Interesting Times

IT’S FAIR to ask: empowering women is well and good, but can one do this effectively? Does foreign aid really work? William Easterly, an economist at New York University, has argued powerfully that shoveling money at poor countries accomplishes little. Some Africans, including Dambisa Moyo, author of “Dead Aid,” have said the same thing. The critics note that there has been no correlation between amounts of aid going to countries and their economic growth rates.

Our take is that, frankly, there is something to these criticisms. Helping people is far harder than it looks. Aid experiments often go awry, or small successes turn out to be difficult to replicate or scale up. Yet we’ve also seen, anecdotally and in the statistics, evidence that some kinds of aid have been enormously effective. The delivery of vaccinations and other kinds of health care has reduced the number of children who die every year before they reach the age of 5 to less than 10 million today from 20 million in 1960.

In general, aid appears to work best when it is focused on health, education and microfinance (although microfinance has been somewhat less successful in Africa than in Asia). And in each case, crucially, aid has often been most effective when aimed at women and girls; when policy wonks do the math, they often find that these investments have a net economic return. Only a small proportion of aid specifically targets women or girls, but increasingly donors are recognizing that that is where they often get the most bang for the buck.

In the early 1990s, the United Nations and the World Bank began to proclaim the potential resource that women and girls represent. “Investment in girls’ education may well be the highest-return investment available in the developing world,” Larry Summers wrote when he was chief economist of the World Bank. Private aid groups and foundations shifted gears as well. “Women are the key to ending hunger in Africa,” declared the Hunger Project. The Center for Global Development issued a major report explaining “why and how to put girls at the center of development.” CARE took women and girls as the centerpiece of its anti-poverty efforts. “Gender inequality hurts economic growth,” Goldman Sachs concluded in a 2008 research report that emphasized how much developing countries could improve their economic performance by educating girls.

Bill Gates recalls once being invited to speak in Saudi Arabia and finding himself facing a segregated audience. Four-fifths of the listeners were men, on the left. The remaining one-fifth were women, all covered in black cloaks and veils, on the right. A partition separated the two groups. Toward the end, in the question-and-answer session, a member of the audience noted that Saudi Arabia aimed to be one of the Top 10 countries in the world in technology by 2010 and asked if that was realistic. “Well, if you’re not fully utilizing half the talent in the country,” Gates said, “you’re not going to get too close to the Top 10.” The small group on the right erupted in wild cheering.

Policy makers have gotten the message as well. President Obama has appointed a new White House Council on Women and Girls. Perhaps he was indoctrinated by his mother, who was one of the early adopters of microloans to women when she worked to fight poverty in Indonesia. Secretary of State Hillary Rodham Clinton is a member of the White House Council, and she has also selected a talented activist, Melanne Verveer, to direct a new State Department Office of Global Women’s Issues. On Capitol Hill, the Senate Foreign Relations Committee has put Senator Barbara Boxer in charge of a new subcommittee that deals with women’s issues.

Yet another reason to educate and empower women is that greater female involvement in society and the economy appears to undermine extremism and terrorism. It has long been known that a risk factor for turbulence and violence is the share of a country’s population made up of young people. Now it is emerging that male domination of society is also a risk factor; the reasons aren’t fully understood, but it may be that when women are marginalized the nation takes on the testosterone-laden culture of a military camp or a high-school boys’ locker room. That’s in part why the Joint Chiefs of Staff and international security specialists are puzzling over how to increase girls’ education in countries like Afghanistan — and why generals have gotten briefings from Greg Mortenson, who wrote about building girls’ schools in his best seller, “Three Cups of Tea.” Indeed, some scholars say they believe the reason Muslim countries have been disproportionately afflicted by terrorism is not Islamic teachings about infidels or violence but rather the low levels of female education and participation in the labor force.

