My buddy Elie, a member of the GiveWell project and a passionate diarrhea guy, is trying to get you excited about the idea of saving lives for about $1000 a pop (see below). Hey, it is a good deal, and I agree with his take that repairing someone’s fistula is pretty comparable to saving her life. Why settle for pretty comparable, though? How much would you have to pay to literally stop a child from dying?

Turns out, the answer is less. Way less. For your real charity bargain shopping, go on down to Africa, especially the regions afflicted by malaria. According to this study, “About six lives can be saved each year for every 1000 children protected with insecticide-treated nets.” Insecticide-treated nets can be had through Nothing But Nets for a whopping $10 each (transportation and distribution included), and they last 3-5 years and generally cover 2 people each … which means buying 500 nets (for $5000) can cover 1000 children and save let’s say 24 lives over 4 years … which comes out to ~$200 per life saved.

Hang on. This is crazy. Let me say that again.

$200 to save a freaking life.

But that’s not all. The weirdest thing about Elie’s high-priced offer is that he’s forgetting about his own favorite cause, fatal diarrhea. This is one we don’t understand as well, largely because the organizations we’ve seen in this area don’t seem as careful about tracking their results. So I can’t give you an exact dollar figure … but I can tell you that an ORT, a tiny packet of nutrients that a child can swallow and ensure that he survives his bout of diarrhea, costs … wait for it …

5 cents.

There’s a word for this, friends. It’s called a bargain. We’re all familiar with the idea as it applies to junk: if someone cuts prices enough, you’re usually in, even if we’re talking about a DVD of Deuce Bigalow, European Gigolo. (Admit it, you smiled just now. No, I’m not proud.)

Well, it just so happens that this is your lucky day! Cause thanks to a combination of global disparities in wealth, ineffectively distributed charity, and horrible disease epidemics, SAVING LIVES HAS NEVER BEEN CHEAPER! WE’RE PRACTICALLY GIVING THESE THINGS AWAY!! ACT NOW BEFORE IT’S TOO LATE!

(And hopefully, this sale won’t last much longer.)

There’s a scarcity of $250,000 Ferrari 599 GTB Fioranos, and that’s ruining Christmas for 49 investment bankers who can’t buy the Christmas gift they want. I have an idea of what they can do with their money instead: Save 250 lives. How, you ask?

I recently learned about the problem of Obstetric Fistula. Briefly, childbirth is often more than a young, teenage girl’s body can bear, and it leads to, essentially, a hole in her body that does not close. Because of the hole, the young girl cannot control her wastes, and is often sent to live alone, far from other people. While these women don’t die, it’s hard to see the lives they end up living as anything much better than death.

Currently, approximately 2 million women have the condition, and the UN estimates that there are approximately 100,000 new cases each year. The Fistula Foundation and the UN claim that it costs $300 to perform one operation. (I’ve also seen estimates of $450.) We’ve found that a per-person cost estimates are often understated (ignoring necessary overhead, for example), so let’s be conservative and estimate the cost of curing one Fistula at $1,000. Assuming that there are currently 2 million afflicted women and that it costs $1000 to cure each, the total cost of curing everyone with Fistula is $2 billion. Assuming that 100,000 women are newly affected each year, it would cost $100 million/year going forward.

OK, not pocket change. On the other hand, this is the season of the Wall Street Christmas bonus, and stories abound with what the newly minted bonus babies will buy. The New York Times reported that Goldman Sachs will pay about $16.5 billion in employee compensation this year, much of it coming in year-end bonuses. Yes, that’s right. $16.5 billion. If each Goldman Sachs employee contributed 1/8th of their bonus, Goldman Sachs alone could essentially eradicate the problem of Obstetric Fistula. And that’s only Goldman Sachs. Well, that’s just Goldman Sachs - why put all the onus on them? CNN estimates that bonuses paid to the people working in the securities industrey will come to approximately $24 billion in 2006.

So, I’d like to offer a different perspective on bonus season. For each $5,200 hour you choose not to ride on a Gulfstream IV chartered jet, you can save 5 women. And, if you just can’t believe that there’s a dearth of Manhattan properties being offered in the $20 million range, don’t worry. You can spend $10 million on a starter apartment, and use the savings to save 10,000 lives.

Corrective surgery organizations love to make generalizations: $250 can save a child’s smile, $10000 makes children smile for miles, smiles are magical, frowns are a leading cause of death, etc. I asked the organizations I was looking at for more details, because there are all kinds of ways that numbers like that can be ambiguous … when I’m quoted $250 to fix a child’s cleft, does that include overhead? Donated supplies? Is it an average, or is it what I would actually be funding with a donation? Is it just for the initial surgery, and is that initial surgery enough to make the child smile/be functional for life?

My questions got a variety of responses, from actual information (more detailed budgets, information on followup surgery, etc.) to hostile accusations (I’ll talk about that one later) to … a movie (”In response to your request for added info, I wish to mail you a DVD”). Well, I’m a sucker for movies, so I was pretty pumped about this, and even talked myself into how a movie can capture what you can’t put into words etc. When the DVD arrived, I insisted to my GiveWell buddies that we get out some pretzels and watch it together.

