Archive | May 2014

The famous “aho/baka” map of Japan.

ahobaka1Japan, despite the refined image it traditionally likes to present to the world, has no shortage of words with which to call people stupid.

These words are mostly regional and the uses and nuances of calling people stupid also vary by place.

Over dinner, I was reminded of an episode of Tante Night Scoop, an investigative television program which ran throughout the 90’s. They did an exhaustive survey and mapped the locations of the common ways of calling people stupid throughout Japan.

Of interest is the centrality of the word “aho,” commonly used throughout the Kansai region of Japan (and denoted in red) and the radial spread of “baka” (denoted in blue), a word mostly associated with Tokyo and commonly found in Kanto-centric anime programs.

The map was intended as entertainment, but it has serious historical significance.

When people move, they take words with them. It would appear that people in Kansai, historically the political and economic center of Japan, had little reason to leave the region, which would explain “aho”‘s limited spread. Baka, however, can be found on both sides of Kanto, indicating that there were strong connections between the two sides, despite the distance between them.

Oddly, the other words for “stupid” occupy the same radii from Kansai indicating that certain groups of people had peculiar spatial advantages in trade, where as others did not. Though I really have no idea, I’m thinking that particular perishable products traded with Kansai might have different spoiling times necessitating particular proximities. It’s important also to note that the extreme peripheries might have been trading non-perishable resources like coal, which, though heavy, doesn’t rot.

Economics, trade and language have deep links. English wouldn’t exist without it, and the many forms of English spoken throughout the world have been influenced by the multitude of groups of people who chose to speak it to facilitate trade.

OK, enough for now and back to Kenya.

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Sunburn…. and thoughts on the dynamic nature of genetics, disease and politics

Not a tree to stand under.

Not a tree to stand under.

I just got back from meeting with our field teams on Lake Victoria in Mbita Point in western Kenya. Normally, I wear up to three layers of clothing, but for some reason, I only wore a single shirt so that an 3cm square area of skin, which would have normally been covered, was exposed to the sun.

Over the course of the day it went from white to brown to red to black. I’m thanking Columbia clothing that the rest of my isn’t black as well.

It sounds really trivial; I got a sunburn. But I’m a really pale guy, and there’s a reason for that. The bulk of my genetics come from northern Europe, an area which is mostly dark, and even when it’s not dark, the sun is filtered through a thick wall of air and moisture.

My skin is not suited to Kenya’s blistering sunlight. My Japanese colleagues inexplicably do their best to keep themselves from tanning. Honestly, I’m jealous of their ability to brown in the sun and don’t really understand why they don’t take full advantage of their innate ability to protect themselves.

In short, I was born pale white, but wish I were black or at least able to brown. It would make field work easier.

Which brings me to this. I often hear people engaging in common conversations about what humans “were meant to do,” as if we were created as complete biological entities designed to perfectly perform specific assigned tasks within the narrow confines of specific environments.

This is a creationist view, but it’s interesting that even non-Christians in the West readily use the same assumptions and terms that are common to religious fundamentalists. The idea is that everything that came after we were kicked out of Eden, in this case East Africa, the birthplace of humanity, is an abomination. Whatever health or social problems we suffer is payback for violating the terms of our initially assigned roles as living beings.

For example, arguments (incorrect ones, by the way) are often made that humans are “meant to be” vegetarians since we don’t have developed canines, an argument of course made preposterous when one runs through the list of mammalian omnivores which also do not have canines. Worse yet, the argument fails to recognize one of humanities greatest adaptations, which is that we can eat just about anything and survive on little for extended periods of time, a skill that allowed us to rapidly move out of East Africa into every corner of the globe.

More salient, however, is that humans were not “meant to be” anything. Like all living beings, we move in response to environment pressures and then adapt while suffering the devastating loss of infants who will not live to pass on traits unsuited to the current environment. Those babies better suited to make it to reproductive age pass on whatever it is that got them there to their children, who then pass it on to their own and mix with others in a sort of genetic democracy.

