First, Mothers and Children: A Postscript to “Moving Zion Southward, Parts I & II”

View PDF

In “Moving Zion Southward, Part II,” I noted that from 1985-2000, average LDS church cash donations to humanitarian aid were $20 million annually.[1] An “alert reader,” as Dave Barry would say, has pointed out that since 2000 humanitarian donations have actually jumped to the range of $100 million per year. This fact is not published on the church internet site and verification required a phone call to LDS Welfare Services to obtain a “fact sheet” documenting the growth in giving. The church has not drawn attention to this increase. Nevertheless, I wish to praise the increase here, as the additional donations could save the lives and/or prevent the disability of more than 10,000 children annually in less-developed countries (LDCs) as well as alleviate the malnutrition of hundreds of thousands, if spent efficiently. That having been said, the increased amount as a percentage of church budget is still only a quarter of what is donated annually to humanitarian causes by those Christian denominations that truly earn a grade of “A” for their efforts.[2] Still, had I known of this increase, I would have assigned a grade of “B” to the charity of Mormon members instead of a “C.” I’m happy to be corrected. 

One can only speculate as to the causes of the increase, but certainly publicity could have played an important role. Church authorities have, in fact, spoken out in recent years about the terrible plight of the poor and homeless in the world and of the power of the church’s plan and programs to overcome such problems.[3]

In “Moving Zion Southward, Part I” (Dialogue 35, no. 4), I took the position that, based on the pronouncements of church presidents and leaders, the presence of tens of thousands[4] of chronically malnourished and starving and/or dying children attending LDS congregations in less developed countries was, in fact, accidental and due to a combination of factors, but not due to intentional church policy decisions related to allocation of the $400 million[5] in cash welfare donations available to the church. Only about $33 million of that $400 million, I estimated, would be required to relieve the malnourishment and disability or death of the LDS children in these countries.[6] I also, therefore, assumed that simple publicity, that is making both membership and leadership aware, first, of the nature and extent of the problem, and, second, of the potential for meaningful intervention, would likely lead to at least a partial resolution. However, a recent conference address, given in October 2003 by Elder Dallin Oaks, has given me pause and lead me to suspect that these assumptions were overly optimistic.[7]

I am happy to note that Elder Oak’s address responds, if indirectly, to the existence of seriously malnourished LDS children in less developed countries: 

The doctrine and practice of personal responsibility and personal effort collide with individual traditions and local cultures in many lands. We live in a world where there are large differences in income and material possessions and where there are many public and private efforts to narrow these differences. The followers of the Savior are commanded to give to the poor, and many do.[8] But some gifts have promoted a culture of dependency, reducing their recipients’ need for earthly food or shelter but impoverishing them in their eternal need for individual growth. The growth required by the gospel plan only occurs in a culture of individual effort and responsibility. It cannot occur in a culture of dependency. Whatever causes us to be dependent on someone else for decisions or resources we could provide for ourselves weakens us spiritually and retards our growth toward what the gospel plan intends us to be. 

The gospel raises people out of poverty and dependency, but only when gospel culture, including the faithful payment of tithing[9] even by the very poor, prevails over the traditions and cultures of dependency. That is the les son to be learned from the children of Israel, who came out of hundreds of years of slavery in Egypt and followed a prophet into their own land and became a mighty people. That lesson can also be learned from the Mormon pioneers, who never used their persecutions or poverty as an excuse but went forward in faith, knowing that God would bless them when they kept His commandments, which He did. 

Elder Oaks’s discourse raises some issues I would like to discuss. First, and by way of context, we live in a world with tragic suffering arising from disease burden, malnutrition, disability, and death among the poor. Two billion people, 33% of the world’s population, suffer from micronutrient deficiency, and tens of millions of survivors are blinded and/or mentally retarded as a consequence. Eight hundred million have frank protein-energy malnutrition. Ten million of the world’s 50 million annual deaths are children in less developed countries, at least half of whom die because they are unable to consume enough food. A minimum of another 40 million children annually are permanently disabled, and by far the most common disability is the decreased cognitive and work (or functional) capacity that results from chronic malnutrition in utero and in childhood. 

