Did you watch any of the BCS Bowl Games this year? If so, did you see the commercials asking you to donate $10 toward providing mosquito nets for Africa? If you did, did you donate?
I hope not.
That’s probably not what you were expecting me to say, so I’ll repeat it. I hope not.*
Wow, I must be meaner than you thought. How could I be opposed to providing mosquito nets to Africans, people I talk about with much fondness? Am I not in support of ending malaria, the deadliest disease in Africa?
Well, it’s not that simple. Of course I am in favor of ending malaria, and yes, I think that using mosquito nets is an effective method of prevention. But I don’t believe that handing them out for free is the answer.
As we traveled around the world, we encountered many different types of aid, and what we witnessed over and over is that as an everyday form of charity, handouts don’t work.** Sometimes what is being given is not what the people most need. Sometimes what is being given might work for us but doesn’t work within the recipients’ set of values and beliefs or with their lifestyles. And sometimes what is being given is taken not because it’s wanted, but because it’s free.
Come on, admit it, you do the same thing. Free stuff is hard to resist.
But when you receive something for free, it has no value to you. You didn’t have to give up anything to get it, you didn’t have to decide that that item was worth the price or the sacrifice of getting it. So if it’s lost or broken, if it crumbles to the ground, if it sits around and is never used, it’s no sweat off your back.
Also, sometimes when you get enough free stuff, you begin to expect that you’ll continue to get free stuff. You start to believe that you don’t have to work hard to get what you need and want, that you don’t have to hold those who are actually supposed to be providing for you (i.e. family, government institutions, etc.) responsible for delivering on their promises, but instead you just have to put your hand out at the right time.
Time and again in Africa, we encountered the case of the free mosquito net. In theory, it sounds like a great idea. In practice, it doesn’t work. Rarely was the free mosquito net being used properly; most of the time, it was actually being used as a net for catching fish, birds, or other animals that could be turned into dinner. I’m not saying that’s a completely invalid use; I’m just saying that using the net in such a way doesn’t help prevent malaria. And as far as I’m aware, that’s what all these charities giving away the nets are trying to do.
So what’s the answer then? Should we deny people the simple protection they need to prevent an often fatal disease? Should we demand that people with little money pay a hefty portion of it for a net?
No and no. What we need to offer people in cases such as this is the skills and knowledge that they might not currently have but once acquired can put to good use themselves (for instance, in regards to the mosquito nets, knowledge about what malaria is, how it’s transmitted, and how it can be prevented). We can also offer them stuff, things that they need but cannot for whatever reason get, but we shouldn’t give it away for free. That doesn’t mean it has to cost much, or even anything. But, those in want or need of the item should have to “pay” for it, whether with money or through barter of goods or services. This means that the “purchaser” will truly want whatever it is on offer and thus be more likely to put it to good use. It also means that they will feel like a valuable person; someone who has something to give, not just someone who takes. I think most of us want to feel this way.
You might now be wondering if this works, if people are willing to pay for things that some charities give away for free. I can tell you that yes, it does work. I’ve seen it firsthand.
One of the most outstanding aid outfits we saw while on our trip was the Bwindi Community Hospital, a place we were invited to tour while staying in Bwindi to trek with the mountain gorillas. Here, a British couple run an Anglican-sponsored hospital for locals (and by local, I mean people who can walk to the hospital in a couple of days). They take in a few foreign volunteers each year, but other than that, all staff is Ugandan–nurses, doctors, janitors, secretaries, AIDS counselors, etc. This hospital is vested in the community. (The couple running the hospital are even drawing up plans to eventually remove themselves from their roles.) And though they offer excellent mendical services–a maternity ward that allows women to stay for their entire third trimester, preventing multi-day walks to and from the hospital; x-ray and surgery facilities; health workers who go out into the community and seek out those in need of treatment–what they’re most proud of, and rightfully so, is their education program.
The “Small Families are Rich Families” campaign has helped lower the birth rate in a country with one of the highest, by educating men on the benefits of having a small family they can take care of and by providing women with access to birth control (which is often literally a lifesaver). The Village Health Promoter program means that each of 200 villages in the area has at least one trained resident teaching his/her neighbors basic health care practices, thus helping lower the number of cases of easily preventable diseases like dysentery. The Community Garden program teaches mothers not only how to grow food that is nutritious but also how to cook food that is healthy. And the sale of mosquito nets has translated into 15,000 children protected from the disease.
While we were touring the hospital, I specifically asked how the mosquito nets were sold, finding it interesting that they weren’t given away for free. What I learned is that the nets have a set price, a small amount less than $1 that people can pay for them, but that if even that small amount is too much, they can offer whatever it is that they have that they feel is worth the set price. I was laughingly told that they have an entire closet of carved masks and animals that they have accepted as payment. It’s not money; but it is an item of value. They could, after all, probably sell those carved goods to gorilla trekking tourists for much more than $1.
When we left the hospital, I felt uplifted. This, I thought, is how aid is supposed to work. It is supposed to promote empowerment, rather than dependence, to create systems that works whether the aid workers remain or go, to ultimately render itself unnecessary. So many times, we’d seen the remains of projects that simply didn’t work; it felt good to now see one that not only worked but worked well.
Aid is a tricky issue. What works one in one time and place doesn’t always work in another. And for those of us wanting to give, trying to determine what organizations are doing work that works can be nearly impossible. If you’ve been thinking about giving to a new organization this year, or if that mosquito net campaign from the BCS bowl games got you pondering how you could really make a difference, may I suggest Bwindi Community Hospital? There are lots of aid organizations doing good work, but this is one I’ve witnessed firsthand. For more information, or to make a donation that will help the hospital to help others, please visit their website.
*If you did give, good for you. It’s not that giving mosquito nets away for free is bad; it’s just that I think there are more effective ways of providing aid.
**I’m not referring here to the giving of aid during one-time disasters such as the current one in Haiti, but to prolonged aid efforts.