Monday, January 29, 2007
Wednesday, January 24, 2007
Starting Sunday I spent three days at Moi International Sports Stadium going to seminars and watching documentaries. There were at least 80 different seminars going on at any given time, and I always found numerous things that interested me. Discussions like "UN Peacekeeping: Force or Farce?" "The World Bank in Africa: What it's up to, why you should care, and what you can do about it," meetings on the future of the DRC, cattle rustling in Eastern Uganda, giving electricity and public services to Africa, how agricultural subsidies have affected Ethiopian coffee growers, how Wal-Mart is the poster-child for everything that's wrong with transnational corporations, the article of the Japanese constitution forbidding a military, the similarity between the wall in Palestine and the Southwest USA, using the Nordic model of Socialist government worldwide, women under occupation in the Arab world, why 50% of all internationally signed peace agreements fail within five years of the end of the conflict, moving beyond the ivory tower to make university research more socially responsible, Hurricane Katrina and global warming, the Iranian nuclear crisis, Jerusalem under Israeli occupation, a website wikileaks.org to create a wikipedia-like outlet for government leaks to help create open and good government, rolling back the power of transnational corporations, boycott and divestment from Israel, and Gandhi's role in the politics of today. Sounds fascinating, no? You'd like to think that, wouldn't you?
So socialists are cool for a couple reasons. They obviously care about the plight of the poor, and they're for open borders and some sort of world government. But the Forum wasn't a bunch of people talking about specific ways in which we could motivate rich-country governments to end farm farm subsidies that destroy the income of poor-country farmers, nor was it a discussion of ways we could modify specific structural adjustment policies of the WTO, World Bank, and IMF that are hypocritical and unfair (such as making poor countries eliminate their own farm subsidies and privatize education and services that have never been private in any rich country). It was more just buzzwords like "down with neo-liberalism," and "challenge the power structure." Great, but how and maybe even why might be good to know.
In addition to the lack of specifics,I was frustrated by the lack of reasoned moderation. I consider myself pretty pro-Palestinian, but the Palestinian organization's poster they put all over the place said "It's either return...or return." Argggh! Are you kidding me? There's no other possibilities? There's no hope for compromise? (It was pretty clear that "return" didn't just mean a return to pre-1967 borders.) And the head-honcho of one the organizations, after listening to a couple first-hand accounts from Iraqi women that had been held in Abu Ghraib, said, "I encourage Iraqis to kill as many Americans as they can to get them out of their country as soon as possible."
I could also complain about how very poorly organized the events were, how half of the events I was interested in didn't even happen, and then by the time I finally found a real event on the other side of the huge complex, it was mostly over, or I could mention my bad luck in not really running into many people that I could talk about things socially with, but I won't spend too much time on that because thinking about the guy that thinks more violence is the solution has made me too angry.
So there were a few good notes. I saw a couple decent documentaries (one on Ethiopian coffee growers and one on Canadian UN commander in Rwanda Romeo Dallaire), I saw a "Guns & Cameras" store in Nairobi (that might not actually be allowed to sell guns but just magazines and photos of guns, but does sell real cameras), as well as the "Stomach Clinic Restaurant," I hung out and ate really good apple pie with some cool Peace Corps that I met when I ran the marathon, I read a fun spy book, I bought the tourist-obligatory Tusker beer t-shirt, and I found part two of the bootleg James Bond DVD collection (19 of the movies on 3 discs). In conclusion, if you're ever in a country when the WSF happens to come through, I highly doubt that the event will have security, so there's no need to pay the $106. Just show up and enjoy or not-enjoy, and maybe pay if you thinks it's a worthwhile thing to do. Me, I'd rather deliberately get three parking tickets in Berkeley and spend the money on that. OK, it wasn't that bad.
Or maybe it was. I thought the "International Feminists for a Gift Economy" seminar was the funniest/least likely to occur thing I saw there, but this poster was pretty cool in a ridiculous sort of way.
Saturday, January 20, 2007
"But some people would ask, 'How can you expect others to replicate what you're doing here?' What would be your answer to that?"
He turned back and, smiling sweetly, said, "Fuck you."
Then in a stentorian voice, he corrected himself: "No. I would say, 'The objective is to inculcate in the doctors and nurses the spirit to dedicate themselves to the patients, and especially to having an outcome-oriented view of TB.'" He was grinning, his face alight. He looked very young just then. "In other words, 'Fuck you.'"
