Normally, we focus on identifying outstanding charities, and minimize the time spent on opaque or otherwise lackluster ones. But lately, we’ve gone into a bit more detail about our take on several of the best-known and most appealing charities out there.

What all of the charities below have in common is that (a) we have major questions and concerns about their activities; (b) the information necessary to see how serious these concerns are does not seem to be available. (In most cases our assessment is based on significant back-and-forth with the charities themselves, though in some cases we are going off their website.)

• Kiva: commonly perceived as a way to (a) make interest-free loans to (b) entrepreneurs you personally select. In fact, it is neither. (See GiveWell Board member Tim Ogden’s summary of the recent discussion/controversy.)

  We ultimately see a Kiva “loan” as a gift to a microfinance institution, and we have major concerns about supporting any but the most outstanding microfinance institutions as well as concerns about Kiva’s due diligence process specifically.

  Full set of blog posts on Kiva

• Grameen Foundation and other large U.S. microfinance charities: in addition to our general concerns about microfinance charities (and the fact that these charities have not provided the information that would address them), we find that these organizations are rarely even clear about what their value-added is. Also see the disappointing (and eye-opening) evaluation of the Village Phone program.

  Full set of blog posts on Grameen Foundation

• Heifer International: commonly perceived as a way to “give a cow to a poor family as a gift,” but this is in fact a donor illusion -donations support Heifer International’s general “agricultural assistance” activities. We have concerns about this general area and concerns about giving livestock specifically. Neither Heifer’s website nor its grant application have provided the kind of information needed to address these concerns.

  Full set of blog posts on Heifer International

• Smile Train: Prof. Steven Levitt of Freakonomics sees it as using an innovative model to deliver cleft surgeries for $250 apiece. Our analysis suggests that it has “more money than doctors” and that it is therefore out of room for more funding. Smile Train’s recent removal of the charts we questioned and its own explanation of why it is giving grants to other major charities appear to support our analysis. In addition, we have major concerns about surgery charities that Smile Train has not provided enough information to address.

  Full set of blog posts on Smile Train

• UNICEF offers donors the chance to “buy” vaccines and other items. We suspect that this offer is a donor illusion, but the larger issue is that UNICEF provides almost no information at all about its huge variety of activities and how they are going. Most giant international aid charities (Save the Children, World Vision, etc.) are similarly complex and opaque, with CARE coming the closest to meaningful transparency.

  Full set of blog posts on UNICEF

• The Acumen Fund stresses its metrics-driven approach to “patient capital,” investing in businesses that aim for long-term sustainability (i.e., profitability) and social impact. As of now, we see no substantive available information about its track record.

  Full discussion

• The Robin Hood Foundation also stresses its emphasis on metrics, quantification, and analytical thinking. But we have found that it is unwilling to share any information about the results of its grantmaking. (Note that it also pushes the “0% overhead” donor illusion.)

  Full set of blog posts on The Robin Hood Foundation

• The Millennium Villages project states that it is “demonstrating that it’s possible to escape … extreme poverty” (front page of its website). As far as we can tell, very few results have been demonstrated to date, with a few boosts in crop yields as its main evidence of impact - evidence we feel is highly questionable.

  Full discussion

• The Worldwide Fistula Fund has been praised by Nicholas Kristof as “giving new life to the pariahs.” Our assessment is that the Fund is pushing a debatable agenda whose effectiveness has yet to be shown.

  Full discussion

• The Carter Center is, in our view, by far the “best bet” (for an individual donor, our focus) of the charities listed in this post. It has achieved substantial, demonstrable impact in the past through its work on guinea worm eradication, and unlike all of the charities listed above, it publicly discloses substantive technical information on the impact of its past activities.

  However, there is a crucial piece of information missing: how it allocates its budget between programs (in particular, how much it spends on its stronger and better-documented vs. more questionable programs). It has declined to share this (basic, in our view) information in repeated exchanges.

  Full set of blog posts on The Carter Center

We think the above charities are fairly representative of “average” charities in international aid. Some tell better stories than others and some have more disclosure than others. But in almost all cases, international aid charities are (a) carrying out complex projects that can fail to do good (or even do harm) in a variety of ways, and (b) not systematically sharing the information that would make it possible to assess how their work is going.

GiveWell is devoted to finding charities in which we can have more confidence. We’ll be discussing our two top-rated charities working internationally in forthcoming posts.

Nicholas Kristof’s excellent column describes the problem of obstetric fistula and the World Fistula Foundation.

We strongly share Mr. Kristof’s view that obstetric fistula is a pressing problem, and have written before that it’s one of the problems we’d most like to help donors address.

However, we still have not identified a fistula charity that we can be highly confident in. Here’s what we do know about the Worldwide Fistula Fund (WFF), the charity discussed in the column:

We’re confident that WFF is a legitimate operation working hard to address the problem of obstetric fistula. We’ve had significant back-and-forth with Dr. Lewis Wall, the founder and President of the Worldwide Fistula Fund.

Obstetric fistula is correctable, but the surgery is complex and may have a high failure rate. More at our discussion of the condition of obstetric fisula.

WFF’s current initiative is building specialized fistula facilities. The proposed plan (PDF) states that “cases such as fistula repair are chronically “bumped” from the surgical schedule by a continuous string of emergencies,” and thus that “without dedicated
facilities for fistula surgery, these operations will never get done.”

Is it the case that regular hospitals are unwilling or unable to treat fistulas reliably? Or might this approach represent an unnecessary diversion of resources from other pressing health problems (for example, pneumonia)? Especially if WFF’s focus is on lobbying the government to reallocate funding rather than using donations to increase total aid flows? At this point we don’t have the information to say.

We don’t know:

• The skill level of the surgeons that will be working at WFF’s new facilities, or the success/complication rate of their surgeries. Hopefully this information will become available in the future.
• The full story of what happens to the women who get corrective surgery. We have some information about the medical benefits of surgery, but very little about the social implications. To what extent can a “pariah” be re-accepted into her community?