"The glory of God is man fully alive, and the life of man is the vision of God." -St Irenaeus of Lyon

Posts tagged “life in general

Thinking about Schumacher

International development creates funny and interesting policy spaces when you start to think about prevailing processes.

E.F. Schumacher is an author who has fallen out of fashion in development. In 1973, he wrote a book called Small is Beautiful which springboarded the appropriate technology movement. Largely I think people missed the big idea behind his thoughts and zoomed in on a particular (likely perceived to be easy) strand of his thinking. Appropriate technology became almost synonymous with non-governmental organisations trying to give away random agricultural implements. Yes, I am being deliberately uncharitable in my thoughts regarding the appropriate technology movement but I see Schumacher’s argument being picked up again by Yunus. Yunus argues for microcredit to spawn business enterprises, looking more at entrepreneurship as a route out of poverty.

But I have been watching the news to see what’s coming out of the United States as it relates to job creation, reading far too many books, and thinking big dissertation thoughts. One big idea contained in Small is Beautiful concerns the cost of job creation. It seems that capital level investment largely determines worker salaries… at least trying to read Schumacher’s analysis. I am not an economist nor do I play one on the internet… but this thought intrigues me.

Right now the main piece of “capital” at my disposal is my computer. Roughly, my computer costs $1200. The challenge for me is to leverage this capital to create some broader income earning strategy for myself. As a graduate student, I can roughly expect a salary around $12000, largely “earned” through putting my computer to work for me to make connections with knowledge spaces relevant to my field of study. But really, anyone with a computer could ostensibly put that computer “to work” in a way that generated a broader income.

The challenge then becomes creative positioning. If I try to save $1200 during one year, how could I reinvest that $1200 in a way that creates a broader stream of income? I could, for instance, broaden my life experiences by spending that $1200 on a perspective widening trip or an educational experience. Schumacher is rather big on honouring “the human substance” so spending that $1200 on personal wellbeing is in game. But this lump sum savings amount is 10% of my annual income.

Check it: when you look at Muhammed Yunus’s work, this regular small savings amount actually guides some of the principles behind microsavings. The idea behind microsavings seems to be that if the poor can save, then they can also invest in a business. Similarly, microcredit functions in a way to try to help people get towards microcapital.

My computer is a form of “microcapital” that actually seems to be doing rather well for me at the present moment. But I wonder if one of Schumacher’s critical observations was that this appropriately sized micro-capital (sized at 10% to 100% of a person’s income) really doesn’t exist very well among the world’s poor.

Paul Polak made a name for himself by mainly talking to farmers and identifying key capital gains that could improve their livelihoods at scale. His best known interventions are small-scale drip irrigation systems and treadle pumps. Many non-governmental organizations talk about the $25 treadle pump. WAIT. If someone is making less than a dollar a day, then that $25 treadle pump is right at that sweet spot of 10% of their annual income. The farmer who gets a pump (or a drip irrigation system) is in a prime place to actually utilise farming knowledge to make the technology work for her or him.

But there’s a question still about job creation. When I use my computer as a graduate student, I’m honestly not having a go related to my own entrepreneurial skill and talent. In a previous life, I had a gem of a boss who said, “Be careful with this machine. It is worth 5 graduate students.” Imagine Schumacher said that though. The capital investment from the machine gave 5 graduate students employment. When you put 5 of us in the mix at roughly $40,000 a year for related costs, then you have a machine investment of roughly $200,000. [I actually did try to cost a micro-CT scanner to see if that number has any bearing in reality, but I couldn’t easily find a website making the price of that particular technology visible. Whether that machine was fully utilised in employing 5 graduate students is an honest question.] The raw capital investment of an annual salary creates an opportunity to earn an annual salary.

What happens though when the technology cost needed to do a particular job far exceeds the available salaries in an area? Here I’m thinking of landless persons. What sorts of technology, scaled at roughly $300, have the potential to create an authentic fully realised job? Most of the landless generally rely on their body and skill set to create a job for themselves. But what if there were a way to transfer some sort of machine that would enable them to effectively stair-step to the next level?

