An excerpt from Bill Gates' interview with Katherine Boo, author of Behind the Beautiful Forevers (about a slum in Mumbai):
Bill Gates: Your peek into the operations of some non-profits was concerning. Are there non-profits that have been doing work which actually contributes to the improvement of these environments? Katherine Boo: There are many nonprofits doing work that betters lives and prospects in India, from SEWA to Deworm the World, but in the airport slums, the closer I looked at NGOs, the more disheartened I felt. WorldVision, the prominent Christian charity, had made major improvements to sanitation some years back, but mismanagement and petty corruption in the organization's local office had hampered more recent efforts to distribute aid. Other NGOs were supposedly running infant-health programs and schools for child laborers, but that desperately needed aid existed only on paper. Microfinance groups were reconfigured to exploit the very poor. Annawadi residents dying of untreated TB, malaria and dengue fever were nominally served by many charitable organizations, but in reality encountered only a single strain of health advocate—from the polio mop-up campaign. (To Annawadians, the constant appearance of polio teams in slum lanes being eviscerated by other illnesses has become a local joke.) I tend to be realistic about occasional failures and "leakages" in organizations that do ambitious work in difficult contexts, but the discrepancy between what many NGOs were claiming in fundraising materials and what they were actually doing was significant.
In general, I suspect that the reading public overestimates the penetration of effective NGOs in low-income communities--a misapprehension that we journalists help create. When writing about nonprofits, we tend to focus either on scandals or on thinly reported "success stories" that, en masse, create the impression that most of the world's poor are being guided through life by nigh-heroic charitable assistance. It'd be cool to see that misperception become more of a reality in the lives of low-income families.