Archive | July 2014

Who pays for development?

I was just reading this on the Guardian’s Poverty Matters blog:

First, identify the most important issues. One of the main problems of the MDGs, as noted in countless analyses, was their failure to bring the major structural issues to the table. I know of no one who thinks that aid is the most important contribution that wealthier countries can make to development, but the vague terms of MDG eight allowed politicians to get away with aid promises (which in some cases they didn’t keep) rather than setting a bold agenda for transformational change in global financial governance, dealing with illicit financial flows, for example, taking bold steps towards international tax reform, and introducing fairer mechanisms for working out debt repayments.

Well, yeah, very true, but again this type of reporting skirts the issue of where those illicit flows are coming from and who took out the loans. The problem with the MDGs was that it failed to put any pressure on leaders of developing countries to stop being parasites. Worse yet, they didn’t allow for the provision and protection of basic individual rights to free expression, judicial rights and economic freedom, instead opting for a few vague and unverifiable targets which failed to address structural problems WITHIN developing countries.

In Kenya, at least, the government is bleeding the populace dry. Evidence from countries such as Botswana and Korea has shown that countries who want to develop can. The biggest obstacle (among all the other obstacles) to development is a lack of political will to do it.

To its credit, the article goes on to point out that domestic ag subsidies in wealthy countries are distorting the world market and preventing developing countries from being competitive on the world market. Eliminating these subsidies will be a real challenge, at least in the US. First, subsidies control price and market volatilities. The US electorate would go bonkers if the price of food went up and down like the price of corn does in developing countries. Second, Americans simply like subsidies and enjoy protecting agricultural interests at all levels. The right likes to pander to farmers for the rural vote while the left is somewhat bummed out because their favorite organic farms don’t have access to them. Though the left loves to pay lip service to ending ag subsidies, I can’t imagine they’d be all that sad if they were offered to their local hippie farmers. That’s speculation for another day, however, and I’m no expert on ag matters.

I hate to be pessimistic about development, but the barriers to progress are hobbled by forces both within and without developing countries and no one seems to be tackling the right issues to improve matters.

Links I liked

Some links I liked. Believe it or not, I do like things.

1. A dissection of structural vs. indivdual determinants of poverty. Take that Paul Ryan. (Noahpinion)
2. Unhappy cities. Was excited that Detroit is not the most unhappy city in the US. Whew. (WP)
3. A dumb article, but I liked it anyway, at least for its scientific value. Practically speaking, it’s a fairly useless piece. Why hand shaking is bad and we should stop doing it. (NPR)
4. Tough realities for the vinyl market (Pitchfork)

In the Kenya airport again….. and talking of Marsabit, Camels and cell phones

DSC_270222JKIA has to be one of the worst airports I can think of, and my five hour delay has drawn out the awfulness of this place. No wonder someone burned it down!

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.

“Kenya is a cash based economy”– Not.

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.

Nagasaki U./Gembe East Football Match 2014 (in Kenya)

DSC_0060I’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.

An injured field worker and unfair labor practices in research projects

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.

I paid a bribe

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.

Fucking Kenya.

The issue of borders…

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.

Noah and the cursed Africa

noah-posterI 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.

The need to look for more than just malaria

I was just reading a comment in the new Journal of the American Society of Tropical Medicine and Hygiene “After Malaria is controlled, what next?”

Fortunately for all of our jobs, there is little to worry about. Malaria, as a complex environmental/political/economic public health problem, won’t be controlled anytime soon. As there’s no indication that many sub-Saharan countries will effectively ameliorate their political problems and also no sign that, despite the “Rising Africa” narrative, African countries will develop in such a way that economic rewards will trickle down to the poorest of the poor, malaria transmission will continue unabated. This is a horribly unfortunate outcome for the people, particularly small children, who have to live with malaria in their daily lives.

In all of the places it occurs, malaria is merely a symptom of a greater political and economic failure.

Indeed, we really know less about the causes of suffering and death in the tropics than many believe. Even vital statistics of birth and death are unrecorded in many areas of the world, much less the accurate causes of disease and death. Some diagnoses, such as malaria, dengue fever, and typhoid fever, are often ascribed to patients’ illnesses without laboratory confirmation. Under the shadow of the umbrella of these diagnoses, other diseases are lurking. I have found significant incidences of spotted fever and typhus group rickettsioses and ehrlichiosis among series of diagnostic samples of patients suspected to have malaria, typhoid, and dengue in tropical geographic locations, where these rickettsial and ehrlichial diseases were previously not even considered by physicians to exist.4–8 Control of malaria or dengue would reveal the presence and magnitude of other currently hidden diseases and stimulate studies to identify the etiologic agents.

This is the problem with our public health fascination with malaria. We are missing all of the other pathogens and conditions which case untold suffering in the poorest and most isolated communities. It can’t be the case that malaria acts in a box. In fact, it could be the case, that multiple pathogens coordinate their efforts to extract as many human biological and behavioral resources as possible to obtain maximum opportunities for reproduction and sustenance. A public health system only designed to look for and treat a limited window of diseases misses the opportunity to disrupt what is probably a vast ecological complex.

First, we have a problem of poor diagnostics. Facilities traditionally treat most fevers presumptively as malaria, dispensing drugs appropriate to that condition. However, conditions like dengue fever exhibit similar symptoms. While is it extremely likely that dengue is all over the African continent, particularly in urban areas, there is little ability to identify true dengue cases in the public health sector, and thus, in addition to mistreating patients, the extent of the disease burden is unknown. We cannot tackle large public health issues without proper data.

Second, we have the problem of all of the “known unknowns,” that is, we know for a fact that there’s more out there than we have data for but we also know (or at least I do) that there is a greater disease ecology out there. We know that many pathogens interact with one another for their mutual advantage or to haplessly effect significantly worse outcomes. The awful synergy of HIV and TB is just one example.

OK, I’m going to go and deal with my own pathogenic tenant which I think I’ve identified as an enteric pathogen of the genus Pseudomonas, which might have taken hold opportunistically through an influenza infection. This is complete speculation, however. Data quality issues prevent a reliable diagnosis!

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