Publish What You Fund (PWYF) has been pursuing ambitious goals with limited means since 2008. Operating out of “a modest one-room office above an Italian restaurant on London’s South Bank” (Honig and Weaver Reference Honig and Weaver2019: 579) with an annual operating budget of less than £1 million, PWYF is dedicated to “the global campaign for aid and development transparency,” envisioning “a world where aid and development information is transparent, available and used for effective decision-making, public accountability and lasting change for all citizens.”Footnote ¹ This ongoing campaign’s already significant impact owes much to PWYF’s flagship publication, the annual Aid Transparency Index (ATI), an open access “ranking of [the world’s largest] donor agencies” that aims to “galvanise major donors to progressively increase and improve the aid and development information they make available.”Footnote ² Within just a few years, the ATI has become an essential source for the international aid industry’s key players, “as important for gaining prestige in the development aid sector as Guide Michelin is to high-end restaurants” (Hedlin Reference Hedlin2018: O506).

PWYF is just one of a “dazzling range of aid transparency and accountability initiatives [TAIs]” (McGee Reference McGee2013: S108) that have emerged since the turn of the century in response to the widely held understanding that previously acceptable ways of delivering international aid have been insufficiently scrutinized. TAIs proceed with the assumption “that, through greater accountability, the leaky pipes of corruption and inefficiency will be repaired, aid and public spending will be channeled more effectively and development initiatives will produce greater and more visible results” (Gaventa and McGee Reference McGee2013: S4). Whether or not these initiatives are successful in delivering on the promise entailed in this assumption, they have unquestionably brought the international aid industry’s most powerful stakeholders in line with a growing number of other transparency-focused global actors.

TAIs affecting the work of international aid have developed alongside a wide range of global transparency and accountability initiatives, including the Extractive Industries Transparency Initiative (EITI) discussed elsewhere in this collection. Indeed, PWYF was modeled on Publish What You Pay (PWYP) – a “global movement” of organizations and coalitions that has been campaigning for an “energy transition that leaves no one behind.”Footnote ³ As with PWYF and other TAIs of international aid, PWYP and the EITI are commonly represented and understood as necessary correctives to a corruption-ridden status quo. No matter what the industry, it seems, the effects of prescribed transparency are meant to be similarly cleansing. As Sovacool notes in a largely positive assessment of what the EITI has accomplished since 2002, “sunlight is the best disinfectant,” by which he means that “opening things up to heat (greater public scrutiny), light (independent data), and fresh air (institutional forms) offer a compelling antidote to corruption” (Sovacool Reference Sovacool2020: 1452; citing Matisoff Reference Matisoff2013). Questions remain, however, about the tangible effects that the EITI has had for the “citizens living in resource rich countries” (Klein Reference Klein2017: 773) whose empowerment and improved wellbeing are among the initiative’s goals. Most obviously problematic is that whatever is brought to light in the reports demanded by the EITI remains largely inaccessible to many of those whose interests these revelations are intended to serve, “locked up in pdf files” and written in “highly technical” language that demands “sophisticated levels of expertise in order to be critically analysed” (Klein Reference Klein2017: 773). Also concerning is all that is not revealed in these reports, including “the social and environmental [impacts] of extraction” and “accounts of public expenditures linked to extractive revenues” (Klein Reference Klein2017: 773), as well as the ambiguities entailed in small-scale extractive work, such as artisanal mining of gold and gemstones (Pederson et al. Reference Pedersen, Nielsen, Mempel, Bager, Jonsson and Corbera2021; Walsh Reference Walsh2004), through which the global extractive industries’ least powerful stakeholders operate at the margins of global markets, engaging in practices and relationships that can be incompatible with the EITI’s standards for transparency and accountability. It seems that whatever successes the EITI might be said to achieve, key stakeholders, sites, and dynamics are destined to remain in the dark.

