Think of poverty like a bathtub. There’s a faucet pouring people into the bathtub of poverty, and a drain letting people out. The level of what (or who) is in the tub matters less than the flow.
 
Tuesday’s proceedings opened with a candid presentation by Anirudh Krishna, Professor of Public Policy and Political Science and Associate Dean for Academic Programs at Duke University. Author of One Illness Away: Why People Become Poor and How They Escape Poverty, Dr. Krishna expounded on his findings from interviewing 35,000 households to explore the “whys” of poverty: why does someone fall into poverty, why does someone stay impoverished, and why does one person manage to lift himself out of poverty while his neighbor cannot.
 
His ambitious project doesn’t attempt to provide all of the answers, nor does it attack some of the larger, structural issues surrounding poverty, What  his study did find, though, was that poor health and high health expenditures were common reasons for a family to move from wealth to subsistence living. From expensive treatments to treat often common illnesses to expensive funeral rites, if treatments are ineffective, to repeats of this same cycle in areas with limited access to proper, affordable health care, health and availability of affordable, effective, equitable health services were key to successfully moving up a wealth quintile.  For those who fell into poverty, it was typically a sequence of events that brought them down, rather than one catastrophic incident.
 
Dr. Krishna also focused on the need to look at poverty at a household level, rather than only through aggregate statistics. This focus on the household and on communities resonated throughout the day, in conversations and group sessions. MCHIP, as a project, has a number of community-based service provision programs, from implementation of integrated Community Case Management of childhood illnesses to providing support and training to community health workers. Dr. Krishna’s findings only underscored the importance of this kind of work and the support that MCHIP and other USAID projects provide. By providing necessary health services to the poorest of the poor, we work to slow the flow of the people running into the bathtub of poverty.
 
If you’re interested in more of Dr. Krishna’s work, you can read about his Stages of Progress methodology for the book online.