PABBO, Uganda — Ana quietly joined the line, her 2-year-old daughter, Margaret, in tow. She carefully placed her green and yellow plastic containers behind the hundreds of others, and then joined the other women to chat and to wait for water.
It is a daily ritual by which Ana receives water for her family of eight from a giant black tank mounted on metal pillars. The tank is one of 24 water sources built by international relief organizations in this camp for displaced persons, where 63,000 people scrape by and try to survive.
From the water tank, Ana made her way to a tent where small children are weighed and measured, one after the other, so that it can be decided whether they will get an extra food ration. Speaking softly, with a pained smile on her face, she said she was “glad” when a relief official deemed Margaret too small for her age and in need of more food.
“I would like my girl to be normal, but I also want to feed my family,” 28-year-old Ana said. “Tonight, we will add a little extra to whatever my husband brings home.”
Extras are essential here. The 1.6 million people who live in the displaced persons camps of war-torn Northern Uganda receive on average only half the daily minimum amount of water prescribed by health authorities in emergency situations. Their food comes almost entirely from rations handed out by the World Food Program.
International development experts have long urged savings and investment by the world’s poor to grow their way out of poverty. That seems unlikely here in Pabbo. Residents have no income, and they don’t save or pay taxes. They lack access to sanitation, jobs or education.
This is what a new breed of development experts, led by economists like Jeffrey Sachs at Columbia University and politicians like British Prime Minister Tony Blair, call “the poverty trap”: Too poor, sick and hungry to accumulate capital, and lacking sufficient infrastructure to attract investment, they sink deeper and deeper into despair.
According to the World Bank, some 1.1 billion people, one-sixth of the world’s population, lives on less than a $1 a day, the threshold of “extreme poverty” below which basic needs cannot be met. Every day, nearly 20,000 people die as a direct result of extreme poverty. More than two-thirds are in Africa.
While the proportion of extreme poor dropped dramatically in some parts of the world between 1981 and 2001 — from 58% of the population in East Asia to 15%, and from 52% in South Asia to 31% — it has remained virtually unchanged in sub-Saharan Africa at almost half of the population (about 315 million people).
Five years ago, at its Millennium Summit, the United Nations set out a goal of halving, by 2015, the number of extreme poor that existed in 1990. Little progress has since been made.
Now an ambitious gambit has been advanced by a group of European governments and international bodies, including the U.N., the World Bank and the International Monetary Fund. The gambit aims to attack Africa’s most extreme poverty by doubling the level of international development aid.
The main opposition comes from the Bush administration, which advocates relying on private markets and on trade in order to fight extreme poverty. Washington also opposes channeling aid to countries that have governments known for corruption or mismanagement.
Negotiations are under way between Europeans and the Bush administration to reach a compromise to increase aid, as well as to cancel the grinding debt of the poorest nations, before the July summit of the Group of Eight wealthy nations.
According to a new school of development experts, Washington’s assumptions ignore the constraints of Africa’s “poverty trap.” The experts instead point to several factors in explaining the continent’s predicament. One is high transportation costs; Africa has many landlocked regions with few navigable waterways. Another is low-productivity agriculture, often affected by droughts. Africa also suffers from a deadly heritage of slave trade, colonial rule and Cold War meddling, all of which have decimated local social norms. Also, Africa gets too little technology trickling down from abroad, especially in health and agriculture; mostly because of harsh soil and climate, the continent has not undergone a high-yield Green Revolution of the sort that transformed India a generation ago.
Most devastating, Africa suffers from major exposure to diseases, including 25 million infected with HIV/AIDS and nine-tenths of the world’s 1 million annual deaths from malaria. Malaria is the number-one killer in Sub-Saharan Africa, and 70% of the deaths are of children under 5.
The mosquito-borne disease is a major presence in Pabbo. Health workers acknowledge they do not have enough medicines to fight it. “Malaria is our number-one problem,” said Alfred Okwonya, head of the camp’s overcrowded government-run health center. “We have between 1,000 and 2,000 cases a month.”
The disease is visible in the yellow eyes and listless demeanor of Vicky Akumu, age 2. Her mother, Parasesta, said that “several” of her 10 children suffer from malaria. The health center gives them treatment — a harsh regimen of medicines to allay symptoms and prevent death — “from time to time.” The fever and chills are worrisome, she said, but “our main worry is food.”
Unlike AIDS, malaria can be dramatically reduced through simple and affordable means, such as mass distribution of insecticide-treated bed nets to repel mosquitoes. Akumu’s family members, who live together in a one-room adobe hut, has never had them. They cost about $3 each.
However, it is AIDS that has received the bulk of media attention and Western funds, including a $15 billion, five-year program from the Bush administration.
Seeking to shift the focus, the World Bank announced plans last Monday to raise $1 billion in additional funding in order to combat malaria. The bank estimates that the disease costs Africa some $12 billion a year.
This is not the first time that efforts to mobilize the generosity of the rich countries have gathered steam. That’s a point critics make to argue that the solution has failed repeatedly and that a new setback actually could end up hurting Africa rather than helping it.
In 1977, Germany’s then-chancellor, Willy Brandt, led an international panel that recommended rich countries give the equivalent of 1% of their Gross National Product for development aid by 2000. The goal was never achieved; rich countries now allocate an average of 0.25% of GNP to aid.
The latest call, from the U.N., Britain’s Blair and others, is for rich nations to boost development aid to the equivalent of 0.7% of GNP. Critics, particularly in Washington, argue that such a boost would reward countries regardless of their past behavior.
The issue of corruption has been at the forefront of American and Western concerns. Zimbabwe and Kenya, both of which were once regarded as promising regimes, are now pariahs. Western donors suspended aid to Kenya several months ago to punish the government for allegedly mismanaging development aid.
A related complaint is the lack of “absorptive capacity” of many impoverished countries, meaning their inability to use the aid efficiently.
This skepticism helps explain why the Bush administration favors a mechanism called the Millennium Challenge Account, which channels aid to governments whose policies are seen as sound. Bush is requesting $3 billion for the program in his 2006 budget, double the amount Congress appropriated for 2005.
In order to balance Western concerns for accountability with African complaints that aid pledges do not materialize, the U.N. is calling for clear interim benchmarks and for detailed multiyear plans to fight poverty.
Among the U.N.’s priorities are family-planning efforts to reduce birth rates, and new coordination to steer medical, agricultural and energy research toward the problems of poor countries. The world body also wants to prod African nations to work together more closely, to lower trade barriers between them and to cooperate on regional infrastructure projects.
But for Ana, those grand ideas are just that.
“For me, every day is a challenge,” she said with a mixture of resignation and resilience so commonly found here. “I can’t really think about tomorrow.”