In international development, money is pervasive in determining power, influence, access, wealth (of course) and social status, just as in most interactions in society. Money is more than simply a measure of livelihood or used in day-to-day transactions.

At face value, money and lack of money relates to relative wealth or poverty. Poverty is defined by the World Bank in terms of the capacity of someone to earn more than USD $1.90 per day. This international Poverty Line combines different national measures that benchmark levels at which a person’s minimum nutritional, clothing, and shelter needs cannot be met. In 2015 the poverty line was raised from $1.25 per day to $1.90 per day to reflect the ‘real’ costs of living (known as purchasing power parity in economic terms).

Beyond face value, the role of money in alleviating poverty – and perpetuating it – is much more insidious than individual transactions for food, shelter and other exchanges of currency. For the 700 million people estimated to be living in extreme poverty around the world, earning $1.90 per day is neither a simple nor an easy task.

In Nepal last week, I had the opportunity to reflect on the complex and layered role that money plays in international development, wielding power and enabling recognition beyond its actual numerical value. Let me tell the story of money, power and influence intertwined in the scene of foreign aid, community volunteerism and private sector interests in empowering women by describing three characters I met.

Volunteerism or exploitation? Meet two community health outreach volunteers, the first characters in this scene. They work in a Northern and remote district of Nepal, bordering China. The region was one of those most heavily affected by the earthquake in April 2015. The two women are grandmothers, who regularly met with other women in their communities to talk about health care and how to access services at the local clinic. They work as volunteers, unpaid, except for when they travel to attend a training. On these occasions, they receive a small allowance. They described their role in linking people in remote communities with health care professionals and essential primary health care and other services. I listened as the women spoke of the huge amount of pride that they take in their work, and their determination to do more because they are proud that even though they have not been educated and cannot read or write, they play an essential role in supporting the health system. They wished they could have more training (both to expose them to new skills as well as to give them more opportunities to be paid). For such a lynchpin role in extending access to health services in rural communities, shouldn’t more be done to compensate the women for their time and properly remunerate community health volunteers?

Investing in success or setting up for failure? The second character in this unlikely montage is an entrepreneur, working for a local Nepalese bank that provided loans to women for income generating opportunities. He talks enthusiastically about his project as we walk the 1 hour cobbled and water-soaked path between the road and the health clinic. The bank would loan a maximum of 60,000 Rupees (approximately USD $600) for a period of 18 months. The women would take the loan to develop their own small businesses, such as making and selling soap or raising and selling chickens. After one month, the women would have to pay back 5,000 Rupees (approximately USD $50), and thereafter would pay 18% interest on their loan until it was repaid. He said this was a lower interest rate than if they borrowed from private wealthy individuals in their communities, who would charge at least 30% interest accord to him. At 18 months, if they had not repaid their loan, they faced fines. At 2 years, if the loan remain unpaid in full, they would face additional fines and their products (the soap or the chickens) would be seized and become the property of the bank.

In responding to my doubts about the achievability of these repayments and within this timeframe, the entrepreneur shrugged it off and questioned why anyone would take a loan if they didn’t intend to make money and be able to pay it back. He had been in the job only for 2 months, and as yet was failing to see how landslides, gender inequality, access to markets, literacy and numeracy levels and other structural factors may impede a woman – despite her best intentions and back breakingly hard work – in repaying her loan on time.

Foreign aid or control? Meet the consultant, the last character in this scene. She is college educated on a short term contract in Nepal representing a generous foreign donor agency. She runs a training to ensure that the rules and regulations stipulated in the funding agreement are adhered to. She is an excellent trainer, and in a friendly and efficient manner deftly covers details of laws, healthcare service provision and grant management in less than 2 hours. A significant portion of the training concentrated on ethical concerns such as informed choice and the voluntary uptake of services (as opposed to coerced or forced service use). So far so good.

Dilemmas emerge for programme managers, faced with responsible grant management in the eyes of the donor compared with daily realities of implementing projects within the constraints of scarce and tightly monitored resources. Some services are not condoned by the donor, but are part of the package of services offered by the clinic. How to ensure that donor funded equipment (such as vehicles, medical equipment and clinical staff time) is only used for the kind of service provision condoned by the donor? As the training went on, we explored, laughed, and problem solved our way through some suggestions….

Try a timesheet to separate staff time, someone said, so that a doctor paid by the donor from 8am – 2pm can only provide authorised services. After 2pm, if paid for from other source of funds, that same doctor can provide all the services within their capability as long as it is clearly documented. Have alternative transport lined up, was another suggestion, to be sure to prevent an objectionable use of a vehicle funded by that donor to transport staff to/ from a meeting where prohibited services were to be discussed. Go to the bathroom during the discussion of a prohibited service at a national meeting, was suggested (in all seriousness!), to be sure that donor-funded project staff were not comprised, and check that it is documented in the minutes. A bathroom break, minuted, is that really the best use of time and resources?

Other suggestions followed, some more serious than others, and all seeming somewhat ridiculous when taking the priorities and needs of communities into account first rather than the reporting and monitoring requirements of the foreign donor. And yet without a doubt grant recipients must be accountable for spending money in accordance with the terms of their grants, and that money needs to be tracked, invested wisely, and report back to the donor and their tax payers.

The dilemma becomes even more polarised when considering the nature of the prohibited services in this example. Those services, which are to many an intrinsic part of a package of comprehensive sexual and reproductive health and rights services, are prohibited by that donor even though those services are legal and socially acceptable in Nepal. The services were prohibited in the eyes of the donor not because they were unsafe or untested – quite the opposite in fact – but because of the political currency of those services in domestic politics at home. In other words, politicisation at home translates into vast resources spent on consultants and compliance training, and stringent controls that limit access to comprehensive sexual and reproductive health and rights in a grant recipient country.

Nepal is a beautiful and unique country. The characters described in this scene and the dynamics of money, power, and influence that they represent are not unique to Nepal. Whose politics counts? Whose time is valued and remunerated? And whose interests are prioritised in income generating opportunities? More often than not, the answers are not communities but rather institutions and people who already hold the balance of power. Beyond the face value of money, we need to recognise, engage, question and transform the dynamics of influence and accountability relating to money that are impeding rather than enabling effective community development.

Lucy Stackpool-Moore, 30 August 2016