Spare change

Arvind Iyer, one of the most intellectual personalities I have had the fortune to call my friend, sent me this link echoing the question asked at the very end of the video (which you must watch), “How can anyone fail to want to help these people?” For those of you spoiled by executive summaries, I’ll indulge you and give you a gist of what the organization 50pence.org seeks to do. Their contention is that with just 50 pence (75 cents), you can buy a person treatment from six debilitating or fatal diseases for one whole year. What person, except for the sado-psychotic, would not offer their money for a cause as ridiculously important as saving a life? Yet, we all do it routinely. All of us hold on to our purse strings and those 50 pence never really reach the people to whom it means so much more. It’s plain that our miniscule donation could save a life, and yet, we fail to make that donation. What gives?

The answer lies in a thought exercise that I encountered as a graduate student at Harvard. During a lecture on ethics by the exceptional Daniel Wikler, he told us to imagine a scenario. This is what he said, “Imagine there’s a button on the wall. Every time you press it, a life somewhere is saved. Every single time. Will you press it once?” A couple of bewildered looks later – this was the school of Public Health, after all – there was general agreement that the button would be pressed once. “Would you press it twice?” Dr. Wikler countered. “Of course”, we all yelled. “How about 10 times?” “Definitely.” “A hundred times?” “Bring it on!” “Ten thousand times?” After the slightest hesitation, “Why not?” Then, he said, “How about the whole day? No bathroom breaks, no breaks for lunch, no breaks for sleep. Nothing.” We now knew where this was going; and we didn’t like it. I mean, what do you do when nature calls?! He didn’t leave us thinking too long. “How about for the rest of your life, you keep pressing that button?” Of course, the question was a rhetorical one, but its power was not lost on any one of us. Here we were, eager public health professionals, having dedicated our entire existences to saving lives through the world by any means possible. Here we were, and when we were offered something as simple as a button to save lives, we were reluctant to use that facility for the rest of our lives. Gosh, we balked at committing ourselves to it for even a full day.
Essentially, the matter comes down to how we think at the margin. After the ten thousandth button-press, do we think of the ten thousand lives that we have saved? Or do we think of the one life that we could save by pressing it one more time? And then another, and another, until one reach six billion presses. It really does boggle the mind, and honestly, I do not know how I will react if I were to find the fabled button-on-the-wall.

Pressing that button on the wall is akin to donating 50 pence to deliver the life-saving treatments to those who need it most. In essence, every 50p donation is a button-press. If you plan on buying this BMW, you could as well have used the money to help 84,000 people for one year. My education at Harvard could have in fact bought services for 50,500 lives. The money spent on the opening ceremony at the Commonwealth Games in India one week ago would have brought the services to 42.5 million people. The math is staggering. Critics will argue and accuse me of being the cynic who knows the price of everything and the value of nothing. Admittedly, the above analysis is an oversimplification of much more complex economic forces that are at play in such calculations. Nevertheless, I believe it’s something to think about.

In the final scenes of Steven Spielberg’s “Schindler’s List”, Oskar Schindler, who uses his entire fortune to buy the lives of Jews who would have otherwise been executed at Nazi concentration camps, brings this entire conundrum to poignant, dramatic prominence. “Why did I keep this car?” he says, “it could have bought us 25 more lives…and this golden ring, it could have bought us 4 more lives.” That’s a dilemma to which I don’t pretend to have an answer. All I know, is that 50pence.org will continue to do the good work they do, while always being short of funds to save that one extra life. In the meanwhile, we shall enjoy our Lamborghinis.

Note 1: At the rate of 100 button-presses a minute, it would take 115 person-hours to save 6 billion lives; essentially, two life-times. If I find the button, will you find two volunteers?

Note 2: The author, sadly, does not drive a Lamborghini.