbage ALL OVER THE WORLD. They are sending trash to Haiti, to the people most in need.

If you want to donate clothes or furniture, take it to your local Salvation Army or a homeless shelter or a battered women’s center. If you want to donate food, take it to a soup kitchen or a food pantry in your town. Donate *things* in your local community (but please, don’t donate your grungy old couch or worn out shirt or about-to-expire food just because you think it’s wasteful to throw it away; trash is trash, send it to the dump).

If you want to help people recovering from disasters and crises and emergencies, in other parts of the US or in other countries, send MONEY. If the NDGs had sent the $5000 they collected to the Red Cross or Children of Chornobyl or any other well-established aid organization in Ukraine, they could have bought locally-produced medical supplies that (a) would have been approved for use in Ukraine and (b) would have met the actual needs of the hospital – and to boot they would have supported Ukrainian businesses that employ Ukrainians, and thus they would have helped the Ukrainian economy, too. Instead, Mission Outreach took the NDGs money and sent garbage to Ukraine. They do this every day, swindling hundreds (thousands?) of Naive Do-Gooder organizations out of their members’ donations. And to make matters worse, the American taxpayers were swindled when USAID gave a grant to pay for the shipment of that garbage. Mission Outreach is, in my opinion, a sham.

And their fuss about “family planning” continues to stick in my craw. The irony being, of course, that in the end they were perfectly fine with sending expired medical supplies to a needy hospital. I guess it’s OK to use trash for treating sick children, just not for legal abortions.

Mission Outreach, you have embarrassed the United States and made all Americans look bad. You have sent America’s garbage to Ukraine in the guise of “humanitarian aid”. It is insulting and disgusting.

The Korosten hospital administration had been very skeptical and hesitant to get involved with another humanitarian aid shipment, having had bad experiences before when so-called donors sent broken equipment, expired medicines, and other unusable items. We worked hard to convince them that it would not happen this time. We gave our word. We staked our personal and professional reputations. And they believed us. We advocated for the hospital and were adamant that items needed to be what the hospital requested. We thought this was at last a true humanitarian aid shipment, with helpful and usable items, not just a bunch of junk and leftovers that Americans would never accept for their own families.

I was excited and proud to be a part of this project in the beginning, but now I am only embarrassed. I am embarrassed before my husband, whom I asked to be a part of this project. I am embarrassed before his colleagues and friends and neighbors, whom he asked to help with this project. I am embarrassed before my adopted country, for having let them down. I am embarrassed before my own country, that organizations like Mission Outreach are allowed to misrepresent the true charitable nature that I believe is inherent in the American people.

Mission Outreach has reinforced the belief among Ukrainians that the humanitarian aid community is a farce, and reinforced the terrible stereotype that Americans are selfish and arrogant. You have damaged the reputation of all legitimate and worthy organizations.

Mission Outreach, you should be ashamed of yourselves.