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New insurance product protects pastoralists from losses due to drought in Kenya

This is rather interesting. Pastoralism is characterized as a complex system of avoiding, accounting for and taking advantage of risk, not unlike hedge fund managers in the United States. Animals represent potential earnings, prices at markets vary with grazing conditions and perceived long term benefits, and decisions to sell animals are not made lightly.

In the past, pastoralists have protected against devastating losses through herd maximization and cooperation and conflict over prime grazing spots, along with systems of redistribution where animals from wealthy herders are given away or stolen with the approval of the community. The world has become complicated, though, as droughts become more and more frequent, political borders and conflicts constrain the movements of pastoralists, and as the spear has been replaced with the AK-47.

An interesting though appropriate insurance system might help to mitigate losses and stabilize communities.

Capital and inequality

Joseph Joyce, professor of economics at Wellesley College wrote and interesting piece to day on capital liberalization and inequality.

I’m glad to see that so much attention is being fawned on Piketty’s most excellent book, “Capital in the 21sr Century.” It’s sure to go down as a classic in the economics literature, but the debate and discussion surrounding the book couldn’t come at a better time.

I don’t think it’s an accident that Piketty’s book, would top the NYT best seller list just a week after appearing, that a sitting President of the US would mention that inequality is one of the most important issues of our time, or that Christine LaGarde, head of the IMF would make a case that we need to address inequality at a global level.

They (Florence Jaumotte, Subir Lall and Chris Papageorgiou) analyzed the effect of financial globalization and trade as well as technology on income inequality in 51 countries over the period of 1981 to 2003. They reported that technology played a larger role in increasing inequality than globalization. But while trade actually reduced inequality through increased exports of agricultural goods from developing countries, foreign direct investment played a different role. Inward FDI (like technology) favored workers with relatively higher skills and education, while outward FDI reduced employment in lower skill sectors. Consequently, the authors concluded, while financial deepening has been associated with higher growth, a disproportionate share of the gains may go to those who already have higher incomes.

This is a scenario we’re all mostly familiar with, though the broad effects are still debatable. Increasing investment by giants like the US in overseas manufacturing push down wages on domestic unskilled labor, but it’s hard to say whether this had a major effect on overall employment. Unemployment remained steady even after Clinton signed NAFTA, and continues to remain well under European levels today, though the lowest level of workers feel the worst pain. I’m not sure if I can really advocate for protectionist measures to keep capital at home or dissuade foreign investment on principle alone, but it is true that the worst effect of foreign competition has been the erosion of labor’s political power.

Jayati Ghosh of Jawaharlal Nehru University of New Delhi has examined the role of capital inflows in developing countries. She maintains that the inflows appreciate the real exchange rate and encourage investment in non-tradable sectors and domestic asset markets. The resulting rise in asset prices pulls funds away from the financing of agriculture and small firms, hurting farmers and workers in traditional sectors. Eventually, the asset bubbles break, and the poor are usually those most vulnerable to the ensuing crisis.

Well, this is somewhat more interesting. Foreign investment in developing countries appreciates the exchange rate, leading domestic investors to put their money into, say, real estate assets. This is certainly the case all over Africa. Land and building developments are occurring at a breakneck pace, with the hopes that expensive properties will be bought up by foreign companies and individuals. It’s certainly the case that no common African could ever afford some of these places (or would even want to buy them if they could). Nairobi, Dar es Salaam and Luanda, Angola are all in the middle of a real estate bubble. The problem, of course, is that domestic investors are hoping to make a quick buck, rather than attempting to create long term, profitable industries. No wonder Africa imports the lion’s share of it’s manufactured goods. No local will invest in the infrastructure to create it locally since urban real estate is so absurdly profitable right now. This, of course, means that money flows directly into the pockets of the urban elite and then sent back out to bank accounts and retailers in France and England, further entrenching the poorest of the poor.

Without the development of local industries, domestic economies can’t function and opportunities for revenue collections are missed. and countries like Tanzania and Kenya, for example, will continue to be beggar economies which depend on the good graces of the international community to support domestic social programs.

Do field research projects do the world any good?

