Covering global health as billions of dollars of aid are cut from programs : NPR

ROB SCHMITZ, HOST:

Gabrielle shares her work on global health and development with fellow NPR correspondent Fatma Tanis. Last year, they both studied the global impact of billions of dollars in U.S. aid cut from programs around the world. In the United States, many headlines have focused on Washington: the chaos, the ideology and the politics. So Fatma traveled to Uganda last September to see what it looked like on the ground. What she discovered was something unexpected – not anger, but something harder to explain.

FATMA TANIS, BYLINE: I really understand that the United States is seen as a major superpower. I remember an elder in the community who kept referring to Donald Trump as Father Trump when he talked about, you know, aid cuts.

SCHMITZ: Fatma was struck by this description.

TANIS: And I asked him, why… why do you call him father? And he said, well, he’s the supplier.

SCHMITZ: Father Trump. This expression – equal parts respect and bemusement – ​​conveys something of the way American foreign aid has functioned for decades – not just as money, but as identity, as presence, as power. And with the United States withdrawing, Fatma wanted to know who was moving in. So for this week’s Reporter’s Notebook, I sat down with Fatma to talk about who’s moving in to take America’s place.

TANIS: In Uganda, you still see the remnants of American aid everywhere you go – posters and murals with, you know, the American flag, guidelines on how to handle, for example, the COVID-19 pandemic. We see this almost everywhere on the ground. And on the other hand, in big cities, shopping centers are built in China. The roads you take to get everywhere are built in China. The GPS in the cars people drive is Chinese GPS, and people certainly know what comes from where.

And, you know, China’s aid strategy has long focused on infrastructure, these very large infrastructure projects. But they also had problems with that – you know, quality problems. You know, when we were driving on these roads, there were a lot of places where they were pretty messed up, and no one was fixing them. So, you know, at one time this road was nice and paved, but now when you drive on it, there are potholes everywhere.

But you know, China is changing its approach. And that’s something I’ve been looking into because of this: a lot of the criticism about the way she helps has damaged her reputation. So they’ve taken a slightly more US-like approach, which is to fund these little projects here and there to win hearts and minds. Actually, they call them small, beautiful projects, which, you know, range from – like, they’re very different – you know, to building a bridge on an island or renovating a maternity ward in Zimbabwe, to helping, you know, get medical supplies into a Latin American country. And so, at a time when the United States is moving away from its aid model and moving more towards a bilateral version, we see China moving in the other direction, and that’s something really interesting to watch.

SCHMITZ: It’s interesting because I used to cover China, and back when I covered China, China focused its aid, as you said, on infrastructure like roads, public transportation and especially ports. And a lot of it was built partly to help this country, but also to extract resources from this country and then quickly export them to China. So it was, in many ways, selfish. You know, what you’re saying right now is that they’re actually turning to other types of aid, basically to help this country develop in health care and also education, things like that. But it’s an interesting change for a superpower like China.

TANIS: Absolutely. And I think there’s something interesting about that, because the way that governments like the United States and China provide aid, I mean, there’s always an element of selfishness. But I think the way China acted was so obvious that, you know, people viewed – in many places, like Kenya and elsewhere, Chinese aid as suspect. Like, OK, you build us a port, but what are you going to get from us? This kind of transactionality was…

SCHMITZ: That’s true.

TANIS: …So, so obvious in a sense that it wasn’t because of American aid. And I think China is now moving towards a more subtle form of aid. But I think she remains very attentive to the positive spin-offs that she’s going to get, because when China gives something to – you know, when China builds a bridge on an island, there are always positive gains for China. People will see it in a positive way, and it’s still a win.

SCHMITZ: I mean, are the people that you talk to, for example, in Uganda and other African countries, are they starting to see China in an ambitious way like they saw the United States as an ambitious country?

TANIS: I don’t think the new Chinese model has sort of – I think it’s still new…

SCHMITZ: That’s true.

TANIS: …In that sense. I think this has not happened during decades of US aid influence. But I think that, you know, perhaps China’s biggest advantage is that the United States withdraws. And so right now, where the United States is not giving anything, China is, and that alone is a victory for them.

SCHMITZ: So, Fatma, I also wanted to touch on how you report when you’re, you know, in the field. You know, there’s this thing that happens in reporting where you go to cover a story – especially in developing countries, this happens a lot, especially to me – and you end up noticing something completely different, and then you’re sort of, you know, pulled in a different direction. How often does this happen to you, and did this happen to you while you were working on these stories, you know, when you were covering China aid and things like that?

TANIS: Yes, it certainly is, and I do, you know – when I plan my reporting, it’s something that I definitely build in a space that, both, you know, logistically, but also mentally. More recently, when I was in Uganda, I was working on a story. You know, obviously, we were talking about the USAID shutdown and its impacts and, for example, the change in foreign aid policy.

But I also wanted to do stories that had nothing to do with that. And so there was this program in a rural part of Uganda that I was profiling. It was a program intended to, you know, push people who were living in extreme poverty by giving them money and coaching. This is a program that, you know, has had high success rates elsewhere, and this one was doing something interesting. It was neither funded nor supported in any way by the United States. It was financed by the private sector.

And so, you know, we’re on the ground. We talk to participants in these programs, trying to understand how their lives are changing with, you know, the help of this money and coaching. And we realized that there had been something that was preventing people, for example, from being able to invest as much as they could have or that they had been encouraged to do so in the creation of their business.

And it turned out that the cuts in U.S. aid caused a serious downturn in the local economy because the people who weren’t participating in the program, the people in the area who were receiving aid, no longer had the resources to spend money in the markets. And it was affecting local businesses. It also affected people in the program who were trying to start businesses. So even a story that I had — that I was intentionally trying to do outside of aid cuts — ended up getting dragged into it.

SCHMITZ: Fatma Tanis is NPR’s global health and development correspondent. Fatma, thank you very much.

TANIS: Thank you for inviting me.

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