Famines, civil wars, images of suffering humanity still have the power to move us, not just to tears but to action. And while credit card fatigue may set in at the prospect of yet more electronic beeps and buzzes in yet another telethon, our compassion seems far from fatigued. As a nation we are awash with it.

People knit, collect food and medical equipment, deliver false teeth across Europe, and bus refugees across frontiers . . . or at least want to. Seeing a starving child on television still, thankfully, provokes the impulse to go there, feed it, 'to do something'.

The trouble is that the big charities want dosh, not direct action. It's a frustrating mismatch: their practical need for cash (efficient, negotiable, cheap to move around) with the public's enthusiastic, but often ill-informed, need to respond humanely. Charities would rather see this enthusiasm channelled into sponsored bungee-jumping in Yorkshire than have amateurs setting up soup-kitchens in Somalia, and only rarely call for volunteers. If they do, it is specialists - nutritionists, water engineers, logistics experts - they seek. Colin McCallum of the British Red Cross is co-ordinating the big seven charities' Somalia appeal, which now in its second week, has raised pounds 1.75m. 'We do have people contacting both the Disaster Emergency Committee and British Red Cross who want to do their own thing. We have to say that it will be more effective through us. We'll pay seven times less for food than you, and we can ensure security.'

None the less, the spirit of Florence Nightingale bubbles through. This weekend the Walsall Aid Convoy for Yugoslavian children sets off for two refugee camps in Zagreb and Reijeka, led by the West Midlands Police. The 15-lorry convoy has involved every school, church and mosque in Walsall in the collection of clothes, toys and food. It is difficult to imagine, in terms of educational impact at least, that any amount of fund-raising could have been this worthwhile.

Oxfam's emergencies co-ordinator, Tony Vaux, just back from Somalia, has lived with this dilemma for 20 years. 'People see pictures of starving children and they don't think giving money is adequate. Our position is difficult. We're saying 'We're the experts, give us the money and we'll sort it out.' It seems arrogant to say it, but the ones who insist on doing something are usually making a terrible mistake.'

He recalls an example from Sudan in 1986, when a lorry driven by a determined volunteer - after a great deal of trouble with customs - broke down a few miles outside Port Sudan. The Oxfam representative had then to rescue him, his lorry, and his medical supplies while also co-ordinating a relief operation involving tens of thousands of tonnes. 'It's terribly irresponsible,' says Vaux.

But he also concedes that the 'must do something' enthusiasm may produce better results than the more staid approach of the big charities. The saintly Bob Geldof's Band Aid is one example of faith moving grain mountains.

Oliver Wolston's 'send-a- tonne' appeal to fellow farmers during the same famine is another. 'If he'd asked for money he wouldn't have got the same response. These things can be inefficient but effective.'

It was the shining example of Geldof that inspired Tom Budell, interviewed on this page. Mr Budell talks a lot about people with hearts of gold, and clearly has one. He says the Red Cross accuses him of interfering, but believes he covers different ground, offering 'the kind of things that make life worth living - false teeth, sanitary towels, shampoo'.

Freelance troubleshooting can be transformed into effective involvement, says Eric Dugdale of the Oak Tree Trust, a network born in August 1990 in response to the plight of Romanian orphans. Five friends got together 'to do something'. They spent six months planning, visiting Customs and Excise, learning about the area, a further month in Romania discovering particular needs, and only then tried to raise the goods and equipment in this country. Now they advise other groups, including many, recently, who have wanted to leave immediately for Yugoslavia in vans.

'We say, spend a couple of months getting local people helping and take a lorry instead. It's more economical and more people get involved,' says Dugdale, whose own motivation was, in part, his Christianity.

There are similarities between some of these amateur initiatives and Oxfam's own origins, when a handful of people formed the Oxford Committee for Famine Relief for starving people in blockaded Greece 50 years ago. Oxfam believes it still maintains the 'doing something' ethic - it continues to organise the knitting of clothes and squares for blankets (about 80,000 knitted tops are going to Mogadishu this weekend). Shop volunteers, as well as raising pounds 18m for the organisation, also occasionally get the chance to visit Oxfam projects.

There are other things people can do without flying out to trouble spots, says Vaux: 'Find out more. Talk to Somali people here. Nearly all the feeding programmes are run by Somalis, not expatriates.

'We want people's money, of course we do, but we also want to avoid stereotypes of white people feeding blacks so that the relationship moves to understanding, not compassion.'

