Tuesday, January 06, 2009

Upstream and Downstream

Do you know the difference between upstream and downstream work? Sometimes they're called justice and mercy work. Upstream or justice work addresses the root causes of a problem, while downstream or mercy work concerns itself with delivering immediate help to people who need it now. It's prevention versus cure.

For example, Haitian Hearts mainly works in the downstream or mercy arena. We provide medical care to poor Haitians and bring children and young people to the United States for surgery. We respond to these emergency problems, most of which have their root in poverty. We don't more broadly address this poverty.

Some of our patients with heart problems have these problems due to rheumatic fever, a preventable disease. For rheumatic heart disease, upstream work might focus on educating doctors and people on strep throat and its treatment (penicillin) so that rheumatic fever doesn't develop. Work further upstream might be getting funds for more clinics and doctors and nurses in Haiti so that health care is more widely available.

A nun I know frequently talks to me about a friend of hers who runs an orphanage in Ecuador. This orphanage takes in mainly disabled children who have been abandoned. This seems to fall under the category of downstream or mercy work. But then it struck me: any work that benefits children must be considered upstream work, too. Children, we have so often heard, are the future. They will grow up and create the world anew. Helping children contributes to a just future, a future that is downstream for us now.

What could be better than that?


Jen@TRTP said...

Maria-I wrote to you on Haitian Hearts but the email came back. This is an awesome blog! I am with The Red Thread Promise, a small charity out of Downers Grove, IL. We focus on the medical needs of orphans. We would like to work "upstream" with you, helping you help the orphans of Haiti. Our website is www.redthreadpromise.org. We are putting together a collection for medical/health supplies for Haitian orphans, and would like to discuss working with you. Please write to me when you have a chance! Thanks. Jen

Maria Carroll said...


Thanks so much for your comment. I loved reading about The Red Thread Promise. What a great organization. What is your email?


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