Cute, very cute, comma. (Farmer supposedly ends sentences with "comma" when he means to end them with "..., asshole.") But it doesn't really answer the question about cost effectiveness. Someone in the book makes the point that if you have six million dollars, and can treat 90% of the people in one population with TB with half the money, it might be good to spend $3 million each in two locations and heal a lot of people rather than using $3 million to get the first 90% and then the other $3 million to treat the 10% that have harder cases. Another quandary follows:
Low-cost second-line antibiotics would soon be on their way to Russia, but at the moment various snafus had delayed their arrival. Other organizations, now intent on treating MDR in Russia, were still waiting for the inexpensive drugs. Farmer and Kim, by contrast, had gone to Tom White and asked for $150,000, and bought enough drugs, at high prices, to start treating a few dozen MDR patients in Tomsk right away. Why do that, why spend $150,000 now on drugs for thirty-seven patients if, by waiting a while, they could spend the same amount and buy drugs to treat a hundred? Well, Farmer said, project managers could afford to wait for low prices, but not all patients could.
No, seriously. What if you ran out of money, and then in the end you ended up saving fewer lives as a result? But there is something to be said for this kind of "build it and they will come" type attitude about donor money. Farmer's projects helped to bring down the price of MDR drugs, and maybe they would never have come down if somebody hadn't ignored cost-effectiveness and taken the plunge. I don't know. Hopefully I'm not just ragging on Farmer because I like to pick apart people that are morally superior. (Do I have any heroes that I don't try to bring down? Maybe Cal Ripken Jr. and my friend Scott Williamson.) And maybe I shouldn't think Oprah's lame for spending so much money on just one school (especially since she's spent a lot of money on other less publicized good works.) Maybe I'd be cooler with Farmer if I'd ever met him or heard him speak to get his side of the story (I'm the only Mormon I know that likes John Krakauer and I'm OK with ultra-runner/self-promoter Dean Karnazes solely because they seemed nice when I met them in person.) Or maybe it's just that public health is not my personal shtick. Who knows. The book was definitely worth reading.
Thursday, January 18, 2007
Saturday, January 13, 2007
I'm back from vacation and getting settled back into the routine. Sort of.
First of all, here's what I thought of the books I read recently. Graham Greene's The Heart of the Matter was amazing. It's about a colonial officer in west Africa, but it could've been set anywhere; just a good story about a dude trying to be honest and/or happy. Chinua Achebe's Things Fall Apart was nowhere near as cool as I was expecting ever since I put it on my list several years ago. Maybe it's an accurate portrayal of Nigerian tribal life, but it didn't really have a plot or storyline as such. Rory Stewart's The Places In Between, I'd seen on some NY Times best of 2006 list, which, after reading it, is a total shocker. It's a travel narrative by a dude that walked across
I now had a half dozen friends working in Afghanistan in embassies, think tanks, international development agencies, the United Nations, and the Afghan government, controlling projects worth millions of dollars. A year before, they had been in Kosovo or
East Timorand a year later they would be in or offices in Iraq and New York . Washington
Their objective was (to quote the United Nations Assistance Mission in
) "the creation of a centralized, broad-based, multi-ethnic government committed to democracy, human rights, and the rule of law." The worked twelve- or fourteen-hour days drafting documents for heavily funded initiatives on "democratization," "enhancing capacity," "gender," "sustainable development," "skills training," or "protection issues." They were mostly in their late twenties or early thirties, with at least two degrees--often in international law, economics, or development. They came from middle-class backgrounds in Western countries, and in the evening, they dined with each other and swapped anecdotes about corruption in the government and the incompetence of the United Nations. They rarely drove their SUV's outside Afghanistan because their security advisers forbade it. Kabul
Some, such as the two political offices in Chaghcharan, were experienced and well informed about conditions in rural
. But they were barely fifty out of many thousands. Most of the policy makers knew next to nothing about the villages where 90 percent of the Afghan population lived. They came from postmodern, secular, globalized states with liberal traditions of law and government. It was natural for them to initiate projects on urban design, women's rights, and fiber-optic cable networks; to talk about transparent, clean, and accountable processes, tolerance and civil society; and to speak of a people "who desire peace at any cost and understand the need for a centralized multi-ethnic government." But what did they understand of the thought processes of Seyyed Kerbalahi's wife, who had not moved five kilometers from her home in forty years? Or Dr. Habibullah, the vet, who carried an automatic weapon in the way they carried briefcases? The villagers I had met were mostly illiterate, lived far from electricity or television, and knew very little about the outside world. Versions of Islam; views of ethnicity, government, politics, and the proper methods of dispute resolution (including armed conflict); and the experience of twenty-five years of war differed from region to region. The people of Kamenj understood political power in terms of their feudal lord Haji Mohsin Khan. Ismail Khan in Afghanistan wanted a social order based on Iranian political Islam. Hazara such as Ali hated the idea of a centralized government because they associated it with subjugation by other ethnic groups and suffering under the Taliban. Even within a week's walk I had encountered areas where the local Begs had been toppled by Iranian-funded social revolution and others where feudal structures were still in place; areas where the violence had been inflicted by the Taliban and areas where the villagers had inflicted it on one another. These differences between the groups were deep, elusive, and difficult to overcome. Village democracy, gender issues, and centralization would be hard-to-sell concepts in some areas. Herat
Policy makers did not have the time, structures, or resources for a serious study of an alien culture. They justified their lack of knowledge and experience by focusing on poverty and implying that dramatic cultural differences did not exist. They acted as though villagers were interested in all the priorities of international organizations, even when those priorities were mutually contradictory.
