The man who gives away a third of his income

Would you give up a luxury to save a life?

Toby Ord has been giving away a third of his income for quite some time. A 33 year old academic at Oxford, he allows himself £18,000 a year, and donates the rest to charity.

"I’d always been idealistic about helping others", he says. "People would say “if you think that why don’t you give all your money to people in poor countries?" I think this was meant to make me shut up."

Instead he started giving away a large sum each year, and in the process set up a campaign - Giving What We Can - to encourage others to give away at least 10 per cent of their earnings.

Ord's subject is philosophy, and he came to the decision in a philosophical way. "I was writing on the subject of luxuries, and I came across the question of whether we should forgo a luxury if it would save a life. I realised this decision happens in our lives all the time."

"I was reading [the philosophers] Peter Singer and Thomas Pogge. The two of them think furiously about the problems of the world today. They both took their ideas very seriously and gave away a large proportion of their incomes. I decided I was going to make a commitment to give money to poor people."

To his surprise, people soon contacted him to see if they could do the same thing - and Giving What We Can was born.

"I'm not a natural leader for such an organisation", Ord says, describing himself as "more of a theoretician". But he has a very clear vision for the project.

"For me it [giving away a large percentage of income] doesn’t seem too odd. We literally have a choice to save hundreds of lives."

Yes, but giving money to charity never seems quite as straightforward as that. Can we ever be sure that what we give is really saving a life?

He agrees that would be more motivational if there was a "clear line of operation", and that the path from your wallet to saving someone's life can sometimes look "messy". "But if your money goes on, say, 200 mosquito nets in a malarial area there is no question. You will save a life."

What about the horror stories, the charity money that never makes it, the corrupt organisations that divert aid to their own ends?

"There are lots of rather garbled stories about problems with aid. These are bit stupid. The whole of the world is paying billions of dollars in aid, and people point to one or two things that go wrong. It is quite easy to find these problems which then act as excuses for not giving", he says.

"There is a perfect storm of excuses for forgetting about charities."

He admits that some charities are more effective than others, though.

"Charities can often benefit from thinking of effectiveness more. One of the targets for criticising them is the amount of money that goes into  administrative costs – but this is a bad measure of ineffectiveness - an organisation might need that level of spending on admin. I do think organisations should think about how they can help people more. There is a big academic literature on this. They should focus on outputs, and  not get hung up on brand – for example they should be prepared to  change the disease they are working on, if they could help more people that way."

French beggars. Photograph: Getty Images

Martha Gill writes the weekly Irrational Animals column. You can follow her on Twitter here: @Martha_Gill.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear