Abstract

PIP: In Ethiopia, obstetricians from Australia and New Zealand set up in 1975 the Addis Ababa Fistula Hospital to cater to women with fistula who were being turned away from local clinics. This kind of development assistance seems an ideal to be replicated--humane, skilled, practical, a mix of charitable and government aid, meeting an urgent clinical need, and enabling new knowledge to be passed on to locally trained doctors. However, the Fistula Hospital raises many troubling issues about its sustainability in a politically and economically unstable environment. It is important to recognize that the needs of Third World societies are completely different from their Western counterparts. Part of the problem lies in the unequal power relationship, availability of research funding, trained scientists, information, and equipment. Moreover, the highjacking of clinical and research agendas by Western organizations causes profound insult to the poor countries. Overall, it is noted that research is a significant means of achieving a sustainable health infrastructure. It is essential that development be viewed as a respectful dialogue and not the colonization of the imagination of other societies. Development, in this formulation, is not only development as freedom from deprivation and oppression but also the development of a common horizon or perspective.