In a seminar in
, I heard Mary Robinson, the UN High Commissioner for Human Rights, say, "Afghans have been fighting for their human rights for twenty-five years. We don't need to tell them what their rights are." Then the head of a major food agency added privately, "Villagers are not interested in human rights. They are like poor people all over the world. All they think about is where their next meal is coming from." To which the head of an Afghan NGO providing counseling responded, "The only thing to know about these people is that they are suffering from post-traumatic stress disorder." Kabul
The differences between the policy makes and a Hazara such as Ali went much deeper than his lack of food. Ali rarely worried about his next meal. He was a peasant farmer and had a better idea than most about where his next meal was coming from. If he defined himself it was chiefly as a Muslim and a Hazara, not as a hungry Afghan. Without the time, imagination, and persistence needed to understand Afghan's diverse experiences, policy makers would find it impossible to change Afghan society in the way they wished to change it.*
*Critics have accused this new breed of administrators of neocolonialism. But in fact their approach is not that of a nineteenth-century colonial officer. Colonial administrations may have been racist and exploitative, but they did at least work seriously at the business of understanding the people they were governing. They recruited people prepared to spend their entire careers in dangerous provinces of a single alien nation. They invested in teaching administrators and military officers the local language. They established effective departments of state, trained a local elite, and continued the countless academic studies of their subjects through institutes and museums, royal geographic societies, and royal botanical gardens. They balanced the local budget and generated fiscal revenue because if they didn't their home government would rarely bail them out. If they failed to govern fairly, the population would mutiny.
Postconflict experts have got the prestige without the effort or stigma of imperialism. Their implicit denial of the difference between cultures in the new mass brand of international intervention. Their policy fails but no one notices. There are no credible monitoring bodies and there is no one to take formal responsibility. Individual officers are never in any one place and rarely in any one organization long enough to be adequately assessed. The colonial enterprise could be judged by the security or revenue it delivered, but neocolonialists have no such performance criteria. In fact their very uselessness benefits them. By avoiding any serious action or judgment they, unlike their colonial predecessors, are able to escape accusations of racism, exploitation, and oppression.
Perhaps it is because no one requires more than a charming illusion of action in the developing world. If the policy makers know little about the Afghans, the public knows even less, and few care about policy failure when the effects are felt only in
Yikes. It's not like I thought development was actually working before I read this, but still. Like usual, I don't think there are any easy answers. The only thing I do know is that it makes me wish I'd been born about 70 years earlier, because I could've made a pretty bad-ass
And I read another book on
Enough about that. After four months some of you may be wondering exactly what I'm doing here and why I keep complaining that the office has no chairs, so here's the history of Innovations for Poverty Action--Kenya as I understand it. Sincere apologies for any inaccuracies.
