Book review: Reinventing Philanthropy

Eric Friedman's book Reinventing Philanthropy: A Framework for More Effective Giving came out this month.

The book opens with an example that I find particularly compelling. Friedman gives the example of two sick children, one who received world-class care at an American children's hospital, and the other who perished for lack of basic care at an underfunded clinic in Angola. Both healthcare facilities are “good causes,” and donors might feel proud of supporting either one. But one is funded to the tune of millions of dollars a day, and the other lacks basic supplies. Rather than patting themselves on the back for supporting the state-of-the-art American hospital, Friedman suggests donors should consider funding the Angolan clinic that would be able to save far more children with the same money.

The book emphasizes the difference between giving to feel good and giving to do good (or, as he calls it, the “do-gooder approach” and the “do-bester approach.”) He argues that too much charitable giving is focused on making the donor feel good, regardless of what their money is actually accomplishing. But he proposes that it's possible to have both – to choose effective giving strategies while feeling the warm glow of knowing you helped others the best you could.

I'm sure there are donors out there who will not be persuaded by Friedman's approach – if their mother had Parkinson's, they will devote their charitable giving to Parkinson's research. In fact, the whole industry of charitable fundraising is built around this type of donor preference – show the donor giving opportunities within their chosen area of interest, but don't suggest that they consider some other area, even if they could help more people elsewhere.

But I think others will be compelled by Friedman's questions: what are you actually trying to combat? Is it Parkinson's disease in particular? Is it grief at watching a loved one grow ill and die? Is it human suffering in general? And if what you actually care about is preventing human suffering, shouldn't you fund whatever cause will best accomplish that goal?

Reinventing Philanthropy also provides sections on choosing charities to donate to, choosing whether to restrict your donation to a particular fund within a charity, and choosing to fund innovation vs. proven approaches. It also touches on ways to use your time to help, whether that's working or volunteering for a nonprofit, choosing a career that lets you donate more, or just talking to other people about how you make giving decisions.

Parts of the book are aimed at donors giving substantial amounts of money – for example, those giving a few hundred dollars won't be able to meet with the leadership of nonprofits they are considering, as Friedman advises. But the book's principles are sound, regardless of how much you donate.  By putting in some thought and research, donors at any level can be "do-besters."

Why I'm glad other people will do research for me

Popovers are a little tricky to make, so when I want to bake them, there's only one cookbook I go to: Cook's Illustrated New Best Recipe. Unlike most cookbooks, which maybe test a recipe once or a few times, Cook's Illustrated goes through dozens of variations and puts them through a taste-test panel. Is a popover better with pastry flour or a higher-protein flour? Skim or whole milk? Should you leave the oven at a steady temperature or bump the temperature down after an initial blast of heat? Honestly, I'm not going to take the time to figure these things out on my own.  But I'm glad someone else did.

When Jeff and I were first trying to pick a charity to donate to, I spent a couple evenings browsing the internet. I found a charity that seemed to match our values and had a good reputation. I tried to find dirt on them and couldn't find anything significant. So for the next few years, we donated there.

But this was kind of the equivalent of developing your own popover recipe. You'll probably wind up with something pretty good. But someone giving the task 40 hours a week, year in and year out, is almost certainly going to do better.

Which is why I'm glad there are professional charity evaluators out there. I'm glad the J-PAL Poverty Action Labs and Innovations for Poverty Action exist to do impact evaluations on different interventions that might help people. I'm glad the Copenhagen Convention exists to advise policy makers on how to tackle the world's most important problems.  I'm glad GiveWell exists to recommend specific charities to donors. I'm glad the Cochrane Collaboration compiles the best evidence on health in a format I can (usually) understand. I'm glad that randomized controlled trials of interventions seem to be catching on more.

Food.com offers 179 popover recipes. By looking at them, I have no idea which ones are duds and which produce perfect, airy results. Most charity evaluation sites rank thousands of charities, also pretty inscrutable to a casual viewer. I don't want 179 recipes or thousands of charity ratings. I just want the best.

There's probably a better popover recipe out there. There are almost certainly better charities out there than the ones I know about, and better ones that could be invented. But in the amount of time I'm willing to give the task, I'm not going to find them. So I'm glad there are people smarter and more dedicated than I am whose job it is to work on these hard problems.

(Want a popover?  The recipe's here.  Eat them with butter and jam.)

Photo: Jeremy Noble [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

Malaria, one-trick ponies, and lasting change

It's a summer afternoon, and I'm reading the latest debate about narrow vs. systemic charitable interventions.  Scratching a mosquito bite, I'm reminded of a public health intervention that took place in my own country.

When my grandparents were growing up, the American South was still plagued by malaria (or ague, as it was often called.)  And what was the effect of the disease?

