While I sit here in Nairobi Java House (which now has a branch in Kisumu…. Kisumu Java House?) eating my standard “Chicken and sun dried tomato sandwich with ABSOLUTELY NO MAYONNAISE” I’m thinking about an exchange I just has with a guy in the line for check-in.
The guy was a tall, obviously northern Kenyan who turned out to be from Marsabit, one of the most remote and lawless areas of Kenya. He works at an American university on HIV things in Kenya. We started talking camels and public health and I just couldn’t help but ask.
“How did you….” I was almost ashamed to try and finish the sentence which I kind of interjected since my interest overrode wherever the conversation was going.
“I was sent to boarding school when I was six.” I didn’t even have to finish it. He knew exactly what I was asking.
To be from a place like Marsabit and working for a major American University is no small feat. First, I have never met anyone from Marsabit and the few times I’ve met people from remote places like Pokot and Turkana, I’ve been tempted to just shake that persons hand and congratulate them. Coming up through University in a place where most kids don’t go to school at all deserves a special prize.
“One cell phone is the only piece of technology you’ll see for miles. It’s an oral culture. Communication is absolutely essential and cell phones are the most prized possession a herder will have outside of his camels.”
His brother has 60 camels. I asked if we might go up there and take some blood. I could stand a trip up to Marsabit, even if armed guards have to accompany.
Riding a matatu is one of my favorite activities and without the carbon monoxide and blaring reggae music, the experience is just not complete. Elaborate light shows are just a bonus.
The Kenyan government has partnered with Google to introduce a new Android based transit card system to replace the current cash based “system.” The idea is to standardize price, eliminate volatility in drivers’ incomes (reducing incentives to drive badly) and efficiently tax the ridership.
The NYT did a great write-up on the Kenyan transit card effort, which I won’t rehash here, but one part of the article stuck out to me.
One of the matatu drivers expresses his resistance to the pre-paid digital system by barking “Kenya is a cash based economy!”
Nothing could be further from the truth. Digital payments are common everywhere in Kenya now. People send and receive money regularly through the M-PESA system, with transactions exceeding 6 billion dollars per month in a country where the average person makes less than $5 a day, many much less.
People buy things at the biggest and the smallest stores with M-PESA, as evidenced by a visible placard displaying the shops M-PESA number. I buy groceries with M-PESA, gas and even have paid my rent with M-PESA. Once, I even bought a $.50 bunch of bananas with M-PESA from an informal vendor on the side of the road.
In Nairobi, where it’s always possible to get robbed, M-PESA is great. I don’t have to carry around big wads of cash with me. Even if my phone gets ripped off, I can still access my money digitally.
Cash is a fiction. While it may seem like poor people benefit from using pieces of paper inscribed with pictures of the first president, cash is unwieldy and simply unsafe in many cases. Moreover, the crumpled and worn bank notes are easily lost and change not always available. Try using a 1000 (or even a 500) schilling note to buy bananas. You’ll be waiting a long time.
I’ve been tasked with resurrecting and project that has been languishing in the world of neglect for years. As I was brainstorming some ideas to revitalize and reconnect with communities we work in, I invited the chief of one of them out for choma, to discuss some options. Somewhere in the conversation, the idea of sponsoring a football match came up.
Gembe East is a community of approximately 14,000 people just east of Mbita Point in Homa Bay County, Kenya. It is quite poor and filled with numerous challenges, but it’s a mostly pleasant place to be and the Chief of the area has been incredibly supportive of all of the Nagasaki and JICA activities.
We met a couple of times, had a few discussions as to what should happen and who should do what, set up a budget for the event and proceeded to pull everything together. It was a lot like putting on a rock show, but with considerably more politics.
Gembe East is divided into four sub-locations, each of which has a soccer team. It was decided that the four teams would play and the winner would receive a new set of uniforms, some money and a trophy.
In addition, we’d have a match between Nagasaki U. and some older folks from Gembe East, a band and a few speeches from “opinion leaders.”
For the two days before the match, we strapped a sound system to the top of a Land Cruiser and drove around the area making announcements. I love seeing trucks like this do political speeches. It was great to be in the car driving around in the bush on awful roads announcing a soccer match (over Luo music) to people tending their farms.
