For quite some time I have been exasperated and even somewhat disgusted by Gambians expectation of receiving "per-diem" or some other form of financial remuneration for attending work-related workshops, trainings, and in-service meetings. These workshops are extremely common and the amount of time and energy that is put into dealing with this financial compensation has always seemed like a collosal waste of time to me. I could not understand why people should expect to receive additional compensation for doing their job on top of their existing salary. Today, however, it all started to make sense.
It turns out that Gambian health workers, as well as many other civil servants, receive very minimal salaries, to the point that it is generally not enough for them and their dependents to live on. For a little perspective, low to mid-level health workers are paid base salaries of 1,500-3,000 dalasis per month (which comes out to roughly $2-3 per day). These people are often the primary "bread winners" for large extended families (15+ people) who are depending on them. Culturally, for a salaried individual, it is absolutely obligatory to support your family in such a fashion, especially if you have family living in poor rural areas. Even in a country with a low cost of living the numbers simply don't add up, and the social and cultural pressure to support one's family is enormous. Therefore, the gaps have to be filled somehow. This is where per-diems come in. These per-diems are often hundreds of dalasis per day, not including food and travel reimbursements, and can be paid out for one day meetings, short trainings, or even month long activities. Teams of health workers typically rotate who is sent to trainings and split the compensation equally among themselves. Even when split several ways this money adds up quickly. This is why the health workers take their per-diems so seriously. It is not greed, it is not an obsession with money, it is a matter of making ends meet for themselves and for their families, which they cannot do without the per-diems. Jacob later used a good analogy when he compared this system to how waiters and waitresses in the US whose salaries are often below minimum wage, and rely on tips to make up the difference.
As my coworker was explaining all this to me, something clicked when I thought about where the money for these per-diems was coming from. It is coming mostly from big international health institutions such as Global Fund, WHO, UNAIDS, etc. They are probably aware that they have line items written into their budgets for workshop per-diems, but I wonder are they aware they are providing for health workers' extended families in a way that is completely financial and has nothing to do with a health project. I don't have the numbers for how many health workers there are in the country or how much money they make from per-diems per year, but I would venture a guess that these contributions by international health institutions contribute in no small way to the country's economy. While that is not necessarily a bad thing, I highly doubt it is the intended use of the funds by provided by those institutions or indirectly by their donors.
This is just one more layer in the complicated web of dependance on aid. This line of thought raises a whole host of other complicated social and financial issues. One big related issue is rural-urban migration, which is severe enough that some rural villages can be almost completely devoid of educated, motivated young men. It's easy to shake your head at those men who fled to the cities, but those men are sending a lot of resources back to the villages to support their extended families there. Their families need money to buy rice, oil, fish, sugar, etc, and cash-paying jobs are few and far between in rural areas, so they are dependent on money flowing in from their urban bread-winners. Of course, not anyone can get a cash-paying job in an urban area, you need to be educated, so that means it is the educated young people, generally men, who are the ones playing that role. It's interesting to see the similarities between this system and the way remittances work on a larger scale.
A couple generations ago, these issues weren't nearly as big a problem because most Gambians were subsistence farmers, and thus ate what they grew, and didn't have such a need for cash. So how did we end up here? Jacob is a much better person to answer that question, so I asked him, and this is what he says:
"Historically every culture existed based on subsistence farming. In many cases, at one point or another, something changed which allowed people in this culture to start specializing in certain money making activities and transition to a cash based economy. For example, early in American history much of the country existed as a subsistence agricultural economy. Many rural families produced the vast majority of what they consumed. Partially, this was because the cost of transportation and difficulties associated with it made it prohibitively difficult to produce farm products for far-away markets. As transportation improved, state government sponsored canals and roads are a good example, it became possible to ship large quantities of produce quickly and cheaply to market. This allowed people to move away from a subsistence life style and start specializing in various methods of production. The problem in The Gambia is by switching from cous, cassava, and sorghum as the staple foods that were capable of feeding the entire population to rice (which has become trendy recently since, rather ironically, it is associated with the West, resulting in the country importing rice from Asia, mainly Vietnam and Thailand, in large quantities) without the accompanying specialization in jobs that inject cash into the economy the country has difficulty providing for all their food needs and most of the available cash gets sucked into purchasing rice and is thus diverted from the investments that would create future economic growth."
It's quite the conundrum, but understanding all various moving pieces of the problem is the first step, right?
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