Maybe ten years ago, Harvard prof Michael Kremer (who created World Teach) started working with one of his friends from World Teach, who was the
I believe IPA is officially run by a Yale development economist Dean Karlan. All the profs are closely tied to the Abdul Latif Jamal Poverty Action Lab at MIT. Mostly the employees are younger Kenyan field officers (FO's) who administer surveys or distribute scholarships or deworming drugs, a few Kenyan data analysts and one young, usually western, evaluation consultant (EC) that is the go-between for the principal investigator professor and the field staff for each project. The organization may not be the most effective in the universe, but it's pretty good. It's a collaboration of numerous professors in the
I'm the Tracking EC. In 1998-2003 ICS administered a deworming program in primary schools in the Budalangi and Funyula divisions of Busia district. The program was randomly phased in, so some students in the district received more years of treatment than others. People have evaluated deworming before, but they randomized the deworming within a given school, and since deworming has huge externalities (if your friends don't have worms in their poop, you're less likely to get worms yourself) the results weren't great. But ICS randomized across schools so you can get a more accurate measurement. The short term results were outstanding. (See Ted Miguel and Michael Kremer's 2004 Econometrica paper for details. Seriously, google scholar "worms miguel kremer" or I can send you the pdf if you don't have JSTOR access.) It's the cheapest way anyone had found to increase school attendance. In 2003-2005 we tracked down the subjects and re-interviewed them. I started working for Ted on this project in early 2005. The FO's administered a survey on all sorts of stuff (schooling, health, fertility, labor market outcomes, the home, family, religion, social capital, and more). These are all adolescents we're tracking down, so a ton of them have moved to Nairobi or Mombasa and one even moved to the UK, but we do long-range tracking, so we managed to get something like 83% of the sample (including the Londoner). In
In addition to the KLPS, I also work on the Girls Scholarship Program. In 2001 and 2002, ICS ran a scholarship program in 175 primary schools in Busia and Teso districts. We randomly selected half of the 175 to be eligible for scholarships. The scholarships were awarded to girls in standard six that scored in the top 15% of all girls in the scholarship schools on the end-of-year exam. (Kenyans take an exam to finish primary school after standard 8 (the KCPE) and they take yearly practice exams in years prior.) The scholarship was worth two years' of school and uniform fees. In the short run the program was great. It made girls at the top do much better on the test, and it even helped girls that had scored low on pre-tests and were thus unlikely to win the scholarship. In Busia district, it even seemed to help boys, even though they were ineligible for the scholarship (it sucks to get chicked, even in
So my job is to manage the team of five FO's and the data collection and cleaning process. I go to the field about once a week just to watch the surveying (it's in Swahili, I don't understand much), I collect all the surveys they get, I get the data entry firm to enter them, I get the data analysts to check the double-entry of the data, I write code to check the final data for skip-pattern and logical errors, and I construct the data into one big massive dataset.
So that's what I do. Tomorrow I'm going to church at the "
Thursday, January 11, 2007
A big glacier and stuff.
My altimeter watch at the summit. It's actually 5895 meters (19340.5 feet). Unfortunately Marcus sat on my watch a couple days later and erased all the stored values.
Me at the summit, January 1, 2007. Happy New Year everyone.
Tuesday, January 09, 2007
A dhow seen from my snorkeling trip (I actually did get to snorkel after the storm ended, but not in the marine park, in kinda murky water in a bay of sorts. Since I've never done it before, it was still pretty cool.)
A couple of Austrians (with hot girlfriends) are driving this converted fire truck around Africa. We thought they were jerks because they didn't talk to anybody else in the campsite, but apparently they threw an awesome New Year's bash after I left. Yes, their truck totally makes me want to do the overland trail.
A car stuck in the mud on my drive down the coast from Mombasa towards Tanga in Tanzania.
A 5 or 6 inch long snail crossing the road on my way to the campsite in the Usumbaras outside of Lushoto.
After the nightmare with the Bank report was over, I went and bought a bus ticket to Nairobi. The bus wouldn't start, so it was an hour or two late leaving. It wouldn't go faster than about 40 km per hour, so they switched us onto a new bus in Kisumu. Ten minutes outside of Kisumu there was flooding which caused a two hour delay. I got to Nairobi in the morning and was told by 4 or 5 bus companies that all the buses to Mombasa were sold out for several days. Finally I found a matatu that was going the whole way, and I made it to Mombasa that night.
On the 24th I went from Mombasa to Twiga Lodge at Tiwi beach. I got out of the matatu and started walking the 3 km from the main road to the beach. About halfway I got a call from Willa:
"Hey. Where are you?"
"Walking down the road to the beach."
"Ummm, that's actually a _really_ bad idea. There's a lot of robberies. The last time I came here some guy tried that and he showed up in his underwear."