In this chapter, I suggest that something similar is apparent in the global aid industry. Taking the qualitative approach that others have used to reveal what transparency initiatives in the extractive industries have left unexposed, I focus especially on what the aid industry’s TAIs do not and cannot tell us about what has been called “citizen aid” (Fechter and Schwittay Reference Fechter and Schwittay2019), “grassroots international non-governmental organizations (GINGOs)” (Appe and Schnable Reference Appe and Schnable2019; Schnable Reference Schnable2021), “demotic humanitarianism” (Taithe Reference Taithe2019), or, as I will call it, DIY aid – an increasingly prevalent means by which global citizens looking to help others are “connecting” (Fechter Reference Fechter2019), fairly directly, though often from afar, with people in need. Although DIY aid’s practitioners are commonly motivated by concerns shared by advocates of TAIs – for example, concerns over the perceived ineffectiveness of traditional ways of delivering aid – they tend to operate outside of the existing international aid arrangements that organizations like PWYF are looking to reform. Indeed, if PWYF and other small but increasingly powerful watchdog organizations are among international aid’s most promising start-ups – that is, a growing sector of small projects with the potential to revolutionize the existing aid industry from within – DIY aid might be understood as the domain of upstarts – that is, a growing sector of small projects that frequently defy, confound, and undermine the logics and systems of the existing aid industry.

Drawing from recent work on DIY aid generally as well as from ethnographic research with a specific project in Madagascar, this chapter addresses how DIY aid is incompatible with certain expectations of transparency and accountability. While DIY aid projects are unquestionably tripped up by many of the obstacles to effectiveness that TAIs are meant to identify, their small size and distinctive relational foundations and operations can make them resistant, if not immune, to the kind of corrective scrutiny that TAIs demand. This doesn’t mean they go unscrutinized, however. Rather, stakeholders in DIY aid tend to scrutinize themselves and one another in pursuit of what is most important to ensuring the effectiveness of the projects they share – that is, trusting relationships.

TAIs and DIY Aid

I first became aware of the growing importance of DIY aid while doing ethnographic research on conservation and artisanal mining in northern Madagascar in the early 2000s. The first decade of the century brought both an influx of visitors to the region (tourists, researchers, missionaries, gemstone traders, and Peace Corps volunteers, among others) and the telecommunications infrastructure needed to enable long-term connections between these foreigners and would-be local collaborators. The subsequent arrival of cheap smartphones, Facebook, and WhatsApp, and the spreading popularity of GoFundMe appeals and cellphone banking only improved conditions for DIY aid. By 2010, it hardly seemed strange to meet an Australian toyshop owner, Eve, devoting herself and her resources to the construction of a schoolhouse in an out-of-the-way Malagasy village. While visiting an eco-lodge in the region in 2008, Eve had learned from a frustrated local teacher that children in a neighboring community had to walk over five kilometers to and from the nearest school. She proposed to do something about the problem presented to her and, surprisingly to some, followed through with action.

I began referring to projects like Eve’s as examples of “DIY foreign aid” following Nicholas Kristof, who lauded the revolutionary potential of the form in a New York Times Magazine cover story (Reference Kristof2010). Kristof presented DIY aid projects as poised to succeed precisely where their large-scale counterparts fail. Emerging from the intimate collaborations of just a few “global” and “local” actors intent on achieving modest goals, they promise to achieve the truly participatory interventions that tend to elude international aid’s big players carrying out much more ambitious projects. What’s more, given that funding for DIY aid generally flows fairly directly from benefactors to beneficiaries through new social technologies, online fundraising campaigns, paid volunteering, and direct marketing to ethical consumers, it promises possibilities for short-circuiting dysfunctional global “aid chains” (Bebbington Reference Bebbington2005) that are traditionally mediated by the complex, impersonal, inefficient, corruptible, state-supervised arrangements that have inspired so many TAIs in recent decades.

The growing popularity of DIY aid has also raised red flags among those concerned with the emerging sector’s capacity to enable neocolonial “white savior” (Cole Reference Cole2012) fantasies and encourage problematic visions of international aid as the domain of selfless, apolitical, well-meaning people whose good intentions and resistance to reproach means they can work without oversight (Algoso Reference Algoso2010; McLennan Reference McLennan2014; Reference McLennan2017). Even the cover image accompanying Kristof’s story – a photograph of a young, white, American woman surrounded by Nepalese children – suggests a concerning cliché that is widespread enough to have been parodied through the popular “Barbie Savior” Instagram account (Schwarz and Richey Reference Schwarz and Richey2019). Critique and parody seem to have had little effect on the growth of DIY aid, however. In fact, as I will argue shortly, DIY aid’s practitioners are in many ways immune to the concerned scrutiny of critical observers who might question their intentions or methods.

