Thanks for this post! To add one thought that keeps bugging me: I believe joining an EA org on average lowers career capital by a medium to large extent in comparison to alternative plausible careers.

1. many jobs are less specifically relevant for the continuous development of industry-job market cash-cow skills (or whatever one wants to call that).

2. joining an EA-org feels rather awkward to explain to the majority of employers with a feeling that most are not particularly moved towards "PRO-employ" by the explanation one will give.

If true, this has some severe implications which IMO are not discussed prominently enough (both in the struggle for attracting talent and in the discussion on leadership's abilities which this post adresses, see e.g. lock-in effects and biases).

In my personal career decisions, this suspicion has had a large multiplier effect on the uncertainties I am struggling with (say, the good-ness of E2G (I believe the community under-estimates), EA (..), how much to invest into career capital vs. when to start cashing in).

FYI: The link to the summary (https://maternalhealthinitiative.org/final-summary-of-our-work/) does not seem to work for me (404).

Thanks for this source, ezrah! These 6,3k seem to possibly be a bit misleading to me. Without taking a closer look, it sounds like the costs of the treatment (currently covered by the hospital's CSR funds or donations?) are hidden from the total costs as someone had the great idea of splitting the true costs into two different donation opportunities, both of which on each side suggest that "if you give to this opportunity, the other side is covered". But given the high-quality medical facility/treatment the children receive, the true cost of donations consumed per patient are probably much higher. Am I mistaken here?

Thanks for your post! As mentioned in other comments, one central factor to understand how cost-effective your procedure appears, could be the cost of having a medical professional as you are (or a person with the minimum required medical expertise and local context knowledge) spend their time roaming, (incentivizing people to meet them, this one was easy for you and probably always is), meeting people and identifying patients to support. Could you roughly estimate these costs per case if you were to do that as your main occupation?

The second part of it, paying for their treatment, seems like something that could be rather easy (much uncertainty here ofc) to do when embedded into the right framing. As pointed out by Jason and others in the comments, these are patients with very tangible, heart-warming stories and very obvious direct impact-connection to a donation, which makes them suitable for successful fundraising within the broader non-EA target-groups.

This is of course without evaluating the potentially quickly arising adverse effects such as the deterioration of informal institutions of local fundraising among families and friends due to them pointing potential patients to you etc..

Thanks for sharing your thoughts on this very interesting topic!

Did you consider the impact that companies like or in particular Elon Musk's Starlink is going to have on the situation? Starlink seems to be focusing their efforts exactly at countries like those studied here, countries with high entry-costs for cable-bound telecom means which they don't have since they already largely invested in their now existing satellite fleet and a significant remaining gap in the population without access to telecoms.  

Without knowing much about it, it seems to make much sense to run a business model that is based on either very low prices for those that weren't able to afford telecoms before Starlink and/or heavy advantage over the existing (weak) competition in terms of quality. Looking at Starlink's current activities, they could change the situation in many LMICs drastically within a few years.

That being said, I have also heard that Starlink seems to be quite expensive to deploy atm (but as before, I'm no expert on the topic).

Starlink is AFAIK a much discussed topic at least in Mozambique, Nigeria and Zimbabwe atm.