Small Things Lead to Great Things

"Wherefore, be not weary in well-doing, for ye are laying the foundation of a great work. And out of small things proceedeth that which is great." -- Doctrine & Covenants 64:33

I at times get bogged down in my efforts to do good, feeling that things aren't moving quickly enough. However, I believe I am doing a number of small things that are providing some value today while setting a foundation for greater things to come. Reading the above passage today was a good reminder to keep things in perspective.

Without a Cell Phone I Am Nothing

When I first heard people in the economic development space talk of rolling out mobile phone networks to serve even those making less than $1 a day, I thought they were promoting a consumerism culture that would hurt the poor more than help them. I thought cell phones were a luxury good since even I had only recently started using one regularly.

After traveling to Zambia last October, my perception is much different. I met Nell, a woman who buys tomatoes from farmers and resells them at the market for a profit. When I saw that she had the same model of $20 cell phone that I purchased when I arrived in the country (since my BlackBerry wouldn’t work on the local phone system), I asked her why she uses a cell phone. She shook it in front of my face and said, “Without this I am nothing.” She went on to explain that since she travels miles into the countryside and transportation is very expensive, it is much more convenient and economical for her to call farmers prior to making a trip to their farms.

Basically, Nell uses a cell phone for the same reasons I use a phone: productivity and convenience. The difference is that when I got my first cell phone, I already hand a land line and a vehicle. So even though my first cell phone was largely a luxury, I would go so far as to call Nell’s cell phone is a necessity for her, enabling her to increase her income and raise her quality of life.

A key takeaway for me from this experience is to not rush to judgment before fully understanding the context. And in order to understand the context, it is important to get out and do field research.

Universal (But Unequal) Healthcare in Brazil

I recently traveled to Brazil for a medical conference, and according to the surgeons and businesspeople with whom I spoke during the trip, healthcare coverage is something that is available to every Brazilian via the public hospital system. However, that doesn’t mean that all people receive equal healthcare treatment. Of Brazil’s approximately 200 million residents, perhaps 20% of them, or 40 million, have private insurance that offers reasonable coverage. Among the ~40 million insured by the private sector, plans vary widely in what is covered. There’s definitely a “bargain” option that covers less, while premium offerings can provide state of the art care at top facilities such as Albert Einstein hospital in Sao Paulo, which I’m told is on par with other top hospitals in the world. Out of a sense of duty to serve mainstream Brazilians, as well as out of a desire to feel challenged, most surgeons in Brazil work at both a private and a public hospital.

There is much talk about universal healthcare in the United States these days. I am by no means trying to hold up Brazil as the model for healthcare in the US. But as a country with a per capita GDP of $10,300 vs. the United States’ $48,000, Brazil shows that some degree of universal healthcare can be offered to all citizens, even of relatively poor countries. In per capita GDP terms, Brazil ranks 103 out of 238 countries in the world.