The day of the match came yesterday, things fell unsurprisingly behind schedule, there were a few planning problems and some usual chaos, but in the end everything kind of fell into place.
The first of rounds went smoothly, though one of the teams was late. At first, the spectators were just a few old ladies, but soon the place filled up. We probably had about 2,000 people over the course of the day.
The old man team from Gembe East turned out to be guys closer to their late 20’s (though there was one guy who must have been 60). I haven’t ever played soccer in my life. Unfortunately for the team, the ball came into my vicinity a couple of times.
A real highlight was the Omena Jazz Band, a four piece outfit who have been together since 1970 and whose members were all born before 1950.
I did some speeches on the meaning and nature of our research and presented some simple results to the community. It’s incredibly satisfying to present research results to the people who are actually being surveyed. We can’t do this research without these people. They have a right to know.
Overall, it turned out to be a great day. It was great to meet so many people from the area and have the chance to interact with them. There were some challenges, but there always are when putting on big events. I hope we can do it again in the future.
After all of the negative stuff that’s happened recently, this was a welcome change.
Good day and bad day. Good news is that our field manager Paul invited all of us over for dinner at his home tonight. Katie (Masters student) is leaving on Sunday and he wanted to give her a good send off. His wife made us an excellent meal that I’m going to be sleeping off for the next week.
Earlier in the day, though, I was walking up to the office when I saw a couple of our staff outside looking troubled. I asked them what was up and they told me that Lucy, a survey worker who has done projects for me multiple times over the past few years, had just been assaulted by a local drunk while out working for me. He accused her of stealing his cell phone, she said that she didn’t know him at all and he punched her in the head.
People around grabbed him and were about to kill him when a police officer showed up and broke it all up. Apparently, the guy was bleeding profusely and was in terrible shape.
Lucy now suffers from a ruptured ear drum.
It’s doubly painful since she had stopped me early in the day to tell me that she needs to get a loan to help pay for her four kids’ school fees, which total $2800.00 per year. I can’t figure out where she gets the money. She only pulls a little more than half that working for me but the financial lives of people around here are far more complicated that one would normally assume. She’s a single mom.
Lucy works without a contract, only doing temporary work for whoever will hire her, and receives no benefits. Since she, and all of the other people who work around here, have no access to health insurance, I paid her medical bills since they would have taken nearly two weeks pay away from her. She was injured in a work capacity. There is no reason she should have to bear the financial impact of an event which would have not otherwise occurred.
Troubling, of course, is that this isn’t an uncommon occurrence. Lucy was lucky in that I know her quite well and happened to be around. Other people aren’t so fortunate.
Research projects have to start taking seriously the fact that they have human beings working for them. Labor practices by many research projects border on the deplorable, assuming that workers are disposable, uncomplaining and easily replaced. While the argument can be made that we are providing employment opportunities where none existed before, many of us seem uninterested in doing any sort of community development, or creating sustainable work opportunities for experienced and capable field workers.
If we don’t take care of our field workers, our projects can’t exist. Worse yet, it is unacceptable to stick to a double standard of providing generous benefits to nationals, while refusing similar benefits to the people on the ground who work day and night to collect our data for us.
Coming out of the Serena Hotel in Nairobi, I got stopped by two police officers for driving the wrong way on a one way street.
The guy threatened that I would have to go to the police station and pay 20,000 Sch ($230). The following day I would have to go to court, where I would have to pay another 50,000 Sch ($600) or go to jail.
“It’s for your safety, I am trying to protect you.”
I note that everyone drives the wrong way down this road. “No, no one ever drives that way.” Of course, someone does just as he says that and the other guy pulls his over.
He tells me to get in my car, where he has me pull all of the money out of my pockets. I have 8800 Sch ($100). “Add more.” I tell him that it is impossible for me to add more since that’s all the money in my pocket.
I’m getting slightly irate at this point and finally his partner comes along and says that he’s going to take the other guy in.
“Just get 10,000 from him and let’s take the other guy in instead.”
I protest that I only have 8800 and bark at him to just take it at let me go.
Finally, the guy lets me off and even tries to give me directions home.