As I have been working on my MA, it is hard for me not to think about asset transfers and social protection. I think the main “technology” at the annual income level is a cow. But what if there were more options? What if there were more options for the types of businesses that the poor tend to run that created opportunities for reinvestment at 10% of the annual income? Recognising that the body is the core asset of persons, what would it look like if the poor had options other than investing their 10% back into managing their medical expenses? What if non-governmental organisations (or a broader social movement or the private sector) thought about ways to improve access to durable material goods connected largely with a vision of a particular person?


What is “Vulnerability” All About Anyway?

As an academic who regularly conceptualises about poverty and vulnerability, I get into a lot of back and forth arguments with people about the nature of poverty and vulnerability. Everyone thinks they know something about both of these concepts. To some extent, everyone does know something about both concepts. But it’s tricky when we try to generalise from our own experiences. What follows is one of my more readable syntheses on the nature of vulnerability. Should you want full citations, I’m happy to provide. One core citation is Paul Farmer’s Pathologies of Power: Health, Human Rights and a New War on the Poor. Strongly recommended.

I want to ask the reader to think about vulnerability and deliberately invite the reader to think of an infant known personally by the reader at some point in the reader’s life.  At the most basic level, what does an infant need?

When I did the exercise above, my one word answer was “care.” My friends welcome new babies into this world constantly. Almost everyone my age has direct, full-time responsibility for an infant. Conveniently, I do not have children of my own so I can stay out of the “fog of war” of the daily parental struggles associated with caring for children and notice some themes across the experience. In caring for infants, fears regularly collide with hopes. Parents want their kids to be healthy, happy, successful, and cultivate a broad sense of being able to have fun living life. Almost without fail, parents rejoice when these desires seem to be “on track” and mourn in seasons where these desires seem to be little more than pipedreams on a rainy day.

Measuring these conceptual insights against the literature, many people have written about analyzing failures to be healthy, be happy, and develop capabilities for life. Some physicians like Farmer recognize that “to be healthy” requires a lot more than simply bodily integrity. To Farmer(2004), “health” involves a holistic sense wellness that enables the poor people to realise their social and economic rights. To use Farmer’s criteria of discerning decisions that most prefer the poor, I demand evidence that the poor describe their poverty in terms of health and/or wellness. A major project conducted by the World Bank to ask people about their poverty indicates strongly that the poor view their principal challenges in life related to failures to achieve wellness. Building from the voices of the poor, advocates for the poor assert that wellness has dimensions of material wellbeing, bodily wellbeing, social wellbeing, and security while permitting freedom of choice and action (Narayan et al., 2001). Further, development scholars (Gough and McGregor, 2007) have begun the arduous task of synthesizing a vast volume of work across a range of scholarly disciplines to advance a more rough-and-ready wellbeing framework for use in development policies.

Thinking about caring for infants, I observe people differ. After all, no two infants are exactly the same. Even when infants live in the same family, their caregivers quickly realize that each infant represents a unique person and needs a different approach to care.[1] When theorising about the nature of individual care, Sen identifies at least five categories that change the basket of the goods and services needed by individual persons for human flourishing: 1) personal heterogeneities like age, gender, or disability, 2) environmental diversities largely presented as climatic regimes, 3) social climate concerning the overall quality of common public goods, 4) relational perspectives as to how one navigates various norms and customs in communities, and 5) intra-household patterns of distribution related to providing care (Sen, 1999, 70-71). Using Sen’s analysis (1999) encourages thinking about people as individuals, acknowledging that certain decisions, such as allocating resources within a household (1983), may be nearly impossible for an outsider to see.[2]

[1] The observation of no two infants having identically the same needs holds true even amongst the identical twins I have met.