IMG_3931It’s a reasonable question to which no one really has an answer. I work in a field site located on Lake Victoria, the office of which is based out of the International Centre for Insect Physiology and Ecology (ICIPE) station on Mbita Point.

We do malaria field surveys and have a large health and demographic surveillance system that has monitored births, deaths, migration and health events of nearly 50,000 people over the past six years.

The goals of the project are to monitor changes in demographics, outbreaks and changes in the dynamics of the transmission of infectious diseases and gauge the effectiveness of interventions.

While I view those as scientifically important, I don’t think that people on the ground experience any immediate benefit from scientific research activities. In fact, I’m pretty sure that, unless they’re getting a free bednet, it’s mostly an annoyance. Of course, we appreciate their cooperation and they are free to tell us to bugger off at anytime.

We are seeing rapid declines in malaria incidence, infant mortality and fertility in the communities we study. This is, of course, cause for celebration. Less kids are dying and people are having fewer of them.

In fact, the shift in the age distribution was so dramatic from 2011 to 2012, that we thought it an aberration of the data: the mean age of 12,000 people rose nearly two years from the beginning of 2011 to the latter part of 2012. Old people died off, and fewer babies were there to replace them, resulting in an upward shift in the age distribution. Cause for celebration in an area where women normally have anywhere from 5 to 10 children, who often end up malnourished, poorly housed and uneducated.

But we have to ask ourselves, how much of this is representative of trends in communities similar to the ones we study and how much is directly influenced by the presence of the research station itself?

A recent article in Malaria Journal documents the positive impacts that a research facility had on the local community:

To make the community a real partner in the centre’s activities, a tacit agreement was made that priority would be given to local people, in a competitive manner, for all non-professional jobs (construction workers, drivers, cleaners, field workers, data clerks, and others). Of the 254 people employed at the CRUN, about one-third come from Nanoro. This has strengthened the sense of ownership of the centre’s activities by the community. Through the modest creation of new jobs, CRUN makes a substantial contribution to reducing poverty in the community. In addition, staff members residing in Nanoro contribute to the micro-economy there.

Another crucial benefit for Nanoro and CRUN stemming from their productive engagement was electrification for the area. This was made possible by the mayor of Nanoro leading the negotiations for extending the national electrical grid to the CRUN, and with it, to the village of Nanoro. Electrification spurred a lot of economic activity and social amenities that enhance the wellbeing of the community, such as: (1) improved water supply through use electricity instead of generator; (2) ability to use electrical devices, such as fans during the hot season (when temperatures can reach 45-47°C), lighting so students can study at night, the use of refrigeration to safely store food and the extension of business hours past sunset.

Health care services have been improved through CRUN’s new microbiology laboratory. Before this laboratory was established, local patients had to travel about 100 km to the capital city, Ouagadougou, for the service.

This agrees with my experience on Lake Victoria. The presence of the research facility (built originally in the 1960′s) and the subsequent scale up of research activities has been transformative for the area. As more and more people have moved to the area, a bridge to Rusinga Island has been built, two new ferry routes have been installed, the existing ferries have been upgraded, power has been extended to the area and finally, after years of waiting, a paved road has been built from Kisumu to Mbita Point.

..which brings back me to my initial question. It is clear that the building of research facilities can be a major spur for economic development and economic activity in a previously desolate and marginalized area. In case of Mbita Point, it is possible that these gains can be sustained even following an eventual cessation of research activities and strangled funding. In this sense, field research projects are doing at least some of the world good.

However, the gains which these communities are experience really have little to do with the research projects themselves and more to do with the influx of employment and infrastructure that come with research stations and research projects. This is non-controversial and I’m sure that the locals appreciate it.

But the quality and goals of research need to be assessed. Are the results we are seeing truly representative of communities which may be similar to the Mbita Point of the past? Are we unnecessarily influencing the outcomes of the research and then perhaps inappropriately generalizing them to contexts which little resemble our target communities? From a scientific perspective, this is troubling.

Of greater concern, however, are we claiming that gains against malaria are being made, when in fact, morbidity and mortality in communities we haven’t looked at is increasing? This could result in a dangerous shift away from scaled up ITN distributions or even a total reduction in international funding. If this happens, kids will die.

