Wednesday, June 27, 2012

What I learned

I think one reason people want to help locally, and to do something hands-on rather than just writing a check, is that they want to see the situation first-hand. I can see the appeal of this.

I'm finishing up my visit to Ecuador. I wanted to experience a developing country, and to some extent I have. I've seen kids begging in the streets. I've seen people with deformities that probably would have been corrected in the US. I see how nothing is wasted here. Yesterday my host family curiously asked me if it's true that in America we throw out things that are still good. I confessed that it was.

And yet I'm not sure that this experience has changed my goals or how I think about philanthropy. Yes, it hit me in the gut the first time I saw a child begging on the street at night, when I saw her playing with broken glass for lack of any other toy.

But I pretty already much knew that poverty sucks, and that I want to do something about that. My donations won't go to help that girl, because the best organizations I know of don't work in Ecuador. But they will help other people who had the bad luck to be born with few resources.

Some people are more driven by emotion and first-hand experience than others. If you're one of those people, maybe it would make sense to go see the work you think is important. Charities are very happy to tell you about what they're doing, and if you want to pay your own way, you could probably visit their field sites.

I'm affected by the poverty I see here, and for that matter, by the problems I see at home in Boston. But for every person I see who tugs at my heart, there are millions more I don't see. I feel I owe it to them to give the best help I can. Which means giving based on the best research I can find, not who I happened to see.

Saturday, June 16, 2012

When is your help special?

I've heard the argument that we should “think globally, act locally” because we understand the needs of our own communities best. I'm willing to accept this for some situations.

I think it boils down to where your special help would be useful. If you pass a car accident, yes, your your physical presence means you have a unique ability to help.

Likewise, when it comes to personal interactions, people are not interchangeable. Getting a card or letter from a stranger is not so comforting as hearing from someone you love. We evolved to interact with people we know in real life, and this still satisfies us more than some abstract kindness from a stranger.

So recognize the areas where you can be uniquely helpful: being kind with your family and friends. Sudden emergencies where you are physically present. Being a good neighbor.

But here's where I think people go askew with this logic: they feel that financial help should also work this way. After all, don't I understand the needs in my own community better than anyone? So I should fund projects in my own community, and other people should take care of theirs.

But rich people live in communities with other rich people, and poor people live near poor people. Your average American probably has several relatives or neighbors who have a few thousand dollars in their bank accounts. Your average Liberian does not know any such people. When both rich and poor people give in their own communities, the opera gets a lot more funding than the maternal health clinic in Liberia.

Of course, lots of first-worlders have given misguided aid because they misunderstood the needs of people in other countries. But you can misunderstand the needs even in your own community.

I'm in Quito, Ecuador right now, and several of my fellow travelers have been volunteering at a local orphanage. The place is in bad shape, and you can't see the kids without wanting to do something. So some Americans decided to raise money for the orphanage from their friends at home. After all, they had played with the kids, seen the need.

Except it turned out the reason the place was falling to pieces was that the owner was embezzling money. That money would probably never have reached the kids. Americans weren't alone in being duped by this guy. Every Christmas he had a big fundraiser and lots of Ecuadorans gave money, clothes, and toys. The locals were just as misinformed, despite it being in their own community, because they hadn't looked at the financials.

I saw a lot of misguided community help the summer I worked in a domestic violence shelter. We had a garage overflowing with blankets, because people had this idea that battered women need blankets. What they actually needed was a child's car seat. The fact that donors were local didn't give them special insider knowledge about the women's needs. It would have been better for them to donate cash so that we could use it for what was most needed (the car seat).

There are good and bad charities working in all parts of the world. Find ones that will use your money well, and that are doing important work. (And if you live in a rich part of the world, the greatest need probably isn't local.) Then donate money, which will help more than your blankets, old clothes, or volunteering.

And then, if you want, find someone you love and give them the hug or the kind word that only you can give.

Friday, June 8, 2012

The way it was

In thinking about problems that currently affect developing nations, I try to remember that the US was a developing nation not so long ago.

Malaria once plagued the American south and Midwest. It's the reason English colonists abandoned the Jamestown, Virginia settlement for somewhere with fewer mosquitoes. In 1946, the Centers for Disease Control (CDC) were formed to fight malaria. Five years later, malaria was eliminated from the United States.

In her memoir Little House on the Prairie, Laura Ingalls Wilder describes her family's experience with the disease in Kansas in 1870:

Laura tried to get up, but she was too tired. Then she saw Ma's red face looking over the edge of the bed. Mary was all the time crying for water. Ma looked at Mary and then she looked at Laura, and she whispered, "Laura, can you?"

"Yes, Ma," Laura said. This time she got out of bed. But when she tried to stand up, the floor rocked and she fell down. . . . She knew she must get water to stop Mary's crying, and she did. She crawled all the way across the floor to the water-bucket. There was only a little water in it. She shook so with cold that she could hardly get hold of the dipper. But she did get hold of it. She dipped up some water, and she set out to cross that enormous floor again. 

It drives me crazy when people in rich countries hesitate to address developing world health for fear of "overpopulation" or "environmental impacts." Do they wish that for their own families? Do they feel they have too many siblings, too many cousins, and we really ought to get some contaminated water or intestinal parasites in here to deal with the problem? Do they wish we hadn't eliminated malaria from the US?

No one wants that for their family. We want low child mortality and reasonable family size. Developed nations made that transition, but it took a while.

Hans Rosling does an excellent job at making public health statistics understandable to non-statisticians. I recommend his talk on "The good news of the decade”, especially for its comparison of child mortality rates across nations (at 8:40). Rosling notes that his home country of Sweden had a high child mortality rate in 1800, twice as high as anywhere now. Over time, with better education and better public health, the rate declined to its current low level. Most countries are currently on this journey of decreasing family size and child mortality, many of them progressing faster than Western countries ever did. (The site Gapminder lets you play with the charts yourself.)

While it's clear that large family size is correlated with child mortality, I'm not as convinced as Rosling is that lower child mortality is the main cause of smaller families. I gather it's a combination of fewer child deaths, female education, access to birth control, and urbanization.

The Ingalls family were typical 19th-century Americans – they had five children, one of whom died in infancy and one of whom went blind from a fever. I come from a typical 20th-century American family with two children, both still alive and healthy. I'm thrilled we made this demographic transition. My hometown no longer has malaria. I'm educated, I drink clean water, and I control my own fertility. When I choose, I will raise one or two children who will probably also be quite healthy.

We've come a long way.  Now I want this life for everyone.