Dr Nick Laing writes about global health and what it means to be rich. Nick will be preaching at St Barnabas on Sun. 31 Oct.

It’s 4:00am. “Doctor, please come now”. I sleep not very well on a bamboo mat in our most remote health center Pwunu Dyang. The rain starts pounding on the roof, and soon also on my conscience.

Midwife Scovia has fear in her eyes and since I know how tough she is, her fear soon becomes mine too. To cut a long story short, Lucy* is in labour. She had 4 previous cesarian section operations to remove babies from her womb, so there’s no way Scovia can safely deliver her baby in the health center. If Lucy doesn’t get an operation in the next few hours, her womb might rip open and kill her and the baby.

Except that the hospital which performs the operation is 4 hours away. And the road is close to impassable, even on a motorcycle. And the rain pours. And its 4:00am

But we can overcome these challenges. Scovia’s husband had hired a motorbike for a couple of days, and is willing to brave the rain and the road to take Lucy to a halfway point, where she can catch a NGO ambulance the final two hours to the hospital. You might scream “how can a woman in labour with scars on her uterus travel two hours on the back of a motorbike on terrible road?” To which I can offer only an insufficient answer. Because she must.

But one challenge remains – Lucy has no money. And the motorbike transport needs money, as does the ambulance driver. She needs about 20 US dollars in total, not a huge amount even here but still money Lucy doesn’t have. But this time everything might just be OK, because the rich white man is here. The rich white man who can pull 20 bucks out of his pocket and not even notice it has gone. The rich white man who 10 years ago used to earn that 20 dollars in a mere half an hour. The rich white man who used to earn the same amount in a week as our incredible midwife Scovia who’s skills might save Lucy’s life earns in a full year of hard work.

This dragon who hoarded his wealth, is about to flick one of his thousand gold coins towards a suffering mother who might then survive the day. Should this dragon feel good about that? Am I somehow a good person because I “helped” someone with 20 dollars?

$#!%loads of money in this world

There’s Ugandan book that you can buy on the bus and in the market entitled “Why have you chosen to be poor when there is so much money in this world?” That could be a good question, if it wasn’t for the “chosen” part and the poverty shaming (we’ll get to that). There is in fact $#!%loads of money in this world, more than enough to go around. The per capita GDP on this humble earth is US$11,000 a year for every woman, man and child. With a few tweaks in our global system we could all happily live on that much money. There’s more than enough money in this world to transport this woman to hospital. More than enough even to transform the healthcare infrastructure so that her transport and healthcare could be free.

But unfortunately that won’t happen tonight. The $#!%loads of money does not reach midwife Scovia, let alone labouring woman Lucy. And why is that?

Because we are dragons

A lot of us are dragons of various sizes, hoarding our wealth as we build our personal or family empire. Us dragons pour our money into bigger and bigger dragons dens (houses), bank accounts with many zeros and the kind of lifestyle the other half of the world can only dream of.

And the dragon problem is getting worse. Inequality during the pandemic has skyrocketed across the globe. In America during the pandemic, the top 1% of Americans looted an incomprehensible 50 Trillion dollars from the bottom 90% of the population. Those dragons must need a massive cave just to store that much gold. An estimated 300 new HUGE dragons (billionaires) were also spawned during the pandemic, on average one a day.

Many of us smaller dragons in Western countries like to take aim at much bigger dragons like Bezos and Musk, who to be fair are twisted enough to fly into space for fun while a global pandemic rages. Instead of cavorting into space, those two could have paid to vaccinate the whole of Africa for coronavirus by now*.

But I digress, because we are indeed dragons too, not just Jeff and Elon. Most of you reading this are rich, perhaps richer than you realise. If you own assets worth more than just $90,000, you hoard more gold than 90% of humans. If you have just $4,000 of assets to your name, you are richer than half the people on the earth. I’m not saying this to evoke guilt, only to bring us to the realisation that yes, you and I might just both be dragons.

How did I become a dragon?

Well most of it was probably chance. There may have been sound decisions and hard work along the way, but your path to a healthy hoard was largely decided even before you were born. You won the lottery, congratulations! Or perhaps more accurately a series of lotteries. Two lotteries define the lions share of how rich we will become. Your birth country, and your parents’ wealth

Lottery 1: Your birth country. For me I spun New Zealand, and straight up won the lottery. Your birth country usually has the biggest effect on how much money you will be able to earn and save. A minimum wage earner in New Zealand might not feel lucky because they will understandably compare themselves to their richer neighbours. But by age 40 or 50, many minimum wage earners in New Zealand will find themselves in the top 10% of the world’s richest people. Even an unemployed New Zealander has a higher living standard than our amazing midwife Scovia, who is tertiary educated and gainfully employed but earns just $120 a month. While unemployed in New Zealand though, you will probably live in a house with more than one room (Scovia has a hut), have running water, electricity, free high quality education for your kids, free healthcare and perhaps even a car! I’m yet to meet a Ugandan nurse who owns a car.