Development as a faith-based activity: the role of the RCT in alleviating poverty

DSC_0060The essence of epidemiologic field trials is the RCT (randomized control trial). A random set of people get some sort of treatment (like a new drug), another random set of people don’t and we compare the results. It’s pretty simple stuff.

The trouble with RCTs is that they don’t necessarily work well when people from the two groups are able to influence each other’s outcomes. As a simple example, a trial of a vaccine which prevents people from getting infected with some pathogen might have impacts on people who don’t get the vaccine, since the number of opportunities for transmission are reduced. This is a welcome outcome (and may even be the point of the study), but it doesn’t help us to understand exactly how effective the vaccine is in the individuals who actually receive the vaccine.

Many RCTs make the (flawed) assumption that individuals are independent entities, following a long tradition of statistical analysis. This is a reasonable assumption to make in some cases, but entirely wrong in others (i.e. most public health outcomes).

Development economists have recently adopted the RCT as a means of evaluating the effectiveness of programs intended to relieve poverty or improve human well-being. On the surface, there’s nothing wrong with adopted public health methods to deal with economic problems, as most public health problems have their roots in economics. Jeff Sachs, or course, would argue that many economic problems have their roots in public health problems.

The major problem with RCTs is that while we do our best to control for all of the possible other factors that might impact outcomes given a particular treatment, without a trove of detailed data and prior knowledge of context and contingencies, we really have no idea at all whether and how some public health intervention works. Epidemiology tends to fall back on the “reasonable suspicion” argument, backing up claims of effectiveness with potentially reasonable assumptions of causal pathways. This is clearly quite easy when doing drug trials, where animals models and a century-plus of medical research has given us a reasonably clear pictures of the pathophysiological pathways that might lie between drug and outcome.

But with issues of human behavior and economics (which is essentially a science which seeks to uncover mysteries of human behavior), the causal pathways are much more difficult to assess and the factors which lie between intervention and outcome are for more difficult to measure. For example, assessing the outcome of an education program on reproductive behavior is really, really difficult without monitoring all of the possible things that happened between the time that a woman attended an NGO sponsored event at a clinic and the time when she chose to use or not use a condom. In fact, we can’t even really verify that she used the condom, since we weren’t around to observe it.

But we assume, and assume to the point of falling back to faith that our efforts did what we intended them to do.

Lant Pritchett, a Harvard economist that I’m a great fan of for his work on economic measurement in developing countries, penned an interesting article on the website of the Center for Global Development seemingly questioning the merit of the RCT as an rigorous and necessary evaluation tool for poverty alleviation development programs.

First of all, the argument that RCTs had, until recently, been used sparingly, if at all, and yet are important in achieving good outcomes sits in kind of embarrassing counterpoint with the obvious fact that lots of countries have really good outcomes. That is whether one uses the Human Development Index or the OECD Better Life Index or any social indicator—from poverty to education to health to life satisfaction—there is a similar set of countries near the top. (In the HDI the top five are Norway, Australia, USA, Netherlands, and Germany. In the OECD Better Life Index they are Australia, Sweden, Canada, Norway, and Switzerland.) No one has ever made the arguments that these countries are developed and prosperous because they used rigorous evidence—much less RCTs—in formulating policy and programs. While one might have faith that RCTs can help along the path to development, RCTs didn’t help for those that are there now.

It is very true that development in the United States occurred without the help of RCTs. In fact, malaria elimination in the United States occurred without any of the complex set of interventions that we’re so desperately selling to malaria-endemic countries. It’s even true that, despite more than a decade of research on ITNs, that we aren’t really sure whether the declines in malaria that we’ve seen all over Sub-Saharan Africa are due to ITNs or just simply due to processes associated with urbanization and development (as in the US). Actually, a lot of research is telling us that the declines in malaria might be false and that we are simply suffering from a paucity of accurate measurement in malaria endemic countries.

And this is where Pritchett comes in. He’s right. Research in developing countries is inherently challenging to the point where the conclusions we draw from research are somewhat contentious at best, and the result of blind faith at worst.

