There’s a saying that I think about a lot: “If you can’t explain it to your Uncle Bob, you don’t understand it.” (Note: may be a rewording of a real saying, or not a real saying at all; I’m not sure. If it’s unclaimed, mark it down as mine, thanks.)

How many times have you sat down to write something – for a blog, for a report, heck, for an email – that you were 100% sure of, then realized as you were writing that you have to rethink things entirely? It happens. When you’re talking to no one but yourself, everything you vaguely recall and intuitively believe sounds reasonable; you’ve got no check on it. When you’re talking to your fellow Program Officer, there’s a little more of a check, but the two of you are still in the same bubble, and you can still use jargon to skip over concepts you should be reexamining. When you talk to your Uncle Bob, that’s when you have to be clear – and that means getting clear in your own head.

That’s why, as we’ve written up our reviews for our public website, our opinions have changed drastically. Because as I write a review, I’m not trying to explain my reasoning to Elie, I’m trying to explain it to Uncle Bob. I’m trying to put it down so I can literally send a link to my grandma and have her understand why I’d rather give to Year Up than St. Nick’s. And even before anyone actually reads it, this makes me think much harder about it, question all the little assumptions I’ve been making (without knowing I’m making them), recheck all the sources for things I’ve been vaguely recalling, and get really clear on what I think.

I put it to you that in terms of clarifying and improving your thoughts, there is no substitute for the process of explaining your decision to a general audience. Everyone who thinks for a living knows this. Except, perhaps, for Program Officers at foundations.

Cause what I’m saying comes down to this. I believe that what we’re doing is exactly what every foundation, everywhere, all the time, should be doing: documenting everything we decide, with links to every single material we used to decide it, and releasing it so that anyone can see it and critique it. The benefits are obvious in terms of public information sharing, but one of the lame objections that is sometimes raised is that documenting your views for the public is “too time-consuming.”

Well heck yeah, it’s time consuming. But not because of the typing – because of the thinking. We’re spending ungodly amounts of time writing up decisions we think we’ve already made … and we’re getting every second’s worth back in terms of improving our decisions, clarifying them for others and for ourselves. Even before anyone has jumped in the ring to challenge our views (and a few people have), we’ve gotten a good dose of skepticism, feedback, and improvement from Uncle Bob.

Every single foundation should be writing up its decisions in public. Uncle Bob is fine with that statement. Who wants to challenge it?

Look, another story where a foundation is accused of violating its original funders’ values.

It’s ridiculous to accuse the foundation. The funders violated their own values, the second they handed over their money to an organization set up to exist forever.

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Many moons ago, I listed the metrics we planned to use in evaluations. Well, here’s a shocker for you: when looking at actual charities’ activities, the reality is 10,000x as complicated as anything that can fit into these metrics.

We always knew we would run into the following problem: if Charity A saves 100 people from death and 1000 people from mild fever, while Charity B saves 150 people from death and 500 people from mild fever (assume the same cost), which is better? And we planned to tackle it in a slightly unusual way – rather than trying to “adjust” everything to the same terms (disability-adjusted life-years, or dollars of income gained, or some such nonsense), we would simply focus on how many lives were deeply changed. So in the case above, Charity B wins because it saved more people from death, and to heck with the fevers. Not perfect, but no solution to this problem is, and at least this approach is easy to understand and makes it easy for the donor to draw their own conclusions.

I reasoned that cases like this hypothetical should be rare anyway, as long as we’re separating charities into different causes (some aiming to educate children, others aiming to save lives, etc.) and only comparing charities when they share the same fundamental goal. For example, the charity that saves more lives is probably preventing more fevers too; when charities meaningfully diverge, it’s probably a sign that they belong in different causes.

Well, it hasn’t been even as simple as our messy expectation.

We initially wanted a cause to “save lives in Africa,” but we quickly realized that many charities are trying to prevent permanent blindness, debilitating skin disease, or a cleft lip that can lead to permanent malnutrition issues and ostracization. This isn’t exactly the same as saving a life, but doesn’t it seem pretty close? So we changed Cause 1 to “prevent death and extreme debilitation.”

Well, now we are in a pickle. What do you do when Charity A treats 10,000 cases of malaria and another performs 150 corrective surgeries? Now, bear in mind that malaria can be fatal; or it can lead to brain damage; or anemia; or it can just be a fever and stop there. And we don’t know how often it does each of these things (anyone have a source? Seriously, we can’t find it.) Now about those corrective surgeries. Some of them repair clefts (possibly, though not necessarily, life-ruining in the way described above). Others repair hand deformities or eyelid deformities, which we believe are usually cosmetic issues and not as bad as clefts (though how bad is the penalty for looking weird in these societies? We have no idea). And other surgeries are unclassified. Oh, and we don’t know for sure how many fall in each category – we just have to estimate based on past data.

How do you figure THAT one?

Here’s what I think. By default, I think the more comprehensive a charity is, the better. There are lots of things that make a community program – serving every need that everyone has – better than a narrower program (like running around distributing bednets). A more comprehensive program has tighter integration into the community, probably better relations with it, and better ability to observe it and make sure that people’s lives are improving on the whole (not trading some problems for others). On the other hand, there is exactly one thing that is worse about this approach – that you might help fewer people for the same funds. If malaria is cheap to prevent, running around and preventing everyone’s malaria could save many, many more lives than sitting in a village working on everything from AIDS to hangnail.

So, what I say is that the burden of proof is on the less comprehensive program to show that it’s getting much better results (same money) than the more comprehensive one. We’re still estimating our “dollars per life changed” metrics, using largely the same philosophy we started with – just focus on the really huge life changes – because we want to see if one program is obviously more cost-effective than another. If one program saves 10-100x as many lives as another (and I’d include cleft repair in “saving lives” for only this purpose), we’ll take our chances on it. But if it’s close at all, we’ll go with the communal/comprehensive program.

Since so much is unknown, that often makes things tough for distribution-type programs, but that matches with common sense too. If you’re trying to help people in a faraway land, you’d better be really confident to run around the countryside with nets, instead of sitting down in a village where you can see everything that’s going on.

So that’s what I’m thinking. Keep quantifying charity, as messily as we have to, knowing that we’re only going to use the wacky numbers we come up with if they show enormous differences in cost-effectiveness. Otherwise, we’re giving the edge to charities that work with one person/community at a time (instead of one problem at a time). What do you think?