Monday, November 9, 2009

Ritik Tiwari Working with SLA in Zambia

EXPERIENCE WORKING WITH SLA IN ZAMBIA
By Ritik Tiwari (2008)

I am a student from Houston, Texas in the United States, hoping to enter medical school within the next few years. My previous education was in Cognitive Science (studying the brain and mind) and I had worked in Information Technology for three years before deciding to switch careers.
I wanted to learn about tropical medicine in sub-Saharan Africa by living there. After much research on idealist.org, I was impressed by the professionalism of the Savings and Loan Association (SLA) group in Zambia and contacted them. We exchanged emails over the next few months and they prepared to host me for two months in Kabwe.

Upon arrival in Zambia, I settled into one of the members home and was overwhelmed by meeting all the members of SLA and their church's Home-Based Care (HBC). My host and others had set up an opportunity to work with HBC, a nearby clinic, and the general hospital in town. This would be my main work for the two months in Zambia.

The first week was tough, not because of adjusting to Africa, but because of boredom. The country's entire healthcare system was on strike, effectively shutting down hospitals and clinics. But this worked out well because I had to get paperwork to enter the clinics and hospitals. Everything was cleared up by the next week and I was ready to start volunteering.


The Zambian hospital was an interesting experience because it was so different from what I had seen in the U.S. Readily apparent was the shortage of doctors and clinicians. I believe the entire country had only one pathologist on staff. Most cases I saw at the hospital were related to either hypertension, heart disease, or diabetes. It was disappointing because I do not have any clinical training and could only walk around with the doctors to watch them work. However, it was encouraging because I know I can go back after medical training and make an impact.

Clinics were a different experience from the hospitals because they tended to a local, neighborhood clientele. They were served by clinic officers (COs) whose qualifications range somewhere between a doctor's and a nurse's. The position was created to fulfill a shortage of medical doctors. Most patients the COs see had symptoms of infections and parasites such as malaria, tuberculosis, and bilharzia. Patients also had flu and colds because it was the cold season.

The scourge of HIV was also rampant at the clinic. I cannot cite any public health statistics, but where I was, it seemed like one in five to six people was infected. Every household in the neighborhood had a child orphaned by the epidemic. In fact, HBC members were assigned around half a dozen orphans each to keep watch over. They ensured that children were being properly fed, taking any medications they were supposed to, and that they were able to afford and attend school. I went around for a few of these Orphans and Vulnerable Children (OVC) visits with The Team. It seemed children mostly needed money for school supplies.

Though it was not the focus of my visit, I also saw the inner workings of the SLA. It provides an excellent opportunity for its members around Kabwe. Meetings are conducted every week on a strict basis. If a member does not have a valid excuse to miss a meeting, they must pay a penalty. If they are late to a meeting, they must pay a penalty. These penalty fees are added to the group's total fund. Such behavioral engineering creates a high level of accountability. It also creates a type of dedication that was very much visible across each member's face. Nobody grumbled about paying the penalty fees because they knew it was contributing to their overall benefit.

SLA has a high level of transparency with their finances. I was fortunate enough to sit through a meeting. Their accounting is well-kept and the books are easy enough for anybody to understand. Meetings also have multiple record keepers to keep the numbers accurate. I was very impressed by this level of organization and professionalism.

Unfortunately, the meeting I attended did not have members borrowing money, but I was able to see the fund's benefits while living in the neighborhood. I saw a member using money from SLA's funds to raise animals and grow maize. Another member was able to purchase school supplies for her children. Yet another had purchased critical medicines for her ailing mother.

Obviously the fund would not last too long if people borrowed without paying back. People are able to provide for their own businesses selling small goods thanks to SLA's fund. The loans are seed capital that generate income for members, allowing them to pay back the borrowed amount plus interest. Penalties are assessed if loans aren't paid back within three months.
Small loan associations are crucial for the development of nations like Zambia because so much of the population is under-served by conventional banks. These banks only undertake the risk of lending to institutions and individuals able to make large deposits. SLA, however, does not rely on the fixed policies of a bank and can move around more freely. As with the standard micro-lending model, risks on loans are spread throughout the entire group. All members are obliged to help if a single member is not able to pay back their loan.

SLA has been sustaining itself well since its formation but needs to raise its funding. Not having enough money to can be stifling for people heavily hit by unemployment and epidemics like HIV. By providing grants to increase SLA's base funding, more opportunities can be opened for its members. They can pursue larger-scale entrepreneurship. In turn, they would be connected to larger markets, which would open up many more opportunities to improve their lives.