But coarse and incomplete data and loose assumptions shouldn’t discourage public health (or even economic) professionals from doing research in developing countries. While I have issues with the condescending, neo-classical nature of RCTs in economics (another discussion, but can a peasant lady’s behavior in Western Kenya be reduced to that of Homo economicus? ), the truth is that policy makers don’t care about data. They care that people are making the case for action in an impassioned and convincing way. While academics should strive to be as rigorous as possible, the sell won’t happen based on our complex data collection strategies and statistical methodologies. They (and the public) are convinced through impassioned calls for action.

What I’m reading now

While I was in Kenya, I picked up a number of books from Kwani?, a Nairobi based publisher which (mostly) specializes in Kenyan writers.

Established in 2003, Kwani Trust is a Kenyan based literary network dedicated to developing quality creative writing and committed to the growth of the creative industry through the publishing and distribution of contemporary African writing, offering training opportunities, producing literary events and establishing and maintaining global literary networks. Our vision is to create a society that uses its stories to see itself more coherently.

At the very least, reading these books allows one to see Kenya somewhat more coherently.

one-day-i-will-write-about-this-placeOne Day I Will Write About This Place: A Memoir Binyavanga Wanaina is now famous for bravely having come out as gay in an area famous for conservative and often violent attitudes toward homosexuality. He should be more famous for his books or at least for taking the prize money from one of his literary accolades and starting Kwani Press.

“One Day I Will Write About This Place” is a memoir of growing up in a middle class household in central Kenya, following some of the country’s most tumultuous social and political upheavals. Wanaina experiences Kenya on the periphery, looking in at Kenya through the lens of reruns of the Six Million Dollar Man, formerly colonial schools, local libraries and the staggering complexity of Kenya itself. Wanaina even makes several attempts to leave Kenya for good, jetting off to South Africa for law school during apartheid and after, even coming back to Kenya for the disastrous and bloody 2007 elections. His descriptions of the latter and of supermarkets sold out of pangas are no less than chilling.

Kenya has long been a mystery to me. While the country was set to become on of the world’s economic success stories, it’s progress was rapidly squandered due to a combination of demographics and bad politics. Wanaina might be even more perplexed.

If anything, the book needs to be read for Wanaina’s excellent prose. It doesn’t matter whether one understands or knows anything about Kenya (though it helps). His writing is engaging enough to keep ones attention even without understanding the details. This is one of the best books I’ve read in years.

kwani7Kwani? 4 Kwani? is a series of collections of Kenyan writing from both writers within and without Kenya. This volume focuses on subjects of travel, emigration, immigration and the lives of the Kenyan diaspora. Discussions of Africa must recognize that Africans are some of the most mobile people on the planet.

The experience of the diaspora is essential to understanding the state of present day African people, who often lay on the front lines fighting for survival in a world which mostly doesn’t want them, while providing support for all the people who depend on them back home. Immigration nightmares, the loss of connection with home, and the shaping of new identities make up this great collection of stories, poems and artwork.

(Note that the link is for Kwani 4.)

the-stone-hills-of-maragoli The Stone Hills of Maragoli – Stanley Gazemba I have not finished this one yet (“reading now”), but I was excited to pick up something from Gazemba, who bills himself as a humble gardener living in a slum outside of Nairobi. He is clearly much more than that. He is a prolific writer and journalist, whose works have appeared in many of the major Kenyan newspapers, New African and the New York Times (where I first became aware of him).

“The Stone Hills of Maragoli” follows Ombima as he overcomes his morals to find that stealing food from a garden is delightfully empowering. Mostly, the book is about life in a rural area of Western Kenya, filled with the complexities of daily life and a tightly knit, though deeply divided society.

The book won the Jomo Kenyatta literary prize in 2003. Gazemba apparently has frou other novels waiting to see the light of day.

Kenya Day 9

We visited another rehabilitation facility in Nairobi. We found out that the guy we are looking for has been telling his counselors about his employers, but they thought he was just making it all up. His story was so implausible that his employers were a figment of his troubled imagination.

