NickLaing

Country Director @ OneDay Health
Working (6-15 years of experience)

Bio

Participation
1

I'm a doctor working towards the dream that every human will have access to high quality healthcare.  I'm a medic and director of OneDay Health, which has launched 35 simple but comprehensive nurse-led health centers in remote rural Ugandan Villages. A huge thanks to the EA Cambridge student community  in 2018 for helping me realise that I could do more good by focusing on providing healthcare in remote places.

How I can help others

Understanding the NGO industrial complex, and how aid really works (or doesn't) in Northern Uganda 
Global health knowledge
 

Comments
95

I can tell you the exact cost of ibuprofen 200mg here in Uganda right now is about 8.50 for 1000 tablets, and it will be very similar in Nigeria, so the price may even be cheaper than the hli estimate. I have big questions about the morphine office though which I will reply to later.

This is a fantastic post. I love the combination of real life stories,  logic and hope - all written in a pleasant and easy to read style. Nice one!

Actually haven't done second one yet, hoping it will be better haha ;).

I love this - with all the talk around, surely some more concrete action in reform can be taken that can benefit the community long term.

I like the idea of an "Governance, Transparency, and Reform Contest" contest. I don't think the prize would have to be so high to garner entries, as I think there is a lot of passion around this to motivate people as well. To raise the stakes, the competition could state something like "At least a portion of the proposal of the winning 3 entries would be enacted in some way by xxxx" or something like that. Obviously we don't know what decision making processes, community things or institutions would be suggested, but I think people would be incentivised to write if they thought it could lead directly to concrete action, however small.

Love that you fronted up with a bit of "skin in the game" too, very cool.

One big question is what exactly could be reformed and who would sign up to the reforming? Willingness to participate in this kind of process  would be necessary from CEA at the very least, then perhaps other orgs could voluntarily sign up to be part of it too.

Thanks I resonate with this too. I had a go at my first part post, before realizing from the comments it had probably been discussed a lot before so wasn't very interesting. I did try to search the forums first but obviously missed something. Second time better haha

Love it nice one Xavier! I completely agree with you, and I don't see the pledge as even having to have a direct relationship to EA. I think anyone could legitimately sign the pledge outside of any direct EA framework, giving money to whatever was in your opinion was an effective organsation.

"but it seems a lot cheaper to use existing literature on cash transfers (if appropriate) or to try to piggyback your subjective well-being questions into someone else's cash-transfer study for an analogous population" I really like this.

You are right again that two trials would show the bias separately, but doing 2 separate trials loses the key RCT  benefits of (almost) removing confounding and bias. Selecting 2 populations for different trials that are comparable is very, very difficult.

Thanks that makes sense! To be clear my criticism was specifically about what was said in this video about CATF AFrica, and not about CATF in general.

The pledge seems to have moved from more specific and concrete, to more general and flexible . The reasons for this you've outlined make sense, but it does now have a more "watered down", generic feel since the originals. I'm not sure there's any easy remedy to this though.

The one that feels t have the best balance to me is the middle one (copy pastad below) which doesn't have any blanks. There's strength and sense of comradery in everyone signing up t exactly the same pledge. I remember the pride in taking the hippocratic oath as a doctor. This retains the "10%" and "for the rest of my life or until the day I retire" rather than blanks to fill in.

"I recognise that I can use part of my income to do a significant amount of good. Since I can live well enough on a smaller income, I pledge that for the rest of my life or until the day I retire, I shall give at least ten percent of what I earn to whichever organisations can most effectively use it to improve the lives of others, now and in the years to come. I make this pledge freely, openly, and sincerely."

Jeff just answered this and I agree it's a good line now :)
My only tiny question to add is why do you need the "now and in the years to come" at the end of the second to last sentence. It seems redundant and doesn't add much flourish.  

But this is mostly my instinct and vibe, I can understand the reasons for moving in the direction you have!

I think that your idea of sham psychotherapy Jason is a great idea and could well work, although it wouldn't be ethical unfortunately so couldn't be done. Thinking of alternatives to cash is a good idea but hard.

I think the purpose of testing Strong minds vs. cash is good not because we are considering giving cash instead to people who are depressed (you are right about it not being able to scale), but instead to see if SM really is better than cash using the before and after subjective question system. If SM squarely beat out cash, it would give me far more confidence that the before and after subjective wellbeing questions can work without a crippling amount of bias, as cash is far more likely than psychotherapy to illicit a positive future hope rating bias.

  Would be interested to hear what's included in your "among other things" that you don't like about cash vs. Strongminds

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