A recent post at the change.org global health blog discusses a few global health programs that do not improve global health very much for how much they cost. Examples include Hospital ships and flying patients to the US for medical care. You could say that these programs use resources irrationally, Alanna goes so far as to say that such programs are immoral.
I think a key issue at the heart of some such of programs is the balance between long term effectiveness and the fierce urgency of now. I agree that the programs she describes would play a very small role in an ideal global health care service, but ultimately what we need more than any specific program is for people to give a damn. Some people have excess resources; we need them to care enough that they are willing to share some of those resources with the rest of the human family. If irrational programs will occasionally inspire people, perhaps they are worth the cost.
I’d like to discuss an example. The organization Partners in Health works in Haiti, and will occasionally fly patients to Boston to receive complex treatments that are not available in Haiti. They call it their Right To Health Care program. One recent patient was a young boy who needed to have a hole in his skull repaired. The flight and the procedure were admittedly expensive; the same amount of money might have purchased many bed nets or vaccines. But for the health care providers involved, the issue at stake was whether they were willing to treat this little boy like a beloved family member, whether they were willing to do whatever it would take to help him be healthy. In this instance PIH chose to respond to the fierce urgency of now.
PIH’s difficult work is possible in part because they have attracted very dedicated staff by telling controversial and emotionally charged stories, and following up with stories of hope and healing. Such acts are not purely metaphysical, they shape PIH programs. PIH has incredible, even enviable support in the communities where they work, in part because community members hear about stories like this little boy’s and they think, “wow, these people must really truly care about us an awful lot.” I also know individuals in the USA who have had the course of their lives changed by this brand of irrationally inspiring dedication. I’ve met people who heard a PIH story like this and decided that they were going to donate what they could to PIH every month from that point on – indefinitely. In my own case, I read of such efforts and decided that I too would become a doctor for the poor. I dare say my contributions to humanity will outweigh the cost of flying one needy child to Boston and performing a pro-bono surgery. I cannot emphasize enough how plausible it is that I might not have come to care, that I might have marched though life without being inspired.
Logistically, economically, such decisions do not make sense. They are irrational. And yet, a great many people ache for that kind of leadership, and to emulate such reckless devotion. I am forced to conclude that there are depths of the human soul which I do not yet understand.