Medicine. Travelling through Indonesia many years ago I and my fellow travellers came across the site of a bus crash. Some of my companions were medics and set about helping the injured. The rest of us just milled about feeling a bit useless. Other people I know have stated their envy of doctors who clearly have real meaning to their careers: saving lives. Thus Medecins Sans Frontieres and other similar organisations can be easily categorised as doing good. It’s also relatively easy for them, and their employees, to quantify how much good they’re doing by answering the question “how many lives have we saved today?”
Except that direct provision of surgical expertise and equipment is not cheap. At one step removed, public health professionals can argue they save more lives per $ spent than our doctoring friends. Or at least they can if not working in a country or sub-sector already saturated with aid money. However, it can be much harder to quantify impacts of public health campaigns. Is the 101st AIDS awareness campaign really value for money? The case is thus harder to argue, and doubts may start to creep in.
Education is another sector that gets a lot of support, and, on the face of it, is hard to criticise. Even if the connection with economic development is sometimes hard to demonstrate for the poorest of the poor, many people recognise education as a good thing in its own right. However, this good becomes questionable when the beneficiaries have more immediate problems like inadequate diets. Also you suffer from the same problem as public health. Either you are in the business of directly educating people (volunteer teachers, relatively low bang for buck, cultural and ethical issues), or you are funding general inputs such as school buildings, books, teacher training and salaries, none of which may actually deliver more education to those children in need, either because of mismanagement, corruption, and/or other constraints.
Then there are all the development projects associated with economic activities of one kind and another; agricultural extension workers and subsidised fertilizers, vocational training, new roads … all the way to macro-economic stability and creating more enabling business environments. Alleviating poverty is not hard to justify, and will have all sorts of knock on effects for health and education etc. However, identifying the causes of economic development is notoriously difficult, and thus determining the impact of these programmes is not always easy. If a farmer’s income went up was it because of your agricultural extension project or the new road? The answer is probably (hopefully) both, but attributing the contributions of individual projects can be somewhat subjective. And as with health or education, the further away one gets from the intended beneficiaries, so generally the possible size of impact increases, but equally so does the difficulty of measuring that impact.
An ex-colleague of mine had a stark criterion for evaluating any of the above kind of projects. If you took the total cost of the project and divided it up between all the intended beneficiaries, would they prefer to receive the cash or the benefits of the proposed project? You can bet that most beneficiaries are big skeptics (they have, after all, seen it all before, many times), so you’ll need a really convincing argument for them not to just want the cash!
I work in community conservation, which actually brings a slightly different view point. For a start the conservation agenda is 99% one that we have brought ourselves, though we’re quite pleased with the small number of local collaborators we have indoctrinated to the cause!*Conservation is a global good (if one mostly espoused by Westerners), and thus our ultimate beneficiaries are not just the local communities, although they are always front and centre in our minds. If our project achieves zero rural development but has substantial conservation impact it may still be judged a success. (Negative development, however, even if massively compensated by conservation gains, is to be avoided.) There are lots of areas where environmental and development concerns overlap: abuse of land rights, lack of clean drinking water, soil erosion, and sustainable livelihoods. But doubts constantly assail us, and I and my colleagues often question ourselves whether there might be better ways to help those we are trying to help.
I really do believe in what we are doing; we can claim some real successes, and, to my view at least, they justify my meagre salary. But sometimes it would be nice to be able to point to someone, and say “I saved their life today.” That you can feel good about.
* For the avoidance of offence, I should stress this is supposed to be humorous. There is a small, but growing voice for conservation here. It may first have been inspired by Western conservationists, but the views of local environmentalists are genuine, and not an elaborate piece of puppetry.