It is often said that charity begins at home - but this can be challenged when we are confronted by something so dreadful that it is impossible to just look the other way.
The Ethiopian famine of 1984 is a good case in point. The devastating images of children starving to death under a burning African sun galvanised the west into belated action.
But that towering tragedy was largely caused by a prolonged and savage drought. The immediate task was to treat the symptoms, not the cause.
Occasionally, however, humanitarian disasters are entirely man made.
Welcome to Romania in the late 1980s - a shameful spell when thousands of orphans were left to rot in stinking state-run institutions.
But first a rather unpleasant history lesson.
Nicolae Ceausescu ruled the country with an iron fist, and his greed undoubtedly planted the seeds of the crisis.
The dictator believed that population growth would lead to economic growth - so at the stroke of a pen both abortion and contraception were forbidden.
Unsurprisingly birth rates soared. By 1977, people were taxed for being childless, so a bad situation inevitably became worse.
This increase in the number of births resulted in many children being abandoned in orphanages, which were also occupied by people with disabilities and mental illnesses. Together, these vulnerable groups were subjected to institutionalised neglect, physical and sexual abuse, and drug use to control behaviour.
The conditions in orphanages had declined after 1982, as a result of Ceausescu’s decision to seize much of the country's economic output in order to repay its foreign debt. Due to the economic downturn, electricity and heat in orphanages were often intermittent and food was scarce.
The worst conditions were mostly found in institutions for disabled children. Many lacked both medicines and washing facilities, and physical and sexual abuse of children was reported to be common. In some cases, the children were often tied to their own beds or dangerously restrained in their own clothing.
Because the staff had failed to put clothes on them, the children would spend their day naked and be left sitting in their own faeces and urine.
The nightmarish conditions finally came to light in 1989 when the regime was overthrown. And the end, when it came, was violent.
Ceausescu faced several charges, including genocide. After a show trial which lasted little more than an hour, both he and his wife Elena were found guilty and sentenced to death.
The firing squad began shooting as soon as the two were in position against a wall. The execution happened too quickly for the television crew assigned to the trial and death sentence to videotape it in full; only the last round of shots was filmed.
It was Christmas Day - and for many ordinary Romanians, the stark footage of the fall of the house of Ceausescu was the best present they received that year.
But the celebrations were short-lived. Romania was in ruins, its precious finances bled dry. And then came the images of the orphanages - and those sallow and emaciated children. The dark secret was finally exposed.
Antrim businessman Terry McCullough and his friend Michael Masserella were profoundly moved - and they decided to offer some practical help.
In early 1990 they asked local people to dig deep and soon they had four tonnes of supplies, and they embarked on the 4,500 mile round trip. What they saw, by their own admission, changed their lives forever.
It was, said Terry, ‘another planet’.
“It felt as if we were passing back in time. The poverty, the conditions, the deprivation was so obvious.”
Their first stop was at Suceava where they got their first inkling of the scale of the task ahead.
“There were 1,000 patients in the hospital and when a doctor showed us into his pharmacy we were sickened to find that all they had in stock were 90 bottles of iodine, a few plasters and bandages, five ampules of some unknown vaccine and a quantity of out of date antibiotics that had recently arrived from the west.”
But there was worse to come. The following morning they travelled on to Ionasceni, a children’s home outside the village of Birfucunfurnui.
“The home housed 118 children, most of whom were handicapped but there were also perfectly normal youngsters as well who had just been abandoned by their parents.
“The first thing that hit me was the smell. You just could not describe it. That smell will haunt me for the rest of my days.
“The conditions that these children endured were terrible. The beds they slept in were crawling with lice and cockroaches and the mattresses were like sponges with the amount of urine that had seeped into them.
“The atmosphere reeked of filth, death, disease and deprivation and was like nothing that you could experience in the present day.”
Five members of staff were charged with the task of running the institution, but they were ‘fighting a losing battle’.
One of Terry’s first glimpses of the young charges underlined the brutality of the former regime.
“I saw what I took for a little girl standing naked in the corridor so I mentioned to someone that shouldn’t we get her some clothes on her before she caught her death.
“The person I was with agreed with me but added that it was a little boy, not a girl.
“Apparently Ceausescu decreed that all ‘mentally retarded’ male children be castrated so they would not breed and spoil his ideal of ‘Ceausescu’s Children’.
“His policies lay behind all the suffering as he made the women of Romania mother at least five children. If they were slow in doing this they were taken into hospital and given a medical examination to ensure that they were able - and if so they were sent to a male prison where they could conceive.
“A lot of the parents could not cope with the children and dumped them in homes such as Ionaseni.”
And amongst the despair, inevitably, there was also death. During his visit Terry looked on helplessly as a three-year-old girl finally succumbed to sickness.
“She was suffering from AIDS, a disease she was born with. It was as if she knew she was going to die as she just sat on her emaciated knees and stared into space just waiting for her end.
“I clicked my fingers to the side of her to see if there was any recognition of my presence and after four or five attempts she began very slowly to pivot her eyes around. Thinking back now I wish I hadn’t tried to look in her eyes. Those big eyes, like glass balls, still come back to me today. I will never forget that look.
“Two hours later she was dead - dead on her knees.”
It was not the only sight seared onto the Antrim man’s memory.
“I remember one boy, around one and a half years old. His head had swollen to an enormous size - larger than the average fully grown man’s.
“It would have been a simple operation in the west, taking up to 20 minutes, but that child lay for 18 months just looking up, again just waiting to die. He died shortly after we left.”
But while many of the children were gravely ill, others were being psychologically damaged by their grim surroundings.
Terry recalled that one abandoned child had been brought to the orphanage and put into a room with disturbed youngsters. The next day he emerged, blood streaming from his head.
“Apparently what had happened was that all the rest of the kids in the room had a habit of banging their heads off the wall and to appear to be normal and avoid violence the lad did just the same.”
Other behaviours were more of a mystery to the children - like the day Terry and Mick organised an impromptu disco.
Soon Elton John was blasting from their ghetto blaster, but the young people simply stared. They had never heard anything like it before. Was this a prelude to some new punishment?
The Antrim men led by example, and soon the children were dancing for all they were worth. It was an emotional moment, as tear-jerking in its own way as the degradation and inhumanity Romania had piled on their most vulnerable citizens.
And it was at that moment that the local men decided they had to do more.
They resolved to return to Antrim to raise £30,000 too send over three 40-foot containers packed with supplies.
It was a huge challenge, but they were men on a mission.
Those deaths on Christmas Day had lifted the lid on unimaginable need - and proved once and for all that it is truly better to give than receive.