[2] Sen’s framework can be misused, particularly when applied to the identification of vulnerable groups and in no way should be understood as the only framework to discuss wellbeing at an individual level. Sen’s conceptualisation around entitlement theory and development as freedom represent watershed moments in the intellectual history of analysing poverty and vulnerability.


The Double Whammy of Welcome

As I interact with the world around me, I see that “Welcome” is a contested concept. Generally, we begin with the operating assumption that few things are more important than to be perceived as welcoming. With the world vastly estranged from one another, pursuing reconciliation means being a people of welcome.

But the double whammy of welcome is that we often expect people to come to us. That is to say, we posit ourselves as being the welcoming rather than the welcomed. Being the welcomed can be challenging and hard. Being the welcomed requires taking a moment to pause and see what’s going on.

For instance, monasteries in the Christian tradition tend to focus on practising hospitality. They have a sacred duty to welcome the stranger without expectation of return. But when one goes to a monastery and receives their welcome, one has an opportunity to learn to be a guest. And I love being welcomed by a monastery. Yet, the more I receive the welcome of the monastery, the more I want to be accepting as much hospitality from them as I can. I want to express authentic appreciation for the food they serve me, I want to breathe deeply in the space of silence and receive the silence in joy, I want to join them in their life of prayer (even as that means crawling out of bed before sunrise for at 0300 or 0500). I  hope they forgive me for being sleepy while they pray and can see my intention of engaging with them in their life.

But if I were to say that monastics would be more welcoming if they did not choose to pray at O-Dark-Thirty, then I think I have violated the sacred trust that makes hospitality possible. It is true that I do not have to go join the monastics at prayer, although I have gone to visit monasteries that make an explicit request at the outset that travellers to the monastery make every reasonable effort to attend the prayer services. With the plethora of options afforded to me as a traveller in the modern world, I am not exactly forced ever to accept the hospitality of a monastic.

Receiving the welcome of others often requires surrendering aspects of one’s own preferences. When a vegetarian friend offers to make me dinner while I have a meat craving, I have a choice: I can forgo temporarily my desire for meat to accept freely my friend’s hospitality or I can constrict the available options for my vegetarian friend’s hospitality to the point where my friend is forced to accept my hospitality. I can even go so far as to assert my meat craving, my desire to cook meat (and only meat), and reach the conclusion that I simply must pass on my friend’s invitation for dinner all together.

As an ideal, “You are welcome here” sounds absolutely amazing. I’m welcome! I’m welcome! I’m welcome! But to be welcome, I’m required to receive something. Being welcomed requires joining myself, at least temporarily, to another’s experience. Being welcomed means turning off the intrinsic complainer to accept the gift for what it is.

So, on the balance, being welcoming requires creating space to accommodate people. Sometimes it is physical space. My current living space means it’s really hard for me to welcome more than one person… and even that’s awkward because the table in my kitchen doesn’t sit two comfortably. To welcome someone to sit around my table, I honestly have to bring my table into my bedroom.

Yet, being welcoming requires having something to offer. The hard part of being welcoming is that someone might absolutely refuse what you’re offering. People might have good reasons to refuse what it is that you’re offering, but ultimately you need a space to be yourself. Someone might choose not to receive the hospitality of a monastic community because they experience difficulty breathing in a desert climate. Placing a monastery in the desert does not mean that the monastery is unwelcoming; it means that the monastery invites guests into the desert. If I extend hospitality to another person by offering them a meal, I am constrained by my cooking abilities and my budget. But to extend someone the hospitality of a shared meal, what I have to offer is my shared food. My friend might need to refuse for a health reason (like they will puff up like a balloon if they eat shrimp), but I cannot be faulted for trying to offer my friend shrimp.

Life happens at the pragmatic interface. Extending a welcome really does not mean much without some authentic giving. If all we give is a statement of “Everyone is welcome” then we wind up with a collection of people who can receive that statement. It sounds great. It really does not help people understand what welcome means. I could say “Everyone is fantastic.” Without some effort to say what I mean in word and deed when I say “fantastic,” the phrase will ring empty. From my vantage point, welcoming requires providing some translation.

