MaterCare - Background on CIDA refusing funding (more to come...)

(This was released by MaterCare last year)

MATERCARE INTERNATIONAL

SUMMARY OF DISTRIBUTION OF

MUSKOKA FUNDING OF THE GOVERNMENT OF CANADA

FOR MATERNAL HEALTH CARE

&

 - 11^TH TIME MCI HAS BEEN DENIED

10 October 2011

        The funding announced on September 22^nd, by Prime Minister Harper, of  $82 million for 28 NGO’s as part of the G8 Maternal, Newborn and Child Health Initiative went as expected to the "big" agencies for "maternal health and family planning" which included IPPF - $6 million and UNFPA - $40 million, both non Canadian organizations.  As far as we can see there is little, if any, funding for essential obstetrics, which the Muskoka initiative was supposed to deliver, and only one for the drought area of east Africa e.g. Kenya.  However there are 23 other agencies not listed.

        In May of last year MaterCare International (MCI) was invited to the P.M’s office to meet with a senior policy advisor, about the work of MCI in west and east Africa since 1981. The meeting focused on MCI’s maternal health essential obstetrical projects, which met with the objectives of the Muskoka initiative.  Also discussed were the reasons MCI’s has been denied funding for all its last applications since 2002 i.e. 11 times.   

        Reproductive health (abortion and birth control) has been the ideology of Canadian International Development Agency (CIDA) for years, which it is determined to impose throughout the developing world, especially sub-Saharan Africa, now despite the intent of the Muskoka G8 initiative. The way it is distributing these funds favours large abortion/birth control/population agencies, which have little interest in providing essential obstetrics as that is not their prime interest.

        Abortion and birth control are irrelevant to reducing maternal mortality as most deaths occur during the last 3 months of pregnancy, during labour and delivery and one week afterwards. It is egregious to suggest to mothers that in order to save their own lives they must kill their babies, rather than to provide them with safe comprehensive maternity care. Early abortion is being promoted, by oral medication, and surgical means using manual vacuum aspirators (MVAs).  The problem with these procedures is that having been given the pills or having undergone and MVA, the mother is sent home where bleeding or infection may result but she has no access to medical follow-up. Many African mothers are anemic due to malnutrition and malaria and with post abortion haemorrhage or infection death may well occur.  In addition, these MVA kits are supposed to be for one time use only but as we know with injection needles and AIDS there is no assurance that they will not be used again, and as they cannot be sterilized, further use may result in spreading infection and leading to more maternal deaths.

         To deny the provision of essential obstetrics is a form of violence against women. Violence may be by commission i.e. a person is physically assaulted in some way, or by omission i.e. by culpable negligence not to have done what is necessary – in this case, providing essential care during pregnancy and childbirth.  

           MCI applied to CIDA for Muskoka funding for a comprehensive rural obstetrical project for the severely affected drought district of Kenya, which has been badly neglected by government and NGOs.  MCI’s proposal has been turned down twice.  The first time was due to a CIDA technical issue in uploading our proposal to their site.  We were told that we had not pressed a “submit” button however there was no indication that this was required especially as CIDA confirmed it had received the 29 page proposal/budget and 27 other documents.  Thus as the application was complete, a project number was assigned.  We challenged this reason on the grounds that process was flawed, which CIDA later agreed.  If we had not done so, we would have been unfairly denied.  MCI was then told that the application had been found and was being “decoded”. 

This had happened to other NGOs also.

        Having followed the guidelines for funding, we understood that of the total budget of $2,917,968 MCI was required to raise 25% of the total budget with CIDA providing the remaining funding up to a maximum 75%.  The proposal was then turned down, for a second time on the grounds that MCI had not met the requirement that:

"The average total annual revenues of the organization over the past three years or total unencumbered financial assets under the financial control of the applicant (e.g. endowments) must be greater than the average amount requested from PWCB per year of the project)."    

        MCI was asked for further explanation and were told that of the $2,917,968 total MCI had to raise over the 3 years of the contract, the amount of the CIDA contribution of $2,188, 476 (75% of the total) from Canadian sources but of this MCI would have to contribute only $729,492 (25% of the total).  This would, however, then leave MCI with an unused surplus of  $1,458,984 which leads to the problem that as a charity MCI has to follow strict guidelines as to the use of funds received and these this funds being designated had to be used for the Kenya project purpose. This the funding process makes it impossible for smaller NGOs to obtain CIDA funding. This is the 11th time MCI has been denied project funding by CIDA since 2001. We were told in writing that as MCI did not provide “reproductive health services”, it would never receive funding and also verbally that MCI was “too Catholic” and “too close to the Pope”!  Other reasons have been mostly technical/process ones but never on the substance of our proposals. 

        MCI has developed a model of comprehensive rural (where most of the deaths take place) obstetrics that takes into account not only the obstetrical causes of death and provides prenatal care, treatment for life threatening complications and postnatal care, but also other obstructions to survival, e.g. lack of transport, poor roads, lack of infrastructure and trained personnel.  During the last three years MCI has provided $1.2 Million to build and equip a 28 bed obstetrical hospital in the town of Isiolo, Kenya capable of treating all life threatening complications; built a rural maternity clinic in Merti, district some 225kms from Isiolo; provided an emergency transport 4 X 4 ambulance for providing long distance safe transport for severely ill mothers, provided two motorbike ambulances for the villages; and trained over 100 traditional birth attendants. This area of Kenya is located in the drought region where in some areas there has been no rain for 6 years and where there has been no health care at all.  The communities served are nomadic pasturalists, who have lost many of their cattle and goats due to the drought; internally displaced refugees; and those from Somalia, the border is 200 kms and Isiolo town is a transit centre. Thus the maternal mortality and morbidity is one of the highest in sub - Saharan Africa.

        Our application to CIDA was for operating costs for the hospital, for refurbishing and equipping five rural maternity centres. The project would have been a unique demonstration project conceived and implemented by an experienced Canadian NGO in partnership with a Kenyan NGO and with Kenyan colleagues. The hospital and clinic are both ready to provide care.  This has been achieved by generous donations from Canadians individuals, foundations and women’s groups as well by government and private donors in the UK, Italy, Australia, Poland, and the US.

        The problem with CIDA is that it functions in a typical bureaucratic way from the top down and not from the bottom up, and thus fails to consider the needs of those whom it is supposed to be helping. It more concerned with its form rather than function and is CIDA is blinkered by its own ideology. It is without the health professional input it had 20 years ago and has especially an antipathy towards smaller NGOs “there are too many of them”, especially those which are faith based.  NGOs such as MCI are more efficient; they are closer to the people; their expertise is invited not imposed; they listen to, live and work within the communities which they serve and are thus more acceptable.

        So now there is a project which will save mother’s lives in a drought area of Kenya conceived and developed  by a Canadian NGO with provides essential obstetrics  in a maternity hospital with one rural clinic, all built  by generous, after tax, donations from individual Canadians including many seniors,  as well as Canadian foundations and the Canadian Catholic Women’s League  but is denied operating funding from the Muskoka initiative, even though the P.M’s office sought advice from MCI and which congratulated it for what it  had achieved.  This could be a major embarrassment for the Canadian Government.

Dr R. L. Walley

Executive Director

Professor Emeritus of Obstetrics and Gynaecology