I still felt kinda safe, despite having a large pack, expensive sunglasses and my iPod totally visible, so I kept going. Then I made a turn and some guys headed towards me. They told me I absolutely could not keep going because they'd seen three bad guys hiding in the bushes just ahead waiting to jump me. So I went back to the small shop at the turn and waited for Willa and Eva to come in a cab. To make it worse, I called Eva, but the connection was bad, so all she heard was "theives!" and then the connection went dead. Later I read the part of the guidebook where it says the road is notorious for robberies.
Then Christmas Day we all went on a snorkeling trip. We didn't bargain well, so we overpaid. Then when the boat got to the awesome snorkeling place, they got report of a dolphin, and since lame-o's complained that we hadn't seen any, we immediately left to go chase them. We saw a lone dolphin from hundreds of meters away, then a storm blew in. It was raining crazy hard and you couldn't see land anymore, and the guys had no navigation system, so they had no idea where they were going, and I was trying to use the compass on my altimeter watch to tell them which way Africa was. We were hoping we'd be picked up by Somali pirates so that it would be the worst Christmas in history rather than just our own personal worst.
After getting some really deep coral slivers in my feet, seeing a dead body washed up on shore, and finding a scorpion under my tent, I left Tiwi and went to Tanzania. I stayed one night in Tanga and the only company was an arrogant anti-semite. Then I spent a day in Lushoto in the Usambara mountains, and realized that in Tanzania, a) my phone doesn’t work, b) they don't speak any English, c) every single price, from long-haul bus fares to hotels to food needs to be haggled over, especially if you're a mzungu d) they get disappointed/mad if you're a mzungu and try to pay in Tanzanian shillings rather than US dollars.
I made it to Moshi on the 30th, but it took me hours to find the campsite that Marcus and I had agreed to meet at and one matatu driver sent me walking a couple kilometers down the wrong road. So by the time Marcus showed up I was in no mood for the constant attentions of street touts. Marcus, of course, loved yakking it up with them, and lined up our Kili trip with one. That night in Moshi it rained non-stop, dumping meters of snow on Kili. We started Kili on the 31st at noon. Our guide didn't want to continue from the crater rim to the actual summit, Marcus barfed twice, I got a cold and a massive, massive glacier burn, and we still had to shell out a $15 tip for a porter who we never actually saw, who certainly didn't carry anything of ours, and who may or may not have existed.
On the 3rd when we tried to leave Moshi we discovered that the street tout Marcus had used to line up a special-hire taxi to Dar es Salaam was a liar, but after that fell through we managed to get bus tickets. 150 km from Dar a diversion had washed out, and the bridge was in disrepair, so we waited for 6 hours for a lone Cat to dump dirt on the bridge(?), then tow buses across the bridge when they got stuck on the newly dirt-covered bridge.
We had to go to three places in Dar before we could find a (spendy) room. The next day we bought ferry tickets to Zanzibar, then went to get buses back to Nairobi for a couple days later, but they were all sold out for a long time, so we went back and returned our ferry tickets. We arranged a flight for $212 from Dar to Nairobi, then in the process of twenty minutes of comparison shopping the flight sold out and we had to take another, less convenient flight, $267 flight instead. We finished Dar by walking around the beaches and counting the syringes.
We arrived in Nairobi at night, and couldn't get a ticket that night or the next morning to Busia to save our lives. Finally we took a supposedly "prestige" direct matatu, but we both wanted to die by the end because the road is in such lousy shape and feels much worse in a matatu than on a big bus. When we finally got to Kisumu it wasn't raining, but the boda's didn't know where the hotel was, so it was raining by the time they got there. It was full, so we had to walk to 4 hotels in the pouring rain to find a room. Marcus spent the night dry heaving.
I returned to the office on Monday to discover that none of the taxis in town have the proper license, so now that we've decided to do legit transportation this year, none of the teams can actually go to the field, so no work can get done. Also, the office doesn't have any desks or chairs.
Marcus and I finished the vacation off by going for a bike ride. In the 6 or so hours, we had 8 separate bicycle break-downs, 4 of which required a fix-it guy. The seats are about as comfortable as a brick, so my ass is bruised.
So, in summary, I was told 11 or more times that the bus I wanted was sold out, I was almost robbed, almost lost at sea, I'm sunburnt, I have a cold, and I have diarrhea. A British/Kenyan family I met at the beach had a family motto when stuff like this happens: "DIA: Dis is Africa."
DIA dude, DIA.
My flight out of here leaves Nairobi February 26th.