Schnable’s Amateurs Without Borders (Reference Schnable2021) offers an excellent overview of DIY aid, drawing attention to the tremendous growth and developing patterns of what she terms grassroots international NGOs. That DIY aid operates outside of the international aid’s mainstream is maybe most obvious in the CVs of those who make it happen, the “amateurs” of Schnable’s title, who, although generally well educated, typically have “no professional experience in international development” (Schnable Reference Schnable2021: 3). These are people who tend not to aspire to careers in “Aidland” (Mosse Reference Mosse2011), where “professionalized” (Schnable Reference Schnable2021: 8; citing Hwang and Powell Reference Hwang and Powell2009) aid workers move “among NGOs, government agencies, and for-profit contractors” (Schnable Reference Schnable2021: 10; citing Mosse Reference Mosse2011; Reference Mosse2013) in ways that make learning the ways of the mainstream a must. DIY aid is also set apart in how it depends not on the “contract revenue or foundation grants” that makes the salaried work of aid professionals possible, but, rather, on the largesse of project founders, the purchases of ethical consumers, and the “volunteer labor and individual donations” (Schnable Reference Schnable2021: 2) of millions of supporters.

While DIY aid projects often stay afloat thanks to the modest contributions of many, they are almost always dependent on a few energetic individuals (Schnable Reference Schnable2021: 16) – people like Eve – whose visions, dedication, and, often, money make them happen. These individuals never act alone in realizing their projects, however. Another common feature of DIY aid identified by Schnable is that it always takes shape “in a personal, relational context” (Reference Schnable2021: 13) in which benefactors, beneficiaries, and an array of intermediaries engage with one another as something more than just stakeholders. Eve certainly couldn’t have built a schoolhouse in Madagascar on her own. Her project could never have been completed without the support and friendship of the English-speaking Malagasy guide who helped her negotiate the complexities of Malagasy banks and marketplaces, the collaboration of local teachers and parents, and the hospitality of villagers who hosted her every year. Although it was Eve’s proposal that started the project, it was her relationships with these others that drove it to completion.

The features that set DIY aid apart in the world of international aid – that it is dominated by amateurs, sustained by private donors, and driven by relationships – are also what render this emerging sector invisible to those in the aid industry’s mainstream. More than just unnoticed, DIY aid projects tend to fall “outside of the purview of governments, NGO registries and coordinating bodies, and other official systems” (Watkins et al. Reference Watkins, Swidler and Hannan2012: 291) in ways that make them hard to track or scrutinize in any systematic way. Not that practitioners of DIY aid are necessarily interested in, or likely to invite, such scrutiny. Drawing “resources from their personal networks” (Schnable Reference Schnable2021: 16, emphasis in the original), and without the ambitions of aid professionals, they have little use for what the mainstream offers and so need not play by its rules. In fact, some DIY aid practitioners avoid the mainstream as a matter of principle, contrasting their own bare-bones, action-oriented approach to helping others with what they portray as the bloated, corrupt, bureaucratic operations of international aid’s biggest players.

Over the past ten years I have been working with a team of Canadian and Malagasy colleagues and students to study the development, operations, and impacts of DIY aid projects in northern Madagascar. We have been following, and sometimes collaborating with, a variety of projects: the previously mentioned schoolhouse project, an urban home for neglected children, an early childhood nutrition program, and, the case I focus on here, Madagascar Health, a project dedicated to providing free medical care and education to residents of underserved communities. All these projects were conceived and founded by foreigners with good intentions but, in most cases, limited training or experience in international aid, and each has produced an array of new relationships between these and other foreigners and a wide range of Malagasy stakeholders with interests of their own. We learned early on that in choosing to do something for the people of Madagascar, the foreigners who catalyze and support these projects inevitably find themselves doing something with specific and heterogeneous groups of Malagasy people. Not surprisingly, the relationships produced in the process are characterized by the power differences, ambiguities, and potential for exploitation or corruption over which proponents of TAIs might express concern. As discussed in the following sections, however, these relationships can be hard to assess according to the “calculative rationalities” of “audit culture” (Shore and Wright Reference Shore and Wright2015: 421) so fetishized in the TAIs of international aid’s mainstream.

