Opinion

Is Prevention Better than Cure?

Note: This article is hosted here for archival purposes only. It does not necessarily represent the values of the Iron Warrior or Waterloo Engineering Society in the present day.

An idea that is coming up again and again in my work is the conviction that “Prevention is better than cure.” I’m looking at the issue of rural water infrastructure functionality, and in this case prevention means performing preventative maintenance on infrastructure – basically, swapping out spare parts for hand pumps before they break down. This supposedly leads to fewer major breakdowns that would otherwise require a “cure”, or major rehabilitation of the pump. However, I’ve recently been questioning this wisdom – is this assumption accurate when applied to water infrastructure, and more importantly is it a prescription that can realistically be followed?

Most of the rural population in Malawi, and in much of the developing world, currently rely on hand pumps for access to safe drinking water. A hand pump is basically a piece of equipment which is installed on a shallow well or borehole, which a community can use to manually draw water from aquifers deep in the ground. A hand pump represents a sizable investment for a government or NGO, and they understandably want to protect that investment. This has led to the mantra “Prevention is better than cure,” being applied to maintenance of hand pumps – in documents, policies, and repeatedly in conversations that I have with people working on water access. Two key assumptions are made when making this prescription: that preventative maintenance does in fact lead to fewer breakdowns, and that communities are capable of carrying out preventative maintenance.

The first assumption is unsupported (to the best of my knowledge) by any actual data, and is incredibly difficult to prove. A hand pump can last for decades without suffering a major failure, which makes carrying out controlled tests difficult! The second assumption, that communities should be able to perform preventative maintenance on their own, is something that I’m beginning to seriously doubt.

The attitude amongst members of most of the villages I visit is that “If it’s not broken, don’t fix it.” As long as a hand pump is working, there’s no need to spend hours taking it apart. If the pump is functioning, investing hard earned money in replacing parts that may eventually break down just doesn’t make sense, especially when that money could otherwise be used for school fees, food or investment. If this seems like a harsh assessment criticizing Malawians for failing to understand the need to plan ahead – it’s not. After all, planning ahead to maintain our own investments is something most of us fail to do.

For example, many Canadian university students use a vehicle to get to and from school, to travel home on weekends, or to do errands. How many of those students perform regular oil changes, replace fast wearing spare parts in the engine, and take precautions against the vehicle breaking down over time? If it’s eating into their available funds – which could be used for leisure, school fees, or living expenses – the answer is likely to be very few. Now imagine sharing that vehicle between two-hundred and fifty other people (the number of people a hand pump is supposed to serve) and imagine the additional complexities that are introduced!

A more applicable example is large public works in the North, managed by a small group in order to serve large number of people. The road system in my hometown, as anyone living there can likely tell you, is in dire need of repair. Every year it is repaired piecemeal using the same process that has led to the rapid breakdown of the road in the past. This comes as a result of an incredible number of pressures acting in the area – political, financial, social, etc. All of these same factors affect people struggling to manage a hand pump in a rural Malawian village.

If we as fairly well-to-do, and supposedly educated Northerners are unable to perform preventative maintenance for our own investments, why is it a prescription that we are willing to make for people in the global South? I suspect that a lot of it has to do with the “Us and Them” mentality of development. Us, as wealthy Northerners can afford to ignore the issue of prevention. In our fast paced and demanding lives how can we be expected to organize our community to effectively manage our own roads and water supply? If a small group of people can manage it for us, even inefficiently, that is a luxury we can afford. For Them, we believe the situation is different. The poor should be forced, by virtue of their circumstances, to manage their resources effectively. They should be able to develop the necessarily complex structures required to manage infrastructure cooperatively, because of their (incorrectly perceived) lifestyle that is already built on cooperation and working together.

The decision to prescribe preventative maintenance of infrastructure for people in the South needs to be seriously reconsidered. The issues arising from failure to perform preventative maintenance – lag times in repairing hand pumps, abandonment of pumps, and cannibalism of infrastructure for spare parts – are far too easy to ignore in a policy environment that views them as merely the failure of communities to follow basic instructions. More importantly, the attitudes and beliefs that have led to this being thought of as a viable means of management need to be addressed if a shift in the dual-standard of our relationship with the developing world is to shift.

Cheers,

Rob

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