Thanks Cam for making me aware that this thread, apparently, still creates some emotional reactions... and emotional they definitely are - often not hindered at all by any real knowledge...
Maybe to put a few things in perspective (and my former fellow townspeople will surely find enough reason to speak with authority about the work we do or not do): I used to work in private business, for blue-chip companies, back home and in Europe, making LOTS more money than I make now - and before you reply with a smart-ass remark asking if I should now earn a medal or something, no, I don't - I just love the work I do and I love being here... no altruism there from my side... but at least I have seen both sides, unlike many others here...
Secondly, the time of expat doctors, teachers, builders etc is long past, apart from emergency situations where most victims don't really care about who saves their lives, as long as someone is there. Right now I manage a staff of about 200, with zero expat doctors, zero expat teachers, zero expat builders - yet we're working in about 700 villages and serving a bit over one million beneficiaries in health services. I still do have quite some expats working here but all of them either with a specific technical knowlegde (public health, coordination, complex logistics, international finance and donor regulations, ...) - but if I have the chance to find local capacity, trust me, I will - expats are only a pain in the ass to manage, not to speak even about the costs (although, again to put things in perspective, especially for all those who so perfectly know what it is all about, and how things work, the expat salaries here are on average about 3 times higher than local manager positions). Of course, all the experts here can without doubt come up with many examples where countries like Chad, Congo-Brazzaville, CAR, South Sudan and Congo-DRC showed good management skills, due diligence, and the right competences to get things work in a decent way (that is probably why the suggestion to increase local productivity - as an expat of course...)
Thirdly, whether you like it or not, donors (not only institutional ones, but also private donors) still have more confidence in INGO's than NGO's - although I am sure that the good people in Antwerp will love to give their money rather straight to a local Congolese NGO that they have never heard of and are not capable of following up instead of to a well-known organisation like MSF who, indeed, spend money on expats and overhead just to ensure that the money is well spent... Fair? I don't know, but the question is irrelevant since it is the reality...
Fourthly, but this is of course something that definitely the good people in Antwerp will care less about, in a lot of countries (Sudan, Chad, Congo - just to name a few), expats serve as well as a safety for national staff. An international NGO has far more opportunity to be critical of governments (while at the same time trying to keep the balance because after all we need to continue working) than local NGO's - even Bashir will think twice before arresting an expat staff and therefore creating an international scandal, whereas local staff without the backup and protection of expat directors and therefore governments are literally often free game - if you don't know what I'm talking about, just look at what happened in Congo in June...
Finally, and then I will rest my case: of course there is abuse, mismanagement, lack of coordination, wrong type of programs etc... you will find very few (if any) experienced NGO or humanitarian workers who claim the contrary... the same like there are overlanders who travel without any respect for of knowledge of local culture and environment - but does that mean you say all overlanders are bad? Or that you even question the fact how it is looked by locals who have to survive on 1 USD per day when you pass by on a bike that costs with everything included often 10,000 their day income? And after all, even if all those horrible expat arrogant and greedy NGO workers earn too much, at least it's often spent on local restaurants, shops etc... or on businesses set up by real altruistic Antwerp people, so nothing lost, is there?
But must important, for all: enjoy your travels, enjoy local cultures, keep a critical spirit - and drop by for a

(luckily with my huge salary I got an amazingly well stacked fridge - at least if the power keeps working)...