Scrutinizing Madagascar Health

Madagascar Health’s origins can be traced to the late 1990s when the project’s now seventy-something-year-old American founder David (a pseudonym) first traveled to northern Madagascar’s sapphire-rich hills to oversee local operations for a Thai mining company. Unhappy in the company’s highway-side base camp, David moved uphill and pitched a tent near the company claim where he joined a bustling rush of Malagasy artisanal miners. He soon began distributing basic medical supplies to anyone in need, and used his access to and expertise with a bulldozer to level a site outside of the claim on which he and his new neighbors could live more stably in a community that has come to be known as Ambatotsara.

Several years into his stay in the region, David was gravely injured when the bulldozer he was operating tipped over on top of him. Long-time residents of Ambatotsara recall hearing the commotion of the accident and then seeing David stumble out of the bush, bleeding and delirious. Responding quickly, they loaded him onto a makeshift stretcher and transported him to the highway for help. David was evacuated by the company, but, as the story goes, he vowed to come back, intent on repaying his debt to those who had saved him. Several years later he did just that, returning unannounced to Ambatotsara with a Malagasy interpreter and the promise to finance the construction of what would become Madagascar Health’s first clinic. The project has been operating ever since, albeit through many ups and downs. At one point a fire destroyed the clinic and David’s small mudwalled house, taking thousands of dollars’ worth of medicine and most of David’s belongings with it. David responded by returning to the US to drive a truck and earn the money needed to rebuild. Years later, in 2015, he explained his tenacious dedication to the project by describing it as his salvation. After a soldier’s life of violence, death, and trauma, Madagascar Health had brought him the peace of serving others.

Like all international aid, DIY or otherwise, Madagascar Health can be described as supply-driven – it wouldn’t have come to be without David’s decision to create it and wouldn’t continue operating (as of 2024) but for the ongoing support of a small group of other foreigners. That noted, there has never been any question of the demand, and need, for the access to basic healthcare and schooling the project has offered. Surveys we undertook in 2015 and 2023 revealed overwhelming support among the local population for the project’s existence. Not that local observers had only positive things to say, however. In 2015, local observers told us of the clinic’s frequent shortages of medicine, of their confusion over the services it would and wouldn’t offer, and of their dissatisfaction at being repeatedly called upon to contribute unpaid labor to maintaining the project’s infrastructure. And this was only some of what we heard and reported back to the project’s management.

My goal here is not to present a fully transparent account of all we learned about Madagascar Health during our research. Rather, I intend to discuss the project considering the relationships that have enabled it to be effective in the ways that it has been. These relationships have been and continue to be scrutinized, just not in ways idealized by TAIs. In fact, the sequence of best practices that justify TAIs – with expectations of greater transparency leading to greater accountability and more effective aid – can sometimes be upended in a project like Madagascar Health. As discussed here, the mutual trust and accountability of stakeholders in DIY aid projects may even serve to discourage transparency in the name of ensuring ongoing effectiveness.

