We’ve all been hounded on the street by a well-meaning underpaid employee of an international organization calling on us to sponsor a child from another country. Why does no one ask us to sponsor a crippled forty-something? It makes a certain amount of sense that children are the most common objects of these appeals. After all, helping to save vulnerable children is a cause that everyone (at least those of us with a heart) can get behind. Children are cute; and if we don’t have them–at least most of us remember what it’s like to be a child. And the tactic is to point out the gap that exists between our lifestyle and those of children in the developing world. By giving up something that is obviously a luxury to us (a few expensive coffees), we could provide essential care for those who need it most. The cost is small to us, and impact is big.
While there is a certain amount of common-sense logic to these campaigns, what I’d like to point out is that what seems to be operative here—and in other areas of global health policy—is an act of translation. In order to see an issue as important to address, we need to see it on our own terms: translated into a certain number of lattes. This translation manifests itself in a number of different ways. On the individual level, it seems that—despite the good place where the desire to help others less fortunate comes from—these child-sponsorship campaigns often seem to be more about fulfilling our own personal needs, rather than actually giving others precisely the help that they need the most. Take, for example, these three posts on this child-sponsorship forum (emphasis mine):
1. “Where can I find a legitimate website where I can sponsor an African child? I’m looking for one in which you get letters from the child and such. I think my daughters would enjoy this. And it’s for a good cause.”
2. I want to sponsor a child in Africa, specifically a teenage girl. I want to be able to see pictures and also send letters to her. Does anyone know of a good organization I can go through or a website that’ll enable me to do this? Thank you =]
3. Is there a way to meet the child you sponsor on world vision? My mom sponsors a girl from west mamprusi in Ghana and i would love to one day meet her and become pen pals or something instead of just sending her money every month. i want to get personal with her and get to know about her life and become friends. i also want to send her gifts or spending money once in a while or something, you know what i mean? I WANT TO KNOW WHERE IN THE WORLD SHE IS! is there a way to know?
While I’m sure that many of the organizations offering child-sponsorship (of which there are lots–see for example, World Vision, Childofafrica.org, african-child.org, childafrica.org) provide good care to children in the developing world, it seems clear that they are also providing us a chance to feel benevolent (albeit under very circumscribed terms). We love the idea that we are singlehandedly responsible for saving a child’s life, even if the reality is far more complex.
Though some may point out the lack of sophistication in the posts I quoted above, after reading Jeremy Shiffman’s piece, it does seem that a very similar operation is at work on the broader policy level. As Shiffman points out, the way in which our priorities in addressing global health issues are set has less to do with how important—in an objective or material sense—an issue is. Instead, priorities are determined by how successfully advocates have framed the issue in terms that speak directly to the social values and concepts of the political leaders in question (610). In other words, in order for an issue to reach the attention of the relevant people, it needs to be translated from simply a public health problem into terms that resonate with the political elites (e.g. a national security threat or an economic development issue). It’s not enough that people the world over are suffering; in order to get my attention, an issue needs to somehow threaten my own well-being, or at least feel relevant to my life in some way.
It’s important to note that though the exorbitance of American life can sometimes convince us to exchange some lattes to help children abroad, it can also be highly problematic when it is taken as the universal standard in health care. As Sanghavi points out, the fact that health needs in the developing world are translated into American costs (with its retail drugs and expensive infrastructure), means that needy nations are stuck with figures created for rich countries which “overestimate costs for large-scale relief and treatment efforts in the developing world.” (This is why the work of Paul Farmer and co. is so important. Among other things, they buy drugs outright at retail prices, thus avoiding the expense of the pharmaceutical companies).
I think it’s obvious why translation is such a common tool in the global health world; despite our increasing connection to people all over the world, we are still distinct cultures and need to understand things on our own terms and feel that they are relevant to us before we act. Though certainly problematic in many ways, recognizing this fact that can offer good advice for advocates of an issue: choose your frames strategically. If nothing else, we should be vigilant to question whether or not we are really addressing the most pressing global health concerns, or only those whose advocates have been most successful at speaking our language.