Reflection: To Give or Not to Give

Imagine you’re a Peace Corps volunteer invited to a meeting about the village’s maternity (a three-room clinic for delivering babies). Despite the fact that it was built and fully equipped by an NGO only five years ago, the group tells you gravely that there are major problems that require urgent attention. The solar battery died so there is no light, there is only one bed so on busy nights babies are delivered on mats, and deliveries are dirtied by the fact that the nearest source of water is a pump five minutes away. After listing these problems, they then ask you to give money to their association to fulfill these needs. To give or not to give?

I think the first instinct is to give. After all, these are some major problems: babies born on the floor, in the dark, and without water to clean the area. That kind of environment puts both the newborns and mothers at risk of complications that could result in death. You would have to be a pretty terrible person to have the means to prevent this suffering and yet ignore it.

But if that’s true, then why hasn’t the association done anything about it themselves? After all, you point out, a suitable extra bed could be bought for $5, and villagers are replacing their solar batteries all the time. At this point, the association tells you they’re broke because no one pays for the birthing services, pre- or post-natal consultations, or for the medicine. As for the water, you suggest that soon-to-be fathers could simply cart in 100 liters of water with their donkey carts prior to the birth. To this, the association laughs at you. Don’t be ridiculous, they say.

You, the reader, have probably figured out by now that this is a true story. In fact, it happened to us three days ago. But it is only one example of a time when we have left a meeting wondering: “What does it mean to help these people? What is development anyway?”

Sometimes, we think that development is about fulfilling basic human needs or realizing basic human rights. In a moment of frustration last week, I had to remind myself that “human rights are things every people deserves, even if they’re a pain in the butt,” – things such as clean water, adequate food, or a clean birth. And if these things should truly be given unconditionally, then when in doubt, they should be handed-out. This is what the NGO had in mind when they built the maternity five years ago, and what many NGOs do everyday as they almost indiscriminately give villages cash in order to help their schools, health centers, or improve sanitation.

It breaks the heart of almost every Peace Corps volunteer when they learn that this method has adverse and unintended consequences. First, it has created a mindset of dependency among the poor – they say, we can’t do it ourselves; we need the help. Worse yet, this can often develop into laziness over time – why do it ourselves if someone will come and do it for us? These lessons are then transferred into other aspects of life, discouraging innovation and entrepreneurship. Certain Malians realize that can make a living of “hanging around” NGOs, while others work hard to be self-sufficient only to be beat out by the former. In short, when executed poorly, hand-outs lower individual’s incentives to try hard and exacerbate the problem.

Hence, why the maternity association had not done the work collecting the money, and why many villagers were ignoring paying their debts. Because they figured that when things got bad an NGO – the one who built the maternity or some other – would come around and fix it. I know this seems like a harsh analysis, but sadly, it is the truth for a lot of development work. It’s not that the villagers are immoral people, but it’s that their incentives to work for themselves have been replaced by hand-outs.

This is where Peace Corps and a lot of other organizations come in with a different approach dubbed “sustainable development.” The goal here is to encourage behavior change and capacity building with villagers that will last long after the project is in place. In the spirit of this approach, I hope to work with the maternity association to help them collect payments and turn profit. Once they have a system in place, they will be able to manage their own problems themselves, without the help of outsiders. This is also why we do many educational trainings on topics like hand-washing with soap and nutrition – because no amount of donated food or soap will help if people do not understand how to utilize them properly.

However, we are often tormented with how hard this concept is in reality. First of all, it often means holding back immediate assistance, even if it is desperately needed. It might be six months before that association buys another bed, and until then am I responsible for all the babies born on the floor? Moreover, we have found that sometimes villagers do not want to be “sustainable,” but either the matter is not important enough or they rather wait for another NGO to the fix the problem. For example, after we fixed the pumps in our village, we organized a committee to collect (very reasonable) monthly dues from every household so that next time the village can fix it themselves. This was an attempt to make our work sustainable, but yet we are finding that most villagers refuse to pay and many committee members don’t take their job seriously. At the present rate, it seems unlikely that the committee will function long enough to actually repair a broken pump. So next time the pumps break, and children are getting diarrhea from dirty well water, what will be the moral thing to do – to give or not to give?

You have probably heard it said: “Give a man a fish and he can eat for a day. Teach a man to fish and he can eat for a lifetime.” As it relates to development, the saying hints at the difference between hand-outs and sustainability.

But as we are learning, painfully and slowly, it is not one or the other. Rather, it is a matter of which blend of these two philosophies is most appropriate in the present situation. Determining this level requires a judgment call, based on a knowledge of the people involved, the crises at hand, and predictions of the short- and long-term effects. It is a draining and difficult process, one we are far from mastering, and one we tried to keep centered on loving those who we serve.

There is much more we wish to discuss on this subject, because we see so much misunderstanding about what development is or should be from both sides of the world. And yet, it is a goal we must continue to seek for the betterment of millions of people who do, in fact, live without our most basic human rights.

Thank you for reading and commenting below.

-James (& Joye)