FROM THE MEDICAL DIRECTOR'S DESK

Dr. Colin Butler

CHILD SPONSORSHIP

"By the time this ad is over, fifty-five children will have died". Much of the advertising in Western countries (the "North," the "First World") to raise support for the Third World (the "South") aims to do so by individual sponsorship. Ads claim that, by establishing a link with one person, Northern donors can overcome the powerlessness they frequently feel when the rich think of the global poor.

Global births exceed total deaths by more than ninety million per annum. Most of the global births--probably as many as 100 million-- are to the poor. To care for these extra children by sponsorship alone would require some 200 offers per minute, every minute. This is ludicrous, yet the sponsorship approach suggests that all would be well if only everyone in the North could sponsor several "Third Worlders." Unfortunately, the population of the South vastly outnumbers that of the North, and only a tiny minority are likely to be "rescued" by this approach.

Countries with extremes of rich and poor are characterized by the visibility of begging. Both Los Angeles and Bombay come to mind as cities with enormous riches and all-too-visible poverty. While a political attitude that condones such disparity prevails in these cities, begging and its companions crime and violence may be accepted as necessary evils.

According to the "Resource Demand Index," the average U.S. citizen consumes sixty-seven times the resources of the average Indonesian (O'Neill P.: Population summit condemns family planning cuts. BMJ 1993; 307:1162). Because the U.S. itself contains a significant number of the very poor, wealthy Americans (or Australians or Swiss) probably consume more than 100 times the resources of the average citizen in the South. In a world of such contrasts, global begging seems as inevitable as domestic homelessness. Perhaps it is this culture which endorses child sponsorship as a token "solution" to global inequity.

SELF EMPOWERMENT, NOT BEGGARY

During the civil rights movement in the U.S. and the anti-apartheid movement in South Africa, activists did not plead for sponsorship or increased welfare as a means for salvation. To have done so would have been degrading, legitimizing the injustice and inequity against which people daily risked their lives. Instead, these leaders demanded equal political and legal rights. So too, leaders in the South demand a fair go from the economic and political masters of the North. But their message is rarely heard.

Furthermore, there is no evidence that unqualified handouts are of much benefit; indeed, the evidence from the welfare state in the North suggests handouts might be harmful, particularly by reducing self reliance. Our own experience in the South supports this. Instead, what we believe the South needs is what Australians call "a fair go."

Assessed by indicators such as infant mortality rates and literacy--improvements which the sponsorship ads claim to foster--both Sri Lanka and the South Indian state of Kerala are doing very well, despite very poor per-capita incomes. It is no coincidence that both places have relatively evenly distributed economic resources and cultural traditions of self reliance.

Countries such as Zaire and Haiti, on the other hand, have appalling health statistics and tiny minorities who are incredibly wealthy. In some Third World countries, corruption has been so spectacular that the personal wealth of their dictators is alleged to exceed the national debt of the countries they govern!

Sponsorship by the global community as a means to solve problems in the South is only a bandaid. not only are there insufficient people in the North to do this, but also no evidence exists to prove that doing so would be helpful. This is not to say that sending money to individuals with whom we already have a relationship is bad or should be stopped, any more than supporting a distant relative should be stopped.

Welfare has a place. There is no doubt that, if the world is to avoid mass starvation, large scale "food aid" from rich to poor will be required well into the next century. It appears that earthquake and other natural disaster relief will always be necessary. However, neither individual sponsorship nor direct aid alone will lead to a sustainable global future.

ALTERNATIVES TO SPONSORSHIP

In Catholic countries in the North, including Ireland and Italy, population growth is almost static. In contrast, Catholic countries in the South still experience high rates of population growth. Yet, almost certainly, these countries have a high but unmet demand for family planning. Transfer of contraceptive knowledge and technology from North to South would be a far more effective and cheaper form of aid than mass sponsorship. In other ways, including fairer commodity prices and transfer of environmentally sustainable technologies, the North can effectively help the South.

Lastly, international finances have to be restructured. An opportunity exists to write off parts of the massive Third World debt in exchange for the development of truly sustainable projects in the South, as suggested by Dr. Susan George. But loans that are given need to be properly used; too many of them have been squandered.

BODHI believes in a development strategy along the lines proposed by the Dag Hammarskjold Foundation in 1975. This emphasizes endogenous, needs-oriented, ecologically-sound projects that aim to encourage self reliance and structural transformation. Such an ideal is very hard to achieve, however, especially if it threatens the powerful. BODHI's Wild Dog Sterilisation and Eradication of Rabies (BOWSER) project meets many of the criteria endorsed by Hammarskjold; we have learned that, even so, there is a large gap between theory and practice.

In theory, sponsorship minimizes middlemen and trickles right down to the grassroots. This may not always be so, but it seems better than supporting the grandiose "development" projects, too often of the Southern elites, which again and again have failed to help the Third World poor. Finding and supporting genuine self-help movements, like Dawa Dhondup's T.E.A.C.H. projects, described in BODHI Times No. 5, is BODHI's alternative to both these paths.

These efforts in the South will not be enough. The North needs to develop confidence that releasing the strings that currently hinder global development will not lead to its own poverty, any more than the provision of domestic opportunities to the poor (as distinct from welfare) does. We have to convince our own political and economic leaders of this. Ordinary people were instrumental in reducing nuclear tensions. Ordinary people can insure that those in the South receive a fair go.


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