SO WHAT WOULD an agenda for fighting poverty through helping women look like? You might begin with the education of girls — which doesn’t just mean building schools. There are other innovative means at our disposal. A study in Kenya by Michael Kremer, a Harvard economist, examined six different approaches to improving educational performance, from providing free textbooks to child-sponsorship programs. The approach that raised student test scores the most was to offer girls who had scored in the top 15 percent of their class on sixth-grade tests a $19 scholarship for seventh and eighth grade (and the glory of recognition at an assembly). Boys also performed better, apparently because they were pushed by the girls or didn’t want to endure the embarrassment of being left behind.

Another Kenyan study found that giving girls a new $6 school uniform every 18 months significantly reduced dropout rates and pregnancy rates. Likewise, there’s growing evidence that a cheap way to help keep high-school girls in school is to help them manage menstruation. For fear of embarrassing leaks and stains, girls sometimes stay home during their periods, and the absenteeism puts them behind and eventually leads them to drop out. Aid workers are experimenting with giving African teenage girls sanitary pads, along with access to a toilet where they can change them. The Campaign for Female Education, an organization devoted to getting more girls into school in Africa, helps girls with their periods, and a new group, Sustainable Health Enterprises, is trying to do the same.

And so, if President Obama wanted to adopt a foreign-aid policy that built on insights into the role of women in development, he would do well to start with education. We would suggest a $10 billion effort over five years to educate girls around the world. This initiative would focus on Africa but would also support — and prod — Asian countries like Afghanistan and Pakistan to do better. This plan would also double as population policy, for it would significantly reduce birthrates — and thus help poor countries overcome the demographic obstacles to economic growth.

But President Obama might consider two different proposals as well. We would recommend that the United States sponsor a global drive to eliminate iodine deficiency around the globe, by helping countries iodize salt. About a third of households in the developing world do not get enough iodine, and a result is often an impairment in brain formation in the fetal stages. For reasons that are unclear, this particularly affects female fetuses and typically costs children 10 to 15 I.Q. points. Research by Erica Field of Harvard found that daughters of women given iodine performed markedly better in school. Other research suggests that salt iodization would yield benefits worth nine times the cost.

We would also recommend that the United States announce a 12-year, $1.6 billion program to eradicate obstetric fistula, a childbirth injury that is one of the worst scourges of women in the developing world. An obstetric fistula, which is a hole created inside the body by a difficult childbirth, leaves a woman incontinent, smelly, often crippled and shunned by her village — yet it can be repaired for a few hundred dollars. Dr. Lewis Wall, president of the Worldwide Fistula Fund, and Michael Horowitz, a conservative agitator on humanitarian issues, have drafted the 12-year plan — and it’s eminently practical and built on proven methods. Evidence that fistulas can be prevented or repaired comes from impoverished Somaliland, a northern enclave of Somalia, where an extraordinary nurse-midwife named Edna Adan has built her own maternity hospital to save the lives of the women around her. A former first lady of Somalia and World Health Organization official, Adan used her savings to build the hospital, which is supported by a group of admirers in the U.S. who call themselves Friends of Edna Maternity Hospital.

For all the legitimate concerns about how well humanitarian aid is spent, investments in education, iodizing salt and maternal health all have a proven record of success. And the sums are modest: all three components of our plan together amount to about what the U.S. has provided Pakistan since 9/11 — a sum that accomplished virtually nothing worthwhile either for Pakistanis or for Americans.

ONE OF THE MANY aid groups that for pragmatic reasons has increasingly focused on women is Heifer International, a charitable organization based in Arkansas that has been around for decades. The organization gives cows, goats and chickens to farmers in poor countries. On assuming the presidency of Heifer in 1992, the activist Jo Luck traveled to Africa, where one day she found herself sitting on the ground with a group of young women in a Zimbabwean village. One of them was Tererai Trent.