“While there is good land in the Southern United States as in the North, the land in the North sells at about 12 to 20 times the price, the difference being mainly due to malaria.”  - Carter, 1922, quoted here

“The diseases due to all four species of malaria parasite share the characteristic febrile episodes with their tendency to regular periodic paroxyms with chills, rigors, and sweating. They also have many symptoms in common with other infectious illnesses, including body aches, headache and nausea, general weakness, and prostration. . . . Lethargic and with sunken and sallow features, spindly limbs, and hard swollen belly is the general description of the condition. In this state the affected individual succumbs to diseases or other hardships that would scarcely threaten a person in reasonable health.” - Carter and Mendis, Evolutionary and Historical Aspects of the Burden of Malaria

PAHO/WHO, December 1969

The disease had been lessening over the late 19th and early 20th centuries due to better housing (glass and screens for windows) and the use of quinine.  But in the 1940s, the government took matters into its own hands.

During World War II, troops were succumbing to malaria on bases in the Southern US.  The Office of Malaria Control in War Areas was founded in 1942 to protect the areas around military bases. After the war it became the Centers for Disease Control (the CDC) and took on the task of eliminating the disease from the entire nation.  By 1951, the disease was eradicated from the United States.

Woman in rural Georgia, 1941.  Note the wooden shutter - no glass or screen.

This is the type of intervention that I've often heard criticized for its narrow focus.  I've heard single-issue medical interventions called "one-trick ponies", "short-sighted", "kicking the can down the road."  And to be sure, the eradication of malaria in the US was a top-down intervention carried out by a government agency without much community involvement.  There was not an attempt to change the social and economic conditions that prevented people from buying their own windowscreens and DDT. It just dealt with actual disease transmission.

Instead of narrowly-focused efforts, proponents of broad social change advocate "lasting solutions," "systemic change," "a new operating system." Which is great when it happens. But if public health interventions are difficult to carry off well, systemic change is even harder.

And yet it does happen. Interestingly enough, the Civil Rights movement sprang up in the South just as malaria was ending. The newly-formed CDC, located in Atlanta to be near the most malarial areas, declared the disease eliminated from the United States in 1951. That same year Martin Luther King, Jr. graduated from seminary. American blacks still bore the burdens of political disenfranchisement, inadequate education, poor access to health services, violence, and daily acts of hate and humiliation. But they no longer ran the risk of illness or death with every mosquito bite.

Obviously there was a lot more to the Civil Rights movement than a lack of malaria. But it was one of the factors that helped. How likely is someone with “body aches, headache and nausea, general weakness, and prostration” to make it to the polls, to school, or to work? How likely are they to march on Washington?

It's easier to dream big from behind a windowscreen. Easier when you're not hungry. When you're not sick.  When you're not weakened from parasites and malnutrition.  And for those of us who would love to see systemic change, the "one-trick ponies" may be a good way forward.

Cheerfully

As a young person, I was extremely struck by the realization that my choice to donate or not meant the difference between someone else’s living and dying. A lot of decisions started to look very starkly wrong.

I remember telling my dad that I had decided it would be immoral for me to have children, because they would take too much of my time and money away from better causes. “It doesn't sound like this lifestyle is going to make you happy,” he said.

“My happiness is not the point,” I told him.

A few years later, I was deeply bitter about the decision. I had always wanted and intended to be a parent, and I felt thwarted. It was making me sick and miserable. I looked at the rest of my life as more of an obligation than a joy.

So Jeff and I decided that it wasn't worth having a breakdown over. We decided to set aside enough for our personal spending that we could reasonably afford to raise a child. Looking back at my journal entries from before and after the decision, I'm struck by how much difference it made in my outlook. Immediately after we gave ourselves permission to be parents, I was excited about the future again. I don't know when we'll actually have a kid, but just the possibility helps me feel things will be all right. And I suspect that feeling of satisfaction with my own life lets me be more help to the world than I would have as a broken-down altruist.

I've attended Quaker meeting for the last ten years. The founder, George Fox, gave his followers this advice in 1658: “Be patterns, be examples in all countries, places, islands, nations wherever you come; that your carriage and life may preach among all sorts of people, and to them; then you will come to walk cheerfully over the world, answering that of God in everyone; whereby in them you may be a blessing.”

Quakers have tended to emphasize the part about “that of God in everyone,” with its implication about equality: how can it be right to keep slaves, for example, if the slave has an element of the divine in her?

But my favorite part is that word “cheerfully.” Fox was a man who had been jailed and beaten for his religious beliefs – surely he had a right to be bitter. Quakerism later developed a stern and dour style, but George Fox was not about that.

Some things I can do cheerfully. It turns out that giving up children was not one of them. Other people would have no problem giving up parenthood, but I suspect that everyone has something that would cause an inordinate amount of pain to sacrifice.

So test your boundaries, and see what changes you can make that will help others without costing you too dearly. But when you find something is making you bitter, stop. Effective altruism is not about driving yourself to a breakdown. We don't need people making sacrifices that leave them drained and miserable. We need people who can walk cheerfully over the world, or at least do their damnedest.

What's it like to give half?

It's been a while since I ran the numbers on how much Jeff and I give.  Recently we figured out what we gave in 2012: it was about half our income.  In 2012, Jeff was working as a computer programmer and I was mostly in grad school, then starting a job as a social worker towards the end of the year.  In the interest of transparency, here's what we did with the money:

(Note: it's surprisingly tricky to figure out what counts as income and donations — for example, if I do a job for someone and ask them to donate instead of paying me, does that count as me donating or the other person donating?  For simplicity's sake, this post will use the income and donations from our 2012 tax return.  More detailed information on Jeff's website.)

