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Participatory Approaches to Attacking Extreme Poverty

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Foreword

Today, governments and international organizations are scaling up programs for the reduction of poverty, but they have difficulties in reaching the poorest. The extreme poor suffer from many handicaps (lack of financial resources, education, employment, housing, health care, empowerment),which have a mutually reinforcing impact, and often lead to social exclusion. Together, the isolation and the state of deprivation in which the very poor live imply that traditional development programs and policies which may be effective in helping the poor may not always work for the poorest. Reaching the poorest in society remains a challenge for NGOs, governments and aid agencies that design and implement poverty reduction programs.

To understand why as well as identify practical ways of moving forward, a seminar on extreme poverty was organized at the World Bank in October 2005. The case studies compiled in this book emerged from that seminar and they show how helping the very poor to emerge from poverty requires not only extra public resources, effort, and time, but also a broader approach to development policy. In particular it is important to learn from the poor themselves as to how they cope with multiple deprivations and what is needed from their point of view to attack extreme poverty. For example, many factors prevent the very poor from using services that would make a difference in their life. This includes lack of physical access as well as lack of affordability. Beyond those issues, cultural and behavioral issues-including a lack of trust between the very poor and broader society-also reduce the take-up of social services by the extreme poor.

The lessons learned from the case studies presented in this book have implications for grassroots organizations working with the poor, for local and national governments, and even for international financial organizations.Working with the extreme poor requires a long-term process, not one-shot interventions. Efforts are needed to strengthen the capacity of the extreme poor for transforming their own lives, and to build a consensus for a new social contract in which the extreme poor (and excluded people in general) assume the role of subjects in the process of transforming the institutions that regulate decisionmaking as well as the distribution and redistribution of assets. This requires among others a new type of relationship between external agents (such as government officials, civil society volunteers and community organizers) and the very poor. There is also a need to generate better action-oriented knowledge to help the extreme poor in understanding and transforming the reality in which they live. In short, the design of projects aimed at reaching the very poor should begin by asking a very simple question: Will this project allow the poorest the opportunity to advance towards greater autonomy and freedom rather than remaining in a cycle of deprivation and dependency? Sudhir Shetty Sector Director, Poverty Reduction and Economic Management Africa Region,World Bank

Abstract

Relying on contributions from the International Movement ATD Fourth World, this book deals with questions such as:What does it mean to live in poverty, and especially in extreme poverty? How can the very poor be reached through development projects? How can we assess whether projects succeed in changing the life of the poorest? In answering these questions, the emphasis is on exploring what type of knowledge is needed to fight extreme poverty. A key argument is that apart from academic knowledge, a concerted effort is needed to listen to the knowledge of the poor themselves, as well as to the knowledge of practitioners who are engaged with the poor on a daily basis to fight poverty. After the introductory chapter, the text of a speech by Joseph Wresinski (founder of the International Movement ATD Fourth World) at a congress of social scientists held at UNESCO, is reproduced. The next contribution is based on comments by the International Movement ATD Fourth World on the World Bank’s World Development Report 2004 Making Services Work for Poor People. Thereafter, case studies are provided on participatory approaches to attacking extreme poverty in both developing countries (Madagascar and Tanzania, as well as Bolivia, Guatemala and Peru) and developed countries (the United States and Belgium).

Acknowledgments

This report is a product of the Front Office of the Poverty Reduction and Economic Management Sector Unit in the Sub-Saharan Africa Vice-Presidency at the World Bank, in collaboration with the International Movement ATD Fourth World. The report provides contributions from the International Movement ATD Fourth World on “Participatory Approaches to Attacking Poverty,” together with an introduction. Several contributions prepared for this report were presented at a seminar on extreme poverty that was held at the World Bank on October 19, 2005. The preparation of the report benefited from a grant from the Belgian Poverty Reduction Partnership Program, a trust fund from the Belgian Development Cooperation Agency managed at the World Bank. The report benefited from comments by Estanislao Gacitua-Mario who served as peer reviewer.

Chapter 2 reproduces the text of a speech by Joseph Wresinski (founder of the International Movement ATD Fourth World) at a congress of social scientists held at UNESCO. The chapter was published in French in 1991 in Revue Quart Monde (No. 140) under the title “La Pensée des plus pauvres dans une connaissance qui conduise au combat.” The chapter was translated in English by Alice Husson, Bruno Tardieu, Xavier Louveaux, and Charles Sleeth and revised in 2005 by Charles Courtney.

Chapter 3 was prepared in 2003 by the Research and Training Institute of the International Movement ATD Fourth World and written by Xavier Godinot,with comments by Jean-Marie Anglade, Jason French, Jean-Pierre Gollé, Xavier Louveaux, Diana Skelton, Thierry Viard, Susie Devins, and Eugen Brand. Elements of this contribution were discussed and presented by Xavier Godinot on the occasion of two visits to Washington,D .C. (in October 2002 and October 2003) as an invited speaker to the World Bank’s Poverty Day, a training event for World Bank staff.