At the same time, the global food supply far exceeds demand. Each year, the amount of food needed to feed the malnourished of the world is simply wasted. The cost of relieving this human suffering is estimated to be $150 billion annually (1.5% of U.S. GDP or 0.5% of the GDP of all wealthy-countries), yet total donations from all wealthy countries to relieve this disease burden amount to only $15 billion, or 10% of the amount needed. Given these circumstances, I can’t help wondering if we as a people and church should not be more concerned in our public pronouncements over a situation of devastating and needless inequity as over a “dependency” risk in the cultures into which the poor and malnourished are born. Other Christian churches, Protestant and Catholic, have long asked those among their members blessed with affluence to do far more to relieve the suffering of the world’s poor than has ours. 

Second, and with regard to problems of dependency (which are considerable and deserve attention), “Moving Zion Southward” proposed employing the “minimal-intervention package” designed by the World Health Organization (WHO) specifically to avoid dependency problems. (As a proselyting church, we also want to avoid economic conversions.) No cash assistance is offered. No shelter assistance is included. No food staple aid is provided. There is no requirement of spousal separation in order to qualify for benefits. U.S. Welfare and the WHO “minimum-intervention package” are completely different. By far the largest nutritional problem among U.S. welfare recipients is obesity, and their rates of obesity exceed that of the general population. The WHO intervention package addresses an entirely different problem, and of the five proposed “Moving Zion Southward” interventions, three carry absolutely no risk of dependency of any type[10] (visits from home health care workers, vaccinations and de-worming, and health education). One carries minimal risk of dependency if combined with a requirement of regular church attendance (access to minimal health care for the unpredictable, and often rapidly fatal, common infectious diseases of childhood). And one intervention carries some risk of dependency and might need to be combined with a work program in addition to church attendance in some countries, but probably not in most poor countries with current significant LDS populations (“food supplements” not “food” or “food staples,” for children and pregnant women).[11] The intervention package does not seek to “narrow differences in income or material possessions.” It simply seeks to alleviate childhood malnutrition and the death and disability it causes. It is true, an improperly designed program could lead to dependency and economic conversions, but concern over this prospect appears to be ruling out all interventions, including those that would not encourage dependency. For me the troubling question is this: Do we as a church want to abandon malnourished LDS children over de pendency concerns when as a church we have the ability to design an intervention program that would, in fact, avoid or minimize this problem? Moreover, is it possible to harmonize LDS scriptures[12] with a failure to help 50,000 faithful but malnourished and starving children while the church solicits and receives hundreds of millions of dollars precisely to help the poor and needy among us? 

Third, with an eye to doing no harm, it is surely the case that, independent of our intentions, our hesitance to provide nutritional assistance to malnourished LDS children and pregnant women perpetuates the very dependency problem the church seeks to avoid. It is important to see the intervention package as an investment, not unlike the Perpetual Education Fund, but operating at a far more fundamental level. Any child is clearly more likely to learn the lessons of independence and to practice the virtue of self-sufficiency if he or she survives into adulthood, and survives with a functional body and a functioning mind. The most important measure to prevent long-term adult dependency of church members in less developed countries is nutrition assistance to malnourished children and pregnant women. Chronic malnutrition, on the other hand, will create a generation of LDS members who have suffered permanent long-term effects. These include decreased cognitive and functional work capacity. The research literature is replete with this finding: 

The problem of malnutrition in poor societies is best viewed as a “syndrome of developmental impairment”, which includes growth failure; delayed motor, cognitive, and behavioral development; diminished immunocompetence; and increased morbidity and mortality. Growth retardation is often found in association with other problems, such as vitamin A deficiency and anaemia. These clusters of nutritional problems flourish during periods of vulnerability, namely in utero and during the first three years of life, and affect at least a third[13] of all young children in developing countries. Survivors of malnutrition in early childhood suffer functional disadvantages as adults, including diminished intellectual performance, low work capacity, and increased risk of delivery complications. The prevention of low birthweight and the promotion of adequate growth and development during early childhood will result in healthier, more productive adults. Such investments, because they build human capital, are best viewed as long-term economic strategies.[14]

