Review of Killing With Kindness: Haiti, International Aid, and NGOs by Mark Schuller

If you have not read any books about Haiti, you might naïvely expect that their primary goal is provide the reader with impartial information about the country. I have found that on the contrary, virtually every author brings not just a bias but a strong agenda to the table. Mark Schuller’s Killing With Kindness is no exception.

The bulk of Killing With Kindness is devoted to two case studies, namely two Haitian women’s NGOs that Schuller pseudonymously calls Sove Lavi and Fanm Tèt Ansanm. In both cases, AIDS prevention is a major part of the NGO’s mission. A very high-level summary of the book is that Schuller closely examines both NGOs, as well as their relationships with grassroots organizations “below” and donors “above,” and concludes that Fanm Tèt Ansanm, on the whole, does a better job. He offers reasons for this, and lists recommendations in the afterword of the book, not just for NGOs, but for grassroots organizations, donors, and even the government.

This summary, however, fails to convey some of the most important features of the book. One strength of the book is Schuller’s meticulous attention to detail. He carefully observes and records how various people interact with one another on a day-to-day basis, and how special events are planned and conducted. Here is a sample from Chapter 2, to give the flavor.

It took about twenty minutes to set everything up. After that, it took a while for people who had waited for us to actually arrive to show up. The meeting was outdoors, at least until the rain started. The benches were arranged in a semicircle, and there was a hill that made a natural amphitheater. Everyone could see the action.

The seats become full. I would guess that more than two hundred people attended, both men and women. That was actually a very good sign. The rasanblaman (meeting) began with a song, “Rasanble,” featuring the lyrics, “We’re waiting for you. Sit down. Assemble. Assemble.” Then another song about the struggle, featuring lyrics like “We’re working to save our community.” There was a brief scuffle between the guy who led the song and a woman who scolded that he was making this too complicated; according to her, all that extra text should be taken out, as this group is only about AIDS.

Then, of course, a prayer.

After this, all the participating CACs (Community Action Councils) had to be introduced, one by one. That took a long time. I was a little surprised at how old some of the people were, many in their fifties. I thought Sove Lavi worked with “youth.”

As one can see even from this short extract, Schuller is highly attentive to demographics and the way people treat each other. Are some people made to wait for others? Who has authority over whom? Are there inconsistencies between stated goals and the reality on the ground? Which formalities are regarded as necessary and which are not?

These types of observations about social interaction and status are valuable because they are often overlooked, and yet they have a powerful influence on the ability of an organization to accomplish its mission. I would say that the main strength of the book is the spotlight that it shines on the importance of interpersonal relationships, both within an NGO and between the NGO and its partners “above” and “below.” For example, Schuller notes that Haitian employees of an NGO, simply by virtue of being paid well by Haitian standards, become part of an “NGO class,” and this has an effect on how they interact with other Haitians. Also, one of the best chapters of the book is Schuller’s study of USAID, which demonstrates how diverse political forces control and sometimes undermine the efficacy of the agency.

At the same time, I feel that Schuller’s preoccupation with the issue of social inequality is excessive at times. It almost seems to be his tacit agenda to smell out all forms of inequality and to blame it for everything that is bad. I have the feeling that if Schuller were to analyze the U.S. Army, he would spend all his time documenting the hierarchy within the Army and all the ways that that hierarchy was reinforced, ignoring the question of whether the Army was successfully accomplishing its stated objective of defending the United States, or the question of whether that hierarchy was necessary for that objective.

For example, Schuller discusses something called “results-based management” in Chapter 4. This term refers to a management practice followed by large donors such as the Global Fund and USAID. According to Schuller,

Central to this new management style is the donor practice of reimbursing NGOs after they have spent the funds, based on achieving “milestones” or service targets.

Schuller lays out some legitimate criticisms of results-based management as practiced by the Global Fund and USAID. However, his conclusion seems to be that all forms of results-based management are bad. But surely, shouldn’t NGOs be evaluated on the basis of whether they accomplish their stated mission? And if so, then some form of results-based management seems inevitable. In fact, Schuller himself, on page 47, cites “criteria established by donors” such as number of condoms distributed, number of people undergoing voluntary AIDS testing, and so forth, in support of the claim that Fanm Tèt Ansanm was successful. Isn’t this process of evaluating an NGO on the basis of quantifiable results a form of results-based management? (Interestingly, Schuller does not critically examine whether the social structures that he so carefully observes have a measurable causal effect on the criteria established by donors; he takes it for granted that the social dysfunctions he documents are a major cause of failure to achieve satisfactory results.)

In defense of Schuller, perhaps one could say that at least Schuller does document greater social dysfunction in Sove Lavi than in Fanm Tèt Ansanm, and greater success (according to conventional metrics) in Fanm Tèt Ansanm. However, Schuller makes a telling comment on page 73.

Actually, as of 2009, Fanm Tèt Ansanm became like other NGOs offering their services about HIV/AIDS in the provinces. Given this, and the increasing intensity of complaints of committee members, it is clear that participation was eroding further. Committee members like Josette identified the AIDS-prevention program as “work” that they do for Fanm Tèt Ansanm (notice her use of the word “salary” in the above quote), and not as a volunteer effort. This is a further clue into volunteers’ disaffiliation as “members” and with Fanm Tèt Ansanm’s priorities of HIV/AIDS prevention, highlighting how even a generally open NGO can change and how fragile genuine local participation is.

An obvious hypothesis is that the primary reason that Sove Lavi was struggling to achieve its goals was that its mission of offering HIV/AIDS services in the provinces was simply more difficult than Fanm Tèt Ansanm’s mission; after all, when Fanm Tèt Ansanm took on the same mission, it also started to fail. Yet this hypothesis is simply not even considered by Schuller.

Setting aside the above criticisms, let us examine Schuller’s conclusions. After briefly critiquing the approaches of Marx and Foucault, Schuller then offers something that he calls “trickle-down imperialism” as a theoretical framework for understanding how most NGOs currently operate.

The aid system requires the ideology of autonomous, self-governing units and a system of accountability that is by definition hierarchical. Intermediaries are supposed to be responsible managers tasked with implementing superiors’ mandates and supervising subordinates. Given such a vague mandate, a USAID-Washington middle manager, USAID mission director, or NGO director can choose either a “conservative” or “liberal” interpretation (not in the political but the epistemological sense). Consistently at Sove Lavi, it was the former; at each step, an intermediary made more conservative, cautious interpretations. So by the time the policy is implemented with Sove Lavi CAC members, it cannot address local participation and hence it exacerbates conflict. NGO directors like Mme Versailles who are loath to admit they are not autonomous act more conservatively than their donors want or need, because their funding could be cut. This is partially why Mme Versailles and Sove Lavi don’t even think to question or challenge, let alone imagine alternatives. There is often very little room in which NGOs can negotiate. … As long as they act within a small sphere with a pretense of autonomy, practicing “good governance,” a balance is maintained. But the moment an NGO director steps out of the sphere of allowable actions, the organization can be disciplined. The threat of power, in the pulling of funding, is not only internalized akin to Foucault’s “discipline” but is also real and imminent, as described in chapter 4’s discussion of Sove Lavi.

In his afterword, Schuller gives recommendations for actors at each level of the hierarchy. Many of these recommendations seem commonsensical. I only wish that Schuller had taken more care to allow his data, rather than his ideology, drive his conclusions.
Posted June 2016

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