I’ve also discovered that welcoming sustains itself when otherwise autonomous folks decide to stick around to be welcoming. One of the reasons why monasteries can be welcoming places is that they have monastics do to the welcoming. Those people at the core of any group focusing on extending “welcome” need to have a sharp vision of what that welcome looks like. Does it mean that the group stays in one geographic place so others can come? Does it mean that the group travels together to go towards others? What is the rhythm of life associated with being welcoming? Welcoming is nearly worthless without some concrete reality.

In the English language, it is customary to say “You’re welcome” after someone says “Thank you.” It’s one of the first things parents tend to teach their kids. To say “Thank you” one needs to express gratitude. Welcoming, giving, receiving, and gratitude get lumped together in a package. In teaching please, thank you, and you’re welcome, elders invite the younger to become people who can give and receive hospitality. Giving and receiving hospitality involves a growth trajectory. We can (and we do) grow and change in how we receive hospitality from people.

The double whammy of welcome is that to welcome we need to be in relationships characterized by giving and receiving. Giving and receiving involves concrete whats that can absolutely be refused. If we actively refuse someone’s hospitality, it strikes me as a categorical error to say that person is not welcoming. Generally, I think we use the phrase not welcoming as a way to go after someone for not accommodating us. Seeking accommodation is a different space than seeking hospitality. But I think people often confuse the two, demanding that a host give the guest something the host is unable to give.

If all I have in my house is lemonade, I’m not going to be able to accommodate your desire for Diet Coke. If you can accept my hospitality, I’m happy to share my lemonade. But I have lemonade to offer.

Following the money

In a follow-up from my post on Tuesday about the role of the government, I stumbled upon an article describing how the German government functions relative to spending.

I found the article compelling on several points and thought it made sense to see how some of the observations I made on Tuesday might play out in a case study. I suggested that the first role of the government is to follow the money, starting at the national borders.

Leonhardt offers another starting point in stating the German government has been “more ruthless about the wasteful parts of government” while making the observation that German economic growth “has not been concentrated among a small slice of the affluent.”

Tellingly, the German government looked expressly at their unemployment benefits systems that discouraged work. Specifically, the story Leonhardt portrays includes, “The able and healthy were matched with potential employers.” I generally dislike passive voice constructions, and here I have the honest question: matched by whom? And how? From the looks of the article, I would hazard a guess the government followed and tracked people into the job market because provisions were made to allow people to take work below their current benefits level without penalty. The time to gain skills in the workplace likely created a step-up effect where the previously unemployed could take on more responsibilities.

Additionally, the German government coordinated educational reforms, particularly geared around math, reading and science. The skills gained in these disciplines have immediate utility in a technologically orientated economy. [Some historians of ideas recognise that the US conceptions of technology build on a strong foundation of German philosophy and thought.] With the proper training, educated Germans could move into the economy more effectively, reducing the overall need for a later step-up effect.

Yet, then the article goes into the place where I think most Americans would want to turn a blind eye. Leonhardt claims that in a market economy, the central role of government is regulation.

Regulation has a rather nasty image, but I would like to offer a different starting point for thinking about regulation: the regulator worn by SCUBA divers. The regulator worn by SCUBA divers directs and controls the flow of air so the diver can breathe. If the air can’t flow, then we have a problem. Similarly, if money doesn’t flow, we have a problem. If money doesn’t flow, then we call that problem “poverty.”

In Germany, it seems as though regulation concerned principally the people at the bottom creating spaces for them to participate more fully in commerce. Preserving labour unions represented a big part of the government’s regulation, but actually making sure that the labour unions are functioning requires continuing to follow the money. The German government observes that wages for the middle class have risen in parallel with the wages of the top earners.

I’d also like to posit this observation: if the government places meaningful efforts to help its citizenry develop professional skills, then it makes sense that the government might want to ensure that its workers are able to move those professional skills across the borders in a global economy. After all, that’s where I contend that we start following the money anyway.