In South America it is estimated that 16 million children suffer from malnutrition, and of these 16 million many will die and still more will be left with severely diminished cognitive ability.[15]

There is probably no more fundamental way to eliminate poverty than to raise the development potential of children. Nutrition is one of the keys to their proper physical and cognitive development.[16]

Malnutrition is widespread among disadvantaged populations living in developing countries. The consequences of malnutrition are severe and long lasting. . .longer and more severe illnesses. . .higher risk of dying. . .delayed motor development and lower cognitive function and school performance. . . .[individuals who were malnourished as children have impaired work capacity and worse reproductive performance. . .[with] negative effects, not only on those afflicted, but on their offspring as well.[17]

Of course, I don’t have a “vote” on international LDS church welfare policy, only an opinion and sincere hope. But for the foreseeable future, my concern remains that unless and until we change our approach, no matter how generous LDS members are in their fast-offering contributions, the church will have millions of members attending its Sunday ser vices who possess the greatest material wealth ever witnessed in human history, simultaneously with tens of thousands of starving, malnourished children. 

---

[1] Dialogue: A Journal of Mormon Thought 36, no. 1 (Spring 2003): 36n13.

[2] Ibid., 36n12, 37. 

[3] Examples: “I remember as I went through the streets of Calcutta, seeing the great numbers of starving people… .1 remember being on the fifth floor of a big hotel in Calcutta and looking down on the back street where these people in their meager clothing were lying on the sidewalks.. .with no place to go and nothing to eat and no shelter… .1 saw the rain come, and I saw these people move back a little farther under a little shelter. I saw [the people in Peru] suffer, and we were upbraided by one of the press one day for not taking care of all these poor people. ‘Why did we travel the world and do all these things and did not take care of these people,’ he asked. I said, ‘That is something you don’t understand. If these people would accept the gospel of Christ, the program is provided and they could be taken care of, and their sufferings could be alleviated. They could enjoy reasonable conditions in their homes and in their living.’ And that is true, my brothers and sisters. In my feeling, the gospel is the answer to all the problems of the world, if we go deeply enough and are united in solving them. And that is why we work harder in missionary work, so that we can gradually bring the gospel to all people.. .the gospel of serving the poor, taking care of those less fortunate than ourselves.” Spencer W. Kimball quoted by Edward L. Soper in “I have a question,” Ensign (Sept 1982): 30. 

“If every member of this Church observed the fast and contributed generously, the poor and the needy—not only of the Church, but many others as well—would be blessed and provided for. Every giver would be blessed in body and spirit, and the hungry would be blessed in body and spirit, and the hungry would be fed, the naked clothed according to need.” Teachings of Gordon B. Hinckley (Salt Lake City: Church of Jesus Christ of Latter-day Saints, 1997), 458. 

“I hope [and believe] the Church is good at taking care of its own… .It has a responsibility sure and certain that we must take care of our own and assist them with their problems.” “Messages of the First Presidency: Humanitarian Aid,” Church News, week ending 6 Oct. 2001, 2. 

“My plea—and I wish I were more eloquent in voicing it—is a plea to save the chil dren. Too many of them walk with pain and fear, in loneliness and despair. God bless us to be mindful of them, to lift them and guide them as they walk in dangerous paths, to pray for them, to bless them, to love them, to keep them secure until they can run with strength of their own.” Gordon B. Hinckley quoted in “No more tender and beautiful picture,” Church News, week ending 23 Sept. 2000. 

“At this very hour on this very day, some members even in our Church are praying for the miracle that would allow them to surmount the suffering that surrounds them. If, while we have the means to do so, we do not have compassion for them and spring to their aid, we are in danger of being among those the prophet Moroni spoke of when he said, ‘Behold, ye do love money, and your substance, and your fine apparel. . .more than ye love the poor and the needy, the sick and the afflicted.” Joseph Wirthlin, “The Law of the Fast,” Ensign (May 2001): 74. 

