I do have a parallel thought process which finds it pretentious, but I ignore it because it also said that the ice bucket was pretentious. And the ice bucket challenge was extremely effective. I think the dislike is just contrarian signalling, and is why our kind can't cooperate. That or some kind of egalitarian instinct against boasting.

Isn't "pretentious" just a negative way to say "signalling"? Of course that idea might not be effective signalling but abstractly, the idea is that EA is well suited for signalling so why isn't it?

I'd consider value in doing a local hospital. Local community strengthening and good feelings is its own thing with its own benefits, and there's a special value in the aid coming from local people who know what's what - as a natural extension of the idea that aid is better coming from parents to children than from distant government to children. I'm talking about the global poverty crowd here.