The Missing Middle

An unfortunate truth, things in the middle (be they children, book chapters, schedule of the day) tend to get overlooked. We often concern ourselves with the extremes, modulating towards beginnings and endings. If things start out right, we assume that they are well on track for a good end. But we’re not very good at seeing the mundane, ho-hum aspects of daily life. After all, daily life happens in the middle of just about everything else.

This year marks 100 years since the birth of EF Schumacher. His main work is entitled, “Small is Beautiful: Economics as if People Mattered.” But as I read a piece in the Guardian today, I was struck by how easy it is to assume that small is simple.

Schumacher’s emphasis on what he called “intermediate technology” (neither basic nor large-scale) as the solution to many of the world’s problems led to the creation of the Intermediate Technology Development Group, now Practical Action, which recently hosted a celebration of his life. “A crank”, he said, “is a piece of simple technology that creates revolutions”. Nice.

“Intermediate technology” or really the technologies in the middle of the complexity scale. If we consider a crank, we’re not talking about installing a shelf, or bridging a small creek with a fallen log, or re-purposing a table as a chair. A crank, and other technologies like it, requires intentionality and consideration. The crank has a vocabulary of use that is slightly constrained by what the crank desires to achieve. When I think about my own experience with cranks, sometimes they are in challenging access points because of what motion they want to produce. When we start talking about cranks, we have to consider mechanisms.

I think that engineering and business complement each other nicely in this occasionally confusing middle space. After all, these technological challenges go just slightly beyond the materiality that everyone takes into their own hands. Someone might see problems of trying to ride a bicycle at night. Trying to rely on a massive infrastructural system where we install various sorts of beacons might not actually get at the core issue of riding a bicycle at night. A middle solution might be looking at how to attach and power a light on the bicycle itself.

The middle space requires deep knowledge of circumstantial particulars. Because the particulars constrain the available options, these middle spaces almost have the allure of compelling objective reality. The middle space creates choice because it zooms in on particular needs.

Tuesday Tremor: What is the role of the government?

It’s been a while since I’ve been at the blog. Graduate school is rather fantastic at getting in the way of one’s education. But I have been spending the last 8 months thinking about how loosely organised human beings can make a difference to the world’s poor. And today I embarked on a discussion that made me think a little bit more deeply than I had reflected in a while.

This post is an initial muse on the role of the government as it relates to poverty alleviation. I know I have grossly oversimplified principles of economics, political science, sociology, and likely every social science discipline one can think of. Please be kind to a bemused engineer in your comments. I’m likely to pick up with interesting comments in future blog posts. Feel free to read along and think with me as you will.

Poverty, typically conceived, zooms in on what a person lacks materially. The World Bank looks at expenditure (what people buy) and consumption (what people consume) to gain some sense of whether a person is poor. Typically, we think of poverty in terms of money, but a lot of the concerns at the World Bank at the moment involve food. [The world’s poor “work” disproportionately as subsistence farmers with some wage-earning activities so you have people trying to eat both by growing their own food and working for money.]

Yet, poverty has an structural twin: inequality. It’s not exactly a new problem. Entropy aside, stuff builds up in rather predictable places. I know that my dirty clothes will likely pile up beside my bed unless I actually expend the energy to move them into the dirty clothes bag. I know that soda cans will likely pile up on my desk as I’m working on a term paper. I know that spare change piles up on my bedside table. The behaviour of dirty clothes, soda cans, and spare change is all predictable. Moreover, the creation of dirty clothes, soda cans, and spare change happen over the course of daily living. In my mundane expression of living my own life, I have things build up in predictable places. And really, my parents will be the first to tell you that I could benefit from some regular engagement with someone who cares about the condition of my flat.

Generally where we have poverty, we also have inequality. And where we have poverty without inequality, we have some huge problems.

