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KLM Lounge time

The KLM Lounge in Schiphol is a great place. There’s decent coffee, free papers that I might read, food and you can take a shower. Then there’s the odd 60’s futurist decor that makes you think you’ve stepped onto the set of 2001: A Space Odyssey.

In trying to suppress my ambivalence about going to Kenya, boarding a domestic flight the next day and then flying to Japan four days later, I’m reading Joe Stiglitz’s new book, “Creating a Learning Society: A New Approach to Growth, Development, and Social Progress (Kenneth J. Arrow Lecture Series).”

Though I’ve just started the book, I’m finding it quite interesting. Stiglitz and others attribute development to the sharing of innovations rather than the mere accumulation of capital. Societies grow because their people learn new things, and some countries do better because they are better at learning how to learn.

Noting that private firms often entrench themselves in particular modes of operation which discourages innovation, Stiglitz argues that government investments in education and R&D and the guarantee of a legal framework which protects property can allow innovations to flourish.

In reading the book, I kept thinking about this 2km stretch of road in Nairobi which has been under construction for the past five years. It’s absolutely pathetic. Buses have to pass through a one lane mud road next to the construction site, while workers move at a snails pace, slowly pouring concrete by hand. Though the reasons for the slow tempo of road construction most certainly include corruption and mismanagement (the contractor is Kenyan), one also has to notice that nearly all roads in Kenya are built by foreign companies.

The Japanese built a masterpiece of a road, complete with cross walks, bike lanes and dedicated pedestrian ways in a tenth of the time. To Japan’s credit, they use local workers, unlike the Chinese.

Building roads isn’t complicated, or, at least, the complications have been worked with over and over and road building is now an established discipline, with text books and training programs available all over the world.

So why hasn’t the knowledge of road building been successfully transferred to Kenya? What the hell is wrong?

Perhaps this is what Stiglitz is talking about. Without beating up on Kenya too hard (but why not?), Kenyan schools are a shambles and the government is only marginally interested in improving the educational fortunes of the country. Schools are designed to train low level clerks for the civil service, and don’t aspire to train kids for science, math or engineering. Though many, many technologies are already established the world over, perhaps the poor state of education hampers technology diffusion.

Back to my coffee.

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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.

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.

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!

Mfangano (and missionaries in Kenya)

White lady comes to save African children from themselves by having her photo taken with them.

White lady comes to save African children from themselves by having her photo taken with them.

I went and checked out Mfangano, an island close to here that’s home to about 25,000 people (or 16,000 depending on who you ask). It is famous for some 2,000 year old rock paintings done by the Twa people, a group of hunter gatherers whose range historically extends all the way over to Western Africa.

Unfortunately, the Twa are long gone from the island, which is now occupied by Suba and Luo people, though the Suba are quickly being assimilated into the Luo through marriage.

It’s an odd place. They’ve got a small tourism industry, are currently installing new power lines and have recently gotten true ferry service from the mainland, but the roads are still terrible.

We ran into a group of missionaries on the way back. I always feel somewhat violated after talking with missionaries in Africa. What are they doing here? This looked like some polygamous group of Mormons but it turned out they were from Alberta and Kansas.

One of them asked us what we were “lonesome for.” I didn’t know how to respond so we asked them what they were lonesome for, to which they said “Wal Mart.”

While I hate to judge, it was telling that they all introduced themselves to us, but not Victor, an employee of the Kenyan Medical Research Institute who was standing right next to us. I’m convinced that they don’t see the locals as people.

What developmental role do missionaries play? They make no demands on politicians to solve pressing problems of political dysfunction, infrastructural weakness, employment, a lack of access to capital, crippling bureaucracy, corruption, graft, nepotism and terrorism. None of these problems can be solved through missionary activities which emphasize odd moral codes more fitting to white, rural Kansas than complicated and chaotic Kenya.

Development as unfreedom….

Was reading Chris Blattman’s list of books that development people should read but don’t and found this in the Amazon description of “The Anti-Politics Machine: Development, Depoliticization, and Bureaucratic Power in Lesotho.”

Development, it is generally assumed, is good and necessary, and in its name the West has intervened, implementing all manner of projects in the impoverished regions of the world. When these projects fail, as they do with astonishing regularity, they nonetheless produce a host of regular and unacknowledged effects, including the expansion of bureaucratic state power and the translation of the political realities of poverty and powerlessness into “technical” problems awaiting solution by “development” agencies and experts.

Note that I do not harbor any ill will toward development or even, as a general rule, “technical solutions.” Having been involved with bed net distributions and having watched the outcomes of reproductive health interventions, for example, I can say that there are many positive outcomes of development projects. In my area, fewer kids are dying and women are becoming pregnant a whole lot less, decreasing the risk of maternal mortality.

Disclaimers aside, there is no doubt that development projects often fail for a number of reasons, the first of which is that leaders have no interest in seeing that they succeed. While leaders are indifferent to the outcomes, they happily take on the power that comes with them, embracing bureaucratic reforms, which are mostly just expansions of power at all levels of government.

This wouldn’t necessarily be a bad thing, except that African countries never embraced many of the protections of individual rights which restrict the powers of the state. Independence movements in much of Africa was predicated on an eventual return of power to the majority. Not many (none?) of these movements sought to protect the rights of the minority, much less the individual. Thus, there is little restriction on the types of rules which may be created and since many of these development projects influence policy, development projects unwittingly feed into the autocracy machine.

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