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One of the first things I noticed when I started working at Baylor-Uganda was the strange strings of numbers and letters everywhere, etched into tables and chairs, engraved into computers. It didn’t take long to understand what they were: identifiers to connect the items with their respective grant budget lines. And it didn’t take long to understand what they were for: to add a layer of accountability in a country that has seen millions of aid dollars go missing as a result of mismanagement, misuse, and outright theft of funds. This is, of course, a good idea. In theory, if our funders wanted to, they could show up at Baylor’s office one day and demand to see the 10 laptops they paid for in budget line 45 under one specific grant. And, in theory, Baylor should be able to produce those 10 laptops, seared as promised with the corresponding budget codes. If we couldn’t, for whatever reason, we would have to face the consequences.

These systems are well-meaning, put in place to safeguard against corruption and fraud, huge problems in a place like Uganda. If all parts of a grant must be accounted for, the reasoning goes, it will be much more difficult for these funds to be diverted away from their original intent. In reality, of course, it is much messier than that. First, anyone who has ever worked with a government grant knows how complicated and convoluted they are. Second, such grants leave little room for necessary adjustments in a field, and country, where the unexpected happens on a regular basis. And third, the majority of items funded by such grants are not items at all, but intangibles: health worker salaries, staff trainings, community mobilization events. These things can be accounted for to some degree, but the possibility of fraud is always there – receipts or no receipts.

The larger issue, though, is the impact all of these processes have on organizations’ capacity to actually do what they are meant to do. Baylor-Uganda receives approximately 90% of its funding from three large multi-year grants from the US government. It is an understatement to say that the requirements for reporting on these grants are labor- and time-intensive, especially considering the fact that much of the funds are sub-granted to local public health facilities (as stipulated by the US government when it made the grants) and thus cannot be directly monitored. Still, the US government is strict in its demands and will not hesitate to withhold funds if its requirements do not seem to be met. As a result, several staff members at Baylor spend the majority of their time monitoring grant implementation and reporting, regardless of whether or not it is part of their job description. Any directives from CDC automatically take top priority, meaning that other important projects are delayed or abandoned completely. Of course, donor accountability and transparency is necessary. But by requiring such in-depth accountabilities, it is worth asking whether our sponsors could be limiting our ability to do the work that they themselves are supporting us to do. If that is the case, it may be time to consider revising the system to one that is based more on mutual accountability, shared responsibility, and trust.