Pajiba

Good review. This book is terrific, and very apropos to what is going on today in Haiti, giving a portrait of the frustrations endured in the third world.

A short rant from an over-educated reader: people don't starve to death because there isn't enough food, they starve to death because the political system they are in doesn't allow them an adequate entitlement to food. So Mao was exporting food the whole way through the famine in the Cultural Revolution, and the Irish were starving and exporting potatoes simultaneously. And access to healthcare is I think analogous - the poor don't have access to adequate healthcare because of the healthcare entitlement associated with the political system they find themselves in.

So the way to stop famines or poor healthcare systems isn't just to import food or doctors, its to change what they are entitled to by changing political systems.

Anyway, this kind of well-intentioned philanthropy is commendable, and says a lot of good things about the personal characteristics of the people involved, but tends to be a bit of a waste of time. And I do development work in Africa as an economist, so I have seen a bit too much effort wasted on this kind of bullshit, while the real problems go neglected, so it pushes my buttons.

Also, as previously mentioned, I am a bit over-educated.

Saartjie: I hear you, but although I believe Paul Farmer understood the important role that poltics played in this, he decided that rather than sit by and watch poor people die, he would initiate a grass roots effort to do what he could. A broad-brush political solution might work better, but often dies on the vine in the third world.

Damn. Of course that should be "your" not "you're."

... so I suppose for me stuff like this is like putting a flower arrangement on top of a mound of garbage - its nice, and its pretty, and it changes nothing. So ja, go ahead and do it, its great, but don't kid yourself that you are changing the world.

saartjie, the problem with rants like yours is that it makes most people who might have been gearing up to at least try to do something sit back down again and say, "Well, in that case, what's the fucking point? I may as well not do anything at all, since what I COULD do, which is research some charitable organizations that are TRYING to do some good for the actual people who are oppressed, and give them a few bucks towards attempting to do that, is totally and utterly futile, and since I have no idea HOW TO CHANGE AN ENTIRE NATION'S POLITICAL SYSTEM, as the average person doesn't, well then I'm going to keep my $10 and sit on the couch eating some more potato chips and playing video games and doing NOTHING AT ALL, not even that little bit that might have helped one person in the short term." Which seems to me even more pointless than putting some flowers on top of the garbage pile.

Look, I see that you're frustrated by it, but telling people to stop doing the little they can do isn't going to help anything either, is my point. How exactly would you suggest that the average person change the political structure of Haiti so that groups like PIH are unnecessary?

Yeah, what AvB said.

Honestly, saartjie, I am telling you Paul Farmer and the folks at PIH *get* that you have to do things locally. They take a holistic approach and have made things better for a *whole area* of Haiti, the Central Plateau, where believe it or not, the folks are in worse shape than Port au Prince. Farmer *still* makes house calls to patients all over the plateau, for Godtopus' sake! PIH is the epitome of grassroots, of getting help to the people, an ever growing number of people. They do what other organizations have considered impossible. And their administrative overhead is only 6%--that means money given to this organization really goes to the people.

I get that you are jaded and burned out and that you come by that honestly, but believe me, pissing all over PIH, especially when you don't seem to know how they do their work, isn't helping anyone.

Seriously, Pajibans, if you want to do something, if you feel completely overwhelmed and it all seems so futile, Partners in Health is the organization for you. They defy conventional wisdom. And if you don't believe me, check out their web site, read Mountains Beyond Mountains, do your own research.

Oh, and here's an op-ed piece from Kidder that gets to the heart of the matter.

So yeah, if you have a couple of dollars, please, please, please send them to PIH. You really will be helping.

Ok, now I'm really going to stir - hehehehehe.

One of the things that grates about this kind of charity is that its always noble whitey sailing in to save the black folk. As I understand it America has a pretty shitty healthcare system of its own, maybe ya'll could focus on sorting that out first. Alternatively, please lobby your government to stop with the tied aid. You know, the stuff where American aid to places like Haiti is all spent on American goods and services, and then exported to Haiti to crowd out local providers.

And that, Snuggiepants, is how to knock the fucking ship over. While changing the parts of the political system that you can actually reach.

(that one was more for you, ms beaverpuppet)

I'm sorry...are you arguing against altruism?

