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More than Good Intentions by Dean Karlan & Jacob Appel (thoughts)

June 16, 2011

Yet another Netgalley read (I hope y’all don’t mind about one Netgalley title every week or two; I explained yesterday why I’ve become a fan of the site if you’re wondering, since I rarely read traditional review copies; as you’ll see today, how I acquire a book doesn’t affect how I wrote about it)! As regular readers know, I’m a huge international relations nerd, so I couldn’t resist this new Penguin title, which is a look at the practical aspects of development economics (aka attempts to end poverty), primarily microfinance. This is solidly popular nonfiction aimed at the lay reader, and the style is chatty and accessible, if at times too reminiscent of Freakonomics. I very much appreciated the book’s examination of how theoretical measures to end poverty actually play out in the real world, amongst real people and its resistance to a ‘magic bullet’ concept. I also found several of the studies enlightening and the reminder that poor people aren’t one homogenous group important. However, the whole book was embued with far too much unacknowledged Western privilege. This played out most obviously in the way that ‘studies’ were discussed. Now, in order to determine if anti-poverty measures actually make a difference and how much of a difference, Karlan is a huge advocate for control group trials, such as you would find for drugs. Yet, he never acknowledges the glaring ethical dilemma: by denying benefits to some (randomly chosen) people, or providing extra incentives for others, the researcher is harming real, live (non-Western) people in the name of knowledge. Of course, not everything is black and white; in some instances, no one knows if the new policy will actually help or hurt, and thus whether people in the control group or the experimental group will be better off in the end. However, in others, such as waiting three years to deworm the Kenyan schoolchildren attending the unluckiest third school of the program, the morality seems murky at best. I’m not saying such studies should never be conducted, but I found the lack of ethical discussion in the book disturbing, to say the least. Poor people are not lab rats, and as Karlan described study after study in which a computer program randomly affected individuals’ fates, I couldn’t help but wince. Still, it wasn’t until the penultimate chapter that I finally lost my temper. Entitled “To Mate: the Naked Truth,” it included such charming aspects as calling prostitutes ‘whore’ and ‘hookers’ (I understand that ‘good’ writing employs synonyms to avoid seeming repetitive, but the latter two words are in a different register and carry some nasty connotations), the assumption that all sex is heterosexual (for instance, in a study in Mexico on sex workers and HIV prevention, apparently no male prostitutes were interviewed, which I find to be an odd oversight, and anything but sex between a man and woman is never even mentioned), and a persistent refusal to acknowledge that just because a woman wants a man to wear a condom doesn’t mean he will do so. Seriously, in a chapter all about studies on condom use, not one paragraph detailing some men’s attempts to coerce their partner into condom-free sex? Or that the power balance between a fifteen-year-old girl and an middle-aged man might not be equal? Or that power is AT ALL an aspect of sex, paid for or otherwise? Straight male privilege, party of two!

Ok, I’m far over my word count and my hands are not amused, so I’ll have to wrap this up (and keep in mind, I can’t go into further detailed analysis or add a ton of disclaimers due to that pain, but I don’t think the author are horrible people, just oblivious at times). As you can tell, despite the book’s good points, I have serious reservations. If you’ve got a fair amount of knowledge going in and can look past the moral issues and general ickiness of the chapter on sex, you’ll definitely get knowledge out of it (I’m glad that I read it, despite my annoyance). But I won’t be putting it in the hands of readers who don’t already have enough background to see the privilege issues play out, which is a shame since that’s the book’s target audience. (Of course, once you’ve read a few of the books I list below, then you’ll have that background! hehe)

Suggested Companion Reads (linked to my thoughts)

  • The Body Hunters by Sonia Shah (I haven’t posted about this yet, but if your reaction to my concerns over running trials amongst the poor was “Well, otherwise they wouldn’t get any help at all, so it’s still better to conduct trials than do nothing” or something similar, you need to read this. It’s an examination of medical trials and how they manipulate/use the most vulnerable portions of society, both domestically and abroad; it’s also about why that’s so wrong, and Shah managed to destroy several of my own pre-reading beliefs, including the one I just mentioned.)
  • No Place Left to Bury the Dead by Nicole Itano and Half the Sky by Nicholas Kristoff and Cheryl WuDunn (These two are both in response to the sex chapter; if you’re looking for a good analysis of HIV/AIDS in southern Africa, I can’t recommend the Itano highly enough. And if you’re not sure how the gender disparity plays out in different cultures around the globe, Half of the Sky is perfect for those without much background. I never blogged about it, so briefly: it describes several of the biggest issues facing women on both a big-picture and individual level, why everyone should care, and includes suggestions for you to help, all in an imminently readable and engaging style; these two won a Pulitzer for journalism for a reason. As an international relations nerd, I’ll admit that I wanted them to go into more detail, but for the casual reader that’s not a problem!)
  • Bad Samaritans by Ha-Joon Chang and Dead Aid by Dambisa Moyo (If you’re more interested in the politics of development, and why many of the West’s efforts are misguided at best, here are two books written by non-Western economists than lay it out in smart, well-written detail.)
  • The End of Poverty by Jeffrey Sachs and The White Man’s Burden by William Easterly (More background reading on development: both of these titles, published by Penguin, are mentioned in More Than Good Intentions as representative of the two main Western development theory camps. I read them for school pre-blogging, so I don’t have posts to link to, but they’re seminal enough to include the list!)
  • Banker to the Poor (Read about the origins of microcredit from the Nobel Prize winner himself; this is primarily about Grameen Bank in Bangladesh and a fascinating read, although once I again I didn’t blog about it. Good background reading for the critique seen here. Yunus has two other books; Creating a World Without Poverty lays out his fascinating ‘social businesses’ idea and I’ve actually blogged about it! I’ve yet to read his latest, Building Social Business, which expands on the concept.)
  • Development as Freedom by Amartya Sen and The Bottom Billion by Paul Collier (Two more books on development economics; I haven’t read either of these. However, I have read Wars, Guns, and Votes,another of Collier’s critique of the developed world’s approach to the developing world, and was impressed. And when Sen was awarded the Nobel, it was in part due to adding an ethical dimension to economics, which I think this a good sign.)
18 Comments leave one →
  1. June 16, 2011 7:21 am