They are surprised to find these fictional characters standing in the sitting room of their facility. One of them has the same name as a good friend of mine, Justin Farrar. I’m somewhat taken aback by his business card.

Capitalism is the cause of drug problems in Kenya, apparently. The market economy has robbed Kenyans of their culture and they are now turning to drugs for comfort and solace. I’m interested in this. I ask where most of the patients of this $500 a month facility come from. They are mostly children of the wealthy Kenyans, half of which probably have real problems, and the other half of which are sent here to get them out of their parents’ hair.

I’m wondering if all those with brains pickled (or eyes blinded) from changaa (an awful homebrewed alcoholic beverage common in the villages) are the victims of capitalism as well. While it’s important to discuss the causes and roots of social problems, it was an odd aside.

We stop by a new Ethiopian restaurant. The owner is excited because we are the first foreigners at his place, which opened up three days ago. He takes numerous pictures.

I’m told that much of the real estate boom in Nairobi has been funded through proceeds from Somali piracy. I look and find that it’s probably true.

In fact, I reflecting on how Nairobi is in the middle of a real estate bubble. Rents are absurdly high in Nairobi, but then one will pay a premium for security, particularly after Westgate. I keep thinking about what an awful strategy this is. Investors are looking to make a quick buck, building and turning over real estate prices for ever higher prices. I remark that Kenyans are wholly uninterested in developing their country, preferring risky, short term assets like real estate to investment in new manufacturing sectors.

The Kenyan government, of course, is uninterested in encouraging growth through enterprises which create jobs, preferring to skim off the top of real estate in the form of bribes and taxation for imported supplies. It’s all sad, really. I’m wondering when the bubble is going to finally burst.

It turns out the Nairobi Java House that got bombed was the one outside, not the one inside the terminal. I’m looking at it and noticing how dangerous the location is. Anyone could drive by, lob a bomb here and kill five or ten foreigners in a split second.

It’s time to go, though I’m sad. Nairobi is an exciting place, far more exciting than my own boring, though pleasant, Ann Arbor.

Kenya Day 8: Full of complaints

We went and visited Kwale, a relatively small community of Duruma and Digo in Eastern Kenya. I’ve been to so many of these African towns that I’m honestly somewhat bored. Five years ago, I might have been more excited. Perhaps I’m just tired.

People speak Swahili here. For real. In the rest of Kenya, Swahili is a language to connect disparate tribes, Kenyans happily mangle and make a mess of Swahili, but it does its job well enough. Here, I’m struck that even the kids speak Swahili, something you never see in other parts of Kenya.

I keep running into people who don’t speak anything but Swahili forcing me to communicate as best I can with my limited vocabulary. Fortunately, it’s all easy to understand out here.

But, to be honest, it’s quite boring out here. Life is fairly content, it lacks all of the huge and obvious problems of economics and health that persist in the rest of Kenya, and the ubiquity of Islam makes is a safe and tranquil place, if one is willing to ignore the oppressive patriarchy.

We spend the day at the hospital, meeting person after person. I’m growing agitated. Lunch is being pushed back later and later. I’m so bad at this, but its necessary and everyone is well meaning and kind.

Why are we doing this? All of Kenya’s problems are a failure of government. It’s not fashionable to say, but you can’t help but be annoyed when people spin the tired old narratives of colonialism and corruption. You guys voted these assholes in.

We finally get to lunch. I order pilau (mixed rice and beef) and some fried goat, knowing that it will be quick and we can be back on the road. Since he’s not paying, our Kenyan host orders to most expensive thing on the menu, the thing they never have prepared, the thing you have to wait an hour for. It’s hard not to be annoyed, but you just let it slide.

People are telling me what a great President Moi was, claiming that everything was ok during his reign. It was at the beginning, thanks to his predecessors, but his awful policies pushed Kenya to a horribly repressive one party state and spurred a complete collapse of the Kenyan economy, leaving the mess for his successors to clean up. In politics, timing is everything.