Within seconds, the room was filled with moans: “Holden, what the !@#$?” “You’re going to give me nightmares, you !@#$!” “What are you making us watch?” I should have seen it coming, really. There has often been a disconnect between what I want to see and what nonprofits want me to see, but this is as big as it’s gotten, because I most definitely do not want to see this, and that movie was nothing but slide after slide of it. I went easy on you with that link, too–we were looking at closeups, surgeries in progress, the whole deal.

“Look, the guy told me to watch this video, he saw the questions I was asking, there must be something useful here,” I pleaded. “Just let me fast forward.” I fast-forwarded through more horrifying pictures, and more, and more … and we realized that we were basically looking at rotten.com, and there was no end in sight. Finally, with about 2 minutes left in the 10-minute video, we started seeing post-surgery pictures: smiling children with little scars on their lips. Great. I shut off the video and took out the DVD, which we voted to destroy.

Having a cleft sucks. I get it. Worse than not looking good is a host of other problems: feeding difficulties leading to malnutrition, speech defects, and societies that are often superstitious and ostracize deformed people in ways that the developed world doesn’t. I’ve been told that Chinese children with clefts are commonly left by the side of the road; on other regions, they’re believed to be supernaturally evil and are feared and shunned; in most places, they don’t go to school at all. I don’t need to spend 10 minutes trying not to puke up my dinner to understand this. I’ve moved on from “Can you have a reasonable life despite a cleft?” (you can’t) to a host of other questions about cost-effectiveness of methods, needs for followup surgeries, and most importantly: what ultimately happens to a person who gets his/her cleft fixed? What kinds of lives are made possible by these nonprofits’ activities?

With some exceptions, cleft nonprofits don’t market around these questions; they market around before-and-after pictures. It’s what I call Guilt Marketing: making someone feel bad, and reach for their wallet to ease the pain. It’s the wrong reason to give to charity. If you think of giving as something you have to do, you’ll treat it the same way you treat other things you have to do, like homework or taxes: you’ll wait until someone asks you to do it, and then you’ll basically do what you’re told.

I don’t think of charity as an obligation—none of this stuff is my fault, or yours—but as an opportunity, a chance to buy a better life for someone for about the same cost as a PlayStation. And just like buying a PlayStation, this is a decision I can’t make based on a picture.

I’m Holden, and I’m the guy who will be making sure this blog gets updated twice a week (Tuesday and Saturday) at a minimum. So if you’ve been wishing there were more blogs to read, you’ll be getting to know me well. Right now I’m talking to no one, because we haven’t told anyone about the blog launch, but we’ll start tomorrow with friends and relatives and it shouldn’t take long before we’re outdrawing Deadspin.

We’re starting the blog for a few reasons. One is transparency. One of our biggest frustrations in researching the nonprofit sector, and figuring out where to give our money, is that we generally have no sense of what the heck is going on at these places. For a great example, I’ll pick on Oxfam: look at their website and you’ll see a mind-numbing array of regions, programs, examples, and vague descriptions, but it’s almost impossible to picture what people are literally spending money your money on over in, say, Bolivia, and totally impossible to picture what’s happening at the Oxfam office–how are they deciding what to do? What’s going through their heads? You won’t have this problem with GiveWell: this blog is going to be way more information on how we think than a reasonable person would want.

Hopefully you’ll read it anyway, because you like reading random stuff, which brings me to the second purpose for the blog: to keep people interested in our project, despite slow progress on our main website (which represents researched and edited content, and just can’t change as fast as your favorite websites tend to). Personally, I know that no matter how pressed for time I am, I still read random crap online. Now I want to be your crap.

“But why would I read this? I like reading about sports and sex and high-fiving. This is about charity.” Well. That statement of yours comes from a mentality I hope to change, which is the third purpose of this blog. A lot of people–not everyone–seem to hold various impressions of charitable giving that don’t make any sense to me. This include things like “giving to charity is an act of self-sacrifice,” “no one helps others without ulterior motives,” “you can’t devote your life to charity until you’re disgustingly wealthy and have nothing else to do,” “I don’t have enough money to make a difference,” “There’s no point in giving if I don’t make a difference,” and “charity is all about the goodness of your heart.” I’ll go into my gripes with all of these thoughts, in depth, in later entries. For now I just want to put it to you that I think deciding where to give is a huge, challenging, fascinating problem. I like to think about it, yap about it, and argue about it. I think it’s a topic that can be funny, weird, and fun. I hope you’ll read this blog and end up agreeing.

So bookmark this page, or add it to your RSS feed (if you have no idea what this is, check this out). And bookmark the actual website of GiveWell, too. So far this project is just a bunch of friends doing research in their spare time, so progress will be especially slow in the near future; but in a few months, I’m going to be leaving my job to work on it full-time, and then, well … let’s just say malaria shouldn’t be getting too comfortable. Meanwhile, we want your opinions on everything, so please share, even if the only person you are at this point is my mom.