Monitoring and evaluation is often the most difficult part of any development program. It’s often an afterthought for implementers, too busy worrying about rolling out the immediate and the tangible to worry about how they’ll evaluate their work at some later stage.
It’s important that data is not something that’s just written down in a grid each month and never seen again. The strongest programs are the ones in which ground level staff find their reporting useful in their daily work. By making data helpful to ground level staff it makes their reporting in turn more accurate.
Even though RMF put a focus on our M&E from the beginning of our program, it has continued to be one of the biggest struggles in implementing our program on the ground. As our program grows we are not only constantly assessing, analyzing and evaluating our data but also try to give the same level of analysis to the processes by which we collect data.
In this age where there seems to be a tech solution for everything, many development programs make the mistake of thinking that technology will be a “silver bullet” which will fix all of their challenges in the field. The best advice we received from one of the technology experts we were consulting with when deciding which direction we should take our program was “don’t automate a broken system,” meaning that before introducing any new technology, an organization should make sure their fundamentals are solid. As we moved forward with the planning of two innovative technology pilot programs for data collection integrating technology such as mobile phones or digital slates, we also needed to ensure that the fundamentals of our program are strong and that we understand and were honest about our strengths and weaknesses in data collection.
RMF Community Nutrition Educator, Samoti, and a child recovering from SAM. Photo Credit: Ximena Prugue
In March 2009, when I was conducting the initial field visits to develop RMF’s Malnutrition Eradication Program I visited a village called Shali Dana, in Kalwa block of Khandwa district in Madhya Pradesh. I remember being shocked and overwhelmed by the amount of children with severe acute malnutrition I saw in this village and the complete apathy and absence of government services in this village. We saw dozens of glassy eyed children with thinning hair, bulging stomachs, and protruding ribs, empty anganwadi centers, and children who had been tortured by traditional healers in the name of recovery because of the absence of government health services. Seeing this village convinced me that RMF had no choice but to do something drastic about this problem.
Naiara joined me on the second day and we began the day with a quick trip to the toy store. Luckily, the toy storeowners had just gone to Indore and had some more toys for us! We picked up a couple of our CNEs and headed back out to the villages, this time starting with some of the kids living in villages outside of our program’s reach.
I cannot stop thinking of how happy I feel knowing I made the right decision. For as long as I can remember, I have always wanted to have an experience like this. I can still remember how during the first year of my PhD studies I tried to contact several NGOs to try and volunteer in a developing country during my summer holidays. Most of the NGO´s would not accept my help for only a single month. I decided at that point to postpone this experience until my PhD was over.
Naiaraat with child at Jeevan Jyoti Hospital
During my studies, I was lucky when in 2006 the Basque Government gave me a grant to go to Minneapolis (USA) to attend a training course and learn how to identify, isolate, characterize and expand a stem cell type from murine bone marrow. It was during this time when I first had contact with lovely India without actually visiting. I preferred to stay with a local family in the Minneapolis rather than staying in a hotel and that is how I met the most interesting person ever: Nancy Ramer, an elderly Scottish very religious woman. She told me, the day after I arrived, that after finishing nursery she attended many patients during the Second World War in England, and during this time received “a call from God” asking her to help: her help was needed in a foreign country far away. She thought she would be destined to Manchuria, but finally, much to her regret, she was destined to Sangli, near Pune, Maharashtra, India. She thought everyone would hate her because India had at this time just recently become independent from England. She stated her conditions emphasizing she would never stay longer than two years in India.
I finally arrived back to Jhabua after several planes, trains, automobiles, rickshaws, and countries. Go ahead and throw a bicycle in there for good measure. Unfortunately, I can’t say the same for skis, but it was definitely worth sacrificing the slopes for some family time. The United States showed me a wonderful Christmas and New Year, with as much family, friends, and food as I could cram in my short reprieve from India. And don’t forget the hot showers!
Every morning, when I wake up to the honking horns, howling dogs, and bustles of morning life I wonder how the day is going to be. As I lay out my yoga mat and dedicate my practice to what will be, I try to take a deep breath for all that I can not anticipate. See,life in the field is a constant state of uncertainty, a question of what will happen next, and a sequence of highs and lows, equilibrium a state I no longer know.
Get to know the Athletes for Real Medicine through the “Passion and Purpose” interview series. Leading up the the L.A. Marathon, we will be posting monthly interviews as well as additional Athletes for RMF updates here on the Real Medicine Foundation blog. So, stay tuned…
Interview with Athletes for Real Medicine team member Lisa Suen by fellow team member Brandi Howell:
Very good article published in Sunday’s New York Times about the malnutrition and food crisis in India. This focuses specifically on the crisis in Jhabua and Madhya Pradesh where our Malnutrition Initiative and Team India are based.