Thursday, September 20, 2012

Force feeding African children: the conclusion

A little sheepishly I write you to admit that just after I wrote you my earlier blog post, in which I presented a few options for how we might consider dealing with the aid issue, I found out that these options actually more or less represent the two sides of a long-term and very heated debate between two of the world’s leading economists. No wonder I didn’t have an answer all by myself! However, by the end of my time in Ambovombe, I had also come to a decision as to which side I support, and before I close the book on this subject (for now), I’d like to tell you why I’ve come to believe what I believe. Let’s look back at my options from last time.

Option 1: Force feed the children. As it turns out, this is a mild exaggeration of the argument put forth by Jeffrey Sachs of the Earth Institute (at Columbia, coincidentally). Banerjee, in Poor Economics, dubs this the “supply wallah” argument. Essentially he posits that poor countries remain poor because they are stuck in “poverty traps” (they are landlocked, have lots of disease, don’t have clean water, etc), and without an initial infusion of aid and cash, they can never break the cycle. Additionally, giving them that initial influx of aid will set off a virtuous cycle.

Option 2: Forget it and wait for them to ask us to help. William Easterly, an economist at NYU, is the very vocal proponent of this option, arguing that aid does more harm than good by essentially giving people an easy out, which corrupts local institutions and diminishes creativity and ambition amongst local people who would otherwise be searching for a solution to their problems. Essentially this is the free market – what Banerjee calls the “demand wallah” – argument, in which there is no such thing as a “poverty trap,” and given the right incentive people will always strive to find a way out of their predicament.

Many books have been written by experts on these topics, and if they are still fighting it out amongst themselves, I certainly don’t expect to convince anyone here. But nonetheless, before I even knew who Sachs and Easterly were, I had already settled on option 1. Here are some of my reasons:

1)  In the world of children’s health and malnutrition, certain barriers to advancement really are a trap. There are tons of studies that show increases in educational achievement, IQ points, and lifetime earning potential that are independently linked to small interventions such as giving iodine supplements to pregnant women or deworming treatments to children. If you consider that these micro- and macro-nutrient deficiencies are essentially causing a form of brain damage (as evidenced by the significant functional improvements seen after targeted interventions, or by studies such as one done in Ecuador that showed a decrease of 10-15 IQ points in children of iodine deficient mothers), then it is reasonable to assume that as long as that biological disadvantage continues, it is going to be that much harder for those people to pull themselves out of the cycle of poverty or even to be able to see that they need to.

2)    Aid is not universal, it doesn’t reach every tiny little corner of every country, so if option 2 really worked, we’d be seeing more little pockets of progress where people got fed up by their situation and tried to improve it. We are not seeing very much of that. Mostly people just keep on going the way they always have.

          3) If we don’t choose option 1, then we have a double standard. We consider that in our own countries a woman should not be allowed to starve her child, education and vaccination are mandatory for children, and not providing basic health care is considered neglect. If we believe we have a moral imperative to protect American or European children from neglect, even if it means forcing the mothers to do something they don’t want to do, why do we think it’s ok to let African children suffer from the same kind of neglect?

Furthermore, as Banerjee points out, we take for granted that a lot of these decisions are made for us in the rich world. Our water is piped into our houses already cleaned and disinfected, and our waste is pumped back out again and disposed of properly rather than polluting our waterways (most of the time). We don’t even give a second thought to the fact that the government is “forcing” this on us, because we all know and accept it’s for our own good. But a poor person in the developing world has to go out and buy chlorine if he wants to sterilize his water, and each time he gets a bucket of water, he has to actively put the chlorine in it. Does it really make sense for us to wait for him to realize that he’ll be better off with clean water and that in the long run the economic benefits of improved health will outweigh the costs of the chlorine, or is that really too much to ask of anyone who isn’t an economist or public health specialist? We have already decided it’s too much to ask of our own citizens, so why are people in poor countries any different? Given that the benefits of clean water are well known and indisputable, shouldn’t we help this man? I think so.

I could go on, but I wont. I encourage you to have a read through of some of the books on my list if you are interested in learning more, and even more, to go to one of the countries in the “bottom billion” and experience it for yourself, as there is truly no better way to decide about which side you take in this argument.

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