After David’s departure from Madagascar in 2016, Madagascar Health has stayed afloat, and even grown, thanks to the ongoing aid of former volunteers. Having stayed connected with the project’s Malagasy manager, François, on Facebook, these foreigners show their support by sending money and by starting or sharing online fundraising appeals. In return, François regularly sends photographs of Madagascar Health’s operations and new projects in process, a practice he explained as an outcome of a perceived need “to let [supporters] know that things are going well in case they’re wondering ‘Where did my money go?’” Mejia, Urrea, and Pedraza‐Martinez might refer to what François is doing here as engaging in a strategy commonly found on crowdfunding platforms by demonstrating “operational transparency” that serves to reveal “the work that is performed behind a service or system, which increases [a donor’s] perceptions of effort and trust” (Mejia et al. Reference Mejia, Urrea and Pedraza‐Martinez2019: 1773; citing Buell and Norton 2011; Buell et al. 2016). This strategy only works, however, if the foundations of trusting relationships have already been established. Where strangers to Madagascar Health might reasonably expect some transparent and public accounting of how their donations to the project are being allocated, a good number of former volunteers clearly trust that François and other members of Madagascar Health’s local staff are pursuing the project’s goals just as diligently in their absence as when they were there. Simply put, then, Madagascar Health’s effectiveness at delivering foreign aid to intended beneficiaries depends not on how transparent its operations are to a global public of mostly unknown foreigners but on the well-established trust of just a few. How, then, is such trust achieved?

It isn’t unusual for DIY aid projects to be funded, at least partly, by people willing to pay for the “hands-on” (Schnable Reference Schnable2021: 16) experience they offer volunteers. In the case of Madagascar Health, foreign volunteers pay for the privilege of engaging in the daily work of the project’s medical clinic and school. In the process, the connection between their contributions of money and labor and the effective realization of the project’s goals becomes crystal clear – any doubts they have about the effects of their participation in the project are put to rest by participating in its work. In the recent past, before an endowment ensuring that the project’s clinic would always be stocked with medicine, the connection between volunteers’ participation and the project’s effectiveness was established even before their arrival in Ambatotsara. François would meet volunteers at the airport and then take them, almost immediately, to a bank to withdraw Malagasy money and then to a pharmacy to pay for the medicine they would be distributing over the course of their stay. To one group of volunteers I spoke with in 2018, traveling this circuit and then seeing the medicine they had bought be given out at the clinic cemented their confidence in a project they had previously known only through its Facebook page. As one of them told me, participating in the work of the project in this way brought the assurance that their money was “going to the right things.”

Working with Madagascar Health brings volunteers more than just satisfaction, however. It also brings experiences with and realizations of the great depth of need that drives local demand for what the project offers, as well as an appreciation of the complexities of delivering healthcare and education in the region. All fifteen medical volunteers I have communicated with over the years understood that their participation in the project did little to address the most pressing, chronic problems facing its patients and nothing to alter the underlying structural causes of their need. Several also identified the obvious problem of a funding model that, until recently, has been so dependent on the choices and presence of privileged people like them. One former volunteer recognized and expressed concern about how the locally celebrated presence of foreign volunteers at Madagascar Health’s clinic might devalue the care offered by Malagasy healthcare providers; another worried about the possibility that poorly trained volunteers might engage in misconduct. The most critical of the former volunteers I communicated with reckoned themselves complicit in reproducing what they considered to be a fundamentally flawed project: couldn’t the money they and other foreigners spent by traveling to Ambatotsara have been put to better use?, they wondered.

The concerns listed above were communicated to me in confidence, albeit with the understanding that I might refer to them in the way I have here. I have certainly never seen anything like these comments posted on Madagascar Health’s all-important Facebook page or in the project’s visitors’ book. That volunteers sometimes hold back from disclosing their concerns in public should not be taken as a sign of their lack of accountability, however. Those critically minded enough to discern Madagascar Health’s shortcomings were generally self-aware and modest enough to appreciate how little they knew of the complexities involved in running the project. Most of those I spoke with were certain that, whatever the project’s flaws, there is no question that it is effective in its own way. In volunteering with the project, they were unquestionably doing something to help the people it intended to serve, and this was always seen as better than doing nothing. Former volunteers were also conscious of the uncertainties facing the project’s staff and its local beneficiaries, and aware of how public critique might only exacerbate their situations. Given that many volunteers had first found the project through a search on Facebook, they understood that critical posts or comments might dissuade others from volunteering. And if volunteers stop coming and Madagascar Health ceases operations, they know who will suffer. Even the volunteer who confessed to feeling complicit in reproducing a flawed project abstained from public critique, choosing instead to put the project behind them and ignore new fundraising appeals.

