For some countries, often “failed states,” NGOs have become the public health department, the Ministry of Health, and/or the only giver of primary care. With NGOs running the show, we have to consider how care is delivered in many developing nations. Who is receiving care and who isn’t?
NGOs may do great things, such as vaccinate an entire village. But, at the end of the day, they are an organization. They need funding and resources to survive. NGOs have to help populations that their donors want them to help. People want to donate to gap-tooth smiling kids getting vaccines. No one is opening their wallet for an old man with lung cancer. Types of causes are also important to consider. Education is going to get more donations than diarrhea.
Location matters as well. Most NGOs are stationed in major urban areas or even somewhat populated rural areas and villages. There needs to be care outside of these regions, such as slums or far remote areas. The broken health care system can lead to rapid spread of disease through marginalized areas, such as the case of drug-resistance TB in northern Peru. NGOs should go to remote areas of each country. However, it is critical to think about how funding should be divided in terms of poorest areas or areas, where the NGO could have the biggest impact in terms of population size. Someone will always be on the outside. However, if the mission is to provide care, then care for all has to be a priority. We have to consider if it is up to the NGOs to provide this if the government is truly a broken system.
In the case when civil society is working with the NGOs, then political and ethical issues will come into play. What happens to citizens that society does not want to recognize? On the other hand, what happens when government prevents the NGO from doing their job? For example, when the North Korea government prevented Doctors Without Borders from reaching victims of starvation. It is more important for the NGO fight to regain access to provide care or lobby the international community against the government. Finally, when will it be time for the NGOs to leave? There is no set measurement to know when a healthcare system is perfect at providing care for all. The governments may continue to need the NGOs to move forward and begin to build a public system.
NGOs play a critical part in providing care in developing nations. There are many issues that need to be addressed when providing healthcare for a country. Can NGOs address these issues and when will they let civil society take the led?