You've reminded me about Dollar Street: https://www.gapminder.org/dollar-street/matrix which does the same thing as Children Just Like Me but online and interactive.

Hadn't thought of that - seems a likely explanation!

The discussion about Fistulas was here https://blog.givewell.org/2008/08/20/fistula/

In one of the discussions, a founder of Operation Fistula turned up. It's a horrible-sounding condition - described in the disability weighting as "has an abnormal opening between her vagina and rectum causing flatulence and feces to escape through the vagina. The person gets infections in her vagina, and has pain when urinating." It's caused if you don't have access to a C section when giving birth and can be remedied for $288. (The report's a little unclear, suggesting that the operation value lasts for 10 years - perhaps it stops working? Perhaps the lifespan of typical sufferers is in any case low?) Anyway, worth looking at if you are interested in this area.

Thanks for the additional readings. I think Paul Dolan is asking the right questions. I am disappointed that after a promising initial discussion eight years ago, Holden doesn't seem to have spoken again on the subject and to the best of my knowledge there is still no way on GiveWell to put different weights on "impact" to give different results.

I don't understand your last paragraph though. DALYs don't seem to measure economic effects on others at all, so if you do start to consider them wouldn't that be a big argument to make some DALYs negative?

NB smile.amazon.com works like smile.amazon.co.uk. Having written to Amazon Smile they responded: " We are currently working on expanding the AmazonSmile program to other countries.

You are correct in stating that customers can currently support organizations in one of the 50 United States, Germany, Austria, or the United Kingdom."

And moreover it doesn't just improve vision, it removes a source of intense pain.

A note on OPIS - might I suggest finding a way to separate your work on animal suffering from that on human suffering - at least for potential funders? Of course I can understand that you see work on both as important but there will be potential donors/supporters (myself included) who would be very inclined to support your advocacy work on easing provision of opioids for humans but who don't see the relief of animal suffering as a priority and who would not wish their support for one to be used for the other.

I applaud you for your initiative in taking this forward and I do think you seem to have identified an important gap in the existing EA approaches. They appear to see lives saved as the key metric where I would at least offer potential donors/actors the chance to prioritise life quality. I wonder, however (and apologies if this has already been discussed and considered - if it has please point me to it) whether it might not be still more cost-effective to target easily cured very painful illnesses like Trachoma. See this for example: https://www.ncbi.nlm.nih.gov/pubmed/16019692 which finds providing surgery costs from I$13 to I$78 per DALY averted.