Not just in Africa but in more and more areas of the world where economic liberalization policies are underway, individuals with decent incomes must face life-and-death decisions when it comes to responding to pleas for help. PNS commentator Steven W. Omamo is a writer and agricultural economist based in Nairobi. He is a Rockefeller Foundation Social Science Research Fellow at the Kenya Agricultural Research Institute.

NAIROBI -- In Kenya, as in many other countries where "economic liberalization" is underway, the burden of caring for the poor resides not with public institutions but with private citizens. As a result, individuals with decent incomes often find themselves facing decisions that could mean the difference between life and death not just for loved ones but for strangers.

About a month ago, the security guard in the compound where my wife and I live -- call him Michael -- approached us for a loan of 500 Kenyan shillings, about $10. His wife Janet was ill with malaria, he said, and he needed the money to buy medicine. He promised to repay us in a few weeks.

Since we knew that his monthly salary was no more than 3,000 shillings, we decided to give him 200 shillings instead and so minimize our potential loss.

We were wrong to doubt him. Two days ago, when I returned home from work Michael was waiting with the 200 shillings. Surprised and not a little embarrassed, I told him to keep it for as long as he needed it. He accepted the offer, explaining that his wife's condition had deteriorated since he had not been able to pay for any additional treatment. He was now reverting to prayer.

We were appalled and asked him to bring his wife to our house so we could take her to our doctor. Yesterday, our doctor confirmed she was very sick and would die if not treated quickly. He was certain that she had tuberculosis and that her constant headache, nausea, fatigue, diarrhea, stomach ache and mouth sores pointed to other severe ailments. Sensing our uncertainty about the extent of our responsibility, he noted that treatment would be expensive and advised us to consider the matter with care. We agreed but meanwhile offered to cover the costs of diagnostic tests and any drugs he felt she needed right away.

We spent the rest of the day in labs, x-ray units, and pharmacies. The tests and medicines cost slightly over 5,500 shillings ($100), almost twice Michael's monthly wage.

At home that night, my wife and I began to realize how, over a few hours, Janet's life had become our personal responsibility. Even more overwhelming was the realization that a month ago, we had made a decision that could well have resulted in her death.

Tomorrow we will hear the doctor's verdict and decide whether to assume more responsibility for Janet and Michael. In effect, we will be deciding to what degree the boundary of our family extends beyond our little three-person home into that of a couple we met three months ago. It won't be easy.

Already, Michael has started to refer to me as "boss," much to my wife's amusement. It may be good for my ego, but this implies a dependence we'd like to discourage. We know of some people who, to avoid this type of situation, ignore all pleas for help save for those from their immediate families. But we wonder how they live with the idea that the person they refuse to give $5 (or $10 or $1,000) today might die as a consequence tomorrow. Whatever decision one makes, the responsibility is staggering.

For each "successful" Kenyan, there is a multitude on the verge of abject poverty. Clearly, with some self-sacrifice, every successful person has it within his or her power to pluck a person or two from this terrible plight. Many do just that. But is this fair? Should the government be involved somehow?

The current trend in Kenya and elsewhere in Africa is to reduce the government's role in public affairs. Pressure for this "economic liberalization" comes mainly from societies where intrusions by governments into private matters are seen as excessive. But in countries where most individuals still provide several services for themselves that government could better supply -- utilities, social security, primary health care, for example -- the withdrawal is premature.

Without an increased government role in Kenya, a small group of people will continue to bear the burden of caring for the country's poor -- a state of affairs that is neither efficient, equitable, nor sustainable. Indeed, given the limited resources of people like myself, it only reaffirms the cycle of dependence and the inequality that we want to alleviate.