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Aiding recovery? : the role and functioning of international assistance in the rehabilitation of health services in 'post'-conflict Cambodia, Ethiopia and Uganda

Since its inception, international aid has been premised on the existence of stable and sovereign recipient states. Official aid relies upon such states for its legitimacy and implementation, and aims to consolidate statehood. In the 1990s, this organising pillar of the international aid system was shaken. The ability of governments to fulfil the basic functions of a sovereign power is now widely questioned. The principle of sovereignty is no longer absolute; rather, it is increasingly contingent upon states' adherence to international, largely Western-defined, norms of behaviour. Where these norms are violated systematically, as in conflict-affected countries, sanctions including trade, political and military measures are deployed. In these 'quasi-states', where sovereignty is contested or weak empirically and juridically, development aid relations are usually suspended and relief the only form of aid available. However, the ability of relief aid to respond to these chronic political emergencies is increasingly questioned. There are increasing demands to make relief more developmental, and for aid to be used to address the cause of crisis - conflict. This thesis examines how aid has worked in a particular type of 'quasi-state': situations of 'post'-conflict transition, and asks whether the new demands on aid in these environments can be met. Examining the cases of rehabilitation assistance to the health sector in Cambodia, Ethiopia and Uganda, it draws three primary conclusions. First, the political meaning, objectives and instruments of relief and development aid are categorically distinct; linking them is ethically and technically problematic. Ethically it implies compromising principles of impartiality and neutrality. Technically, political conditions prevent the transition to more developmental aid instruments. Second, the empirical weakness and juridical ambiguity of statehood in these environments mean that there is no clearly accepted and competent authority to make public policy - no one and everyone owns it. This leads to highly fragmented aid investments that do not provide a basis for the development of public health systems. Third, the absolute scarcity of public resources means that the developmental goal of sustainability is not compatible with that of maximising coverage of health services, level of coverage summary, it suggests that conceptually and operationally the international aid system remains fundamentally ill-equipped to respond to the challenges of chronic political emergencies and their aftermath. 4

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:325455
Date January 2000
CreatorsMacrae, Joanna Jean
PublisherUniversity of London
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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