We have no idea what poor people do

I was just reading a post from development economist Ed Carr’s blog, where he reflects on a book he wrote almost five years ago. Reflection is a pretty depressing excercise for any academic, but Carr seems to remain positive about his book.

He sums it up in three points:

“1. Most of the time, we have no idea what the global poor are doing or why they are doing it.
2. Because of this, most of our projects are designed for what we think is going on, which rarely aligns with reality
3. This is why so many development projects fail, and if we keep doing this, the consequences will get dire”

Well, yeah. This is a huge problem. In academics, we filter the experiences of the poor through a lens of academic frameworks, which we haphazardly impose with often no consultation with our subjects. Granted, this is likely inevtiable, but when designing public health interventions, it helps to have some idea of what the poorest of the poor do and why or our efforts are doomed to fail.

I remember a set of arguments a few years back on bed nets. Development and public health people were all upset because people were seen using nets for fishing. The reaction, particularly from in country workers was that poor people are stupid and will shoot themselves in the foot at any opportunity.

I couldn’t really understand the condescension and was rather fascinated that people were taking a new product and adapting it to their own needs. Business would see this as an opportunity and would seek to figure out why people were using nets for things other than malaria prevention and attempt to develop some new strategy to satisfy both needs (fishing and malaria prevention) at once. Academics simply weren’t interested.

To work with the poor, we have to understand them and understanding them requires that we respect their agency. If we don’t do this, we risk alienating the people we seek to help.

Links I liked January 6, 2015

I’m trying to lose 20 pounds, sleep more than five hours a night, finish piles of work and keep this blog alive so I’ll cop out and just post to some stuff that other people wrote.

1. Confusion on the internet is not the answer (WaPo). I almost bought the book of the review that he’s writing about here. It’s amazing how limited writers’ knowledge is sometimes, particularly of economics. Is Amazon good or bad? That’s the question, though.

2. A Farewell to Africa Rising (LSE) Some people are optimistic about Africa, others are pessimistic. One thing they share is that they routinely ignore Africans.

3. 2014: The Year Marvel Studios Redefined Itself (Again) I will not hesitate to admit that I have been quite excited by Marvel’s Phase One and Phase Two films. Thankfully, they weren’t like the not so good X-Men movies, which have sadly lost their way.

4. What a Strong Dollar Means for the Economy (NYT) My paycheck is in yen so I now make as much as I did as a graduate student.

2014 in review: I’m not sure what this all really says

It is pretty obvious that after July, something happened and I stopped posting with any sort of regularity. I really need to fix this or whatever is keeping me from posting. I don’t get a whole lot of traffic on this blog, but it seems that every day I don’t post is a missed opportunity for me.

Anyway, to all of you who read this blog in 2014, I thank you. It’s great to have you around. I wish everyone a great 2015.

Pete

The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog.

Here's an excerpt:

Madison Square Garden can seat 20,000 people for a concert. This blog was viewed about 62,000 times in 2014. If it were a concert at Madison Square Garden, it would take about 3 sold-out performances for that many people to see it.

Click here to see the complete report.

Does the environment cause poverty?

SESKwaleAfrican countries are blessed with ample cropland and resources, but suffer from crippling and unforgivable levels of poverty, have some of the shortest lifespans on the planet and the highest rates of infant mortality in the world. Meanwhile, Japan, Korea, Sweden, Switzerland and Singapore are wholly the opposite, yet mostly lacking in everything that Africa has. Clearly, the picture is more complicated than merely having access to a natural resources.

However, within countries, the picture might be different. African countries are complex and diverse places. Poverty is often confined to the most unproductive regions, areas with poor soils, poor rainfalls or dangerous terrains.

I was just working with some socio-economic data from one of our field sites, and noticed some interesting patterns (note the map up top). In Kwale, a small area along the Coast, socio-economic levels vary widely, but neighbors tend to be like neighbors and patterns of socio-economic clustering emerge.

Note that the poorest of the poor are concentrated to an area in the middle, which I know to be extremely dry, difficult to get to, difficult to farm and generally tough to live in.

I tried to see if socio-economic status (as measured through a composite material wealth index a la Filmer and Pritchett but using multiple correspondence analysis rather than PCA) was related to any environmental variables that I might have data for.

I fit a generalized additive model using the continuous measure of of wealth from the MCA as an outcome. Knowing that very few things in nature or human societies are linear, I also applied smoothing to the predictors to relax these assumptions. The results can be seen in the plot at the bottom.

A few interesting things came out. While it is hard to tell much about the poorest of the poor, we can tell something about the most wealthy. The richest in this poor area, tend to live in areas with the richest vegetation (possibly representing water), a high altitude (low temperature), high relief (no standing water) and in locations distant from a wildlife reserve (far from annoying and dangerous wildlife).

