Life is complex. Helping people even more so.

Complicated road. Image courtesy of
Image courtesy of

Helping people move out of poverty is extremely complex. Every part of a culture and economy is tied to every other part. Changing one part could result in some unanticipated change another part. Or another issue may immediately surface as a block to any progress.

I don’t have any answers to the questions raised by the following articles. I am trying to work through these issues. Join me as I ponder.

About deworming medicine…

The complexity of helping is illustrated by this article at Vox on 7/28: Worm wars: The fight tearing apart the global health community, explained. Three main points I draw from the article:

First, there may be other factors that deserve credit for some portion of the effect of deworming medicine. Thus it isn’t merely passing out bunches of pills that makes things better.

Second, the beneficial impact of deworming meds may have been substantially overstated in some of the key studies.

Third, while deworming improves health outcomes, that may not necessarily have any impact on school attendance, school performance, or economic improvement of the community.

I don’t enjoy pointing out this article.

Intuitively, it makes tremendous sense that deworming would tremendously help by removing a massive obstacle to success for so many children. I really hope that is the case. Quantifying the impact and proving the effect is really difficult.

About water…

11/3/13 – Peter K Greer – The Dirty Secret About Clean Water – Drilling water wells is merely the first step to improve health.

The wells must be maintained and repaired. Article points to a study that indicates one-third of wells in South Asia and half of wells in East Africa have broken down. Value of wells goes to negative if they break down in a few months or a few years.

After clean water is available, a cleansing agent is needed to clean hands, cooking tools, and clothes.

Takes more than just drilling a well to improve health. May feel really good to walk away when the well is complete, but that well by itself may or may not have any long-term benefit.

About cash gifts…

6/7 – Marc Gunther at Nonprofit Chronicles – Give Directly: Where Cash is King – Article focuses on GiveDirectly, which gives cash directly to poor people. They are running randomized control experiments to see if they are actually making a difference. They use third parties for evaluations and assessments.

Keep your eyes open for quantified results in the future.

In-kind aid can damage the local economy…

Proponents of cash transfers argue that the poor know their needs best and therefore giving cash is a more efficient way of providing aid. With food aid in particular, providing aid-in-kind can be more expensive and can damage local economies by driving out local farmers.

Giving people cash on the other hand can allow them to buy food locally, which can be more cost-effective for donors and can actually support local agriculture.

On picking and choosing who does and does not get help…

7/29/14 – “GoodIntentions” at AID’s Center for International Disaster Information – Who Deserves to Receive Aid – Difficult stories during recovery from the tsunami raise the question of where do you draw the line for providing help?

Drawing that line at the boundary of houses “directly affected” by the water surge means families in a poor neighborhood whose houses were spared don’t get any help. Their lives have also been disrupted and their economic condition worsened. That fine cut of a line can produce windfall for someone on the ‘right’ side of the line along with resentment and envy from those immediately on other side of line.

All every home in a one small area were allowed to get fresh water lines installed for the first time because some were not damaged. In one neighborhood that gave some poor people fresh water and left out others who were similarly poor.

How does one help in a community without causing more problems in the community?

Previous discussion on unintended consequences.

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