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It has been one year since I moved to Washington D.C., a unique town filled with government officials, bureaucrats, contractors, and lobbyists. These people are known as "beltway insiders," and they work within the motorway that runs around the perimeter of the city.
As I walk to work every morning among the people dressed in what look like uniforms more than suits, I wonder if I'll ever be among the "insiders." Not because of how I'm dressed or where I'm from, but because so often I'm concerned that the interests and priorities of the general U.S. population are not fully represented by those "inside the beltway."
This happens in other countries as well.
I used to live in Malawi as an aid worker and the interests of those outside the perimeter of the capital city, Lilongwe, were also at risk of disregard and neglect by those on the "inside."
That's where people like Martha Kwataine come in.
In rural areas of Malawi, educated health care workers are not interested in serving in rural areas because of the harsh living conditions in these posts. Thus these areas go under-served and people are left without adequate health care. The government of Malawi has used scholarships as a tool to staff these posts.
However in 2010, the Malawian government "insiders" withdrew the scholarships it had been providing to the country's health care training institutions, saying that there was no arrangement with international donors on the best way of continuing the program.
This was unacceptable to Kwataine, who leads the Malawi Health Equity Network, a coalition of local nonprofits and citizens working on access to quality health services and a partner of USAID. Kwataine urged the government to find other means of financing these scholarships, which were so vital to ensuring rural Malawians had access to health care professionals.
"I lobbied hard for the reintroduction of these scholarships since rural Malawians should not be punished for living where they do," Kwataine says.
After the vocal advocacy of Kwataine and her colleagues, government officials responded. The 2011 Malawi national budget included 1,200 health scholarships to staff underserved areas.
When midwife scholarships were cut from the national budget, Kwataine and the Malawi Health Equity Network snapped into action once again and the government of Malawi returned the equivalent of US$13,000 back after their campaign. That may seem like a small amount to some, but a country with one of the highest maternal mortality rates in the world cannot afford to divest from midwife services.
"As a health access activist, my role has to be to link policymakers with the reality on the ground. I have to ensure that the national budget translates into improved health service delivery," says Kwataine.
For Kwataine and her colleagues, this also includes working with rural communities in Malawi to understand and demand their rights as health care consumers.
The health center in Mponela, a town in central Malawi, was not functioning because no health care workers were posted to the facility. People were traveling 30-40 kilometers to access health care services. Upon learning that the Malawi Health Equity Network was working with a committee of concerned local leaders in the area, the responsible government employee deployed a doctor and a nurse to staff the center. The center is now up and running.
When I knew that I would be writing about Martha Kwataine, I asked a Malawian friend and mentor who has been involved in the health sector for many years what he knew about her. His response says it all.
"She is a powerful lady."
He and I agreed that if we couldn't see a doctor, we would certainly want a fierce "outsider" like Martha Kwataine on our side.
In recent years, the US government launched policy reforms that make US foreign aid more accountable to you and local leaders like Martha Kwataine.
Aid works best when it supports local actors to take action and change the circumstances which place or keep them or their fellow citizens in poverty—supporting them to build a dream, build a business, support their family, or help their community.
That's why Oxfam America is working to deepen the US government's commitment to making aid more effective. They can do so by putting more US aid dollars directly in the hands of people like Martha Kwataine.
Read more stories at: www.oxfamamerica.org/aidworks/
Note: Oxfam America doesn't take federal funds, but we do support effective development programs. In 2012, the Aid Effectiveness Team conducted research to highlight effective uses of the 1% of foreign aid the U.S. government spends on poverty reduction and other life-saving assistance. The people featured in this series are not necessarily receiving direct assistance from Oxfam.