Half the Sky Themes
by Nicholas D. Kristof, Sheryl WuDunn

Compassion Fatigue

Prudence Lemokuono’s potentially-preventable death is initially attributed to the loathsome Dr. Pascal Pipi, a staff physician with a disdainful attitude toward the penniless villagers who fall within his catchment area. He is characterized as an intellectual and a man of privilege, “solidly built” in a region where weight implies a steady income, and a notably “superb” French speaker who is twice described as “intelligent” in as many pages. Until Kristof discovers Prudence becoming septic in an “unused room,” the doctor does not appear markedly different from his Western counterparts: “diligent,” yet “contemptuous” of those from a low socioeconomic background.

Unlike Western physicians, Dr. Pipi is not obligated to treat patients with emergent conditions, regardless of their ability to pay. His delay of Prudence’s treatment is portrayed as punitive, even unethical, but his failure to save her owes less to his attributes and more to his context: the hospital does not have the supplies to treat patients with advanced infections, and Prudence had been in obstructed labor for three days before she was transported there. The doctor, who is described as a “hard worker who was hugely overburdened,” is reliably present in a system where absenteeism is rampant, and Prudence is probably not his only patient. He suffers from compassion fatigue from having to treat critical cases within a broken system. Indeed, Dr. Pipi’s primary complaint about the villagers is not that they are less deserving of care, it’s that they do not seek enough of it.

Half the Sky is structured around stories about women with names, because research has shown that “statistics have a dulling effect.” Trafficking, rape, and maternal mortality are not considered newsworthy: people have become numb to “quotidian cruelties.” Public interest is reserved for instances of injustice committed by one individual against another, not broken systems and monolithic data. It’s easier to blame Dr. Pipi and his apparent lack of empathy than it is to blame the broader culture that has conspired to devalue the life of a woman in Sub-Saharan Africa. But he is not the only one who suffers from compassion fatigue. The problem neither started nor ended with Prudence: one woman per minute dies under circumstances like hers. Kristof and WuDunn want to know what “you” plan to do about it.

The Limitations of International Aid

Good people are prone to giving bad aid. Usually, the trouble arises when international donors presume to understand a problem without understanding the affected community. Rather than creating a statistics-based needs assessment in conjunction with local experts, these donors initiate culturally insensitive projects based on their own perceptions.

This includes corporate donors like Procter & Gamble, an American company that tried to solve the problem that inadequate menstrual hygiene presents to female students in Africa. Procter & Gamble distributed their Always and Tampax products in areas that lacked running water, and the company failed to understand “cultural taboos about blood” that made it impossible for girls to change or dispose of used pads and tampons. What was intended to be a low-cost intervention escalated into the need to...