Brooks makes some good points - points that many NGOs will find scary. Rather than continuing to fix the symptoms of ineffective systems (lack of water, toilets, hygiene education, and/or handwashing facilities in schools and communities), we really do need to think about systems and the best place (if any) for external activities and/or funds to leverage changes. Changing the way we work, talk to donors and the staff we have on board will be daunting to most.