Chapter 4 was written by Caroline Blanchard, drawing heavily on several unpublished papers written by Chantal Laureau, who spent ten years in Madagascar working as a physician in a very poor neighborhood of Antananarivo. It was revised and completed by Xavier Godinot and Chantal Laureau. In April 2003, elements of this contribution were presented by Chantal Laureau and Sophie Razanakoto to Shantayanan Devarajan, Director of the World Development Report 2004 Making Services Work for Poor People, and Agnes Soucat, Senior Health Economist at the World Bank, during a meeting at the office of ATD Quart Monde France in Paris.

Chapter 5 is an edited version of a paper first published in 2003 by the International Movement ATD Fourth World as a self-standing working document entitled “Three Years of Learning in Tanzania.” The document was written by the Tanzania team of the International Movement ATD Fourth World under the overall coordination of Niek Tweehuysen and Andrew Hayes, and edited for this report by Rahel Kassahun and Quentin Wodon.

Chapter 6 was originally written in Spanish in 2002 by Jean-Marie Anglade together with the Guatemala, Peru, and Bolivia teams of the International Movement ATD Fourth World. These teams comprise of José Dimas Pérez Vanegas (Guatemala), María Antonieta Pino de Navarrate, Yaque Gusmán Oviedo, Karely Paredes Ochoa, Marco Aurelio Ugarte Ochoa, Nicolás Vladimiro Pino Amache, and Charles Sleeth (all from the Peru team), and María Julia Pino Amache and Charo Carasco Cuba (Bolivia team). The chapter was translated and edited for this report by Diego Angel-Urdinola and Quentin Wodon.

Chapter 7 was written by Carl Egner who used various materials dealing with the Unleashing Hidden Potential seminar that was organized by Fourth World Movement/USA in New York in 2000. In particular, the chapter builds on a CD-Rom and four issues of the Fourth World Journal published by the Fourth World Movement in the United States from September 2001 to November 2003.

Chapter 8 was written by Johan Bellens, Régis De Muylder, Béatrice Meurant, Henk Van Hootegem, and Frank Vereecken, who made up the pedagogical team that led the research-action-training program “Another approach to poverty indicators in Belgium.” This was a two-year program that gathered 23 participants, including 12 who live in poverty chosen from Belgian NGOs that give the poor a chance to express their opinions. The other participants were academics, representatives of various government bodies and institutions, and the pedagogical team.

The views expressed in the various chapters of this report are those of the authors, and they do not necessarily represent those of the World Bank, its Executive Directors, or the countries they represent, nor do they necessarily represent the views of the Belgian donor agency which helped fund this work.

Contents

1. Participatory Approaches to Attacking Extreme Poverty: An Overview

• Charles Courtney, Xavier Godinot, and Quentin Wodon Overview of the Contributions in This Volume
• Seminar at the World Bank to Discuss the Issue of Extreme Poverty
• Conclusion: Where Do We Go from Here?

PART I: Three Types of Knowledge on Poverty

2. A Knowledge That Leads to Action

• Academic Knowledge and Mobilization for Action
• Without Freedom of Thought, No Communication
• The Secret Garden of the Poorest of the Poor
• Restoring Thinking, Supporting the Effort of the Fourth World to Know
• An Action That Thinks and Communicates Itself
• A Committee Ready for Action

3. Making Services Work for Very Poor People: Comments on the World Development Report 2004

• The Nature of Chronic Poverty and the Challenge of Its Eradication
• The Uncertainty of Statistics on Extreme Poverty
• The Knowledge Building Process of the WDR Report
• The Shortage of Truly Participatory Research on Poverty
• Conclusion

PART II: Experiences from Developing Countries

4. Making Health Services Work for Poor People: Ten Years of Work in Tananarive,Madagascar

• Living Conditions and Health Care Provision in Tananarive
• The Decision to Carry Out an Early Childhood Program (1989-1990)
• Starting Point: Lack of Understanding and a Divide Between the Hospitals and the Inhabitants
• Implementation of the Knowledge-Health Program Around Those in Early Childhood
• Extending the Knowledge-Health Program
• The Development Books
• Dialog with Health Professionals and Medical Bodies
• Writing a Book on the Health of Very Young Children
• People and a Neighborhood Gaining Freedom and Pride
• Some Lessons Learned from the Program

5. Taking the Time to Learn from the Poor in Tanzania

• Encountering the Very Poor
• Enabling the Very Poor to Join Forces
• International Day for the Eradication of Poverty
• Other Sources of Knowledge
• Partners in Development
• Conclusion

6. Enabling Children to Learn in Latin America

• Reaching the Poorest Children Through Street Libraries in Peru
• Understanding the Life of Poor Children and their Parents: Doña Elena’s Family in Guatemala
• Enabling Children to Learn from Each Other: The Tapori Network in Bolivia
• Conclusion

PART III: Experiences from Developed Countries

7. The Story of the “Unleashing Hidden Potential” Seminar in the United States

• Roots of the project
• The Street Library in East New York
• A New Project in Boston
• Preparing the Seminar
• The Unleashing Hidden Potential Seminar
• After the Seminar
• Conclusion

8. Another Approach to Poverty Indicators in Belgium

• Goals of the Research-Action-Training and Method
• Results
• General Reflections
• Conclusions