Now the entire health system has been devolved to the provincial governments. I’m thinking this is going to become a disaster of epic proportions. While the devolution of powers to local governments makes some sense in diverse and fractured Kenya, health problems usually don’t recognize political boundaries. A failure of health policy in HIV and malaria infested Nyanza could have devastating effects for Nairobi.

We’ve stopped in a tiny market center in the middle of nowhere. I say “shikamoo” to an old man, a respectful greeting reserved for elderly people. He asks me for 20 schillings. I’m having fun saying “shikamoo” to people younger than I am. It confuses the hell out of them.

The area is partially semi-arid and partially forested. Elephants come out of the national park and wander through the streets, I’m told. Baboons rifle through the trash. The areas close to the forest are doing better than the other areas, but there’s no real economy out here and the wildlife and igneous terrain prevent people from doing any substantial agriculture out here. The houses are in great shape, some even have power, but there’s malnutrition everywhere. The markets are mostly devoid of decent food outside of bags of rice trucked in from other areas. There are signs of American food aid and a World Food Program truck passes us.

A Japanese group is doing a survey on diet and malnutrition. It’s explained to me, but I think it’s pretty stupid. We already know that a lack of food causes malnutrition. They say they want to help. While I’m listening, though, I’m thinking that it’s a colossal waste of time and money. Perhaps it might be more helpful to come up with a better plan.

I realizing that this post is full of complaints, but here not every day is full of wonder and excitement.

We get dinner. It’s nyama choma (BBQ) again. I’m not disappointed but the conversation turns to Japanese academics. I can’t help but remark that I find a lot of it horribly uninteresting. I’m not sure why many of these groups do projects here, and even less sure what the tangible results will be, outside of raising the domestic status of ineffective Japanese researchers. Public health research really has to do one of two things. Either it should push science forward, or provide meaningful public health services to developing countries. The projects that are being described to me fail on both points. My anxiety level is high.

It’s time for me to stop complaining, though complaining is healthy and sometimes leads to substantive change. I’m getting ready to go to get some Ethiopian food at one of my favorite spots in Nairobi, Queen Sheba, which is run by Ethiopian refugees who fled the war there some years ago. Fortunately, it’s not expensive, unlike other places in Nairobi. See, the complaints never stop.

Kenya Day 7: The long wait

I’m having a hard time keeping up with the days. We’ve moved on the Kwale, located on the coast of Kenya, not far from Mombasa. I’m warned that this area isn’t safe for white people, but there seem to be an abundance of German and Italian tourists. I’m wondering if they missed that particular State Department warning.

There is no doubt that this area is filled with Al Shabab leaning fundamentalists, or so I’m told. There was a terrorist training center near here back in the 90′s. This is no joke. Mombasa is famous for terrorist attacks and kidnappings, but they don’t seem to discourage the droves of Western tourist which play an important role in the local economy.

We are hungry. The field manager, Juma, takes us to a place to eat along the beach. Apparently, this is where the rich from Nairobi come to relax and drink beer, but there’s no one here at all. As soon as we place our order, I realize what’s to come.

In Africa, if there are no customers, you will have to assume that the kitchen staff hasn’t cooked anything at all. You might even assume that they have to find, purchase, kill and feather a chicken for you. The wait might get so long that you begin to think that they are tracking down and slaughtering a cow for you. At the two hour mark, you start wondering if they might be raising the animal from birth, waiting until it gets big enough for you to eat.

And this is exactly what happens. We wait… and wait…. while listening to the torturous sounds of every Disney soundtrack reinterpreted by famous American R&B artists, or maybe these are the originals, I wouldn’t know.

Juma hates music. Juma is Islamic and makes sure to tell you about all of the hard and important rules of Islam whenever he can, which seem to mostly be about having sex with his wife. No dancing. No music. He claims that Christians are crazy and don’t value their wives. I agree that Christians are crazy, but keep my opinions on the craziness of Islam to myself. In listening to his constant moralizing, which rivals the constant moralizing of African Christians,

“He lives by the forest that runs along the valley.” These are apparently the lyrics to a song which was corrupting Kenya’s youth. He says he is lucky that his daughters are too young to understand it.

We can’t really figure out what he’s talking about and he can’t figure out why we don’t get it. But then I strain and finally realize what it means.