That Madagascar Health’s former volunteers and steady supporters feel the way they do about the project owes a great deal to the project’s local staff. In fact, François and other Malagasy employees of the project contribute more than anyone to ensuring Madagascar Health’s ongoing effectiveness, in part by playing two key roles that mediators of DIY aid commonly find themselves in. First, they serve as the “trusted associates” (Schnable Reference Schnable2021: 24) of the foreigners who support the project, providing distant funders with photographs and reports of local operations and helping visiting volunteers adapt to life in Ambatotsara, working long days alongside them and sharing meals, bonfires, jokes, and the solidarity that results. At the same time, those who speak English and/or French as well as Malagasy act as “brokers” (Schnable Reference Schnable2021: 24), communicating the project’s plans to its intended local beneficiaries, while also translating local understandings, needs, and concerns for the project’s foreign supporters and volunteers. This can be difficult work, leading François to concern himself not so much with ensuring full transparency in all communications as with deciding how messages might be most effectively communicated to their intended audiences, and what might sometimes be better left unsaid for the sake of ensuring the project’s ongoing effectiveness.

All staff members I have spoken with over the years have noted the difficulties inherent in roles that require them to fulfill the (sometimes difficult to meet) expectations and needs of foreigner supporters and volunteers while managing the expectations and envy of their Malagasy neighbors, who often assume that they benefit more than they do from their proximity to foreigners. Obviously, staff members do benefit somewhat from the project, earning salaries and sometimes receiving small gifts brought, left, or sent by the foreign volunteers they come to know intimately. What troubled François when we spoke in 2018 were rumors of other, illicit, benefits that he and other staff members were said to be skimming from funds meant for the project’s intended beneficiaries. The only way he would win over local doubters, he told me, was with hard work and the results that would yield. He was especially committed to seeing through the construction of a long-promised larger clinic that would enable patients to stay for several days when in need of repeated treatment. Much like the trust of foreign supporters, the trust of local people could not be taken for granted – it had to be earned by demonstrating that it was deserved. This clinic was, in fact, completed in 2021.

For François, ensuring the project’s ongoing operations and effectiveness has meant interacting with others in particular ways. By sending photographs of work in progress to foreign donors or leading jet-lagged volunteers along the airport–bank–pharmacy circuit, for example, he enables the people who keep the project going to do so with confidence. By keeping in touch with these same people on Facebook, sending congratulations on degrees earned and children born, he keeps these relationships alive. The extent to which such interactions are calculated to encourage foreigners to continue supporting the project is not as important as the fact that they emerge from and foster existing social relationships, with all the ambiguities and complexities that entails. I hope it is clear by now that it is these relationships, and not the generosity of foreigners or strategic maneuvers of local staff, that keep Madagascar Health going, enabling it to be effective in the ways it is. Building and fostering trusting relationships among the project’s already implicated stakeholders have certainly figured more centrally in sustaining Madagascar Health’s work than have any efforts at ensuring the transparency of the project’s operations. Does that mean the project has always been as effective at delivering aid to its intended beneficiaries as it could possibly be? I have no idea and I don’t know how such a thing might be determined. The fact that projects like Madagascar Health are by their nature seemingly immune to the “calculative rationalities” of “audit culture” (Shore and Wright Reference Shore and Wright2015: 421), fetishized as ethical in the work of international aid’s mainstream, may be among their most promising features.

Having argued that Madagascar Health is not transparent or accountable in ways expected by the international aid industry’s TAIs, I should add that I am not sure how it might be made so. TAIs promise a kind of certainty – around finances, for example – that can be hard to achieve in even the best relationships. Not that anyone is asking for such strict certainty. Whatever anyone might think of it, this project will go on being effective in its own ways so long as the relationships that keep it afloat allow. This doesn’t mean that we should overlook what can be problematic about projects like this one or ignore the concerns of those who might expect more of them. In fact, as discussed below by way of conclusion, attending to those on the demand side of international aid (DIY or otherwise) tends to reveal a great deal of what can be overlooked or forgotten when foregrounding supply-side priorities and perspectives.