Babies of my ancestors in northern Europe were more likely to survive with lighter skin, while light skinned babies in Kenya were more likely to not. Neither is “better” than another, but both are suited to their respective environments as they are at that time and neither represent a terminus of genetics.

I take issue with a static view of the world, be it from fundamentalist Christians, who claim that humanity was created fully whole in God’s image or from well meaning secularists, who claim that the world was a biologically static place before the Egyptians, the Romans, the Europeans, the Capitalists and whoever else came in and fucked it all up. Really, it’s interesting how the Biblical creation story persists, even in secular debates.

In my own field, a great failing of research has been to ignore the dynamic nature or disease and human health, assuming that each cross sectionally measured point in time represents a final culmination of set of repeatable events akin to billiard balls on a table. Diseases aren’t that simple. They change in response to the challenges we present to them, which in turn feed back into our own behaviors.

I certainly don’t defend environmental degradation or would I ever minimize calls for developing more sustainable energy and food production systems. However, I would offer that the world, like human genetics is not static, but rather, incredibly dynamic and that a static (and somewhat falsely nostalgic) view of the world is destructive in itself because it keeps us from recognizing the challenges of the present day. Only by thoughtfully examining current conditions and recognizing that things can change can we develop solutions to present and potential future problems.

Alright, I’m done.

A day to celebrate JICA toilets in Nyanza, Kenya

DSC_2057Today I went along with some of my colleagues to not one, but four, dedication ceremonies for a JICA sponsored clean water project.

It’s been an extremely long day.

Nearly 80% of people in this area of Kenya practice open defecation. They don’t use toilets. Of course, fecal matter washes into the lake, which happens to be where they all get their drinking water from. Diarrheal disease is, of course, out of control.

As a public health professional, I’m justifiably annoyed that there are people out there who can’t handle even the simplest sanitation solution: shitting in a single hole. However, it is what it is.

JICA has sponsored the construction of put latrines and the installation of water tanks at several schools in the area. These interventions are dirt cheap, but are way beyond the financial reach of impoverished communities along Lake Victoria. While we would assume that the Kenyan government would be expected to contribute money to help protect their children, the reality is that this area has been politically marginalized since independence. Schools can’t depend on the government to provide even sufficient wages for teachers, let alone sanitation infrastructure. Given the political problems between the current Kikuyu government and the Luo, it’s unlikely that the funds would be provided, even if they were available.

One of the schools we visited is 100% community funded. While it was a rudimentary facility, the locals have to be commended for taking matters into their own hands. I just wish they’d take sanitation more seriously.

Talked to a great bunch of people, listened to some great stories and drank 7 bottles of Coca-Cola. Off to bed.


New professional titles? A confusing (but exciting) mess….

But all part of my grand plan.

I now hold two titles, one as an Assistant Professor of Epidemiology at the Nagasaki Institute of Tropical Medicine and another as an adjunct Assistant Professor in the School of Natural Resources and Environment at the University of Michigan.

However, despite having positions in both America and Japan, I am based in Kenya.

This is pretty exciting, but I guess this means I have to do something now!

Thomas Piketty in Nairobi

IMG_1814-e1394200875155I just got back from Bookstop in the Yaya Centre shopping mall in Nairobi, one of my favorite bookstores in the world. It’s an Africanist’s paradise. My bank account is always a bit lighter and my suitcase a bit heavier after I visit.

Today, a customer was coming in to pick up Thomas Piketty’s Capital in the Twenty-First Century, a 700 page economics tome which has been topping the best seller lists everywhere and probably one the best economics books to appear in the past 50 years. The gentleman looked a bit intimidated by its size.

A bit later, a younger Kenyan woman came in with a bag full of books that she was hoping to trade for her copy. The book costs the equivalent of about $70 in Kenya.

The owner apparently ordered 100 copies, but was only able to get 25. He says he has orders for all 100 copies, many from Kenyan college students which he sees as an encouraging sign. I have to agree.

