m More and more governments in Africa and elsewhere, buckle under the strain of economic crisis, structural adjustment, declining legitimacy, and civil war.International aid has traditionally assumed the existence of stable, sovereign states, capable of making policy. In a number of developing countries, this is no longer the case. The big donor agencies have usually responded by suspending development aid and substituting some kind of emergency or relief assistance. Joanna Macrae shows from her on the ground investigations that relief and development aid are very distinct processes and cannot be merged in practice. Where the public authorities are weak, aid becomes highly fragmented, often inadequate in scale, and certainly not capable of leading to locally sustainable programmes. The international aid system, she concludes, faces real dilemmas and remains ill-equipped to respond to the peculiar challenges of quasi-statehood that characterize chronic political emergencies and their aftermath.The government said a#39;yesa#39; to EPI, a#39;yesa#39; to the rehabilitation of hospitals, a#39;yesa#39; to the rehabilitation of Mulago [the main teaching hospital], a#39;yesa#39; to CDD. ... Weibe 1985) , and as part of a project preparation facility for the World Bank (see, for example, Annet and Janovsky 1988; Lee et al. ... Part of the difficulty for those responsible for technical analysis was that the credit agreement for the First Health Projectanbsp;...