The President’s Emergency Plan for AIDS Relief.

PEPFAR is having an external evaluation of the progress being made by its programming. This evaluation is being completed by the US Institute of Medicine within 13 different countries, proceeding by interviewing all PEPFAR partners on how this American PEPFAR money is affecting their daily functioning. This morning we had our PEPFAR evaluation interview for two hours – in english – limiting participation to me and the executive secretary. My colleagues sitting around the table only got tidbits I had time and ability to translate.

There are levels of subtlety in the English language that can indicate attitutes and belief systems that may not be detectable to those functioning in English as a second language. It was unfortunately plain to me – and maybe only me – that this external evaluation was biased from the get go. American interviewers who would not record the exact vocabulary I used. For example, would not record the world ‘undermining’ when I said PEPFAR coordination may be undermining national coordination efforts.

The evaluator said to me, “isn’t that a bit harsh?” I said, yes, and I mean it.

I am happy that PEPFAR is in Rwanda; the are providing ARVs and an amazing sum of money for the care of orphans and vulnerable children. They are doing the monitoring and evaluation that is impossible for many local organizations. They are serving a much needed coordination role, and ensuring some level of transparency and accountability.

But I am scared of PEPFAR. I am scared that all the money in Rwanda is American. I am scared that most coordination seems to be done by PEPFAR. I am nervous that most expats who have worked here extensively do not approve. I am scared that Rwandese priorities are becoming Western ones; I am scared that the capacity here is so low; I am scared that there is very little transfer of skills, I am entirely clueless about what will happen when the American money ends.

But – the evaluators assured me that, of course, the money would never end. Followed by their big smiles and the raise of my eyebrows.


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