Lottery 2: Your parent’s wealth. Even here in Uganda, if you are born to the tiny percentage who are rich, you will have a decent chance to amass a healthy hoard. While Uganda isn’t rich enough to provide your children with the ingredients for financial success, the good education and healthcare your children need can be bought. Even in richer countries, it has been demonstrated that you are better off being born rich than having ability or talent. In the lead author’s words

“People with talent often don’t succeed. What we found in this study is that people with talent that come from disadvantaged households don’t do as well as people with very little talent from advantaged households.”

Lottery 3, 4, 5 etc.. Your race, gender, orientation, neural make up and countless other dice were also rolled before you were born that might affect your potential to stash cash in this harsh world.

The lotteries of life are real. So perhaps we should not feel too guilty about our dragon status, because it mostly happened due to factors outside of our control. For the same reason we shouldn’t be proud of whatever hoard we have amassed. Much of the reason we are rich was probably because of our favourable background, more than our back breaking hard work. For the most part we don’t “choose” to be rich or poor, the lottery decides.

But can we shed our scales?

So what can we do about it? Can we shed our scales? I’m not going to espouse my personal opinions on potential systematic changes like tax or universal basic income, but instead focus on three steps all of us dragons can take to change ourselves and shed our scales.

1. Realise you are a dragon. This may be the hardest step of all. It’s tempting and easy to tell ourselves and others that we are in fact one of the financial strugglers, usually by comparing ourselves to an even richer dragon. I’m afraid there’s always someone richer, unless you are Jeff. Once we realise though that we actually do have a $#!%load of money at least by global standards, we are set free to do something about it and take steps 2 and 3.

2. Disperse your hoard. Whether through personal connections or high impact charities, it might be time to start dispersing your hoard. If you’re interested in the best ways to give money to make the biggest difference, check out this thing I prepared earlier. You won’t be alone, giving away large amounts of money is no longer longer a fringe or religious activity. Through the movement “Give What You Can”, over 7000 people (many very young) have pledged to give at least 10% of their income to effective charities for the rest of their lives – a beautiful commitment.

I also want to personally thank a growing group of insanely generous partners and friends who have given away huge portions of their stash, often thousands of dollars at a time towards launching health centers in remote places like Pwunu Dyang through OneDay Health

3. Shift our future focus from stashing gold, to making a better world. We are so blinded by all our dragon friends with their huge hoards, we feel the need to keep up with the Jones’s by making our hoard bigger and bigger and BIGGER. When we realise we have more than enough to thrive, we can choose to change our life’s trajectory. Whether it’s through choosing a job which makes the world better, volunteering for charity or our struggling neighours, or even earning lot’s of money for the express purpose of giving it away, there are plenty of ways we can shed our scales or at least become better dragons. Be inspired by Gandalf, who knows a thing or two about dragons.

“I wish it need not have happened in my time,” said Frodo. “So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.”

And while the committed, talented, skilled and grossly underpaid Scovia rushed around to orchestrate the saving of Lucy’s life, I put my head in my useless hands and cried. I cried at my own iniquity, I raged at the unequal, unfair and unnecessary state of this precious earth we call home, but in the end I allowed myself more than a sliver of hope.

“Well, he peeled the beastly stuff right off … And there was I as smooth and soft as a peeled switch and smaller than I had been… and there it was lying on the grass: only ever so much thicker, and darker, and more knobbly-looking than the others had been. Then he caught hold of me – I didn’t like that much for I was very tender underneath now that I’d no skin on – and threw me into the water. It smarted like anything but only for a moment. After that it became perfectly delicious and as soon as I started swimming and splashing I found that all the pain had gone from my arm. And then I saw why. I’d turned into a boy again…”

Dragon Eustice has his scales shed – C. S. Lewis, The Voyage of the Dawn Treader

* Lucy is not her real name
* Conservative estimates of over 7 billion dollars spent by Bezos and Musk on their space race would have been enough to buy enough to vaccinate the 1.4 billion Africans twice.