I was just reading this column in a special section of the NYT from Maano Ramutsindela, geographer from the University of Cape Town.
The partitioning of Africa by European empires has had devastating social, economic, political and psychological impacts, and millions of lives have been lost in post-independence Africa defending colonial borders. We are overdue for an African renaissance, completing the decolonization – which remains unfinished business until boundaries are changed.
His piece is mostly about the issue of parks, but the following came to mind.
1. Perhaps the author does not realize that millions of European lives have also been lost over the issue of borders. Historically, countries in Europe also haven’t fully represented linguistic groups (what is a language anyway?).
2. While from afar it may seem self evident to create states based on language, I’m wondering how that plays out in a country like Kenya, where there are more than 40 languages spoken and where, since often ethnic groups represent occupational groups, linguistic regions overlap. The distinctions between languages and cultures are often artificial anyway. Though the Maasai and the Samburu speak mutually intelligible languages and share almost identical cultural practices, they are bitter enemies and have been at war with one another for centuries.
3. Perhaps we might hope that African states worry more about how to keep themselves together and how to mend their internal divisions, rather than arbitrarily create more. It’s bad enough that the Kenyan government is weak and unresponsive to the needs of its citizenry, but the local governments haven’t shown themselves to be much more effective.
4. Perhaps, instead of dividing Africa even further, we might hope that African states learn to trade amongst one another. One of the main impediments to development is that fact that most African countries don’t trade with one another. There is no domestic trade economy. Could one imagine a world where European countries like Switzerland and Germany only traded with China and not each other? Cause that’s what’s happening in Africa.
5. Worse yet, it assumes that there is such a thing as a “natural” political unit. There is no such thing. All countries are artificially and have been created through mostly undemocratic means.
Worrying about colonial borders is a low hanging side show. While the colonial borders certainly impacted the ways in which modern Africa formed, in the end focusing on the issue is a convenient way of not having to dig more deeply into the complexity of present day facts. Present day Kenya is not a basket case simply because of misplaced borders. I think we should give Kenyans much more credit. These narratives often do to little to take African countries themselves to task for their own failings.
I was just watching Russel Crowe’s version of the Noah story at some friends’ house. Setting all of the other absurdities of the story aside, like the impossibility of successfully saving all the animals on the earth from only a pair of each (the lions alone would decimate any chances for herbivore reproduction in days, let alone the massive problems of an extremely limited gene pool), I remembered the crux of the story.
Noah discovers grapes, learns to make wine and then proceeds to become a raging alcoholic. The movie implies that he’s drowning his sorrows over failing to kill his two female grandchildren, thus preventing God’s plan to eliminate humanity from coming to fruition.
His son Ham finds Noah drunk and sees Noah’s genitals. The 950 year old Noah then curses Ham. Noah’s three sons then move out to establish the three races of humanity, the Europeans, the Asiatics and the Africans.
Ham moves to the African continent. All Africans, then, are descended from Ham.
To racists, this would provide a great explanation for Africa’s developmental problems. Africans are suffering under an ancient curse, because a guy saw his drunk Dad’s penis.
People in the United States believe this shit. What’s scarier is that they vote.
I’m not stupid. I know that I’m much more likely to be hit by a car in Nairobi than to be killed in a terror attack, but I can at least minimize the risks of being hit by an automobile. Terror attacks, on the other hand, come from nowhere.
The Kenyatta administration has proven itself completely incapable of dealing with issues of security. It’s pathetic appropriation of the Mpeketoni attacks for petty domestic squabbles is at least as embarrassing as it is dangerous.
From Think Africa Press:
Initially, al-Shabaab claimed responsibility for Mpeketoni killings through a spokesperson, declaring that Kenya was now “officially a war zone.” However, in a speech to the nation the next day, Kenya’s President Uhuru Kenyatta dismissed the notion that the Islamist militants were behind the attack, maintaining instead that it was “politically motivated ethnic violence.”
Though he did not explicitly mention names, local media outlets interpreted Kenyatta’s allegations as being aimed at the leader of the opposition, Raila Odinga. In response to these apparent accusations, Odinga in turn blamed the Kenyatta administration for failing to address the security situation since Westgate and called for the resignation of Joseph ole Lenku, Kenya’s Cabinet Secretary for the Ministry of Interior and Coordination of National Government.