    I wanted to say that I love that you are including Companion Reads in your thoughts on different books. It is so helpful! Thank you for such a thoughtprovoking review.

    • June 17, 2011 7:09 am

      Thanks Zee! Drawing up the Companion Reads is my fave part of my new style; I get to indulge my list-making self but in miniature. ;)

  2. June 16, 2011 7:34 am

    I can’t help but saying that I completely endorse your companion reading list!! I’ve read (and really really loved) 5 of the books, have another two, and just added the others to my wish list :) And now I’ll say that I was cringing reading parts of your thoughts on this book. Eecks yep that would bother me too. But it does sound interesting so maybe one day…

    • June 17, 2011 7:09 am

      I should edit it to add ‘Endorsed by Amy’! You haven’t read the Sen, have you? He’s the only author I hadn’t even heard of before, which is weird since he won the Nobel and he’s Indian.

      • June 17, 2011 7:15 am

        I haven’t yet… but will be watching to see what you think :) He might end up on my wish list!

  3. June 16, 2011 9:18 am

    To echo what was already said, the associated reading is what gets me interested; I try to follow whatever Nicholas Kristoff is doing, because it always seems important and he’s a good writer.

    • June 17, 2011 7:10 am

      Agreed re: Kristoff! If you read Half the Sky, I hope you blog about it. :)

  4. June 16, 2011 5:11 pm

    I’ve read a few articles about the problems in education research when trying to do control-group-based studies, and it is a huge dilemma. Many Western parents hate the idea of their children being the subject of experiments, even when it’s for something where educators really don’t know which teaching approach is best and are trying to do research to figure it out. I hadn’t thought about this dilemma, though, it the context of global poverty. And you’re right, when it comes to something like an obviously helpful medical treatment, it’s hard to justify randomly giving it to some and not others.

    • June 17, 2011 7:10 am

      Yes! So many ethical quandries! You should read Body Hunters. :)

  5. June 17, 2011 4:14 am

    I read this one what I was doing my Masters in Development Communication. Appreciated his “popular nonfiction” approach to the “giving fish” vs. “teach them how to fish” schools of thought. I work in the area, specifically in access to renewable energies, and the most challenging part of our work is to made any of our actions long-term and “replicable”.

    • June 17, 2011 7:11 am

      I agree: I think some of the points were well emphasised, particularly the examination of how we should definite ‘successful’ development work. That’s why I was frustrated by the flaws!

  6. June 17, 2011 4:42 am

    Eva, you are so cool. Thanks for such athought-provoking review.

  7. June 17, 2011 1:09 pm

    Hi Eva,

    Your ethical concern is a common one, but the case is often that there simply are not enough resources to reach everyone anyway. It does not necessarily mean purposely withholding possible support from some people, it just means making the decision which would have to be made anyway about who gets support and who doesn’t, in actually arguably a fairer way; randomly. Furthermore when we don’t know what works it does make sense to learn rigorously first. Newly developed drugs are not just distributed to everyone because there is a need for better health, they are carefully tested, with control groups, until we are sure that they really work. We have these high standards for drugs because medicine is so important, but surely poverty is equally important?



    • June 18, 2011 6:04 am

      You’re setting up a bit of a strawman with the first part of your comment. The example I gave in my post was about Kenyan schoolchildren waiting years to be dewormed; despite the organisation’s ability to deworm all of the kids at once, they decided to divide them up into three groups and wait to administer the medicine to some children to study the effect. So it’s not a matter of limited resource distribution. And I never said it’s always wrong to do these studies; what I said is that the ethics of this need to be discussed and the book never does so.

      As far as your medicine : poverty analogy, I highly suggest you read the book The Body Hunters, which I listed first. The drug industry and its double blind studies present definite ethical dilemmas, and to get around these Western companies are increasingly moving from the more informed developed world to the less informed developing one. And our ‘rigorous’ criteria have become severely watered down over the years. Of course I think that solving poverty is more important than developing a better Vi*gra; however, I don’t think that the drug industry is the best model for ethics or efficiency.

  8. June 18, 2011 8:00 am

    I’m thinking that I’ll add your listed companion reads to my TBR list instead of this book. I’m really interested in reading No Place to Bury the Dead and I think that I’ll go reserve that one from the library. Great post!

  9. June 18, 2011 8:38 am

    I’ll probably be passing this one up but I love reading about your suggested companion reads! In this list I’ve read two and am definitely interested in some of the others. :)


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