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Lending for health or borrowing trouble?

Jeff Trexler | Tuesday 7th July 2009

Is trying to help children always a good thing?

While the rest of the world was watching the Michael Jackson memorial, this afternoon on Twitter an interesting discussion occurred between global health expert Alanna Shaikh and Tori Tuncan, founder of the microloan service Lend4Health.

Although Lend4Health is a celebrated example of an organization that is using online social networks to promote social good, Shaikh confessed that the venture "gives me the creeps." Part of the problem, Shaikh noted, is the medical approach that Lend4Health currently supports: the controversial biomedical approach to autism, "quackery" that should not be a basis for a family's going into debt.

Another problem is more systemic: namely, the way that the microlending model infringes on the privacy of children.

It's a real issue. Lend4Health's website offers photos, names and diagnoses of the kids being served by the loans, and its Twitter account provides updates and detailed appeals. Even if parents are legally free to disclose otherwise private medical information regarding a minor child, Lend4Health raises what is--for me at least--an ethically questionable incentive for parents to make a child's condition public in exchange for cash.

Whatever one's assessment of biomedical intervention, surely the social enterprise community is not so caught up in its own virtue that it can't see how posting "my son Timmy is autistic and we can't afford to pay to get rid of his condition" can hurt the very children that lending for health is supposed to protect. A child's sense of self, relation to parents, interaction with friends--publishing medical information can have payback for the kid years after the loan itself is repaid.

While I admire Lend4Health's dedication to doing good, I am concerned about the potential ramifications for both children and adults should the model go to scale.

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Tori Tuncan | Posted: 8 July 2009

A friend on Facebook saw some of the discussions about this on Twitter and sent this link, about a hospital that used Twitter to give updates to a family in Mongolia while their child underwent surgery. The family gave permission for all the hospital's followers to see the tweets. Interesting concept that gets at where the future might lead re: health and technology and privacy...

http://bit.ly/ENcEt

Jeff Trexler | Posted: 8 July 2009

@Kim Hurlbut: To illustrate L4H and how reactions to an image can differ depending on the context. Objections actually prove my point by exemplifying how responses to an image are not limited to the original intent in posting it.

Rather than trying to shame me out of my assessment--which won't work, by the way--a more productive response would be to develop firewalls to preserve children's privacy as best as is possible given the situation. One way would be to restrict public access to registered users, tho that's easily circumvented. Another would be to limit access to people who deposit a minimum amount for a loan. You cut down on potential users, true, but you also discourage looky-loos.

Kim Hurlbut | Posted: 8 July 2009

L4H going to scale debate aside, if this bloggerof this article is concerned about chidlren's privacy why is he using one of the photos from the site?

Jeanne Cantkier | Posted: 8 July 2009

Alanna,

You may want to dig a little deeper and discover the truth about these treatments for yourself. DAN! protocols are working the vast majority of children. Our kids are getting better. FYI:

1. Mild Hyperbaric Oxygen Therapy (m-HBOT) is effective and safe for autism treatment, according to the latest scientific research. Many families are reporting anecdotal evidence to this end as well.

2. Probiotics have been an effective treatment against gastrointestinal diseases for some time. Please note, many mainstream food products now contain probiotics. Also, many mainstream doctors now prescribe probiotics to patients.

3. Chelation therapy protocols can be, and in most every case are, safe. The one death associated with chelation occurred because the doctor was not trained properly. One must research and be sure they are working with a highly trained physician before allowing their child to be treated, just as with any treatment for any medical condition.

Lavinia Weissman | Posted: 8 July 2009

Tori, thanks for all this clarification. I think in this economic challenging times, there are lots of ways for families to be at choice for how to proceed. And at the same time there are ways short-term to help (like your program) as hopefully more and more communities grapple with how to deal with treatment and challenges for children who may be chronically ill into their 70's or later.

I hope you will read my blog, I would love your comments and thoughts.

http://bit.ly/PmSbP

Health is so much more than health care and what it takes to fund the direct aspects of care that come from the health care system. I am curious can people use this system for treatment that is not traditional or proven through research?

Tori Tuncan | Posted: 8 July 2009

[continued from previous re: privacy on L4H...]

3. Name is optional. In the request form, I ask for the loan beneficiary's name, but I also ask what the preferred online listed name should be. So, really, only I know if the names listed are actually their names. I did this because I know if I were to put my son up on the site, my husband would most likely be concerned with privacy issues, and so I'd use his middle name or something. I don't use last names, and if a family includes it in their write-up, I delete it.

So those are the 3 things I'm currently doing to try to protect privacy. I'm open to hearing other ideas on what else I could be doing in this area.

Tori Tuncan

Founder, Lend4Health

Tori Tuncan | Posted: 8 July 2009

[...continued from previous re: privacy on L4H...]

2. Location is optional. When I started L4H, I didn't include location. I started including it recently, though, because I was involved in some SocialActions http://(www.socialactions.com ) developer discussions where location was highlighted as an important factor in taking action. So, for example, you might be more inclined to make a loan to somebody if you knew they lived in your state.

In the request form I ask the family what location they want listed. Even if they say it's okay to include the town/city, I have decided that state is the "smallest" I want to get. This was after an online discussion I had with somebody who brought up the issue of pedophiles and that sort of thing, as well as discussions stemming out of @Armano's #daniela fundraiser. So I'm going with the thought that the state-level is "small" enough to create a bond or empathy with potential lenders, but not so "small" that it could possibly endanger the child. [...cont]

Tori Tuncan | Posted: 8 July 2009

For the sake of the discussion, I figured I'd let everybody know what currently is in place on Lend4Health in terms of privacy.

1. Photos are optional. I tell each family that photos are optional and that there are a few ways we can do the photo. (a) They can choose a regular photo (b) They can have a photo with the child looking to the side, looking down (see Ezekiel's post), looking out at the ocean, etc. (c) They can choose a close-up on the child's face that cuts out some of the "context" (see Ethan's post). (d) They can choose a drawing the child did. (e) They can choose a clip art or symbol (heart, Thomas train, etc) that they feel represents the child. (f) They can come up with something else. (g) They can have no photo or other graphic. In most cases, families are more than willing to include a photo and are proud to "show off" their cute kids. But I do let them all know that it is entirely optional.

[... continued ...]

Tori Tuncan | Posted: 8 July 2009

Haha, that last "****" is supposed to be "another word for rooster" - it automatically assumed it was a swear word.

That's in reference to a situation where there were Kiva lenders upset that somebody was trying to get a loan for his "rooster" fighting business.

Tori

Tori Tuncan | Posted: 8 July 2009

Hi Alanna, actually lots of the kids are seeing really great improvements from these treatments. I disagree with your assessment of the effectiveness of these things. They may not be effective for everybody, but many kids are doing great with them.

I think the discussion Jeff is trying to have is about the privacy issues for kids' health online, or at least that's the discussion I'm really interested in seeing here. If you want to debate the effectiveness of various autism treatments, that might be better suited for a different forum.

Since Lend4Health might someday do loans for MS, cancer, birth doulas, diabetes, etc, I think the privacy issue is a good one to have, both in regards to kids & adults. The biomedical treatment of autism may just be one portion of the future Lend4Health loan requests, and of course as a lender you would be able to choose not to lend for those requests, similar to how a Kiva lender can choose not to lend to the **** fighting loan request.

Thanks,

Tori