When Friendship Comes First

A Case Study of Chinese Development Aid for Health in Uganda

Zeqi Qiu

• Publisher: Palgrave Macmillan
• Year: 2019
• Print ISBN:
  9789813293076
• eBook ISBN:
  9789813293083
• Topic: Politics & International Relations
• Subtopic: Asian Politics
• Index: Politics & International Relations

This inspiring book looks at the theory and practice of China's foreign aid in Africa, especially in the area of healthcare in Uganda. It provides insights into how recipient countries and regions are selected, and describes in detail how the men and women working in the frontlines deliver aid. Information from past research, participant observations, interviews and other fieldwork are brought together to form a comprehensive picture of how Chinese development aid for health to Uganda has evolved over three decades, how it is carried out now, and the significance of such milestones as the building of the China-Uganda Friendship Hospital. The author also compares and contrasts China's foreign aid with that from other countries.

© The Author(s) 2020

Z. QiuWhen Friendship Comes FirstChina and Globalization 2.0https://doi.org/10.1007/978-981-32-9308-3_1

Begin Abstract

1. Background to This Study: Motivation and Timing

Zeqi Qiu¹

(1)

Peking University, Beijing, China

Zeqi Qiu

Email: [email protected]

End Abstract

1.1 About China-UK Global Health Support Program-Output

This book focuses on the development aid for health from China to Uganda (DAHCU). The research into DAHCU was inspired by the evaluation of the effectiveness of DAHCU run by the School of Public Health, Peking University within the framework of the China-UK Global Health Support Program-Output2 (GSHP-OP2).

The evaluation of social programs has been our expertise. We have teamed up with experts in public health to work on this project. That said, we do not specialize in international aid research, related practice or international issues. Before taking on this project, we had never been engaged with research of such nature. Despite all the hesitations, we decided to come on board at the invitation of the OP2 research group for the following reasons.

First, after preliminary exploration, we found that DAHCU did not fall into the category of large-scale aid programs. Therefore, adopting regular project evaluation methods employed by international organizations, OECD, the USA, and China for large-scale aid programs doesn’t necessarily work the best. Besides, the OP2 research group is in favor of applying evaluation methods used in sociology and anthropology, in which we specialize and have a wealth of experience.

Second, the evaluation of aid for health in Uganda is a multidisciplinary area covering health, international aid, international relations, and related assessment and research. No discipline alone has the absolute advantage or authority. This means experts from any related discipline are at the same starting line. Evaluation research is a hard capacity that requires long-term training. We have an edge in this regard.

The evaluation of policies or programs is essentially about their goals. That is to use the goals as the evaluation criterion (known as the gold standard). We have compared policies, measures, process or impact of programs¹ with the gold standard to evaluate DAHCU.

Regrettably, difficulty arose from the onset of the research. Through two exploratory in-depth interviews, we learned that two ministries are in charge of DAHCU on the government level. The National Health and Family Planning Commission is responsible for technical support, while the Ministry of Commerce is in charge of aid-related programs, which means in order to get access to basic data of DAHCU, we needed to carry a survey in the Ministry of Commerce.

To press ahead with our project, we pulled some strings. However, we failed to get firsthand basic data. Furthermore, we were accused by officials of collecting intelligence for foreign countries. We were stuck in the obstacles. The only agency that had basic data wouldn’t provide data, while those agencies that were ready to help did not have access to firsthand data.

Therefore, we turned to the basic method of gathering data applied in sociology and anthropology, i.e., field research, in the hope that we could get data in Uganda. As planned, the research group traveled twice to Uganda for field research, visiting the medical teams sent by China to Uganda, Jinja Hospital and China-Uganda Friendship Hospital where Chinese medical teams were stationed, the Economic and Commercial Counsellor’s Office of the Embassy of the People’s Republic of China in the Republic of Uganda, the Ministry of Health in Uganda and other government agencies and interviewing staff working there. We also hired Rehema Bavuma, a doctoral candidate from Makerere University, as an assistant to the research responsible for interviewing staff working in Uganda.

