To NGO or not to NGO...

A reader asked me to comment more on what Paul Farmer said about forming more NGOs versus supporting the Public Sector. Dr. Farmer didn't say much more than what I wrote in the blog, but here's the URL for the Partners in Health newsletter, which describes a joint venture between PIH and the Haitian Ministry of Health:

http://www.pih.org/inforesources/newsletters/PIH_e-Bulletin_0108_2.pdf#Haiti

I love a number of things about this. First of all, it's filling a real need in the country. Second, it's Dr. Farmer putting his beliefs into practice. Third, it's fulfilling what Robert Linthicum in his book, Transforming Power, calls "The Iron Rule": get those in need to be part of the solution.

It's clear that if a need isn't getting met, industrious people with the will and resources ought to step up and help. The troubles with creating more NGOs, as good as many of them are, can be many: more NGOs ultimately diffuses the available resources and their ultimate impact; it either creates or perpetuates a "hand-me-down" mentality; and, in the case where America or other powerful countries might be supplying the resources, the temptation is strong to do things "our way" rather than a way that's culturally relevant and effective.

Dr. Farmer's solution seems to bring out the best in an NGO-public sector partnership: the NGO provides needed resources, but not all; it calls the public sector entity to give what they can and be fully involved; and provides empowerment and growth both to the public sector entity and to the local people whose lives would be most directly affected by the project.

Any thoughts?