“Ahhh…” Still, I’m the only one who gets it.

This is a place where old Italian and German women come to hook up with large, athletic young Kenyan men. The signs are even in German. The roads are in great shape, until we get to the places that normal people live, the places I assume the “beach boys” live with their families.

We’re talking and It turns out that Shimada and his wife were communists who met while taking lunches to jailed student protestors in the era of the resigning of the military treaty between Japan and the US. I’m pretty impressed. I’ve never met anyone who was directly involved in the Japanese student protests of the 1960’s.

We stop by a drug and rehabilitation center to see a computer programmer whose help is badly needed. His parents have committed him because he cut his own throat after a week’s long bender. We actually stop by two of them. The first one is in town. There’s a Pakistani kid and two Kenyans there watching TV (though the Pakistani kid might be Kenyan, too).

While we wait they invite me to sit down and they start rattling off the drugs that they’ve done. I listen, somewhat fascinated by the variety of drugs available here. In the west toward Lake Victoria, it’s just alcohol and weed. Here, given Mombasa’s status as a major port city with extensive connections to the Middle East and Asia, just about anything imaginable is available. If the local addicts can’t find something better, though, they’ll just huff glue like they do in Nairobi.

These guys look really bad. They repeat AA slogans and talk of addiction, but it’s painfully rehearsed. I’m wondering what kind of shit they’ve put their parents through to have them stuck in a $700 per month rehabilitation facility, and then wonder if some of them might not be addicts at all, but rather just a nuisance to their families. It’s hard to say. I really hope these guys make it.

The second facility we go to is a bit more upscale. Someone is reading Sun Tzu’s “The Art of War.” I remember that I really don’t like addicts at all. I find the air of feigned sympathy distasteful, given the horrible wreckage they leave in their wake. Addicts can be emotional black holes, sucking the life out of everyone around them. They can’t be trusted, I remind myself. I want to get out of here as soon as possible.

Kenya Day 1: Mini Skirts, Donkeys and the Land of No Pirates

I’m not sure why I number these from “1.” I must have a multitude of “1′s.” Perhaps I should just start a continuing, yet even more unsearchable, series.

It’s 4 in the morning, I’ve slept probably a total of 2 hours in the past 72 hours, but being awake after the stasis of international flights and the crossing of time zone is like a sleep of its own. It might be like that creepy Russian Sleep Experiment story, though, where you’ve stayed awake long enough to arrange your entrails on the floor in an artistic fashion.

What I did today. First day is always hectic, shopping to be done. This time it was a quest for hand shaking, an extension on a research permit to suck more blood from animals, a new phone and as many Remmy Ongala CD’s as existence would allow.

Remmy Ongala is a legendary Tanzanian musician. I was told that one has to go to a special part of town to get Remmy Ongala CD’s. The place where there are no pirates, but apparently, I’m not allowed to go. See, all of the other people on the street selling Jean Claude Van Damme films and Jay Z CD’s are pirates. The Americans can never catch them. Remmy Ongala, however, must have protectors everywhere, because his CDs aren’t available. At least not in the 99% of the country where the pirates live.

I get a call from my friend Tirus. He’s apparently gone to that-place-I-should-not-go and found everything (even a video) for the crushing price of $3.00. He asks me to pay double for his services. I talk him down to a total of $4.25. I ask him how the land of no pirates is.

I buy a new phone. My old one was terrible, though it was recommended by another friend, simply because he has it. It’s supposedly a “smart” phone, but it was one of the stupidest pieces of technology I’ve ever owned. Out of loyalty, I try to buy a Japanese phone, but find they don’t exist, so I opt for one of the former colonies, thinking that they must own everything anyway, kind of like how the Brits still own everything in Kenya (well, not really, but it sounded good).

The lady at the phone store knows everything about all of the phones she has. I’m impressed by the authoritative air with which she answers my questions and her insistence that I tell her what I hated about my other phone. I intentionally play a game with her, asking more and more difficult and probably unanswerable (or so I thought) questions and she doesn’t bat an eye. Best sales lady I’ve seen in a while.

