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I agree with Binyavanga Wainaina - successful economic systems or countries usually solve their own problems - at least the VISION comes from within. If other nations, organizations or individuals want to assist, it is better to seek the input of the country in need before forging ahead. The objective is to build a sustainable governing system - a system that can stand on its own once the donors have left. Wainaina's sleeping sickness hospital example is excellent. They did good work in treating sleeping sickness, but were not equipped to provide basic health care. In distressed African countries, many people die from basic infections because they have no access to antibiotics. If the organization that provided the sleeping sickness hospital had checked with the local authorities, perhaps they could have made arrangements to provide some basic health care services, as well and perhaps even trained individuals native to that country to care for their own people.