Poor, Poorer, Poorest

Apologies for the long silence, and I hope I haven’t lost your attention entirely. I should be posting more frequently now.

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If you spend enough time in development, you are likely to start playing the “poorest of the poor” game. As in, “I work with orphaned children because they are the poorest and most marginalized children among millions of poor and marginalized children,” or “I work in post-conflict countries because they are so much more destitute and devastated than other poor countries.”

I guess on some level, that’s how I ended up in development in the first place. I was originally interested in poverty reduction and health promotion in the U.S., focusing on pockets of poverty in the inner cities, Native American reservations, and Appalachia and the deep South.

Soon enough, however, I figured out that even the poorest of the poor in the U.S. are well-off by global standards, and I set off for the developing world. I started in South Africa, a country with devastating poverty in the midst of dazzling wealth, with staggering rates of HIV and AIDS, and with the brutal legacy of apartheid still alive and well. And I spent time in Latin America, a region I love and in which misery persists – particularly among indigenous populations and other marginalized groups – even as countries stabilize and incomes rise rapidly for the middle- and upper classes.

But then you look around Mexico City or Johannesburg, and you realize that these are far from the neediest cases. These are the stars of the developing world, countries with growing economies and improving standards of living, countries with systems – private, state, civil society – that function more often than not.

And so you end up back in sub-Saharan Africa, a region with 34 out of 50 of the world’s Least Developed Countries. And you end up in a country in the “real Africa” (in contrast to South Africa), a country where the needs are immense and immediate.

You end up someplace like Sierra Leone.

And in a strange way you become accustomed to the conditions there. You become accustomed to the fact that the health infrastructure is somewhere between non-existent and barely functioning; that teachers don’t get paid and therefore don’t teach; that roads outside the capital are treacherous tracks of dirt and rocks; that there is virtually no public provision of electricity in the capital city (let alone the rural areas); that the government does little and the people expect even less.

And you start looking even within Sierra Leone – one of the poorest countries in the world – to find the poorest of the poor. Do I give a few coins to that begger? No, he’s able-bodied and only slightly disfigured by some disease or disaster. I’ll give them instead to the double amputee, whose arms both end a few inches below the elbow. Will I give my leftover breakfast to the Polio Brigade, an amiable gang of teenage boys in wheelchairs, racing on the strength of well-defined upper bodies while their gnarled and shriveled lower limbs fold pretzel-like below them? Nah, they seem pretty happy anyway, and at least they have wheelchairs and friends. I’ll give the breakfast to the woman by the cotton tree, either mad or dull or both, staring without comprehension at the world passing her by.

It’s a strange and vicious cycle, a sort of sympathy triage, and one consequence is that you start to overlook the misery of those along the way. If you’re not the most desperate person in the room, the most miserable I’ve seen today, then you’re not worth my time and psychological energy.

Another consequence is that you start to forget how extreme your situation is, that even those deemed “A-Okay” in your local triage are desperately poor and infinitely deserving by any comparative standards, that your own world is so uniquely destitute as to be almost beyond comparison.

Traveling to Malawi was a bit of a reminder for me of this latter consequence, this skewing of perspective that comes from living in the world’s second-poorest country.

Not that Malawi is exactly prosperous: according to the Human Development Index – a composite measure that takes into account income, education, and health indicators and then scores and ranks all the world’s countries – Malawi is 166th out of 177 countries in the world, just 10 countries “ahead” of Sierra Leone. The tiny, land-locked country is virtually devoid of mineral resources, and is one of the most densely populated countries in sub-Saharan Africa; as the U.S. State Department puts it, Malawi’s 12.5 million people live in a “land the size of Pennsylvania, with a lake the size of Vermont.” Nearly 90% of the population ekes out a living through subsistence agriculture. 14% of people aged 15-49 are HIV-positive; life expectancy at birth is just 39.8 years; and each woman will give birth, on average, to 6.1 children during her lifetime.

In short, Malawi, like Sierra Leone, is unacceptably poor. And yet, in the game of “the poorest of the poor,” Sierra Leone wins hands-down. Two thirds of Sierra Leonean adults are illiterate, compared to a third of Malawians. Half of Sierra Leone’s population but “only” a third of Malawi’s is undernourished. In Malawi, 17.5% of children die before their fifth birthday; in Sierra Leone, that number is 28.3% – nearly one in three.

Visiting Malawi for a few weeks, I was struck by the visible differences. The capital and even smaller cities are peppered with international corporate chains (Nando’s chicken, Shoprite supermarkets) as well as some (admittedly minimal) manufacturing. And there don’t seem to be nearly as many people lounging around with nothing to do. (In Freetown, street corners are filled with young men with nothing better to do than loiter, perhaps hawk some meager wares or money changing services, and watch the world go by.)

Paved roads stretch throughout Malawi, even along steep mountainous tracks, and though far from the smooth raceways we enjoy in the US, they are of reasonable quality. (In Sierra Leone, even the major highway between Freetown and the “second” and “third” cities – Bo and Kenema – is only smoothly paved for 20 miles; the rest is a mess of crumbled half-pavement, gravel, and dirt and rocks.) Government workers like teachers and nurses are provided with decent brick houses, a factor that might help ensure they actually turn up to work (though it doesn't ensure the clinics and schools have the supplies they need.)

All this is not to say Malawi isn’t in need of help. As my brother can attest, there are health problems and educational deficits and poverty to spare.

It’s just to highlight that there is a hierarchy of poverty in this world, and Sierra Leone sits near the very bottom. And it’s to remind me – and you – that Sierra Leone is hardly representative of the continent of Africa (and less so of the rest of the developing world.) Much of Africa is growing and developing and scrabbling its way into some share of global prosperity. The continent’s larger, wealthier, and/or more successful members – countries like Ghana, Kenya, or Botswana – increasingly sport a level of development and standard of living that contradict the common image of Africa, one of starving children, AK-47-toting militias, and bullet-scarred capitals.

Sierra Leone is an extreme, a country emerging from a decade of civil war and decades of governmental mismanagement, and with dramatic shortfalls in infrastructure, industry, and governance, as well as every measure of human well-being.

So when I describe Sierra Leone, don’t imagine that I’m talking about Africa as a whole. The Kenyas and South Africas – not to mention Malawis – of the continent would be very disappointed if you did.