Tererai is a long-faced woman with high cheekbones and a medium brown complexion; she has a high forehead and tight cornrows. Like many women around the world, she doesn’t know when she was born and has no documentation of her birth. As a child, Tererai didn’t get much formal education, partly because she was a girl and was expected to do household chores. She herded cattle and looked after her younger siblings. Her father would say, Let’s send our sons to school, because they will be the breadwinners. Tererai’s brother, Tinashe, was forced to go to school, where he was an indifferent student. Tererai pleaded to be allowed to attend but wasn’t permitted to do so. Tinashe brought his books home each afternoon, and Tererai pored over them and taught herself to read and write. Soon she was doing her brother’s homework every evening.

The teacher grew puzzled, for Tinashe was a poor student in class but always handed in exemplary homework. Finally, the teacher noticed that the handwriting was different for homework and for class assignments and whipped Tinashe until he confessed the truth. Then the teacher went to the father, told him that Tererai was a prodigy and begged that she be allowed to attend school. After much argument, the father allowed Tererai to attend school for a couple of terms, but then married her off at about age 11.

Tererai’s husband barred her from attending school, resented her literacy and beat her whenever she tried to practice her reading by looking at a scrap of old newspaper. Indeed, he beat her for plenty more as well. She hated her marriage but had no way out. “If you’re a woman and you are not educated, what else?” she asks.

Yet when Jo Luck came and talked to Tererai and other young women in her village, Luck kept insisting that things did not have to be this way. She kept saying that they could achieve their goals, repeatedly using the word “achievable.” The women caught the repetition and asked the interpreter to explain in detail what “achievable” meant. That gave Luck a chance to push forward. “What are your hopes?” she asked the women, through the interpreter. Tererai and the others were puzzled by the question, because they didn’t really have any hopes. But Luck pushed them to think about their dreams, and reluctantly, they began to think about what they wanted.

Tererai timidly voiced hope of getting an education. Luck pounced and told her that she could do it, that she should write down her goals and methodically pursue them. After Luck and her entourage disappeared, Tererai began to study on her own, in hiding from her husband, while raising her five children. Painstakingly, with the help of friends, she wrote down her goals on a piece of paper: “One day I will go to the United States of America,” she began, for Goal 1. She added that she would earn a college degree, a master’s degree and a Ph.D. — all exquisitely absurd dreams for a married cattle herder in Zimbabwe who had less than one year’s formal education. But Tererai took the piece of paper and folded it inside three layers of plastic to protect it, and then placed it in an old can. She buried the can under a rock where she herded cattle.

Then Tererai took correspondence classes and began saving money. Her self-confidence grew as she did brilliantly in her studies, and she became a community organizer for Heifer. She stunned everyone with superb schoolwork, and the Heifer aid workers encouraged her to think that she could study in America. One day in 1998, she received notice that she had been admitted to Oklahoma State University.

Some of the neighbors thought that a woman should focus on educating her children, not herself. “I can’t talk about my children’s education when I’m not educated myself,” Tererai responded. “If I educate myself, then I can educate my children.” So she climbed into an airplane and flew to America.

At Oklahoma State, Tererai took every credit she could and worked nights to make money. She earned her undergraduate degree, brought her five children to America and started her master’s, then returned to her village. She dug up the tin can under the rock and took out the paper on which she had scribbled her goals. She put check marks beside the goals she had fulfilled and buried the tin can again.

In Arkansas, she took a job working for Heifer — while simultaneously earning a master’s degree part time. When she had her M.A., Tererai again returned to her village. After embracing her mother and sister, she dug up her tin can and checked off her next goal. Now she is working on her Ph.D. at Western Michigan University.

Tererai has completed her course work and is completing a dissertation about AIDS programs among the poor in Africa. She will become a productive economic asset for Africa and a significant figure in the battle against AIDS. And when she has her doctorate, Tererai will go back to her village and, after hugging her loved ones, go out to the field and dig up her can again.

There are many metaphors for the role of foreign assistance. For our part, we like to think of aid as a kind of lubricant, a few drops of oil in the crankcase of the developing world, so that gears move freely again on their own. That is what the assistance to Tererai amounted to: a bit of help where and when it counts most, which often means focusing on women like her. And now Tererai is gliding along freely on her own — truly able to hold up half the sky.