NickLaing
Bio
Participation1
I'm a doctor working towards the dream that every human will have access to high quality healthcare. I'm a medic and director of OneDay Health, which has launched 35 simple but comprehensive nurse-led health centers in remote rural Ugandan Villages. A huge thanks to the EA Cambridge student community in 2018 for helping me realise that I could do more good by focusing on providing healthcare in remote places.
How I can help others
Understanding the NGO industrial complex, and how aid really works (or doesn't) in Northern Uganda
Global health knowledge
Posts 16
Comments1031
I agree we don't ignore everything with a probability of less than 0.5 of being good.
Can you clarify what you mean y "50% chance of being very good?"
1) Rethink priorities give Shrimp 23% chance of sentience
2) Their non-sentience adjusted welfare range than goes from 0 (at 5th percentile) to 1.095 (at 95% percentile). From zero to more than a human is such a large uncertainty range that I could accept arguments at this point that it might be "unworkable" like Henry says (personally I don't think its unworkable)
3) Then After adjusting for sentience it looks like this.
Whatever way the cookie crumbles I think that's a lot smaller than a "50% chance of being very good"
Worldpop has taken this a step further and combined census population counts with house counts to estimate population.
We use this for our healthcare mapping tool health AIM to accurately estimate the population in healthcare "black holes" where we launch health centers.
https://health-aim.onedayhealth.cloud/login
The problem is that house counts alone doesn't get you to an accurate population estimate. You need to know the number of people living in each house, which varies wildly between direct staff. We used to use a world bank estimate of 1.8 per hut or something in our area but that's far too loose to check population estimates.
An interesting method might be to check world pop's estimates over specific small sample sizes and then physically visit those places and see whether the online counts were consistently higher, lower or similar to the real life counts. I would imagine with a few hundred samples of 15-30 households that might get close to answering the question (can't be bothered doing the power calculation). Could probably do that for somewhere between 50k and 100k for what it's worth.
I agree that there's a big difference between shrimps and nematodes, although the uncertainty for shrimp sentience remains extremely high, to the point where I think it's not unreasonable that some people consider it something like a pascals mugging (personally I don't put it in that category).
Yes shrimp "sentience" or "capacity to suffer" is less uncertain than a mite, but it's still very uncertain even under models like RPs which I think probably favor animals.
It's not that they've just worked on animal welfare. It's that they they have been animal rights advocates (which is great). Derek was the Web developer for the humane League for 5 years... Which is fantastic and I love it but towards my point...
Thanks for the clarification. I was indeed trying to say option a - that There's a "bias towards animals relative to other cause areas," . Yes I agree it would be ideal to have people on different sides of debates in these kind of teams but that's often impractical and not my point here.
I still think most independent people who would come in with a more balanced (less "cherry picking") approach than mine to look at the teams' work histories are likely to find the teams' work history to be at least moderately bent towards animals.
I also agree you as the leader aren't in that category.
I might well have overstated it. My argument here though is based on previous work of individual team members, even before they joined RP, not just the nature of the previous work of the team as part of RP. All 5 of the team members worked publicly (googlably) to a greater or lesser extent on animal welfare issues before joining RP, which does seem significant to me when the group undertaking such an important project which involves such important questions assessing impact, prioritisation and funding questions across a variety of causes.
It might be a"cross cause team", but there does seem a bent here..
1. Animal welfare has been at the center of Derek and Bob's work for some time.
2. Arvon founded the "Animal welfare library" in 2022 https://www.animalwelfarelibrary.org/about
3. You and Hayley worked (perhaps to a far lesser extent) on animal welfare before joining Rethink too. On Hayley's faculty profile it says"With her interdisciplinary approach and diverse areas of expertise, she helps us understand both animal minds and our own."
And yes I agree that you, leading the team seems to have the least work history in this direction.
This is just to explain my reasoning above, I don't think there's necessarily intent here and I'm sure the team is fantastic - evidenced by all your high quality work. Only that the team does seem quite animal welfar-ey. I've realised this might seem a bit stalky and this was just on a super quick google. This may well be misleading and yes I may well be overstating.
I love your framing of this cost and agree with your central thesis, that cash transfers to families with sickle cell might be more cost effective than general cash transfers, while not necessarily being the most cost-effective option. It may well be the most cost-effective of the projects you reviewed as well, so kudos for getting in behind this.
My criticism is more that if the NGO has a great database and connection with families with sickle cell, why not use that infrastructure and the money to help the kids medically in ways more effective than a cash transfer? Buying mosquito nets, deworming and I would argue giving proper medical treatment for sickle cell are more cost-effective than cash transfers.
In this case I would boldly predict you could do more good by actually providing the best medical care you could with that money rather than giving it to the family. Also in sickle cell where medical catastrophes are basically guaranteed, cash transfers might well get used up BEFORE catastrophes happen which would be tragic.
I'm assuming this stuff below is not readily publicly available in Cameroon - some of it might well be then you didn't
If I had 47 dollars a month to help kids with sickle cell I would set up accounts with local health facilities to provide these services for each kid.
1) Pay for the basic monthly meds for sickle cell (pen-V, folate, malaria prevention, pain relief) ($8 a month)
2) Most of these kids would benefit from hydroxyurea ($10 a month)
3) Send a motorbike to pick the kid to take to hte health center AS SOON as they get sick - fast access to healthcare is critical in sickle cell ($5 per month)
4) Administrating the project ($15 a month assuming something like one/two people administrating 20 families)
5) A pool of money which pays for catatrophic hospital admissions when needed ($9)
I might be missing something or overstepping with this suggestion but that's my hottish take ;) For background I'm a doctor here in Uganda with a decent amount of experience with Sickle cell.