baby face

March 23rd

Well, I'm finally clean-shaven after three weeks. I had developed a habit of playing with my mustache, and I went to go do it right now, and was very confused for a second to find smooth skin there

Before


After





I look like an iron worker in this shot, partially because I had been welding all day.



This is Auntie Florence, whom I have mentioned a number of times.



A while ago when we were staying at the Davises during the medical scare I read a book they had called "he White Man's Burden: Why the West's Efforts to Aid the Rest Have Done So Much Ill and So Little Good" about how billions of dollars in foreign aid into developing countries has been remarkably ineffective in changing the daily lives of poor people in those nations.

"William Easterly's The White Man's Burden is about what its author calls the twin tragedies of global poverty. The first, of course, is that so many are seemingly fated to live horribly stunted, miserable lives and die such early deaths. The second is that after fifty years and more than $2.3 trillion in aid from the West to address the first tragedy, it has shockingly little to show for it. We'll never solve the first tragedy, Easterly argues, unless we figure out the second. "
It was a very interesting read, and I recommend it. The author admits he doesn't really have solutions, but he points out some major flaws in the way that billions of dollars are disbursed every year. So i've been thinking about those kinds of things every once in a while. Here are a few relevant thoughts. (and a link to the amazon page with the book)

Book Link

One of the points that the author makes in his book near the end is that the treatment of AIDS has gotten a lot of attention recently. Obviously HHBC is privy to this, having gone through Step Into Africa last year. He contrasts the cost of treatment of HIV/AIDS with the cost of prevention in sub-saharan africa, and concludes that it is approximately 1000 times cheaper (i can't remember the numbers, it's been a while) to prevent the transmission of AIDS than to treat it, with treatment adding on average 3 years of life to the affected person. His point is that aid organizations are able to raise a lot more money, and even governments are able to justify giving money to buy anti-retrovirals because it's easier to raise money with pictures and stories of really sick people than with a story about someone who didn't get HIV/AIDS. For instance, to prevent transmission at birth costs $9 for a one-time dosage, but if that child has HIV, they need to take medicine every day, which costs minimum $150 a year, plus a case worker to visit them, counsel them. The cost goes up to $1500 a year if they aren't faithful in taking the pills and their body develops a resistance to the cheap drugs. So there are lobbys to make drugs cheaper, and governments and drug companies donate billions of dollars, but what if you could sidestep all that and focus on the original problem: how did they get HIV. That doesn't mean we shouldn't treat people of course, but it is an interesting perspective.

I have more to write, but it's off to church we go. more later.
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(later)

The author also pokes at a western tendency to throw money at problems, instead of understanding them. So we have goals (instead of solutions) put forth by the World Bank, or the UN, or UNICEF, or whoever that sound like this: We will provide access to clean drinking water for the 75%[made-up-statistic] of people in sub-saharan africa ( who currently are dying because of simple things like diarrhea.) So that goal goes on the fundraising literature, and they raise 2 billion dollars, and feel pretty good about themselves, and then..... oops, there is no workable/practical way of actually executing the goal, so they give the money to corrupt governments who squander it on nothing. Lets all get back together next year and do it again, shall we? That is a bit of hyperbole, but not as much as you would think/hope.

A good example of this is that recently George Bush pledged to buy mosquito nets for every child in [insert african country that i don't remember here]. It is a nice gesture obstensibly worth millions of dollars. Now, the question that no one has asked is this: what is the mechanism where all the kids are going to get the nets? Will there be education on how to use them, and why to use them? Is there an accountability mechanism for the money given? There was a study done which showed that free mosquito nets, even when they actually made it into the hands of kids, didn't actually reduce incidences of malaria. On the other hand, subsidized nets which were bought with family money at a reduced price were highly effective at reducing malaria cases.

So there are simple problems like clean drinking water (which most people know is a problem), malaria (which kills more people than AIDS in uganda and rwanda) and one that is not so well known, chiggers. Chiggers (or jiggers) are a tiny parasite that leap onto your body and burrow their way into your skin, feeding on your flesh while growing. They like to go next to finger and toe nails, but that is mostly because those parts are in contact with the ground often. So it swells with eggs to the size of a pea, and if not surgically removed, will hatch its 300+ eggs into your body, and the process starts over again. So the problem is that people a) have poor methods of removal, often consisting of a sharp piece of wood, which causes all kinds of infections (or a pin which is shared, which spreads other diseases like hepatitis) and b) they dont' have shoes, and the chiggers live in sandy soil which is most of africa. There is a guy who hangs around New Hope who is cognitively impaired, and soon after we got here he spent a whole day getting chiggers removed from his feet with a scalpel, one person per foot. So there is another guy who sweeps the admin building, and like many people around here, he is barefooted. He is old, maybe 65, which is pretty old here. I looked at his feet the other day, and he was missing parts of his toes, toenails, and his whole pinky toe, most likely from chiggers. Simple solution: shoes, and a box of pins and some education. Not a very "sexy" solution; a box of pins doesn't make for moving pamphlets.

Sorry these thoughts aren't very put together, eloquent, or researched. Ask me more about them when we get back, and (maybe) i'll make more sense. Read the book, anyway, and tell me what you think. I thought it was worth reading, even if I dont' agree with all of it.

john