Wheels of Fortune
Two years ago a man named Ron Rice called me on the phone and said his friend Ayuba Burki Gufwan was in San Francisco and wanted to meet me in my office. He was from Nigeria. OK, Great. And he wanted to tell me about his ministry to the disabled. He would come in two days. OK, Great. The absent-minded professor was in office hours with some students at the time and forgot to write down the appointment. Two days later, the phone rang again. It was Ayuba, on campus right now, could he come up? Oh Yes…er…right…sure. (So much for getting that exam ready by 1pm…)
A few minutes later I met Ayuba. I greeted him awkwardly as he navigated his wheelchair through the narrow door into my office. He wanted to show me a video. What I saw in the video shock
ed me, individuals who had contracted polio as children without use of their legs, crawling around in the dust, often seen as outcasts or even as cursed by God by their families and in their communities. I was moved by the video. And if it doesn’t move you, then unfortunately you have the heart of a kitchen appliance.
Ayuba himself was an inspiration. He had started this ministry based on his own transformation after receiving a donated wheelchair. He loved God and the poor. I read a little more about the disabled across the world because it was something that I knew little about until Ayuba showed up at my office. I learned that there are about 1 billion disabled people in the world today. Most live in developing countries. And they are the poorest among the very poor in the world. When Jesus talked about “the least of these” (Matthew 25), this is who he is talking about.
Ayuba asked me if I could do a study on the impact of his program in Nigeria, because as explained passionately to me, “We have a big impact and I want to show this to the world.” I rarely do this, but I immediately agreed on the spot. And one of my favorite masters students, Justin Grider, was eager to take up the project for his thesis. We planned for the study to take place in Nigeria. Unfortunately a month later Boko Haram began to ramp up its campaign of senseless acts of violence in northern Nigeria, near where Beautiful Gate ministries is located in Jos. The Vice-provost at USF quickly put the clamps on the Nigeria study–way too dangerous, especially for Americans. So we had to look for an alternative. Justin had spent six months in Ethiopia, so that became our next choice.
So we set out to ask the question: What happens when you give a disabled person in a developing country a wheelchair? A randomized control trial was out of the question, as it is unethical to randomize a treatment that is scientifically proven to have positive effects. The issue was, however, to what degree would a wheelchair recipient’s increased mobility have significant effects on an ability to integrate into the local economy, to move from street begging to normal work, to provide things of value to others, and to earn income to support themselves and their families.
Justin worked with three NGOs distributing wheelchairs to the disabled around Addis Ababa, the capital of Ethiopia, and obtained data on 261 disabled persons. Of these, 120 had been given a wheelchair, and 141 had been examined by a physician and were certified to receive one in the future. We used a technique called covariate matching to statistically match each of those who had wheelchairs with a “nearest neighbor,” a representative counterfactual very similar to the recipient, but who did not have a wheelchair, a match created over gender, age, education, religion, socioeconomic status, and type of disability.
What we found was that the treatment group (those given wheelchairs) had more mobility–dramatically more. In a given week, they traveled about 12 km farther away from their homes than those without wheelchairs. But that was only the beginning. Those provided a wheelchair were 15 percentage points more likely to be formally employed. We also found that they spent nearly two hours more per day in income-generating work, and nearly an hour and a half less per day street begging. Their income was $6.23 per week higher than those without wheelchairs, a 77% increase over the very small baseline of $8.02 (yes, the very poor earn this little per week in places like Ethiopia.) Some of our other estimates showed even bigger impacts. We found that an economic investment in a wheelchair realized an internal rate of return of 122%–simply based on the increase in income the recipient would earn. For those of you not familiar with rates of return, 15% is big–122% makes Apple and Google look relatively unproductive.
Justin carried out the econometrics on the study under my direction as part of his masters thesis. His thesis received highest honors at the University of San Francisco. We then learned that it was invited for submission at the 2014 New Economic Talent Competition and Conference, an international competition for economics research hosted in Prague, in the Czech Republic. The university cobbled together some money for Justin to present his paper at the conference. He flew to Prague last May and gave the paper. A day or two later I received an e-mail from him. The paper had received first place at the conference. (Here is Justin holding his big check. I told him he should get to know the cute Polish student who finished 2nd, but he said she had a massive Polish boyfriend in attendance.)
The point of this isn’t about Justin winning the prize, however. The point is that there are things that we can do to make the poorest of the poor better off–simple things that are transformative and that make a huge difference. I encourage you to visit World Renew’s Beautiful Gate/Wheelchairs for Nigeria and think about making a donation that will allow someone to live and work with dignity. A wheelchair costs $150. Do we really need $150 as much as the people we see in the video? Rough question, isn’t it? Another benefit of Beautiful Gate is that it is a Christian organization, but most of its wheelchair recipients are Muslims, helping to promote peace in an area that has seen tremendous violence against Christians.
We just finished submitting a co-authored version of the paper to a development economics journal. It is a study with a modest sample size, carried out in only one region of one country. But our hope is that publication will help us and others secure funding for a set of larger studies to see how simple assistive devices can help the poor lead lives of dignity and participation in the larger society.
Great story!! Certainly inspires one to consider “being a doer of the word”!!