You see, in America, they just want to sell you the most expensive thing they can and get you the hell out of the store so they can sell another. Here, a sale is a sale because there’s 500 more people within a 1 km radius selling the exact same thing for the same prices.

Tirus asks me about America and why it’s so hard to get a visa. I tell him that Americans are scared of Africans because they work too hard. I tell him that there are Americans who want to turn out the lights and force everyone to go back to the farms to keep them from selling cell phones and driving taxis and writing books and networking and succeeding in America or anywhere else because they are so good at all of them.

Though I’m half joking, I’m half serious, but half complaining and Tirus senses it. I buy a hat because I left mine at home.

Uganda has banned mini-skirts. Museveni is apparently paying a political price for refusing to sign the anti-gay law, so, like a good dictator, he’s turned to victimizing another group who can’t defend themselves. Hashimoto Toru would be proud. The irony, of course, is that the law merely makes Museveni even more powerful as Uganda barrels forward to becoming an frighteningly autocratic state.

The social conservatives are nodding their heads, saying that such a law was overdue. “The women are out of control. It’s time for the police to step in.” I remark that I’ve seen more evidence that the men are the one’s who are out of control. It’s amazing how deeply female sexuality is both respected and feared here. Fortunately, the voices are reason are screaming loudly, at least in Kenya.

We eat Nyama Choma (grilled meat). I eat more than I intend and have gained 10 pounds again. I blame the chips. Apparently, though, the big news is that Kenya is falling apart because someone is opening a restaurant which serves donkey meat in Naivasha. The Chinese are blamed. I remark that I’ve never seen a dead donkey on the side of the road (as opposed to dogs and cats) and ask where do those donkeys go? Everyone laughs.

I’m eating my favorite Salticrax. OK, back to bed.

Post-election violence in Kenya, 2007-2008: Let it never happen again

It’s Sunday and I’m catching up on some reading from a number of journals which publish infrequently. One is Conflict and Health, a BMC journal with a self-explanatory title.

I’m reading “A national population-based assessment of 2007-2008 election-related violence in Kenya” which surveyed ~900 households all over Kenya, asking people if they experienced various types of violence before and after the disastrous 2007 Kenyan election. The event left up to 2000 people dead and displaced well more than 100,000 people, though the true numbers will never be known

Of 956 households surveyed, 916 households participated (response rate 95.8%). Compared to pre-election, election-related sexual violence incidents/1000 persons/year increased over 60-fold (39.1-2370.1; p < .001) with a concurrent 37-fold increase in opportunistic sexual violence (5.2-183.1; p < .001). Physical and other human rights violations increased 80-fold (25.0-1987.1; p < .001) compared to pre-election. Overall, 50% of households reported at least one physical or sexual violation. Households reporting violence were more likely to report violence among female household members (66.6% vs. 58.1%; p = .04) or among the Luhya ethnic group (17.0% vs. 13.8%; p = 0.03). The most common perpetrators of election-related sexual violence were reported to be affiliated with government or political groups (1670.5 incidents/1000 persons per year); the Kalenjin ethnic group for physical violations (54.6%). Over thirty percent of respondents met MDD and PTSD symptom criteria; however, symptoms of MDD (females, 63.3%; males, 36.7%; p = .01) and suicide ideation (females, 68.5%; males, 31.5%; p = .04) were more common among females. Substance abuse was more common among males (males, 71.2%; females, 28.8%; p < .001).

The results are horrifying. A huge percentage of people experienced some form of violence during the blow up. Amputations, sexual abuse and mutilations, clearly with the help of officials and police officers. Most analyses to date relied on anecdotal information or interviews with people known to have been victimized. This appears to be one of the first studies which randomly selected households to ask them about their experiences.

Though we like to think of these incidents as randomly occurring events perpetrated by misguided (or mentally imbalanced) individuals, in nearly all cases, there is an organized effort to wage violence against specific targets. This was true in Rwanda, has been true in Zimbabwe and we can go back farther to Europe’s own history of state sponsored genocide.

Fortunately, though there were sporadic events of violence before and after last year’s election in Kenya, the worst was avoided.

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