“I believe that when we face our Maker, we will not be asked, ‘How many positions did you hold?’ But rather, ‘How many people did you help?’.. .when we have eyes that see and ears that hear and hearts that know and feel, we will recognize current trends and current needs of our fellow beings among us who cry out for help. How do they eat—without food? How do they keep warm—without shelter? How do they live—without means? How do they get well—without doctors, medicines, and hospitals?” Thomas Monson quoted by Sarah Weaver in “We will be asked ‘How many people did you help?'” Church News, week ending 28 Oct. 2000, 4. 

[4] The study estimated the presence currently of 50,000 faithful malnourished chil dren, or about 1% of the church’s faithful membership. Had not missionary man-years been allocated in a way that limited the growth of LDC church membership over the last 35 years, malnourished children would probably make up 2-3% of the church’s faithful population at present. But in spite of the limited allocation of missionaries to LDCs, malnourished children will continue to increase as a percentage of the total faithful church membership, and could well hit the 5% mark by the year 2030 (see “Moving Zion Southward II,” 40n26.) 

[5] Per-capita welfare or “fast-offering” spending is $133 in the U.S. and usually $1 or less in the poor areas of LDCs, for reasons documented in “Moving Zion Southward Part I,” Dialogue: A Journal of Mormon Thought 35, no. 4 (Winter 2002): 91-109. 

[6] This proposal conservatively assumes an annual cost per person of $100+ per year, but some studies in Africa project a much lower per-person cost of $50 to $70 a year.

[7] Elder Oak’s office received a preliminary version of the “Moving Zion Southward” study, and he sent me a response through Fred Reilly, Commissioner of LDS Family Ser vices, in 2002. 

[8] Of those blessed with significant affluence and, thus, commanded to make substantial contributions to the care of the poor, the large majority do not, but a significant minority complies. The LDS population in the United States, according to recent reports, is among the most dedicated in terms of charitable donations, but since the large majority of these donations are made to the LDS church itself, the percentage devoted to significant humanitarian relief depends on church policy decisions. This is another reason to be encouraged by the recent increases in humanitarian aid.

[9] My preliminary study raised the concern that payment of tithing by the poorest members was, in fact, increasing the malnutrition and disability/death rates among their children. Would it not be easier to ask these people to tithe if at the same time they were able to receive nutritional assistance provided through the church welfare program?

[10] In my preliminary study three interventions were not recommended for selective application to church members due in part to concerns about dependency. They were: shelter aid, food staple aid, and microcredit of the kind currently being promoted worldwide by the business school at Brigham Young University (though not directed specifically to ward church members). 

[11] Such supplements come in a form that is not particularly palatable, and children must generally be prodded and encouraged by parents to eat them “because this is good for you”—in other words, for moral reasons.

[12] Perhaps the three most applicable would be Mosiah 4:17-27, D&C 38:11-24,39, and Luke 16:19-31. Others: Matthew 19:21,25:34-45; Luke 14:13; James 2:15-16; 1st John 3:17-18; Revelations 4:14-19; Mormon 9:36-39; D&C 42:30,39-40,52:40,56:18, 70:14, 78:6,104:18; and finally Moses 7:18. 

[13] In the Philippines and Latin America l/8th instead of l/3rd is a better estimate; including the Indian sub-continent and sub-Saharan Africa raises this figure dramatically.

[14] Reynaldo Martorell, “The Nature of Child Malnutrition and its Long-term Implication,” Food and Nutrition Bulletin 20, no. 3 (1999): 288.

[15] Norman Kretchmer, John Beard, and Susan Carlson, “The role of nutrition in the development of normal cognition,” American Journal of Clinical Nutrition 63 (1966): 997S-1001S. 

[16] Tadeo Chino and Namanga Ngongi, Foreword to What Works? A review of the Efficacy and Effectiveness of Nutrition Interventions (Manila, Philippines: Asian Development Bank, 2001), iii. 

[17] Dirk Schroeder, “Malnutrition”, in Nutrition and Health in Developing Countries (Totowa, NJ: Humana Press, 2001), 393.