To give or not to give? That is the question.

Written by Sinéad O’Ferrall (@sineadOFGH)

Edited by Helen Jane Myrr and Line Bager (@lbager87)

In early May, 17 students on the Masters in Global Health set off to Moshi, Tanzania to experience a different health care system and to study some different perspectives and cultures. We all had expectations and ideas about how wonderful and rewarding this trip would be, both personally and academically. And to be sure, it has been. But also very ethically challenging and instead of giving a summary of our activities and lectures I want to present an ethical dilemma that we ourselves were faced with. To paraphrase the great Shakespeare, I want to ask the question “to give or not to give?”

Misquoted Shakespeare
Misquoted Shakespeare

Would you have given the money?

On a visit to a regional hospital as part of our academic schedule we were given a tour of the wards, including the female only ward where we encountered a family of three woman – a young mother, teenage daughter and her 5 year old daughter. All three had HIV and were severely malnourished.

We were informed, as we already knew, that their HIV medication was free due to local and international political support. The problem was they couldn’t afford to buy food. This not only meant they were slowly starving to death, but also they couldn’t take their HIV medications since they were too weak to swallow them.

The director of the hospital paraded us to these woman, or perhaps paraded the women in front of us – a huge group of mzungus* through a small ward with many patients all on looking. He passionately explained their circumstances and then implored us to give some money so food could be brought for this family.

Would you have given the money?

As a group of 17 Global Health students and two academic supervisor, some did, some didn’t.

Credit: Giuilia Perazzini Photos
Credit: Giulia Perazzini Photos

Why wouldn’t you give the money?

There were three concerns raised when it was discussed later in class.

It perpetrates the damaging expectation of the white people swooping in and fixing the problem. The concern was that it feeds into the “white saviour complex”. Also, did we really fix the problem? Sure they will get food for a week, maybe two or three. But then what? Maybe we just prolonged their suffering.

The way the request came across could have been perceived as extremely unfair. Some felt emotionally blackmailed into handing over money which we may not have had to give. But since we were white people, it was just assumed we did have the money.

The third issue raised was that – we were asked to help these three women in front of an entire ward of potentially equally deserving patients. No consideration was given to their needs which could have caused a rift between them and the women we did help.

So the ethical sensitivity of the director making this request was raised. Was it ethical to ask us, and to ask us in such a way?

Why would you give the money?

Again three main issues came up to support giving the money.

Firstly, when it comes down to life and death and when faced with human suffering so starkly, surely compassion rules out any other consideration. We were called to step up and help, regardless of our own ideas on ethics. Surely that is the business we have signed up to as Global Health students.

Secondly, the director’s responsibility is to the patients and he did what he had to do in order to protect and alleviate the suffering of three of his patients. Surely that is the most ethical thing a director of a hospital can do. He clearly cared for these people and had no more to give himself except to plead with these visitors to his hospital.

Finally, we didn’t have to give. Despite the pressure of expectation from such a request as we looked on at these emaciated woman, ultimately we had a choice. Perhaps if it was hard not to give, it was because giving was the right choice not because the request was unethical.

To save one now or many later?
To save one now or many later?

So to give or not to give?

There is no clear answer, certainly from the later discussion we had. Individually, we all made a choice to give or not to give and no one needs to declare if they did, or didn’t. But as a group we failed to reach a consensus about what was right. To me, this is not a failing on our part but an example of the difficulty of aid and development. There is the short term aid, of which giving money to a starving family falls under. There is a critical and immediate need, like that often seen after a disaster or war that needs an immediate response. But we also need people with a long- term view focused on fixing the system, so that one day there won’t be a starving family to ponder over.

So the only this left to say is “would you have given the money?”

Feel free to comment below letting us know your answer to the question.

*mzungos is the Swahili word for European/ white people

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