So Much Aid, So Little Development: Stories from Pakistan

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Pakistan has received more than $20 billion in external development assistance but has made little evident improvement in its social indicators. So Much Aid, So Little Development offers a fresh explanation for this outcome.

The author, Samia Altaf, a physician and public health specialist, follows one major initiative, the Social Action Program developed by the Pakistani government in 1992 and funded by the World Bank to the tune of hundreds of millions of dollars. In an engrossing account that reads almost like a novel, at times hilarious, at others heartbreaking, she tells the story of the program’s shortcomings through a series of eyewitness vignettes. She begins with planning meetings in Islamabad, moves through layer after layer of the Pakistani bureaucracy down to the village health trainee, and then returns to Washington for the evaluation. At every stage, she finds skewed incentives, misplaced priorities, and inappropriate designs diverting the project from its original intentions and ambitions. In the process, Altaf introduces into the development conversation the human dimension that most frameworks have neglected to their detriment.

Johns Hopkins University Press

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Editorial Reviews

Regional Studies
This book highlights the well-documented problems with foreign assistance from within the system. It is a must-read for anyone working in development.
New Internationalist
Insightful and highly readable narrative.
History Wire - Where the Past Comes Alive
An engrossing account, at times hilarious, at others heartbreaking.

— Steve Goddard

the leading English-language newspaper in Pakistan Dawn
Samia Altaf gives you hilarious accounts of how advisors from overseas go about implementing their 'projects.' How many at the World Bank, IMF and WHO have read this account of how aid actually works? How many high level bureaucrats with policy making powers at these agencies, will make the effort, or learn from these observations?
Regional Studies - Claudia R. Williamson
A must-read for anyone working in development.
History Wire - Where the Past Comes Alive - Steve Goddard
An engrossing account, at times hilarious, at others heartbreaking.
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Product Details

  • ISBN-13: 9781421401386
  • Publisher: Johns Hopkins University Press
  • Publication date: 6/2/2011
  • Series: Woodrow Wilson Center Press Series
  • Pages: 224
  • Product dimensions: 5.90 (w) x 8.90 (h) x 0.60 (d)

Meet the Author

Samia Altaf, a physician and public health specialist, was formerly the senior advisor to the Office of Health in the USAID Mission in Islamabad, Pakistan. She was the 2007 Pakistan Scholar at the Woodrow Wilson Center.

Johns Hopkins University Press

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Table of Contents

Preface xi

Acknowledgments xv

Introduction: Why This Story Needs to Be Told 1

1 Meeting Lucymemsahib and Starting Our Project 14

2 The Organization of Our Project 24

3 The Pakistan Nursing Council: Adead End 33

4 The Allama Iqbal Open University's Bureau of University Extensions and Special Programs 45

5 The Women's Division: ABrief Encounter of the Worst Kind 56

6 The Population Welfare Division: To Be or Not to Be 64

7 Regional Training Institutes and Other Such Things 81

8 A Day in the Life of a Provincial Health Department 99

9 The UNICEF and UNDP Workshop and the Sindb SAP Proposal 122

10 The Punjab Proposal and the Firing of the Learned Dr. Sahiba: ... And That's the Way It Is 142

11 The Immunization Program in the North-West Frontier Province 154

12 Bank's World: Witches' Oil and Lizards' Tails 178

13 Packed, Sealed, and Delivered: Our Project Is Finished in More Ways Than One 187

Epilogue: The Beat Goes On 195

Index 199

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