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Why Are Poor Countries Poor?

2019-10-01 · explainer · John, Bailor Barrie · 8:17 · watch on YouTube

Topic: Global development · mode: Explainer · tags: heavy topic

Ahead of the brothers' Partners In Health Sierra Leone announcement, John explains why Sierra Leone is poor: colonial resource-extraction systems, a diamond-funded civil war, and disease burden feeding vicious cycles such as Ebola; he argues its problems are ours and that investment works, citing the Kono hospital, and is hopeful.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Coming PIH Sierra Leone announcement; Sierra Leone's population and origins

  • ★★★ John says the brothers will make a big announcement later this month (October 2019) about working with Partners In Health Sierra Leone, and first considers why Sierra Leone is so poor. — 00:00:00 · Partners In Health, Sierra Leone
  • ★★ John says Sierra Leone is a nation of around seven and a half million people, ethnically and religiously diverse. — 00:00:00 · Sierra Leone

00:00:29 — Colonial railways and resource extraction; corruption versus missing systems; spending gap with the UK and US

  • ★★ Most Sierra Leoneans descend from long-time West Africans, but many former slaves in the British Empire were resettled there, so some trace descent to Canada, England or Nigeria. — 00:00:29 · Canada, England, Sierra Leone
  • ★★ In Sierra Leone earlier this year (2019) someone told John to look at the colonial railway map: the tracks linked mineral-rich areas to the coast, not cities to each other. — 00:00:29 · Sierra Leone
  • ★★★ John says colonization was in the business of resource extraction, so colonies got extraction systems and little investment in health or education systems. — 00:00:58
  • ★★ Since independence in 1961, Sierra Leone has struggled to move away from resource extraction and build systems such as infrastructure, health care and even mail delivery. — 00:00:58 · Sierra Leone
  • ★★★ John says corruption is a serious problem in poor countries, but the far bigger problem is how hard it is to build health, education and infrastructure systems in extraction-built communities. — 00:01:27
  • ★★★ A community can't spend what it doesn't have: at the UK's share of GDP, Sierra Leone would have about $45 per person yearly for health care; the US spends over $10,000 per person on health and over $12,000 per child on education. — 00:01:56 · Sierra Leone, United Kingdom, United States

00:02:26 — The civil war, diamonds and the Kono paradox

  • ★★ Sierra Leone's civil war lasted from 1991 to 2002: tens of thousands died, millions were displaced, the health system was devastated, HIV and deaths rose and schooling was interrupted. — 00:02:26 · Sierra Leone
  • ★★ Dr. Bailor Barrie, founder of the respected Wellbody Clinic, had to leave his studies to escape to a refugee camp; John heard similar stories from several health workers. — 00:02:26
  • ★★ Because the war was partly funded on all sides by diamonds and minerals, it especially devastated Kono, the diamond district; the government paid for mercenaries partly by selling the rights to the largest diamond concession. — 00:02:55
  • ★★ Travelling through Kono, John kept thinking of Faulkner's line that the past is never dead; it's not even past. — 00:02:55
  • ★★★ John describes a paradox common to poor countries: almost none of Kono's diamond wealth stays there, so one of West Africa's richest areas is among the world's poorest and least healthy, with few mine jobs for locals. — 00:03:24 · extreme poverty

00:03:53 — Ebola as the vicious cycle of fragile health systems; a survivor and Dr. Barrie

  • ★★★ Sierra Leone exports $100 million in diamonds annually while 6% of all women die in childbirth. — 00:03:53 · Sierra Leone, maternal death
  • ★★★ Poverty can become a vicious cycle; John thinks the Ebola outbreak epitomizes how impoverished, fragile health systems lead to emergencies. — 00:03:53
  • ★★★ When Ebola reached Sierra Leone in 2014 the whole country had about 150 doctors; Indiana, with a similar population, has over 16,000. — 00:03:53 · Sierra Leone, Indiana
  • ★★ With little running water to sterilize and too few gloves or masks, John says this systemic weakness is why Ebola could ravage Sierra Leone but not the United States or Spain. — 00:04:22 · United States, Sierra Leone
  • ★★ John met an Ebola survivor, now working for Partners In Health, who shared a bed with his son at a treatment facility; both survived, but his wife died a few beds over. — 00:04:22 · Partners In Health
  • ★★ a guest: The Ebola survivor says the treatment facility had only three beds for four of them, so he refused to let his son go and shared a bed with him; he lay struggling for nine days, and his wife, also brought there, died. — 00:04:52 · Partners In Health
  • ★★ Bailor Barrie: Asked about treating Ebola patients, Dr. Bailor Barrie recalls seeing maybe 50 patients one day and finding only 20 the next: it was horrible. — 00:05:17

