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What I’m Reading Now

A couple of weeks ago, I was mulling over writing a book. Now that I’m fully disoriented from the ASTMH meetings and the submission of a giant NSF grant, I can’t really put my head together well enough to get it going.

So maybe I’ll briefly write about other peoples’ books instead.

As always, I’m reading several books at once. I’m usually horribly bad at finishing anything at all, and books are no exception. Right now, I’ve got the following on my desk:

cover-davis-quammen-spillover-book1. Spillover: Animal Infections and the Next Human Pandemic (David Quammen, 2012) – Many human diseases actually have their origins in animals. HIV moved from primates to humans. All human influenzas are diseases of animals. Awful infections like ebola and nipah virus are, in fact, bat diseases. However, the story isn’t as simple as humans simply becoming infected through contact with animals. Complex dynamics of inter-species transmission can create a situation where a pathogen turns from benign to deadly. The future of infectious threats requires that we understand these dynamics and prepare for them, particularly as mankind urbanizes and human movement intensifies. A great and easy to read work that doesn’t sacrifice details. Highly recommended.

2. Why Africa is Poor and What Africans Can Do About It (Greg Mills, 2010) – A truly sensible assessment of the roots of Africa’s economic and development problems. Instead of looking backward to colonialism and ambiguous global threats, Mills picks apart what’s wrong with modern African states and pulls no punches. The solutions presented, however, mostly rely on sacking most of the present leaders of African states, a tall order for some places. Even more odd, however, is the glaring absence of the structural adjustment era which attempted to free African states from crushing bureaucracy by dismantling typical state provisions like health care and schools. A great read, though.

3. The Great Escape: Health, Wealth and the Origins of Inequality (Angus Deaton, 2013) Though the 20th century saw incredible advances in living conditions, sanitation and medical technologies which have extended and improved the quality of human life, the benefits have not been uniform. Deaton offers that inequality is not a given, but rather a consequence of progress. It is the case that health disparities between social groups are highly correlated with economic inequality. Health disparities, a consequence of systems which encourage political and social inequality, in turn exacerbate the gaps between the haves and the have-nots. Another great and easy read.

exodus4. Exodus: How Migration is Changing Our World (Paul Collier, 2013) Economist Paul Collier takes on modern human migration, the extent of which the world has never seen before. He explores the political problems behind migration, the process by which people move from migrants to immigrants to citizens and the political implications of newly pluralistic states and an economically integrated world.

5. Asian Industrialization and Africa: Studies in Policy and Alternative to Structural Adjustment (Edited by Howard Stein, 1995) – It’s pretty much what the title says. There are several chapters tracking Asia’s move from a disastrous formerly colonized, agrarian area and poverty stricken area of the world to a powerhouse of industrial development and a major success story. African countries, however, have failed to develop as quickly, some even regressing economically during the 80’s and 90’s. The specific policies that allowed Asia’s success are contrasted with Africa’s failures and recommendations are offered to foster pro-active development in Africa. Asian policies, which were often protectionist and required the active hand of government but worked well at their particular stage of development, were at odds with those recommended during the structural adjustment era which recommended full privatization and haphazard relaxation of government controls.

What the hell was I going to write about?

I can’t remember, but it was one of three things:

1. To complain about Dambisa Moyo’s 2009 book Dead Aid, which I finally got around to reading. Basically, she says that Africa should give up on Western backed “aid” (she makes no effort to distinguish between different types of aid, and the contexts under which it is given), and do three things: 1) Have the west give African countries 5 years to phase out “aid” 2) Let China build all of Africa’s infrastructure for them (rather than the West) 3) Borrow money from private capital markets (she used to work for Goldman Sachs).

Given it’s haphazard treatment of details, it’s a pretty comedic book, but she gets accolades from right wingers who hate giving money to poor people. If you merely replace “aid” with the word “food stamps,” you’ll end up with the basic message of the American Tea Party: any amount of free stuff creates a “culture of dependence.” I’m sure she’s more educated and articulate than her book would suggest, but it appears that she is less concerned with writing useful policy analysis, and more concerned with waving a wide brush so she can raise her status as a celebrity.

While I don’t agree with everything Bill Easterly writes, he gives the subject a much better treatment.

2) To write about realism and caricature in Breaking Bad, or at least to note that I never get to see TV shows until after they are cancelled.

3) To reflect on the conservatism of punk rock music. I was listening back to some 80’s hardcore and remembering how horribly conservative a lot of this was. They had more rules on behavior than the Taliban (an inappropriate joke, but you get the idea…). Exactly what were they rebelling against, and what were they offering? Even Reagan was less uptight. A lot of us came out of some really chaotic situations, it’s odd (or maybe expected) that we’d gravitate toward dogma. Still, this stuff is no fun at all!