I’m not sure the wildlife reserve is meaningful (unless the reserve was an area undesirable for human habitation to begin with), but the others might be and represent a trend seen in other Sub-Saharan contexts. Areas without malarious swamps and ample farm land tend to do the best. Central Province, one of the most developed areas of Kenya, would be an example.

But the question has to be, does a harsh environment doom people to poverty, or do people self shuffle into and compete for access to more favorable areas? Is environmentally determined poverty (or wealth) an accident of birth, or the result of competitive selection?

Alright, back to work. Oh wait, this is my work. Well….

Results of GAM model of SES in Kwale. Y axis is the continuous measure of socio-economic status.

Results of GAM model of SES in Kwale. Y axis is the continuous measure of socio-economic status.

My Best Music of 2014

In no particularly order at all, here are my favorites for 2014:

bohren_and_der_club_of_gore_piano_nightsBohren and der Club of Gore – “Piano Nights” – There’s something fascinating about people who graduate from hardcore, with its rigid rules and narrow forms, to more cerebral musical efforts. While “ambient jazz” conjures up images of new age office soundtracks, Bohren and der Club of Gore are like a horror show, where the characters are unaware of the supernatural nature of their predicament and ignorant of what lays in store.

TrapThemTrap Them – “Blissfucker” – On the surface, New England’s (now Seattle) Trap Them are fairly conventional, but they give themselves enough room to prevent a zero sum competition for sonic space, allowing the listener to fully appreciate their monstrously violent sounds. Not for the faint of heart. Play on 12.

Taylor_Swift_-_1989Taylor Swift – “1989” – I only first heard this record a couple of days ago but I nearly cried when I heard “Shake it Off’s” (near) perfection. Taylor Swift tries to offer herself as a slightly ditzy and social awkward lady of (white) people, but clearly she is so much more. Americans love very exceptional people who try to pass themselves off as unexceptional. In this respect, Swift is more than exceptional. While it is tempting to dismiss her, upon inspection, you realize that there’s a lot going on here. Words and notes are carefully chosen to simplicity and efficiency and she’s clearly loving every second of the entire process. While a couple of tunes could stand to be cut (such as the horribly trite, “Welcome to New York“) “1989” is a fantastic record. At 25 and with no signs of drug or sex scandals, we should expect several more decades of top notch music from an enigmatically gifted artist.

Goatwhore-ConstrictingRageOfTheMercilessGoatwhore – “Constricting Rage of the Merciless” – I love this band. New Orleans metal which channels the best of early Slayer, Motorhead, Venom and Nuclear Assault, Goatwhore don’t sacrifice loudness for efficiency, drawing a brutal and listenable balance of both while, appealing to my old man, old school metal soul.

Swans_To_Be_KindSwans – “To Be Kind” – Well, it’s the Swans, whose repetitive, mesmerizing and driving structures never fail to disappoint, even as grandparents. Post Jarboe Swans is every bit as great as their heyday in the 80’s and 90’s, but with the benefit of sagely brevity and modern production skills. Some bands suffer from being able to hear them. The Swans, on the other hand, require clarity because every sound counts.

st-vincent-2014-albumSt. Vincent – s/t – This one is hard to pin down, pop? Dance? Avant? Difficult to parse out all of the parts of this glorious hodge podge of everything, but the listenability of her latest effort and her formidable vocal and songwriting talents of Annie Clark can’t be denied. Word is that she was the opening act for the Black Keys. I hope that she blew them off the stage every night.

Arch_Enemy_-_War_Eternal_artworkArch Enemy – “War Eternal” – With Angela Gossow planning to leave to spend time with family and be normal, the future of Arch Enemy was uncertain. Finding a replacement for Angela’s impossible combination of invincible vocal chords and super model looks should have been out of the question, but it appears that Canada had been grooming a replacement all along. In many ways, “War Eternal” isn’t much of a departure from the rest of Arch Enemy’s output, but they have to be credited for consistency. It’s too much to expect radical diversions from the formula for a lot of heavy bands, particularly when the formula works so well.

Triptykon-Melana-Chasmata-800x800Triptykon – “Melana Chasmata” – Just about everything that Tom Warrior does is amazing and this is no exception. While the transition away from Celtic Frost is fairly dubious given that everything that Warrior does sounds like Celtic Frost, we can ignore the monikers and imbibe in the brutal violence of his musical output.

SunnUlverSunn O))) and Ulver – “Western Horn” – Ulver were one of my favorite black metal bands. Sunn O))) are, well, Sunn O))). The combination of these two should, theoretically, be nothing short of fantastic. Turns out, that’s completely the case. After having the great pleasure of seeing Stephen O’Malley with Keiji Haino this past April and been sufficiently blown away, this collaboration was a great surprise.

Yob_ClearingYob – “Clearing the Path to Ascend” – Yob have to be consistently one of my favorite bands. There is a group of great active metal bands right which include, for example, Mastodon and Baroness. Yob strips away the Floydisms and the acoustics and boils it all down to a freebase of heaviness without sacrificing skill and power. Listening to a Yob record from beginning to end will rewire your brain in the best way possible.