Unfortunately, we failed to get data as expected for reasons as follows. First, though the medical teams from Yunnan province were very supportive of our research, as the conditions were very harsh during their stay in Uganda, the documents and data of each medical team had not been kept systematically. Some documents were lost when they transferred from Jinja hospital to China-Uganda Friendship Hospital in Kampala in 2012, making the unsystematic database worse. Second, the Economic and Commercial Counsellor’s Office also supported us in our research, but it did not have systematic data, DAHCU data from nonmedical-team sources in particular. Third, agencies of the Ministry of Health of Uganda did not have DAHCU data.

For assessment and research, the absence of the gold standard in itself was a huge impediment, with the lack of data making the situation worse. Without basic data necessary for the setting of the gold standard, we could not carry the research with a regular assessment method. Without supportive data, it was impossible for us to use regular assessment and research models to compare data with the gold standard. This the biggest obstacle we encountered during our assessment of the effectiveness of DAHCU, which was also a big headache for peer who hoped to do research on China’s aid to Africa.

1.2 “Aid”: Some Preliminary Conceptual Clarifications

As this book touches on international aid, there will be terminology. Given that we do not have a clear picture of how much the readers know about this multidisciplinary area, in order to guarantee the optimal readability, concepts and background knowledge are listed in this section. Readers who have been familiar with the information may skip them.

1.2.1 Aid and Official Development Assistance

Assistance or aid is a concept that has been around for ages. Even based on the available legal evidence, such as the UK’s Colonial Loans Act 1889, it dates back to over 100 years ago (Zhang and Sun 2014). However, aid in its modern sense has a shorter history, starting from the period after WWII when defeated countries and impoverished ones began to receive aid. As aid of the old days took place between countries, the term of overseas or foreign aid was used, meaning one country offering aid to another.²

Aid was officially intended to propel development in the recipient countries. As driving development may take different forms, in the practice of aid, different kinds of aid have come into existence, such as development aid or aid, technical aid, international aid or overseas aid, and so on.

Around 80–85% of the aid funds before the twenty-first century came from official organizations. Therefore, another term came into use, that is, official development assistance (ODA), which is quite commonly used by member states of OECD-DAC.

Aid programs run by OECD-DAC cover the following sectors: (1) social infrastructure and services, such as education, health, population policies, water and sanitation, etc.; (2) economic infrastructure and services, such as transport and storage, communications, energy generation, distribution and efficiency, banking and financial services, and business and other services; (3) production sectors, including agriculture, industry, trade policy and regulations and trade-related adjustment, tourism, etc.; (4) cross-cutting sectors, such as general environmental protection; (5) commodity aid and general program assistance such as general budget support, developmental food aid and other commodity assistance; (6) humanitarian aid, such as emergency response, reconstruction relief and rehabilitation, disaster prevention and preparedness; and (7) other sectors. The aid can also be classified into social infrastructure, production, and humanitarian aid.

What should be noted is that different categories of aid aforementioned are variations of aid in different contexts. In this book, we have adopted the regular method used in aid and program evaluation, without making distinctions between aid, foreign aid, development aid and ODA. The use of terminology varies according to contexts. However, in essence, all the variations refer to the aid donors offer to recipients.

1.2.2 Development Aid for Health

Development aid for health (DAH) is a health group of aid. In the classification of OECD-DAC, it falls into the category of social infrastructure and services.

DAH can be further classified into general health and basic health, including aid programs targeted at improving healthcare systems, provision of healthcare services, and health level and treating HIV/AIDS, malaria, tuberculosis, and other diseases in recipient countries. We had tried to set the scope of DAH but failed to find literature on further classification of DAH.

In this book, we have identified aid intended to improve he...

Table of contents

• Cover
• Front Matter
• 1. Background to This Study: Motivation and Timing
• 2. Two-Sided Four-Tiered Embeddedness: An Overview of China’s Development Aid for Health to Uganda
• 3. Understanding the Basics: Debates in the Theories and Practices of Aid
• 4. Aid Recipients’ Experience and Analysis
• 5. Donors’ Experience and Analysis
• 6. Development Aid for Health from China to Uganda
• 7. Effectiveness of the Development Aid for Health from China to Uganda
• 8. A Deeper Understanding of Development Aid for Health from China to Uganda
• 9. Conclusion
• Back Matter