Opposition leader Raila Odinga, a seasoned Luo politician affiliated with the Orange Democratic Party, has been rattling the cage for the past few months, demanding a “dialogue” with the Presidential office. Kenyatta, who ran on a platform of unity, appears uninterested in engaging the Luo stalwart.
If he doesn’t engage Raila, we’re guaranteed a day of demonstrations and inevitable rioting on July 7th, the day celebrating the birth (return to?) multipartyism in Kenya during Moi’s disastrous Presidency. It’s going to be a bloodbath, and Kenyatta will be watching in the safety of the State House. Most likely, though, he’ll be quietly watching football. Regular folks will be blaming this or that tribe for the fallout and we’ll slowly return to the bad old days of tribal violence.
Most troubling is Kenyatta’s refusal to engage the West, instead trying to curry short-term favors from China. A new road to allow Kenyan elites to move around the outskirts of Nairobi is worth more than solid security assistance from the West. Even more troubling is the seeming lack of interest from the Obama admin to a spreading terror threat in East Africa. Recruitment among Kenyans has become even easier given Kenya’s growing political divide, providing a ripe breeding ground for violence which could spread far beyond Kenya’s borders and potentially destabilize the most important economy in East Africa.
From Think Africa Press:
A domestic threat
So far this year, there have been 14 attacks in Nairobi, Mombasa and the nearby coastal tourist area, according to data from Terrorism Tracker. By contrast, there were just eight such incidents in these areas in the whole of 2013. This also marks a geographical shift in the threat, with attacks now being more common in Nairobi, Mombasa and the coast than in the northeastern region bordering Somalia. Although al-Shabaab continues to mount infrequent mass casualty operations inside Kenya, it seems to be Kenyan militant groups operating from Nairobi and Mombasa that now pose the greatest threat.
So the line between Al Shabab and local “militant groups,” the nature of which is mostly unknown, the credit for which goes to a policy of non-communication from the Kenyan Government itself. The Americans are quite good at identifying the nature of the threats, though also quite adept at defining it thereby giving militant groups an opportunity to mold their images in the shape of how the West perceives it. Here, that opportunity doesn’t exist. On the surface, this seems like a destabilizing strategy for militant groups, but in reality, it merely exacerbates the threat by giving it no ideological boundaries to operate in. The violence becomes random, and hobbles the ability to politically engage these groups.
Spent the week in Kwale, a sleepy town on near the Mombasa coast. The security situation prevents me from spending a whole lot of time there. I find this to be incredibly saddening but its unavoidable. Some people brave it out and stick with it, but I just can’t justify the awful risks.
The Japanese folks are mostly oblivious to it all, or maybe just indifferent. I’m convinced that they have no real concept of threat, given the relative safety of Japan itself. It’s a horribly dangerous situation but fortunately they stay locked inside. Japanese people love to sit at desks, even when they don’t really have to. Japan has yet to appropriate the concept of the mobile office. (Sorry, generalizations abound….)
I’ve caught some infection, but it’s hard to say exactly what it is. At first, it looked a lot like malaria, but then everything looks like malaria. Now, I’m just in a general state of not feeling well. It’s not responding to antibiotics, which makes me suspect that it’s not bacterial in nature. I started a round of ACTs just in case. They leave me a bit loopy, but I’m improving somewhat. A malaria test turned out faintly negative, but it’s possible the antibiotics are skewing the result or that the guy doing the test spilled to much assay onto the test. So, I’m not sure. I have a somewhat better appreciation for why the tests are treated with suspicion by the locals.
In any case, I feel like total hell, but thankfully have a normal appetite and digestion. I deeply crave red meat though, which leads me to suspect that the dizziness is anemia and thus, the cause could be malaria. This might be wishful thinking though. I could simply be exhausted.