• Donations: This was our best year yet for donations.  If we earn more in the future, we'll be able to give more.
• Taxes: Our taxes are lowered because of donating.
• Savings: We're saving for a house, children, and retirement.
• Housing: Our costs were unusually low because we're renting from Jeff's parents.  This will go up soon when we buy a house.
• Food, clothes, transit, etc.: We spend about $200 a month on groceries.  We pay $70 each for a monthly public transit pass.  We each get about $40 a week in spending money, which covers clothes, cell phones, gifts, vacations, meals out, etc.
• Medical: Jeff's work pays for most of our health insurance, but we pay for some of the insurance and some out-of-pocket expenses.

These numbers are atypical, because Jeff earns more as a computer programmer than most people do.  (He's an example of the earning to give model — if you want to be able to donate more, seek a higher-paying job.)  We also save on living expenses because we're two people living together.

So let's look at how I might budget if it were just me. This hypothetical budget is based on my earnings as a social worker from the past year, including four months when I was unemployed.  My total income was around $38,000 (close to median personal income in the US).

This assumes:

• Saving 15% of income, which is pretty standard financial advice
• $800/month rent and $100/month utilities, which is doable in the Boston area in a small apartment or an apartment shared with friends
• $150/month on groceries, $80/month for public transit and $45/week on other personal spending, which are all more than I currently spend
• My employer might pay 60% of my health insurance, so I would pay $250/month for insurance and out-of-pocket medical spending
• Leaving $8,500, or 22%, for donations.  Not bad!

So even on a modest salary, it's possible to give a significant amount.  You don't even have to live in a cardboard box, I promise.

Beware false economy

A classic “false economy” is when you get something cheap that turns out to cost more than you thought – a car that breaks down all the time, shoes that fall apart quickly.  But cheap things can cost you not only money, but also time and the goodwill of others.

As a teenager I was suspicious of adults because they seemed less idealistic than young people. I didn't want to become like them. But now I see that it wasn't just that people become more selfish as they age, but also that they have a better understanding of false economies. Some sacrifices that seem noble to adolescents are recognized by adults as wasteful.

I was talking to a friend who gives away a lot of his money but who bit the bullet and got himself a good suit.  He realized that there were circumstances where he needed to talk to important people about these ideas, and having a good suit was part of being credible. Part of him resisted spending the money, but there are times when spending money lets you do a lot more good than donating it.

Saving money may be a false economy if it costs you time.  If you would be doing something worthwhile with the saved time, it may be better to take faster, more expensive methods of transit.   (If you wouldn't be doing anything worthwhile with your time, maybe you should find something.)  An easy-to-use phone and laptop are another good investment. 

Look out for "savings" that tax your relationships with other people. I spent a summer as a houseguest at a stage when I was very concerned about the fuel it takes to heat water, and the family I was staying with found it bizarre that I wanted to wash the dishes in cold water. I should have just done things their way to avoid the conflict – maintaining good relationships probably allow you to do more good than saving a bit of fuel or whatever you're trying to avoid.

I tell myself all this, but I still find false economies hard to avoid.  (Years of skinflintery are hard to overcome!)  I keep telling myself I'm going to spend some money and get decent versions of things I use all the time, like socks and pens. Then I succumb to finding the cheapest ones and usually end up dissatisfied. I think I need to set some kind of price floor before looking. Or maybe have a rule that I can only buy ones I wouldn't be embarrassed to give to a friend.

The ones we choose to mourn

Last week, my city erupted (literally and figuratively). Two bombs exploded, five people died in the bombings and subsequent shootings, and many more were wounded.

Boston has talked of nothing else. The victims' names are everywhere. Their pictures and mundane details of their lives are in the papers. Billboards memorialize them. There are memorials on street corners. We know their names, where they lived, their favorite sports teams.

The next day in Baghdad, 50 people were killed in a wave of bombings.  I had to look that up, because that's a pretty normal day in Iraq. 

Part of me wants to say, “Why are we treating some people's lives as so precious because of the particular way they died? Where are the memorials for the 89 Americans who die in car accidents every day? For that matter, where are the memorials for the 50 Iraqis who were blown up last week? Or the 4,000 people a day who die from unsafe water?”

But I also understand.  When someone you love is hurt or gone, when the loss is not a statistic but a real person, it really does feel like the world should stop and take note. What's remarkable is that we're actually doing it this week (albeit for a small and strangely selected number of people).

I don't think we can actually go around in a perpetual state of mourning. While we're alive, the best we can do is enjoy life and work hard to be sure other people get to enjoy their lives.

But I'm taking this week as a reminder that human lives really are precious. It's harder to think about the larger, ongoing disasters. But every one of those is made of actual, precious people with faces, families, and favorite sports teams. The girl next door. Someone's son. Someone's best friend. They are priceless.