In 1968, in Cuernavaca, Mexico, someone by the name of Ivan Illich gave a speech to something called the Conference for Inter-American Student Projects. “To Hell with Good Intentions” is the signature line from the speech – a line that has come to serve as its de facto title, and that probably now has enough ironic and esoteric cachet to make for a pretty righteous bumper sticker for a global health NGO.
The speech might not be known to everyone (you can get to know it here), but nearly fifty years later it has achieved something of an afterlife as a cautionary message for misplaced ‘dogooder’-ism. It is presented among the first pieces in our global health curriculum, not necessarily to be taken at face value but as a prompt for reflecting on the intentions that might send someone venturing forth from one’s own place into other people’s places, and the potential for some collateral downside. I had a sequence of two reactions to THWGI, both of which I imagine to be pretty common.
The first reaction was immediate and clear: that Illich’s ideas are valuable and need to be internalized in some way. It’s true that you’ll never fully appreciate the perspective of those whose lives you’re intervening upon. The effort and investment of going can create a self-congratulatory tendency regardless of what was or wasn’t accomplished along the way. Illich discomfortingly strikes a chord in me – and probably a lot of us – in accusing us of some adventure-ism. Somewhere deep down, it’s just kinda fun getting on a plane and going places; you might forego some niceties out there, but no one seems to be self-sacrificing in the sense that they just hate going to foreign places to practice health care, but do so anyway. These are criticisms that deserve to be remembered.
Then the second reaction, after a little recovery: that this is all definitely a bit much. There is contained in this speech an important nugget, but wrapped in a gracious layer of hyperbole. Somewhere in the process of processing the message and generalizing it to a modern global health practitioner, I found myself curious about the exact context – What was CIASP? and Who was Ivan Illich? A piece so polemic could not possibly not have a lot to do with who Ivan Illich was. A polemic this specific could not possibly not have had something to do with some true do-gooder syndrome on CIASP’s part.
So I looked up both Illich and CIASP. I hoped in doing so that I might learn a little something about all the skeptics. I hoped I might learn something that pertained to all the people putting themselves into this arena. In total honestly, I also hoped to find that there was something distinctly quaint in CIASP’s approach – something that sort of let us off the hook half a century later, even as I took the speech to heart. Has anything evolved by self-appraisal or did the CIASP’s just stop inviting the Ivan Illich’s to the podium?
I started off by learning about CIASP, which I’ll cover in my next post, and I’ll follow up with Ivan Illich down the line.