4) To complain about my low salary and uncertain prospects to make more money. This would make a horribly uninteresting post, however.

For now, though, here’s a trailer from a new movie on Punk from Southern Africa.

Kim Ki Chan

kim1Every once in a while, I will just pick a book off a library shelf and check it out without quite knowing what’s inside. The University of Michigan is a great place to do this.

This time, I picked up a book of works by Korean photography Kim Ki Chan. Kim passed away in 2005, but spent the brunt of his adult life documenting Seoul, and its (and Korea’s) transformation into one of the richest areas in the world.

His pictures, rather than focusing on rampant consumerism and youth culture, center on the back alleys of the urban poor. Mostly black and white, his portraits of local Korean families struggling to get by are stunningly beautiful. I’m positive that the pictures appeared vastly different at the times they were taken, but looking at them now and thinking about how Korea has grown, one can’t help but thinking that the subjects are filled with anything but optimism.

Kim’s subjects are overwhelmingly poor. This presents a challenge to a photographer, who can often run onto dangerous ground of portraying the poor as sad and helpless, or romanticizing poverty as cute and adorable. Kim does neither. It’s clear that many of the subjects know Kim already, probably as a friend. He probably saw some of the kids he photographed grow up and have their own over his long career.

My experience in Korea is really quite limited. I went there a couple of times in the late 90’s but my lack of Korean kept me from venturing out to the areas in which Kim operated. I’m sad that I never had the chance to see them, but suspect that some of it still remains.

Not All GDP Measures are Created Equal

1365632412893Recently, I got the pleasure of seeing a lecture by Morten Jerven, a faculty member at Simon Fraser University’s School for International Studies. He has written a wonderful book, “Poor Numbers” which asks some very important questions.

Measure of the gross domestic product (GDP) of a country are important to understanding one country’s economic health as compared to another. We use these measure all the time to track relative differences between economies, and to figure out if countries’ economies are improving and degrading from year to year.

The measure is, of course, not without its problems. Gross Domestic product usually measures the sum total of the value of all market goods within a country at a particular time. For developed countries with established systems of taxation, this is not a difficult measure to produce.

Developing countries, however, particularly in Africa are quite bad at collecting taxes from their citizens, they often have opaque informal business sectors which dominate their economies and weak governments which don’t fund their census and statistical offices very well.

This is, of course, exactly the question that Jerven explores in his book. Given the rudimentary infrastructure of data collection and recording in developing countries, how do we know what we think we know about developing world economies?

Global funding agencies and governments make billion dollar decisions based on the recorded GDP of a particular country. Yet, it’s astounding that few of these agencies or anyone else who uses these measures often never asks whether the numbers are valid.

Three years ago, Ghana’s GDP doubled in one day, due to a change in the way that the GDP was calculated. Ghana went from being a developing country, to a low middle income country in one day. This year, Nigeria is also going to revise how it calculates its GDP. We expect that Nigeria’s GDP will rise considerably over night.

These measures matter. The World Bank considers concessionary loans on the basis of the GDP. If a country has too much money, it no long qualifies for special lending terms. This is a serious issue for countries that want to embark on development projects, or, in the case of resource economies (which most developing countries are), weather rapid fluctuations in market prices.

There are three major sources of GDP measures. The World Bank’s Development Indicators, the Maddison Project, and the Penn World Tables.

Jerven pointed out in his book that the rankings of countries by GDP do not agree between the three measures, outside that the Democratic Republic of Congo is the poorest country in the world. Liberia is the second poorest country in the world according to Penn, number seven according to Maddison and number 22 by the World Bank.

Though ranking is interesting, I was interested to see if the measure agreed with one another over time. If we were to measure economic growth of, say, Liberia over time, even if the basic dollar measures did not agree, the change from year to year might. For math people, the intercept might differ between two lines, but the slope might be the same.

Lacking time, I could only download two of the tables, the World Bank’s and Maddison’s. I wrote a script that would extract all of the GDP measure for each country from 1960 until 2012. I then compared the two measures by calculating the correlation coefficient for each country’s series.

I found that most of the country’s series agreed, with correlation coefficients in the .85 to .99 range. However, there were some glaring exceptions. The map to the right shows correlations coefficients for each country, colored by level. Tanzania stick out prominently, as does Namibia, the Central Africa Republic and Sierre Leone. Some of them are even in the negatives.