Here's a scenario:

Joe Blow (who is white) is sitting on his couch after a long day at work at the Hyundai plant, when the news break comes up about Haiti in trouble and earthquakes and people going hungry. He has okay health insurance (that he pays for), and his kids are doing pretty good going to the local public school. He thinks, "I should do something for those people...I'm not in a bad spot. I can send em twenty bucks and maybe some canned food." He gets up to call the number on the screen.

In your opinion...this is bad? He shouldn't want to help someone else? He has major pull in his government/healthcare system/agricultural union, obviously, and so he should not send anything, not help in any way, but write a fucking letter to his congressman?

Yes, you're right...a lot has to be changed. Legislation, corruption, edging out small businesses. But what is the little man on the totem pole supposed to do about helping people who need more than he does right now?

Jesopus, saartjie, you're a lost fucking cause. But I will waste my breath one last time. Paul Farmer and the folks at PIH are on the same wavelength as you in many ways. Yes, he is white, but he saw people in need--he picked Haiti on purpose, because it is the poorest country in this hemisphere--and found a way to make a real difference. If you'd actually read the book, you'd see that you are throwing stones at the wrong organization here. They discuss all of the issues you are raising.

On the other hand, I'm not sure it'd make a difference; you've made up your mind that *all* NGOs are the same and therefore should be dismissed out of hand.

And that's how you've managed to make all of your points seem invalid. Too bad. There's some actual truth in there.

Saartjie: I will send you my five dollars instead. Please change the political system for me. Thanks.

Hmm, I didn't realize that "keeping a sense of humor" means: complimenting yourself multiple times, needlessly bringing race into the discussion, attacking the US health system, calling people "chicken portion" (Seriously, WTF?), and refusing to acknowledge other's points. My bad, I guess I'm not over-educated enough.

I would suggest going back and looking over what people are saying in response to your knee-jerk reaction, which is that PIH agrees with a lot of what you're saying and are doing what they can to implement those ideas. For crying out loud.

What about the yellow people? Does anyone want our help?

*crickets*

In that case, I'll feel free to do as I please and donate to the charity of my choice. Maybe it won't solve the problem of poverty permanently, but it might help one person survive one more day.

Oh, DAMMIT. Jelinas, the yellow people can help me. If you send me $5, I could probably learn how to close my html tags.

Shadows, you can send me all the dollars you want.

Wait, what *kind* of Latino are you?

You're so smart, tamatha.

Anyone can send this whitey any dollars they want. I have a paypal account.

I sure seem to have flipped the stroopwaffle a bit, eh? In my own defense, I am a bit over-educated. If I knew less about the world, I might feel as the rest of you do. Also, as previously mentioned, I am a bit over-educated. So there's that.

Did I mention that I am over-educated?

And my typos are embarrassing ...

Betty for the win. ;)

I'm delurking for the first time, a day late and a dollar short. Wished I'd seen this post when it was still active, but here's my two cents anyway.

I'm one of the doctors in question--I don't spend the majority of my time doing disaster relief or medical missions, but I have gone overseas to do medical mission work. My day job is in a community clinic in Michigan, which as you may or may not know has the worst economy in the country, so I know full well that you don't have to go real far from your own doorstep to find a broken system or people in need. The majority of my patients are un- or under-insured. Many of them pay about 0-$10 for their visits. Many of them get some of their groceries from the free food pantry that we run. Many of them are deciding on a daily basis if they should buy healthy food or their heart medicine, but can't do both. Many of them are now or have been homeless. But from what I've seen overseas, my patients are still in a much better position than lots of folks in other places.

While doing work in impoverished nations, or in a poor community clinic in Michigan for that matter, I think it's very easy to think that the tiny bit of good that you can do is ultimately meaningless in the grand scheme of things. And maybe it is, but it all depends on your frame of reference. It's not my job to change the whole world. It's my job to change just the tiny corner of the world that I live in. And even if the world as a whole isn't any better at the end of my day, if my world got a little bit better, and the world of one or two patients, then my day wasn't a waste of time.

Ultimately, I think saartjie is right on several points. But the real point isn't to pick one approach over the other. You can still give $10 to the Red Cross or PIH or whomever, AND you can write a letter to your congressman and try to change the overarching political system, if you're in any position to do so.

(And, for the record, I'm not and never will be mistaken for a "noble whitey")

Don't have anything new to add to the discussion - Roundapples, you are spot on.

Tamatha - thank you for introducing me to this wonderful organization. I made a donation and now don't feel quite as impotent in the wake of this disaster.