My general approach to the Meaningful Gifts on a Budget problem has been to create something: cards, art, write a song, etc. I've gotten better at creatively dealing with this annual dilemma myself, but until this year I never thought that others might be dealing with the same thing - until I googled it.
I struggle with the sell, sell, buy, buy, thing that happens during the holidays. It can be depressing. So it's easier to judge and bemoan the state of the materialistic west (or try to ignore it) than think of making a difference somehow. Besides how important is giving gifts anyway?