The political mess that is the CAR does not surprise me at all. Tanzania with its mostly righteous government and wealthy Namibia do surprise me very much.

I will have to explore this further, but until then, the take home message is that not all measures are created equal.

MaddWB2

Books of the Week

Lower back pain.

In lieu of writing a review of the 1956 Egyptian masterwork, “Cairo Station,” a story of the sexual obsessions of a handicapped newspaper salesman, I decided to briefly reassess the contents of by backpack. I just looked in it to see what I’m lugging around with me:

1. “The Dialectical Biologist” (1985) – Richard Levins, Richard Lewontin
2. “Accessibility and Utilization: Graphical Perspectives on Health Care Delivery” (1984) – Alun E. Joseph, David R. Phillips
3. “Beyond the World Bank Agenda” (2008) – Howard Stein
4. “Public Health and the Political Imagination in Mexico: 1790-1910” (unpublished, 2010) – Paul Ross
5. “釜が崎:歴史と現在 (Kamagasaki: History and Present Day” (1993)) – 釜が崎資料センター(Kamagasaki Document Center)
6. “くもんの小学ドリル:6年生の漢字(Kumon’s Elementary Kanji Drill: 6th Grade)” –Kumon Press

There’s not much that strings these books together, though five of them are excellent. One of my biggest failings, is being easily impressed. Perhaps it’s a positive, I’m not sure, but I’m easily drawn to books, no matter how relevant or irrelevant they are to what I should or should not be working on. Sometimes, I consider whether I might have some adult form of ADD. It’s possible, or maybe I’m just easily swayed.

It’s hard to pick a favorite from this list, though, out of loyalty to my good friend Paul Ross, I have to say that his is the one I’m most excited about. A full review will have to come later, however.

Dispensing with the obligations of friendship, no matter how willingly assigned, Stein’s “Beyond the World Bank Agenda” is a fascinating account of how a combination of bumbling adherence to neo-classical economics and US economic interests created a behemoth which decimated Sub-Saharan African economies during the 80’s and 90’s. It’s dense reading but an eye-opener to how power politics used flawed economic assumptions to the detriment of the planet’s poorest. Stein does not seek to expose a nefarious global conspiracy, but rather views the failures of structural adjustment as a result of antiquated economic ideas, a disconnect between the goals of the Bank and the realities on the ground and the failure to consider evidence when shaping monetary policy.

In 1985, Levins and Lewontin collected a number of essays challenging standard Cartesian approaches to biology which view organisms as linear endpoints of environmental conditions. They call for a Hegelian, dialectical approach, that views organisms as part of a dynamic whole, which reacts in concert with their respective environments to both respond and manipulate their surroundings. While the writing is incredibly obtuse, the implications are huge. It is difficult (impossible?) to boil the work down into a few sentences, though the underlying message is quite similar to Stein’s. Traditional, “accepted” methodologies are often overly simplistic, based on untested assumptions, and the application of which leads to incorrect, and sometimes destructive conclusions.

I’ll skip the book on health care accessibility as it is only relevant to my research. The book of essays on Kamagasaki is part of an ongoing project and will have to wait until later.

The sixth isn’t really excellent, being merely a drill book for 6th graders, though helpful. I am happy at least to know more Kanji than the average Japanese 3rd grader. One has to celebrate these minor victories.

Book of the Week: “All Things Must Fight to Live” (Bryan Mealer)

Blanking on what movies I seen in the past months, I opted for “Book of the Week.” As the “Movie of the Week” is the least viewed feature on this blog, I pretty much have the freedom to write about whatever is available to me at the time.

The Democratic Republic of Congo is one of the largest countries in Sub-Saharan Africa and one of the bloodiest. Since 1998, the DRC has been home the largest conflicts since World War II, involving no less than seven foreign armies, claiming no less than 5.4 million lives and many times that number in injuries. Sexual violence and rape are common tools of warfare in the DRC conflict, earning the DRC the distinction of being the worst area for sexual abuse in the entire world. More than 200,000 women and girls have been raped and disfigured since 1998.

The DRC has an incredible wealth of natural resources, including diamonds, coltan, copper, zinc and oil. Competition for control of the DRC’s seemingly endless bounty fuels instability and illegal sales of resources funds the conflict. Villagers in the way of potential mining routes are routinely raped, hacked to death, dismembered and displaced, leading to a human crisis of proportions larger than most any other in human history.