So really, I think one of the first roles of the government is to follow the money. Interestingly, in the United States, the Treasury is one of the original 4 cabinet level positions outlined in the Constitution [alongside Foreign Affairs, War, and Attorney General]. Unfortunately, I think some people might read that sentence and think that I’m asking the government to keep an eye on the spare change atop my dresser. I’d like to propose an alternative starting point: the national border. Every government has some territory that it tends to. Living in the world increasingly means that you have people, stuff, and money crossing the border. Money tends to be exceptionally strange because the government usually provides a very valuable service at borders: letting things in and permitting things out. Therefore the government makes money at the border. We see some of the largest exchanges of money at the borders. By having a good and solid system to track money, the nation has sound financial policies that allow the government to protect natural resources from undo exploitation, streamline economic processes through transparent mechanisms that prevent corruption, and identify big giant huge economic players with a plethora of resources.

The border is also a space to check for the diversity of actors that ensure an attuned market place. Do people have legitimate choice for providers? Increasingly, we trade not so much with other nation-states (do we really have all of the tea in China?) but with multi-national corporations. These multi-national corporations tend to follow money around much like the government, only with some very different reasons behind following that money.

When a government follows the money, I think the government benefits from asking where the money is not flowing. If I start at the borders, the little places that are hard to reach in the middle of the country are the least likely to have money flowing around in those places. Where the money doesn’t flow, we may find ourselves looking at poverty. Money moves around to indicate consumption exchanges. And money flowing makes the economy run. Finding out where money does not flow invites further investigation.

The government, keeping track of what’s going on at its borders, has resources to figure out what’s happening within the borders. If the government only looks at its borders, then we’re dealing with my spare change problem on a much larger scale. For the most part, people and goods move past the borders. In doing people things, the money flows pretty naturally. The government can watch the money like a nice flowing stream, with different things springing up to life along the flow of money. To continue with the water analogy, the government benefits from locating drought and flood conditions.

The problem with floods of money is that most people don’t experience the flood of money as a bad thing. But much like my cans of soda, the money pools in predictable places where some people can’t access the money. Now, money might pool in urban areas because businesses find it easier to do business in urban areas. A government that notices that money pools in urban areas can work with businesses to create new market opportunities for everyone. The government’s perspective adds value to the overall task of helping goods flow to the broader citizenry.

If money starts at the border, money is likely to pool at the border. The government has a ton of options when it concerns how to support business and industry in the middle. Sound investment can create new opportunities to make sure that various forms of stuff can leave the borders and go out to other countries. And so a government following the money knows what’s going on in a broader global context regarding what their people consume and what their people produce. Money flows might get knotted up because of fluctuations at a global level; governments can act to keep people relatively insulated from broader global realities.

As governments look to see where flows get cut off owing to broad trends, it’s possible for governments to become aware of the people wholly outside of the whole money game. And again, the word for government action here is options. Just like most people aren’t the big giant huge entities moving stuff constantly across the border, most people aren’t wholly outside of the whole money game. A government works well to be mindful of these people at the very bottom. Knowing what’s going on at the very top and knowing what’s going on at the very bottom helps the government be a good tying-together force in society. After all, at the very bottom, the money doesn’t flow.

It’s in this tying together that we encounter the stickiest wicket of them all: taxes. No one, particularly the people most poised to support the activities of the government, wants to do so with taxes. Yet, the government creates an environment to enable money to flow. If a doctor creates an environment to help a patient heal, we expect that doctor to be paid for the doctor’s work. When the government watches money flow around, the government watches for places where the money pools. Money can pool at individual levels through inheritance and massive mergers. But in both of these activities, the government provides a service.

Additionally, getting to know the people at the bottom helps us understand what might be helpful to start money flowing. For instance, a person may be working full-time but garnering absolutely insufficient resources. Something like living wage legislation might make sense. Another person might be working a range of jobs because of family obligations. Creating options for health care support, more flexible hiring, or respite for family obligations might make sense. Still another community might be completely out of the money game because all of the major employers left town. Working to harness the creative potential of that town along core economic sectors might prove exceptionally fruitful. The government may also discover needs in areas where markets consistently don’t work very well (especially in a locally-grounded service like education or natural resource management). Taking a long-haul look at service provisions might be extraordinarily fruitful.

