“There are some problems that we can solve. But we have to be pragmatic about it and figure out what is actually working and what is not.”
Dean Karlan is President of Innovations for Poverty Action, a non-profit organization that creates and evaluates solutions to social and development problems, and works to scale-up successful ideas through implementation and dissemination to policymakers, practitioners, investors and donors. He is a Professor of Economics at Yale University.
By Kevin Starr (PopTech 2010)
Vestergaard-Frandsen (VF), a manufacturer based in Switzerland, recently distributed about 900,000 of its LifeStraw Family water filters gratis to households in Kenya’s Western Province. Since I’d been a vocal critic of the project in concept, I thought I ought to have a look at how it’s working out on the ground.
And so a couple weeks ago, I flew from Nairobi to Kisumu with Ned Breslin of Water for People. We hired a car and traveled to the epicenter of the filter distribution, splitting up to visit as many households as we possibly could. Driving down forking dirt roads, we got out of the car periodically and walked to random houses. What with explaining what we were up to and the inevitable tea and biscuits, we got to only 20 houses, but every single one had gotten a LifeStraw filter. This was a remarkably effective distribution effort.
What happened to the filters after distribution was less impressive: 10 months after distribution, only three of the 20 were currently in use. One guy showed me his still in the bag—he said he couldn’t figure out how to use it. Another said his kids had burned it up. Yet another told us rats had eaten part of it, and he couldn’t get a replacement. One woman said she only used the filter when her husband made her do so.
Now an informal series of conversations hardly qualifies as science, and some of the houses we visited were in an area where VF rolled out their program on top of another organization’s existing work, and that may have affected use patterns. Still, it was pretty obvious why filters went unused: The LifeStraw is poorly designed. A universal complaint—mostly from women—was that it is too slow and too much work. It takes about half an hour to filter the two liters in the reservoir at the top and it requires continual refilling to satisfy a family’s daily needs. The women in the houses we met simply decided it was too much hassle.
And this is the biggest problem of giveaways: You can give people whatever you want, as long as you can get someone to pay for it. The LifeStraw filter costs $30 at the factory; given what’s been learned from other water efforts in Western Kenya, I’d be surprised if you could get local people to pay $3 for it. If it had to pass muster with real customers—i.e., its intended users—it would be in real trouble. My hunch is that it would simply die a quiet death in a corporate conference room somewhere.
But it stays alive because the real customers are not poor people, but in this case, the buyers of carbon credits. With the approval of the Gold Standard Foundation (one of the two major accrediting bodies), VF concocted a deal—“Carbon for Water”—to finance this giveaway with carbon credits. The crux of the deal, worth about $30 million, is that the filters will replace the wood-fired boiling of water, hence preventing carbon emissions.
After surviving Liberia’s civil conflict, Dr. Raj Panjabi (2010 Social Innovation Fellow) co-founded Tiyatien Health to tackle the triple threat facing health care in post-war countries: a battered public sector, workforce shortages and rampant poverty. In the following excerpt, Panjabi shares a glimpse of the challenges facing Liberian refugees today.
The Ivorian women who fled the violence tell a different story. Over 170,000 Ivorians — primarily women and their children — have poured across Liberia’s eastern border in recent months. A Human Rights Watch (HRW) report on April 9 revealed their horrific testimonies. They have seen their husbands shot point blank, their children raped in front of their eyes, and their villages burned to the dirt.
Last week, our colleagues at Tiyatien Health, a health organization founded by survivors of Liberia’s civil war, provided care for one of those women, Marie, at a public hospital in Zwedru, a Liberian town near the border with Ivory Coast. Three weeks earlier, her village had suddenly been ambushed by rebels. As the guns fired, Marie took cover with her husband on the floor of their hut while shielding her three girls with her own body. The rebels then dragged her out of her hut into the open. Four bullets had already entered her chest — one only four inches from her heart.
Somehow, the blood and sweat dripping from Marie’s body convinced the gunman her fate was sealed — “he told his men I’d die, so it wasn’t worth wasting another bullet on me.” She darted, children in tow, into the forest. That was the last she saw of her village and her husband. After carrying her girls through the bush and across a river, a man found her collapsed in a cassava field near Zwedru and brought her to our hospital.
Marie’s bullet wounds are healing. We are her beginning to address her emotional pain. But, when she leaves the hospital, what will become of her? What of her three girls? Another report issued by HRW last week paints a grim prognosis.
According to HRW, refugee women and girls report ”no choice but to engage in sex” with men who promise to give them food. The challenge is that most of the refugees have taken shelter, not in camps, but with their Liberian relatives, whom (ironically) they hosted not long ago when Liberians lived in exile in Ivory Coast. Food shortages were already rampant in southeastern Liberia, among the poorest places on earth according to the UN. The refugee influx has only made matters more desperate. Last week, a two-week-old Ivorian infant died at our hospital after her mother’s breast milk ceased because the mother herself had gone hungry for weeks.
Writing, respectively, as a doctor and peace activist who have worked on the front lines of war, it is clear what’s needed now is justice and aid. The international community should support justice on both sides of the border for the women and children who have suffered physical and sexual violence.
The amazing Pam Dorr of HERO (Hale Empowerment and Revitalization Organization) in Greensboro, Alabama.
HERO works as a catalyst for community development in areas of the Alabama Black Belt to end rural poverty. As a non-profit housing resource center, HERO provides community resources and housing education.
After surviving Liberia’s civil conflict, Raj Panjabi co-founded Tiyatien Health to tackle the triple threat facing health care in post-war countries: a battered public sector, workforce shortages and rampant poverty. Pioneering a community-based health system, TH serves as a scalable, public sector model for achieving equity in health.