I can’t believe I’m agreeing with Dave Brooks

Dave Brooks’ articles for the NYT are really bad. I mean, head scratchingly bad. I’m convinced that the NYT hired Brooks as a token conservative, or, at least, as a pseudo-conservative who appeals to a a select group of wishy washy liberal-ish readers of the NYT.

Today, Brooks writes on the “The Real Africa.”

There’s been something similarly distorted to some of the social media reactions to the Boko Haram atrocities over the past week. It’s great that the kidnappings and the massacres are finally arousing the world’s indignation. But sometimes the implication of the conversation has been this: Africa is this dark and lawless place where monstrous things are bound to happen. Those poor people need our help.

But this is more or less the opposite of the truth. Boko Haram is not the main story in Africa or even in Nigeria. It is a small rear-guard reaction to the main story. The main story in Africa is an impressive surge of growth, urbanization and modernization, which has sparked panic in a few people who don’t like these things.

While I think that Brooks, like many writers, overestimates “Africa rising,” he’s not incorrect here. In general, Africa only makes the news when something really bad or horrific happens. The stories of regular people just trying to get by against unimaginable economic and political odds are never interesting enough for American readers to start generating sexy hashtags.

I’m convinced that people, even academics, believe that people in Africa are like the uncontacted tribes of the Amazon rainforest. I believe it’s enraging for people to hear that Africans are just like everyone else. They’d rather see dying children or sexy pastoralists in their native habitat than people buying and thoroughly enjoying Game of Thrones or Desperate Housewives on bootleg DVDs.

I’m remembering the time when a friend once chastised me when I wrote of Botswana’s fiscal and political successes which brought quickly to middle income status and insured solvency for decades to come. He criticized me for not addressing the plight of the San people, a group of pastoralists in Botswana whose numbers are fewer than the population of tiny Adrian, Michigan. While insuring the rights and welfare of indigenous peoples and minorities worldwide is of the utmost importance, it was interesting to me, that the rights and welfare of the other nearly two million Botswanans didn’t enter into the conversation at all.

It would seem that liberals are more concerned with maintaining an nostalgic past, imagined by Europeans and educated Americans, than addressing the current concerns of the vast majority of Africans.

The uproar over polio: Is it deserved?

Technically, we can eradicate polio, but a number of reported outbreaks around the world have called the possibility into question.

From a CNN article, which pretty much says anything I could say about the current situation:

The spread of polio constitutes an international public health emergency, the World Health Organization declared Monday.

“If unchecked, this situation could result in failure to eradicate globally one of the world’s most serious vaccine preventable diseases,” the WHO said in a statement.

At the end of 2013, 60% of polio cases resulted from the international spread of the virus, and “there was increasing evidence that adult travelers contributed to the spread,” according to the statement.

Warfare in Syria is compromising vaccination efforts and human movement, presumably by refugees, are spreading the disease to countries like Iraq and Cameroon. It’s obvious that the failure to eradicate polio is a political problem.

I’ve been asked about polio several times over the past four weeks. People appear to be somewhat panicked about the situation.

Every time, I have responded in the same manner. While the eradication of polio would provide a great publicity boost for public health groups, polio does not present a major threat to global human health. While a small percentage of children infected with polio will go on to develop debilitating paralysis, the disease rarely kills its host. Polio is hardly one of “the world’s most serious vaccine preventable diseases.” I can think of many others which are far more serious.

To complicate matters, the social and medical infrastructure to support people afflicted by the disease is quite well developed in Sub-Saharan African countries. It is common to see polio paralytics in African cities living relatively comfortable lives, despite the severity of their conditions.

I do not share the same level of panic surrounding the failure to eradicate polio. Malaria and diarrheal diseases kill far more children, cause far more human suffering and wreak far more damage to social and economic development in developing countries than polio ever did or ever will. To me, those two are “international health emergencies.”

Vaccines against polio exist and are quite effective at controlling disease worldwide at a relatively low price. While the argument can be made that the eradication of polio would allow that money to be used for other purposes within cash strapped health budgets, the futile push to eradicate polio is likely sapping health money from more immediate health concerns.

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