Thursday, February 26, 2009

The Costs of Demining

Cost Benefit Analysis: A process by which you weigh expected costs against expected benefits to determine the best (or most profitable) course of action

We get asked all the time: "How much does it cost you to clear a landmine?" or "How many mines can you clear with the money we donate?"

Let's restructure that questions a bit:

If you were told there was a landmine in the park where your children played, how much money would you spend to find it? Or more simply put: what’s the value of your child’s life?

Cost benefit analysis in mine clearing tries to put a dollar value on a life versus the cost of a clearing program. You tell me what the dollar value of a human life is? I certainly don’t know.

How much does it cost to clear a mine field? We spend whatever it takes.
One mine – One life.

CSHD is clearing mines in ‘low priority’ villages. Many in the government don’t like that term. All villages and all lives are of equal importance. But in reality, some villages will be cleared later rather than sooner. Sometimes it’s because teams are not available, sometimes because funds are scarce, and sometimes because more mines can be cleared in a shorter period of time in other places. All these reasons ‘shove’ villages to the bottom of the list…low priority.

But they are NOT low priority to the people getting blown up.

We’re often asked ‘How many mines can you clear for the dollar?’ It’s an impossible question to answer clearly. If we clear a densely mined filed it’s low. If we clear a jungle field, where we have to hack our way in, with only a few mines per hectare, the cost may be high. The village we’re clearing now is the latter. Yet they’ve lost 5 dead, 3 maimed and 15 cattle. We’re clearing the land slowly because of the jungle bush we need to clear. But when we’re through 15 families will have land to farm and safely raise their children.

I can’t cost/benefit that. Can you?

The next mine field we’ll clear is an open field. We should be able to move quickly and clear it in a matter of weeks. Faster equals cheaper. But if we tried to work faster in Kokchombuk we’d likely miss some little mines. Faster may be cheaper, but it can also be deadly.

How do you cost/benefit a life; or a leg? Is the loss of your right hand worth more than loss of your left? If a child dies, do you value that at a lower amount than a working adult? Or do you calculate the ‘potential’ income the child would have in a lifetime to determine your cost/benefit ratio?

And the ultimate question: if you can cost/benefit a mine field, when do you just walk away and say: “It’s cheaper to let ‘em die.” That will clear the field too.

We don’t cost/benefit mine clearing. We’d rather look at lives changed and villages made free from fear.

One Mine – One Life

Saturday, February 21, 2009

The Recovery of Sim Sao

Sim Sao has been a tuk tuk driver in Siem Reap for 7 years. Before that he was a monk. He’s married with children now and supports them on the little income he gets from the tourists in Siem Reap. When he works, he sleeps on the floor of a restaurant a friend owns.

Those of us who work with Aki Ra and the kids have been using Sao as our driver for the last several years. We hire him on a weekly basis. He can find anything, knows tons of people, and can get us anywhere we want to go on time, and most importantly, in a country where it is bad luck to look over your shoulder (no kidding), he gets us where want to go safely.

About 6 weeks ago Sao was driving home to his village, about 45 minutes from town, when he had a collision with a food cart vendor. Sao was driving down the road on his motor scooter when the food cart turned in front of him. (Remember it’s bad luck to look over your shoulder.) The two collided, and the boiling oil from the food cart spilled all over Sao’s right leg. He sustained severe 2nd degree burns to his inside calf and thigh.

Unlike at home, there is free medical coverage in Cambodia. But like the poor in the US, you have to sit in the emergency room for hours to get treated. To get good, fast care you have to pay, and it starts at about $50 for a visit to a private hospital, plus meds. That may not sound like a lot to us, but the average income over here is less than $1 per day, so private care is pretty much impossible for the average Khmer.

Sao’s options were pretty limited…..
• Sit in the emergency room at the provincial hospital and hope to get treated
• Go to Calmet hospital in Phnom Penh, a 6 hour drive each way and get treated there
• Have the local village ‘doctor’ treat him with potions and herbs

I knew he’d had an accident, but had no idea of its severity until he came back to town on the 30th of January to try and get back to work. He’d sent some pictures of his leg to our compatriot, Asad in the US and Lisa McCoy, a Canadian working here in SE Asia.

I saw Sao about the same time Asad and Lisa saw the photos. We called a Western doctor working here in Siem Reap and he offered another ‘option’. The Royal Angkor International Hospital was opened a year or so ago. It was built by Thais and staffed by Thai doctors. We were told we could take Sao there but it would be VERY expensive. It’s of western standards and better than many I’ve seen in the US.

Let’s see …… we could send Sao to the local hospital where he might get some help, let him keep going to the local ‘doctor’ or spend a little of our own money and get him some good treatment…hmmmm

Pretty much a ‘no-brainer’.

Lisa and I took him to Angkor Int’l on the 30th. He was with the doctor a good 90 minutes. They cleaned and dressed the wound and gave him some meds to take. Then we got the bill! $80.81

We took him back to the hospital every day to have his dressing changed. He’s started calling it ‘The Happy Place.” Poor guy can hardly walk after they clean and dress his burn. On the 15th a nurse from Canada arrived to do some volunteer work and she’s cleaning the wound now and we’ve taught Sao how to change the dressing so he can go home and spend some time with his family.

All the treatments and all the meds have run just over $500. Pretty cheap by western standards, but way beyond the grasp of the average Cambodian citizen. Sao’s friends from around the world are chipping in to cover the costs. If we collect more than we’ve spent, we’ll donate the balance to his local school. If you want to help cover the costs go to: and click on the PayPal button. Drop me a note to let me know the donation is for the Sim Sao Recovery Fund.

I got a text message from Sao right after we started taking him to the hospital: ‘Bill, I am so happy. I’ve never had anyone help me before. Thank you all so much.’

How could we have done less?