Meanwhile, opportunistic foreign powers turn a blind eye to the horrid conditions under which precious resources are obtained. The United States has not, as of yet, demonstrated the political will to get involved. It is unlikely that we ever will, making every single one of us complicit in the vast landscape of death and suffering that is the DRC right now.

Bryan Mealer spent three years as a reporter in the DRC in the late 90’s. His book is a document of his time there, full of stories of drug addled gun wielding teenagers hacking the locals and pillaging their wares, international groups attempting to create some resemblance of stable government against a swirling hurricane of chaos, a largely impotent UN which spends more time keeping itself alive than keeping the peace, and the Congolese who want nothing more than peace and prosperity in their broken country.

Mayer explores the history of how the DRC got it’s present, chaotic state. The DRC could be one of the wealthiest areas of the world. However, the slave trade, exploitative colonial governments, and the brutal and disgusting regime of King Leopold disrupted the natural creation of a stable state. A perfect storm of European indifference to the welfare of Africans helped usher in a series of brutal and corrupt Congolese governments post-independence, leading the DRC to where it is today.

The first half of the book follows Mealer as he insanely enters the most war-torn areas of the DRC. One get the impression that Mealer is either an incredible thrill seeker, a touch mentally imbalanced or a completely dedicated journalist that attempts to document the travesty that which the world has conveniently ignored. The second half takes a more upbeat approach, following Mealer along his trip through the Congolese rain forest and aboard the only “express” passenger train in the DRC. His writing is frenetic, often documenting in a frantic, stream of consciousness style accentuating the chaos of the world around him, alternatively frightened by the insanity around him and exhibited by the level of human resilience of a people attempting to live in the most unlivable of conditions.

Book of the Week: Burma Chronicles (GuyDelisle)

Comic book artist Guy Delisle spends a year with his wife and infant son in Burma, home of one of the most repressive and reclusive governments on Earth. Daily, he chronicles his experiences in Yangon and the vicinity, presenting a series of anecdotal snapshots of the daily life of an expat in a former British colony. While his wife works for the French arm of Doctors Without Borders, Delisle explores Yangon, teaches animation to some of the locals and does his best to interact with the locals. For anyone who has spent any time in a developing country, particularly the former British colonies, it’s a hilarious account of the often surreal lives of expatriate professionals.

Burma Chronicles is mostly about one man’s life in Burma. While the political leanings of the author are not too hard to guess, the dire political and human rights situation in Burma could have been a larger focus of the book. He does mention that he attempted to get a local cartoonist to write an account of his village being forcibly moved by the military junta, but man was either afraid or uninterested in participating. Regardless, the book is excellent, and highly recommended for anyone who wants to know about Burma, or about life in the periphery of a humanitarian expat community.

Book of the Week: The Photographer Into War-Torn Afghanistan with Doctors Without Borders

I had intended to have a weekly “Movie of the Week” post, but the movies I watched this weekend were overshadowed by this incredible book. From 1979 until 1989, the Soviet Union waged a massive war against Afghanistan that led to more than 1 million Afghan deaths, 5 million Afghan maimed and injured and the displacement of nearly half the population of Afghanistan. During the 1980’s more than half of all worldwide refugees were Afghan. Doctors Without Borders proactively provided desperately needed on the ground medical services to stranded and isolated populations, often at great risk to themselves.

French photographer Didier Lefèvre documents one arm of Doctors Without Border’s humanitarian efforts. Travel to medical sites had to be done on foot, as roads did not exist to the areas most starved for services. Doctors and humanitarian workers were smuggled over the Pakistan border under cover of night, riding along weapons supply caravans, where men literally carried munitions on their backs over mine filled mountain paths with few supplies.

Lefevre documents the entire 3 week journey to the inlands of Afghanistan, a month long stint providing medical services to multitudes of wounded men, women and children and a harrowing 4 week journey back. Interspersed with his incredible photographs is a graphic novel style telling of anecdotes from the journey, conversations with the humanitarian workers and interactions with Afghanis along the way. What results is not only an intimate view of life providing badly needed help to a wounded and scarred population, but also a complete portrait of an incredibly deep and complex culture. Lefevre’s work is exceedingly relevant given the current context of the Afghanistan war effort by the US and NATO, and perhaps essential to understanding at least part of the historical context which led to the Taliban takeover, 9/11 and our subsequent involvement.

My only complaint with the book is that the photographs are sometimes small and difficult to see (at least to my old man eyes), but the storytelling and presentation do well to fill in the blanks. This is a historically massive work. Lefevre’s document of events, along with Emmanuel Guibert’s artwork create a relevant and moving view of the senselessness of war and the great price that everyone pays in health and welfare.

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