Kenyatta is universally hated on the Coast, which explains a lot of the violence here. Though people apt to disregard domestic politics when talking of terrorism here, it’s hard to rule it out given the vast resentment toward the Jubilee party here on the coast. In fact, the lack of attention to security by the Kenyatta administration is likely fueling even more resentment, which might be fueling even more violence or at least, helping improve recruiting numbers for Al Shabab. As crazy as I think Luo politics are, Raila Odinga would have made a far better president.
People here are convinced that Kenyatta is a weed-head. “He is smoking the mari-ju-a-na.”
I spent the last two days convalescing in a hotel located within the Shimba Hills Nature Reserve. As much as I wanted to tough out the guest house in Kwale (which really isn’t so bad at all), I really needed a decent few hours of rest in a somewhat pleasant environment. It was worth it. A real hot shower and a set of clean sheets is worth the extra cash every now and again. The only wildlife to be seen were bush babies and squirrels, who seem to have worked out a deal where one begs for food in the day, and the other at night.
Malaria transmission here is low and it shows. Malaria endemic areas are characterized by low levels of education, part of which may be attributable to the inhibited cognitive development of children due to repeated malaria infections. Even if educational opportunities are available, kids in malaria endemic areas appear to have worse outcomes. It’s somewhat staggering at times, after having worked in Western. Part of it also could be the influence of Islam.
I’m now flying back to Nairobi where I’ll crawl into my bed. If I’m lucky, I’ll not come out for a few days.
In my seminal paper, “Distance to health services influences insecticide-treated net possession and use among six to 59 month-old children in Malawi,” I indicated that Euclidean (straight line) measures of distance were just as good as more complicated, network based measures.
I didn’t include the graph showing how correlated the two were, but I wish I had and I can’t find it here my computer.
Every time I’ve done presentations of research of the association of distances to various things and health outcomes, someone inevitably asks why I didn’t use a more complex measure of actual travel paths. The idea is that no one walks in a straight line anywhere, but rather follows a road network, or even utilizes a number of transportation options which might be lost in a simple measure.
I always respond that a straight line distance is as good as any other when investigating relationships on a coarse scale. Inevitably, audiences are never convinced.
A new paper came out today, “Methods to measure potential spatial access to delivery care in low- and middle-income countries: a case study in rural Ghana” which compared the Euclidean measure with a number of more complex measurements.
The conclusion confirmed what I already knew, that the Euclidean measure is just as good in most cases, and the pain and cost of producing sexy and complicated ways of calculating distance just isn’t worth it.
It’s a pretty decent paper, but I wish they had put some graphs in to illustrate their points. It would be good to see exactly where the measures disagree.
Access to skilled attendance at childbirth is crucial to reduce maternal and newborn mortality. Several different measures of geographic access are used concurrently in public health research, with the assumption that sophisticated methods are generally better. Most of the evidence for this assumption comes from methodological comparisons in high-income countries. We compare different measures of travel impedance in a case study in Ghana’s Brong Ahafo region to determine if straight-line distance can be an adequate proxy for access to delivery care in certain low- and middle-income country (LMIC) settings.
We created a geospatial database, mapping population location in both compounds and village centroids, service locations for all health facilities offering delivery care, land-cover and a detailed road network. Six different measures were used to calculate travel impedance to health facilities (straight-line distance, network distance, network travel time and raster travel time, the latter two both mechanized and non-mechanized). The measures were compared using Spearman rank correlation coefficients, absolute differences, and the percentage of the same facilities identified as closest. We used logistic regression with robust standard errors to model the association of the different measures with health facility use for delivery in 9,306 births.
Non-mechanized measures were highly correlated with each other, and identified the same facilities as closest for approximately 80% of villages. Measures calculated from compounds identified the same closest facility as measures from village centroids for over 85% of births. For 90% of births, the aggregation error from using village centroids instead of compound locations was less than 35 minutes and less than 1.12 km. All non-mechanized measures showed an inverse association with facility use of similar magnitude, an approximately 67% reduction in odds of facility delivery per standard deviation increase in each measure (OR = 0.33).
Different data models and population locations produced comparable results in our case study, thus demonstrating that straight-line distance can be reasonably used as a proxy for potential spatial access in certain LMIC settings. The cost of obtaining individually geocoded population location and sophisticated measures of travel impedance should be weighed against the gain in accuracy.