Conclusion

There are many reasons why the international aid industry’s most powerful players and ambitious start-ups have embraced TAIs. Some TAIs, like PWYF’s ongoing campaign, are enabled by and focus on the vast amounts of data generated by the aid industry’s biggest players, and while this work is inspired by the goal of serving “all citizens,” it most obviously affects those it scrutinizes; as noted earlier, a high ranking on PWYF’s annually published ATI means a great deal to those who secure it, and I imagine that a low ranking would be just as consequential. Aiming for different publics, “metacharities” (Singer Reference Singer2015) such as Giving What We Can, GiveWell, 80,000 Hours, and others use a similarly objective, data-driven approach to assessing the work of international aid’s smaller (but potentially powerful) players, producing rankings and certifications intended primarily for the perusal of independent philanthropists, many of whom embrace the tenets of “effective altruism,” convinced that “reason and empirical evidence” ought to govern their decisions in order “to ensure that … donations do the most good possible” (Rubenstein Reference Rubenstein2016: 513). Given the competitive marketplace of a world in which there will always be more demand for than supply of aid, a stamp of approval from one of these “metacharities” can give a project a significant advantage over others, making the incentive for pursuing certain kinds of transparency and accountability obvious.

Since the key stakeholders in TAIs are those who design them, those who are (or who hope to be) evaluated by them, and those who attend to their results, it follows that their impact will be most apparent in these stakeholders’ actions. More than that, TAIs shape how these stakeholders interact. In proposing certain standards of transparency and accountability as necessary preconditions for the delivery of effective aid, they present a clear path: (1) applying certain standards of transparency and accountability ensures the reputations of trustworthy projects and organizations; (2) certified reputations ensure deserved funding; and (3) deserved funding ensures effective aid. The implied possibility that international aid’s effectiveness might be predetermined is obviously attractive, especially to those, like effective altruists, who expect that their generosity should guarantee certain effects. In fact, what TAIs do most effectively is to simplify what could be fraught choices over what people, priorities, and projects are deserving of international aid. TAIs allow aid’s biggest suppliers to outsource their scrutinizing, propping up their confidence and assuaging their doubts while freeing them from the messy prospect of becoming too involved with aid’s local brokers or beneficiaries. In this sense, a commitment to the logic of TAIs can be liberating, delivering suppliers of international aid from concerns over the good that might or might not result from that aid by assuring the beneficence of good choices.

Whatever else might be said of DIY aid, it is anything but liberating. As I have experienced it and have come to understand it through the research discussed in this chapter, it is entangling in ways that can be as confusing and frustrating as they can be enlightening and rewarding. And this is what makes projects like Madagascar Health so interesting to consider alongside TAIs and other aspects of the international aid industry’s mainstream: they offer unparalleled opportunities for observing the fundamental dynamics of international aid in action, requiring that we attend not only to the varying experiences and imaginations of differently positioned stakeholders but to the relationships among them. As suggested in this chapter, these relationships are complicated – just like all human relationships – and this means not only that their internal workings can be hard to expose (with or without the light of TAIs) but also that whatever comes from them is just as likely to result from what is opaque as from what is clear to those they involve.

In the end, though, DIY aid is like all forms of international aid in one important way: it is a product of the choices of those who make it possible. For people living in and around Ambatotsara, Madagascar Health isn’t most obviously DIY (instead of mainstream), an upstart (rather than a start-up), or amateurish (and not professional). To them, this project is most obviously an outcome of that which has brought so much else into their, and their ancestors’, lives – the power of foreigners’ choices. And while the intended beneficiaries of this project are prone to scrutinizing foreigners’ motivations and intentions, they are as unlikely as I am to arrive at a transparent account of David’s motivations for creating the project or volunteers’ intentions in paying to work for it. Not that this lack of transparency matters too much to them. Our conversations with people around Ambatotsara consistently revealed the same simple point: why or how Madagascar Health does what it does is not as important as the fact that it does it and will hopefully do more. For them, benefiting from international aid means living in the uncertainty and opacity of others’ choices.