In the late ’90s, an MIT economics professor named Michael Kremer wanted to find out if school kids in Kenya were better served by being given free textbooks or medicine that would eradicate stomach worms. Reports Michael Hobbes in The New Republic:
The deworming pills made the kids noticeably better off. Absence rates fell by 25 percent, the kids got taller, even their friends and families got healthier. By interrupting the chain of infection, the treatments had reduced worm infections in entire villages. Even more striking, when they tested the same kids nearly a decade later, they had more education and earned higher salaries. The female participants were less likely to be employed in domestic services.
And compared with Kremer’s first trial, deworming was a bargain. Textbooks cost $2 to $3 each. Deworming pills were as little as 49 cents. When Kremer calculated the kids’ bump in lifetime wages compared with the cost of treatment, it was a 60-to-1 ratio.
These findings led to the founding of an NGO called “Deworm the World” which went on to help 40 million children in 27 countries. But there has been little evidence that giving school children deworming pills in other countries have had similar effects. Hobbes writes:
In the 1980s and early ’90s, a series of meta-analyses found that textbooks were actually effective at improving school performance in places where the language issues weren’t as complex. In his own paper reporting the Kenya results, Kremer noted that, in Nicaragua and the Philippines, giving kids textbooks did improve their test scores.
But the point of all this is not to talk shit on Kremer—who has bettered the world more with his career than I ever have with mine—or to dismantle his deworming charity, or to advocate that we should all go back to giving out free textbooks. What I want to talk shit on is the paradigm of the Big Idea—that once we identify the correct one, we can simply unfurl it on the entire developing world like a picnic blanket.
There are villages where deworming will be the most meaningful education project possible. There are others where free textbooks will. In other places, it will be new school buildings, more teachers, lower fees, better transport, tutors, uniforms. There’s probably a village out there where a PlayPump would beat all these approaches combined. The point is, we don’t know what works, where, or why. The only way to find out is to test these models—not just before their initial success but afterward, and constantly.
Photo: Susana Secretariat