With the best of intentions, global development work often falters when NGOs take a top-down approach. As “experts”, organizations believe they know what’s best for communities - routinely implementing projects that realize their concept of development and oftentimes importing Western staff to achieve this. Exacerbating this scenario is the phenomenon of Learned Helplessness, a term most frequently heard in the field of domestic violence, but also applicable to communities that over generations have become used to having decisions made for them. With communities not engaged in the initial planning and development process, it is little surprise that the developing world is now littered with technology and projects that fell apart as soon as the implementing NGO left.

Top - down development can exacerbate learned helplessness

HIV/AIDS work, both domestic and global, has frequently taken a different approach. In forcing governments to acknowledge the existence of the disease, the fight against HIV has been fought from the ground up since the very beginning. In the early days activism by the gay community in the United States forged and guided public health policy and programs at every level, creating effective and powerful models both informed by scientific research and rooted in community needs. As the HIV pandemic spread to other demographic groups, the importance of direct community input and their engagement in the decision-making process was recognized as key to the fight against HIV. The uniqueness of each community group and their own specific needs are identified through such ground-level tools as community planning groups, community-based organization capacity building and, most importantly, the hiring and training of individuals who “walk-the-walk and talk-the–talk” of their community to implement the work.

Key to this model is the concept of development sustainability – ensuring that work will continue once the funding organization has exited the community. The only way to ensure this will happen is through projects that are based directly on community need and that have engaged the community at each step of project development; truly building capacity from within. Projects lacking a feasible “exit strategy” risk creating sustainable work over the long-term solely for the NGO. Both of the two very different global health organizations for which I’ve worked, the International Training & Education Center on Health and Clinton Foundation Health Access Initiative, have examples where after several years of organizational capacity building with government Ministries of Health they have been able to exit countries leaving self-reliant and sustainable HIV/AIDS programs in place. In fact, one nation, The Bahamas, is now providing peer education and support around HIV work to other countries in their region.

Key to sustainable community work is the concept of “servant leadership”; meeting the needs of and working on behalf of others. As global health program manager, one phrase frequently used was “How can I be of help to you?” Communities are more than aware of their specific needs and it often simply takes listening, moving the pieces around and facilitating access to resources in order to create sustainable change. The CEN model works at this most fundamental level by responding to communities’ needs; then providing development tools so individuals can achieve their dreams – for themselves.

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Frances Walker-Dudenhoefer is the Vice President of CEN's Board of Directors and has many years experience in global health.

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