00:05:26 — Rich nations' wealth and an us that makes no them; risks of philanthropy

  • ★★★ The Ebola crisis was caused by a fragile health system and left it more fragile; that vicious cycle is often the story of poverty. — 00:05:26
  • ★★★ The wealth of the US and UK can't be separated from Sierra Leone's poverty: they industrialized with its resources and built trade on West African slaves. — 00:05:26 · United States, United Kingdom, Sierra Leone

  • ★★★ If these problems aren't ours, John is troubled by how we define us: he doesn't want to be part of an us that makes a them of the world's most vulnerable. — 00:05:55 · othering

    “I don't want to be part of an us that makes a them of the world's most vulnerable people.”

  • ★★★ John thinks the idea that Sierra Leone can solve its problems in isolation wrongly imagines that they exist in isolation. — 00:05:55 · Sierra Leone

  • ★★★ Philanthropy risks making things worse or creating new problems; John says to be aware of those risks and minimize them by grounding work in listening and deep partnership. — 00:05:55

00:06:25 — Investment is not pointless: the Kono hospital then and now

  • ★★★ John says it is inaccurate to call investment pointless: he has seen the difference PIH and the Ministry of Health have made in Kono with very limited resources. — 00:06:25 · Partners In Health · also in: Risk Is a Privilege
  • ★★★ Five years ago the Kono hospital had no electricity, few supplies and almost no patients; today it is well staffed, supplied and used, with a blood bank and an operating room for C-sections. — 00:06:25 · Koidu Government Hospital
  • ★★★ The hospital is still totally inadequate, with only 40 maternal beds for 550,000 people, but the progress is real. — 00:06:54 · Koidu Government Hospital, maternal death
  • ★★★ John believes progress will continue if the Ministry of Health, with organizations like PIH, can make long-term investments that address long-term problems. — 00:06:54 · Partners In Health

00:07:23 — Why Sierra Leone is poor, and why John is hopeful; sign-off

  • ★★★ John's answer: Sierra Leone is poor because its systems were for centuries built around resource extraction, because of war, disease burden, and colonialism and its legacies. — 00:07:23 · Sierra Leone
  • ★★★ John is hopeful, not because the problems are easy, but because of Sierra Leonean health workers' commitment and patients who taught him despair is not the right response to big problems. — 00:07:23 · Sierra Leone
  • ★★★ Nothing about Sierra Leone's poverty is natural or inevitable, so John doesn't think it is permanent; evidence worldwide shows systems can strengthen so more mothers and children survive. — 00:07:52 · Sierra Leone, maternal death, child mortality

In the description and comments

Threads in this video

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Mentioned

Central: colonialism · Extractivism · extreme poverty · Kono District · Sierra Leone

Also: People: Bailor Barrie · William Faulkner

Organizations: Koidu Government Hospital · Ministry of Health and Sanitation (Sierra Leone) · Partners In Health · Wellbody Clinic

Concepts: Charity (practice) · child mortality · maternal death · othering · political corruption · vicious circle

Places: British Empire · Canada · England · Indiana · Nigeria · Spain · United Kingdom · United States · West Africa

Events: Atlantic slave trade · Sierra Leone Civil War · Western African Ebola virus epidemic

Only in the description or credits: Jon Lascher · Rosianna Halse Rojas

Also centred on colonialism: SOMALI PIRATES! France Penetrates Chad! · Why is Haiti Poor? · The 51st State · Understanding Boko Haram

Also centred on Kono District: After 15 Years on YouTube, THIS IS THE MOST AMAZING THING · GOOD NEWS

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