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2005-09-25-Aid in Burma-When it's time to give up
When the Global Fund to Fight Aids, Tuberculosis and Malaria decided to stop funding projects in Burma last month, it claimed that aid workers were unable to do their jobs properly.
"Because our funds were not being put to expedient use... it is very unlikely they would have achieved what they set out to do," the fund's spokeswoman Rosie Vanek told the BBC.
There is little doubt that in countries like Burma - which is run by a military junta and is frequently criticised for its lack of transparency and democratic rights - charities and other non-governmental organisations face an uphill task.
Aid workers there speak of lengthy delays in getting the required documentation to visit sites outside the capital. Some areas are often completely off-limits due to local skirmishes, and NGOs are finding it increasingly difficult to obtain visas for foreign staff.
But whatever the obstacles, the local people still need help. And in Burma, as in several other countries around the world, charities face an extremely difficult dilemma: when does the situation become so bad that it is no longer worth staying?
For the Global Fund - an independent financing organisation set up by the UN, with stringent rules about its donations - the final straw was Burma's decision to institute new travel restrictions in July.
In a statement announcing its decision to pull out, it said these measures would "prevent the implementation of performance-based and time-bound programmes in the country, breach the government's commitment to provide unencumbered access, and frustrate the ability of the [recipient of the aid money] to carry out its obligations."
So far, other organisations have decided to stay put - although they admit that they, too, have problems.
Stephan Jooris, the Swiss co-ordinator of the medical charity Medicins Sans Frontieres, said one hurdle was obtaining travel permits for non-Burmese staff.
"Long term access rights are an issue, because right now they're completely frozen," he said. "At the moment it's fine, but there may be problems in the future when we need more staff."
Mr Jooris also said that in order to visit certain sites outside Rangoon, aid workers had to ask permission from the government at least three weeks in advance.
"But we can still do things," he insisted. "Recently we've been given authorisation to open an HIV clinic in the south, and we've also extended our work in the north."
UNAids is another organisation with a presence in Burma - a nation where an estimated 600,000 people have HIV or Aids.
The group's country co-ordinator Brian Williams insists that while the "operating environment is a challenging one", it is still possible to produce results.
"In the area of Aids programmes, we have seen significant changes. We've increased condom use - in fact it has tripled in the last three years," he said.
"Sometimes in difficult countries, progress is slower than people might expect, but this is a lot better than doing nothing at all," he said.
"It still means a world of difference to the people you can help."
According to Karin Christiansen, an expert on aid to fragile states at the Overseas Development Institute in London, an organisation's decision on whether to stay or go will ultimately depend on its donors.
"If the money is there, it will stay - and even if not, another organisation will always come in to fill the gap. Aid is a business - it's important not to forget that," she said.
By far the most important donors for many charities are national governments, and therefore government policy is very influential in an organisation's decision on whether to continue working in an area.
Ms Christiansen said that in each situation, decision-makers will look at both a nation's willingness to engage with the external world, and the capacity it has to implement change.
In the fledgling nation of East Timor, for example, the new government might have little capacity on its own to bring about change, but it makes up for this by its willingness to co-operate.
But Burma's willingness "is on the other side of the scale," according to Ms Christiansen - and this is where the problem lies for aid workers in Rangoon.
Burmese historian Aung Kin said that the nation's ruling junta had a fundamental problem with foreign organisations working inside the country.
"They don't see NGOs as positive, constructive organisations," he said. "They think they are trying to interfere."
As long as this remains the case, outside groups can only have limited impact, Ms Christiansen said.
"If the problem is that a country is weak or unresponsive to change, that is really the problem that needs to be addressed," she said.