Understanding the issues behind famine is the domain of the World Development Movement, whose campaigns officer, Neil McCulloch, believes 'the British public is phenomenally generous. It gave pounds 184m to Third World charities last year. But its generosity is completely wiped out by the miserly approach of governments to debt forgiveness.'

The scale of international debt and its relationship to famine may make writing a cheque seem rather pathetic, and personal intervention the only way of knowing something concrete has been achieved. But the basic message from the charities is still: 'Give us the money and let us get on with it.' And while this may be rational economics, in the face of such public compassion it seems a tragic waste of human resources.

Knitting squares

Mary Whitehouse is on her eighth blanket for Save the Children - this one for Somalia. It all started when she saw pictures of emaciated children in Ethiopia, back in the mid-Eighties. 'I was so moved I just wanted to go out there immediately and do something. Then I realised how ridiculous that was. I thought 'I'm too old, I can't do anything practical, but the one thing I can do is knit.' ' The great thing about knitting, she says, is that you can do it while you're watching television.

For Mrs Whitehouse, the idea of putting herself out for other people is more satisfying than simply sending a cheque.

Her blankets are made up of squares - 'I always pick bright colours because they're so much more cheerful,' - and big enough to cover a cot or wrap up a baby. 'When I saw the first television pictures from Ethiopia there was one particular child who stood out in my mind. I wanted to reach out and wrap him up with love. But I thought, I may not be able to put my arms around that child, but I can make a blanket with love and know that it is keeping some child safe and warm.'

Delivering cots

Tony Budell, 48, sets out on his sixth trip to the former Yugoslavia on Tuesday. His destination is a refugee camp at Reijeka. Packed into his car and trailer will be disposable nappies, food, sanitary towels, a cot and a chess set. 'The chess set is for some eight-year-old boys who've marked out a board on a piece of sheeting, the cot for a girl who's due to give birth. Three weeks ago I found her crying because she doesn't have anything to put the baby in when it arrives.'

Budell argues that face-to-face contact with the refugees - he stays in the camp for three days - is precisely what big organisations can never offer. A chap from the Red Cross said I should send money and stay at home. But people don't just want a thousand tons of flour, they want the small, personal things. I can go up to someone and say 'what do you really need?' and know that in three weeks I'll be able to hand it to them.'

Other people now come to him for advice: 'I get frantic phone calls from people on the border who can't get any further because they didn't sort out the official documents beforehand. It's no good playing at St George if your papers aren't in order.'

Tending orphans

Alison Coles, 26, spent four months earlier this year as part of a five-strong volunteer team in a Romanian orphanage, 150 miles west of Bucharest. A qualified nursery nurse, Coles rejects any suggestion of kind-hearted amateurism: 'Childcare is what I am trained to do, it is a subject which I care strongly about.'

She saw for herself the sort of well-meaning but muddled help which gets do-it-yourself charity a bad name: 'Lorry-loads of toys arrived from Germany which were so badly transported that they were broken and battered to the point of uselessness. I couldn't help thinking about how much money and effort had gone to waste.'

She is clear about the limits of her responsibility in Romania: 'A great deal of British nursery facilities are really not that great, and it would be arrogant to assume that we had the right to set ourselves up as offering some sort of ideal model.'

Back home, Coles believes the experience has radically changed her: 'I stay in touch with other volunteers. Some experiences are so profound that you can really only share them with someone who's been through them too.'

Sinking wells

Marian Richardson, 44, sets off in a month's time to build a well in Kenya. An associate director of a healthcare PR company, her only involvement with charity to date has been 'donating pounds 50 on my credit card whenever there's an appeal.' Then, last year, an acquaintance mentioned she was determined to do something about the near- drought situation in Kenya, and together they formed a plan to build a well in Timbwani, a squatter town outside Mombasa. Costing only pounds 300, this should allow women there to concentrate on more productive activities, like craft work.

'I started knowing nothing about the subject. I'm getting a step-by-step guide to building a well from Water Aid, but you have to remember that we are talking about a bucket on a string, or at best a simple pump. This is not sophisticated stuff.'

Richardson is acutely aware of the argument that her skills would be better used fund-raising in London, but explains: 'I wanted to make sure that money went to an area of need. Of course, there's a sense in which I'm going because it satisfies me. But I'm also absolutely committed to bringing water to Timbwani. I don't expect gratitude.'

(Photograph omitted)