By banning NGOs from foreign funds, the govt is crippling its own services, laws

It was at an airy, well-equipped hospital of 100 beds on a sylvan hilltop in tribal Tamil Nadu that N Devadasan realised how, even when it appears prepared, India’s public health system is not. Catering to about 17,000 tribals at the tri-junction of Tamil Nadu, Kerala and Karnataka, the government hospital could not stop the deaths of many pregnant women. There was no follow-up care after admission, and there were only two doctors, usually loath to physically examine their tribal patients. “There was a local saying,” said Devadasan. “‘You come in on your own, and you are carried out by four people’.”

A soft-spoken, earnest doctor determined to work “in a place of need”, Devadasan spent a decade with his wife in the late 1980s and ’90s catering to the primary healthcare needs of tribals whose children died from reasons difficult to comprehend in prosperous, emerging India, including diarrhoea, measles, respiratory infections and malnutrition. These illnesses continue to kill Indian children by the thousands. Although India has steadily improved its infant-mortality rate (a 53% drop over a quarter century), a million babies die every year at a rate higher than the average of 154 low- and middle-income countries.

Living on the forest edge in the town of Gudalur, initially in a leaky house with no TV, fridge or running water, except in the toilet, the Devadasans represented many idealistic folk who try to fill the country’s biggest governance gap: The last-mile delivery of services, particularly to disadvantaged communities. The Devadasans set up a system of immunising children, monitoring growth and delivering babies, but they could not handle complicated deliveries or treat disease, such as pneumonia. Financed by British and Dutch donors, the NGO they worked for asked the government: Could they volunteer at the hilltop hospital? No. Could they get vaccines to deliver to remote tribal villages? No.

This perverseness is an Indian quality. It also explains why many NGOs that work on governance failures report that Indian donors want to see buildings or tangible things — they are reluctant to donate money for research or training, and, largely, flee from anything that spells “r-i-g-h-t-s”. After a decade with the tribals of Gudalur, the Devadasans left to see if they could address the knowledge gap at the district and state level in the government health system by working with public health services. If they could be strengthened, the poorest would benefit.

Today, Devadasan’s decade-old NGO, the Institute of Public Health (IPH) — run from a modest house in a Bangalore suburb — generates data from within district hospitals to help evidence-based decision making. It shares the data to influence policy — in other words, advocacy (which, Devadasan admitted, is now a “bad word”), and provides on-the-job training and professional education for government health officers.

Some IPH recommendations have become part of India’s public-healthcare improvements. Devadasan was part of the Karnataka government’s task-force on reorganising primary healthcare and the national health assurance mission; a colleague was part of India’s official delegation to the UN in October on anti-tobacco laws; and IPH training programmes — for the police, education, urban development, information, infotech/biotech and other departments — have led to Karnataka, which has tasked the NGO with being the implementing agency, being furthest along in giving life to the country’s anti-tobacco law, more than eight years after it came into force, 13 years after it was passed.

Helping the government implement its own laws in a country full of high-quality legislation but poor execution is an important role that NGOs like the IPH fulfil. That argument did not stop Narendra Modi’s government from banning, “in the public interest” or for “anti-national activities — to use the vague, official reasons — foreign donations to IPH and 24 other NGOs in November. The real reasons, of course, are clearer. 

Some of the NGOs forbidden from foreign donations have helped implement laws in a manner inconvenient to Modi in the past, such as the Sabrang Trust of Teesta Setalvad, which fought cases on behalf of Muslim victims of the 2002 Gujarat riots, and the Lawyers Collective, run by former Indian additional solicitor general Indira Jaising, who defended Sabrang. Another banned NGO includes Gujarat’s 27-year-old Navsarjan Trust, which has built facilities for disenfranchised Dalits and fought legal cases, most notably on behalf of four Dalit tanners flogged by Right-wing Hindu vigilantes for skinning cows.

The IPH had rocked no boat associated with the BJP (although, its anti-tobacco work, I heard, could have riled the tobacco industry). Its foreign-donations ban further illustrates the inherently arbitrary and opaque nature of the government’s actions. Devadasan first got to know of the cancellation of the IPH’s foreign-contribution licence from the newspapers. An appeal to ministry of home affairs, got this reply on December 26: “It is (sic) to inform that the application for renewal is refused in the public interest.”

With four donors (Belgian, German, the United States, and the Red Cross) cashiered, so to say, the IPH’s Rs 2.5-crore annual budget is in disarray, and 30 of IPH’s 40 public health professionals and other staff will leave by the end of this month. Only one donor remains: The World Health Organization, which does not require government clearance.

To use the public-interest justification against respected organisations that work in the public interest, delivering the government’s own laws and services, is an act of irony (consider, the IPH works with the health ministry and faces action from the home ministry). To provide no clear justification is not only perverse but sets yardsticks others can similarly misuse — the precedent for the hounding of NGOs was established by the previous Congress government. And to argue that these NGOs can do without foreign donations — which political parties are free to receive — hides the uncomfortable fact that Indian donors aren’t exactly lining up.

One prospective Indian donor told Devadasan the most it would do was sponsor a bag of medicines — provided IPH carried their logo and name.

Samar Halarnkar is editor, Indiaspend.org, a data-driven, public-interest journalism non-profit

Source: Hindustan Times, 8-02-2017