New Publication (from me): “Insecticide-treated net use before and after mass distribution in a fishing community along Lake Victoria, Kenya: successes and unavoidable pitfalls”

mjThis was was years in the making but it is finally out in Malaria Journal and ready for the world’s perusal. Done.

Insecticide-treated net use before and after mass distribution in a fishing community along Lake Victoria, Kenya: successes and unavoidable pitfalls
Peter S Larson, Noboru Minakawa, Gabriel O Dida, Sammy M Njenga, Edward L Ionides and Mark L Wilson

Background
Insecticide-treated nets (ITNs) have proven instrumental in the successful reduction of malaria incidence in holoendemic regions during the past decade. As distribution of ITNs throughout sub-Saharan Africa (SSA) is being scaled up, maintaining maximal levels of coverage will be necessary to sustain current gains. The effectiveness of mass distribution of ITNs, requires careful analysis of successes and failures if impacts are to be sustained over the long term.

Methods
Mass distribution of ITNs to a rural Kenyan community along Lake Victoria was performed in early 2011. Surveyors collected data on ITN use both before and one year following this distribution. At both times, household representatives were asked to provide a complete accounting of ITNs within the dwelling, the location of each net, and the ages and genders of each person who slept under that net the previous night. Other data on household material possessions, education levels and occupations were recorded. Information on malaria preventative factors such as ceiling nets and indoor residual spraying was noted. Basic information on malaria knowledge and health-seeking behaviours was also collected. Patterns of ITN use before and one year following net distribution were compared using spatial and multi-variable statistical methods. Associations of ITN use with various individual, household, demographic and malaria related factors were tested using logistic regression.

Results
After infancy (<1 year), ITN use sharply declined until the late teenage years then began to rise again, plateauing at 30 years of age. Males were less likely to use ITNs than females. Prior to distribution, socio-economic factors such as parental education and occupation were associated with ITN use. Following distribution, ITN use was similar across social groups. Household factors such as availability of nets and sleeping arrangements still reduced consistent net use, however.

Conclusions
Comprehensive, direct-to-household, mass distribution of ITNs was effective in rapidly scaling up coverage, with use being maintained at a high level at least one year following the intervention. Free distribution of ITNs through direct-to-household distribution method can eliminate important constraints in determining consistent ITN use, thus enhancing the sustainability of effective intervention campaigns.

Links I liked: November 26, 2014

Can African Countries Learn from North Korea’s Handling of the International Media? – An interesting perspective. He argues that African leaderships, rather than seizing crises as opportunities to draw attention and approval for their countries from Western donors, might actually benefit from clamping down on international media coverage, which often exploits and distorts the story. I’m thinking that the Ebola panic might have been averted if the media hadn’t picked up on the most freakish elements of the story, and focused rather on the mundane issues of poor public health care delivery.

Colonialism and development in Africa – “Most of Africa spent two generations under colonial rule. This column argues that, contrary to some recent commentaries highlighting the benefits of colonialism, it is this intense experience that has significantly retarded economic development across the continent. Relative to any plausible counterfactual, Africa is poorer today than it would have been had colonialism not occurred.” The authors, however, note the different contexts of colonialization and remark that results are mixed, but in general, the countries that have done the best (i.e. those which didn’t experience slavery) would be doing significantly better.

Stop Making Intellectually Disingenuous Market Arguments – “Shall we blame Twitter, trolls or bloggers? I am unsure of the underlying reason. But as we have seen far too, financial discussions seem to entail people arguing at cross-purposes. Bull-bear debates devolve into winning the argument at any cost. Previously, we had a true competition of ideas in the marketplace. Now, we have discussions that range between disingenuous and useless. The hunt for the truth has been replaced by the search for bragging rights.” Well, Barry, I don’t think you should limit your observations to only those talking about markets. It’s endemic now.

An autopsy review of sudden unexpected natural deaths in a suburban Nigerian population - “Sudden unexpected natural deaths accounted for 13.4% of all medico-legal autopsies. The male to female ratio was 2.1:1, and the mean age was 43.1 years ± 19.5 SD. Cardiovascular (28.3%), respiratory (18.2%), and central nervous system (12.6%) disorders were the major groups of causes. About 64.4% of cardiovascular deaths were due to hypertensive heart disease. Bacterial pneumonia, intracerebral haemorrhage, and breast carcinoma accounted for 34.4%, 60.0%, and 52.6% of respiratory, central nervous system, and cancer-related deaths respectively. Only 16.9% of cases occurred while the patient was admitted to the hospital.” Twice as many men are dying as women, they are dying of heart disease and the average age of death is 43, give or take 20 years. Time to move our focus over to chronic outcomes in developing countries. They are staring into a tidal wave of disease that’s going to break their health systems.

Economics Is a Dismal Science for Women – Wow. Just wow.

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