Teaching someone to fish

The false dichotomy between relief and development

This article first appeared in African Business.

You know that phrase, “Give a man a fish, you feed him for a day; teach a man to fish, you feed him for life”?

Yeah, I hate that phrase; it creates a false dichotomy.

Why not do both? After all, it’s easier to learn when you’re not hungry.

We often construct a similar dichotomy in global health, pitting relief against development, and assuming only one should happen. For many valid reasons, that one is development. It’s a reductionistic view of global health, and it can leave patients behind. Yes, systems must develop, for sure, but in the meantime, what happens to patients while they’re developing?

One person dies every two seconds from a surgically treatable disease. [1] Over two-thirds of the world’s population doesn’t have access to safe, affordable, and timely surgical care, and nearly half the world’s population would face financial ruin if they accessed surgical care today. Strengthening surgical systems is a complex problem with significant health and economic effects: the lack of surgical access, for example, is estimated to decrease the gross domestic product of low- and middle-income countries by as much as 2%.