Saving a life

By phoebe b @ 2025-03-24T16:38 (+67)

I recently decided to check how much I've donated to GiveWell's Top Charity Fund over the last three years. I only got properly bought into EA in 2021/22, and only started donating on a monthly basis in Jan 2022. I also don't earn a huge amount, so haven't been donating much monthly in real terms, although 18 months ago I stepped up my donation amount.

I kinda forgot about my donations, as one does, until recently I was like "oh, I've been doing this for like 3 years now, I wonder how much I've actually donated?"

I couldn't easily find a way of seeing my total donations at a glance on my Giving What We Can dashboard (which might well be me not looking at the right thing) so I just got my calculator out and added up all the individual payments.

I was kinda shocked to see that including Gift Aid, I've donated about $7,000 dollars worth total.

Which basically means my donations have probably helped save at least one life.

This feels like a really big deal to me.

But what does that actually mean?

Now obviously there are lots of caveats - GiveWell's calculations of the cost to save one life are full of approximations and uncertainty, and I've also got no idea of what would have happened without my 7,000 dollars sent monthly over the course of 3 years. Maybe actually in a world where I didn't donate, nothing really would have changed, as it's too small an amount to actually affect the block grants that go to the health charities and lead to x thousands of people getting x medication, etc.

But looking at it in more fungible/loose terms, it doesn't seem completely implausible to think that my choice to donate this money every month for three years, rather than not donating it, might well mean that at least one person is alive today who otherwise wouldn't be.

(I might be completely wrong about this, so very much welcome correction if I've thought about this all wrong - I've basically naively taken the notion that GiveWell says it's like 3k-5k dollars to save one life for their top rated charities, and so me donating 7k total seems to naively imply that my money has at least saved one life. But as I say, this is genuinely very much me taking that naive implication and not really having the expertise or understanding to properly try to understand if it's true - would really appreciate if anyone is able to explain if I've got this wrong!)

How it feels to (maybe) save a life

Anyway, if I do basically assume my donations have saved someone's life, well...

That feels pretty cool!!

Honestly, way beyond cool.

It feels like a really serious result from my taking seriously the ideas of EA, and actually trying to put them into practice.

It feels like it's surely one of the best things I've ever done.

Abstract vs concrete impact

It feels simultaneously intensely abstract, and intensely, heartbreakingly concrete.

On the abstract side: this was just me clicking buttons on websites to set up a completely passive direct debit from my bank account to silently transfer numbers on a screen.

I basically forgot it was happening apart from when I saw it show up in my monthly statements, and I didn't even realise when (theoretically) it passed the point where I'd meaningfully donated enough to save someone's life.

If it did save someone's life, I've never met them, I don't know who they are, I don't know how or when money I donated was part of a larger grant that allowed a health charity to buy medical supplies and then go and distribute that medication. 

All of this is total abstraction that feels about 1000000x less real than me making some kind of social faux pas with an acquaintance on the street and worrying that maybe I've made them feel insulted and that I've done something slightly immoral.

But then, on the concrete side: assuming my choice to donate has led to a world in which someone is alive now who would otherwise be dead... well, that's about as real and concrete as outcomes get.

Taking GiveWell's hypothetical breakdown and running with it.... because of my donations, a couple of thousand children got medication who otherwise wouldn't. Of those couple of thousand, many of them were prevented from being seriously ill by the medication, whereas in a world where I didn't donate, many of them suffered immensely from being seriously ill. And in that world of my non-donation, one of them died.

It's hard to think about this in the actual way it would have happened. It's hard to imagine the child's consciousness, moving slowly from just very ill and suffering, to completely winking out. I think about times when I was very sick, and that delirium, especially when I was younger.

The thing that feels easiest to imagine is this child's parents. Their siblings. How crushing that grief is, and how human and relatable it is, how unaffected by different levels of income or culture.

And then... I think about the world we actually live in, where I did donate that money, and that child got medication, and so didn't get as seriously ill, and so didn't die.

And I think about every day of their life since then. Their hardships, their happiness, their relationships. How now their whole life stretches out in front of them. They're still in crushing poverty, they still might have a hard or horrible life. But they also will experience immense joy, and happiness, and heartbreak, and they might fall in love, and have children of their own, and hold their child in their arms and work to give them as good a life as they can.

And yeah, I feel really glad that I didn't just spend this money on a really nice holiday, or put it into my savings so that I might be able to put down a deposit to a flat in London a bit earlier than I currently expect to be able to.

Does this make me a saint?

Obviously, this now really sounds like I'm saying I'm an amazing person.

Which I really don't think or believe at all.

Firstly, me being in this position where I have the choice to donate some money to save a child’s life, is purely a matter of luck. I got born into a middle class family in the UK, and the child I (maybe) saved didn’t. So really, all I’m doing is trying to make up for the injustice of my accidental affluence.

Secondly, most EAs have donated way more money than this! And donate way more each year, and so I feel very much like I'm just starting to try to live like this, and I hugely admire and respect all the EAs who donate so much more than me (and for longer).

Thirdly, of course, to focus in on a singular child who I might have saved with my 7,000 dollars is not the full picture.

The full picture is that thousands and thousands and thousands of very similar children just actually died, and are still dying, and were not saved.

And so it's kinda like I ran into a burning building full of thousands of children and pulled one out while the others screamed and now I'm giving myself a medal and sitting back to enjoy spending the rest of my disposable income on trying out that new roast at the pub across the park that looked really nice, and booking my flights to Italy for that holiday I'm planning with a few friends in June, while the fire keeps raging and the children keep screaming, and the US government has just decided to end PEPFAR.

I think Scott Alexander’s concept of rivers of drowning children going past us at all times feels pretty correct to me.

And I don't really try to duck it.

I choose every day to not donate more, and that's something I have to be ok with admitting - it makes me a worse person.

I probably could have donated twice the amount I did in the last 3 years by cutting back more on luxuries and holidays and savings, and so maybe the better way to think about this is that I let a child die over the last three years.

Finding a balance I can live with

But I don't actually really think like that. I'm not a naturally very scrupulous person. I'm pretty kind to myself, and good at focusing on the positives.

And if I'm totally honest, I'm just proud of myself.

Because I think the default, the norm, the thing the vast majority of people like me in rich countries do, is just not donate at all, or donate a tiny amount infrequently to highly ineffective charities (obviously this is better than nothing, but not much).

And I very much think the default of the person I was pre-EA, just wouldn't have done this.

So I'm really proud to be part of this community, and grateful for all the people working so hard at places like GiveWell and the global health charities they support to stop children from dying of diseases that can be cheaply prevented.

And I’m proud of myself for making choices that have led to a world in which one less child is dead.

It feels good to reflect on this, and write about it, and post about it here. To make it feel a bit less abstract, and help inspire me (and anyone else) to keep donating.