The government should recognise where the government adds value to society (such as by tending to national border and enabling goods to move within the country) to generate the government’s income and invest accordingly along key priorities that improve the well-being of people apparently out of the game. I would contend that without looking at inequality, a government cannot look at poverty at all. Poverty exists mainly as a relative term with few absolutes. How can you know the poor if you don’t also know the wealthy?

As a final aside, I would like to point out that my suggestions involve the government focusing on the big giant huge players and the people completely sidelined in the system. Most people in the middle get concerned about being perceived as a big giant huge player. This post is called a Tuesday Tremor because it hits a bit of my nerve to post such a reflection. Again, please be kind in the comments.

The Inconsistency of the Ciderhouse Rule

The Ciderhouse Rules premièred when I was in high school. I know I didn’t see the film in the cinema, but I remember watching it shortly thereafter. The premise of the plot is the quest for a young doctor to come to terms with questions of abortion rights. The film tracks through a variety of elements, but the convincing argument comes near the end as our young doctor must contend with a woman suffering from a botched self-induced abortion.

The Ciderhouse Rule is that we should establish proactive measures to ensure that women have access to abortion services because women will seek the procedure anyway. Because people will go to desperate measures to access the procedure, medical doctors have an obligation to provide safe, reliable access to the procedure.

Increasingly, this particular justification of abortion strikes me as totally odd. For instance, we do not typically argue that youth violence needs a safe, reliable outlet. We do not focus on trying to convince a person engaging in cutting behaviour to cut more safely. These behaviours fall into a category of behaviour that we would like to see stop. Humans engage in all sorts of activity that is both dangerous and problematic. We don’t direct our energies into making things safer. We try to address the broader problematic.

Recently, I read about a woman so desperate for an abortion that she paid someone $150 to beat her until she miscarried. I’m struck not by the context of abortion in this story, but rather by the woman’s willingness to be beaten. This woman’s willingness to be beaten might have come principally from an emotional imbalance that lead to risky behaviours to seek validation. Was this woman not, in effect, screaming out, “I’m worthless!” with her choice of mechanisms? Might not that view of self-worth influenced what drove her towards a sexual encounter? It does not take much for me to see that the presence of a child is a symptom of a much deeper root cause.

Having a child occurs amidst an interconnected web of causal factors. Some of these causal factors are distinctly biological. But I also think these causal factors are influenced a great deal by social realities. It is much more difficult to parse the differences between young poor women unexpectedly pregnant and partnered professional women inconveniently pregnant at the “wrong time” in their career. Encouraging girls to pursue their education with a healthy self-esteem and regard for the integrity of their bodies requires a very different approach than addressing the need for financial stability in the midst of an insanely paced professional world.

It’s much easier to cite the problem with a lump of unwanted cells in a woman’s uterus and remove those cells surgically. Because if those cells just go away, then everything will be better. After all, routinised technology solves everything.

But we can also fall into a huge trap of embracing a technological solution. I cannot for the life of me understand why some people treat abortive surgeries as minor procedures. The people I’ve talked to regarding the procedural aspects of an abortion are absolutely shocked to learn that I stayed awake for my wisdom teeth extraction. They could recite danger upon danger of wisdom tooth extraction and didn’t differentiate between exposed and impacted tooth. But I think there is also something that when my doctor extracts my wisdom teeth, he has to look me in the eye. Dental surgeries are uniquely human in that regard.

Acknowledging the uniquely human dimension means that yes, doctors will need to be prepared to support women with a myriad of pregnancy implications. Some of these implications may come from self-induced procedures. Yet, acknowledging the human dimension means looking beyond the technology while serving the full person present before you.