Some time ago, in a time and place I’m not going to specify, a middle-aged woman brought me a human uterus in a jar. She was a pathologist, and she’d stolen it from her place of work. It was a healthy uterus, she said, with a healthy fetus inside, that had been removed by a gynecologist under pressure from the government to keep birth rates down.
Needless to say, my project could do nothing to help her. We didn’t even know where to begin. We weren’t a human rights project, or even a reproductive health project. We didn’t have the contacts with the government to make them stop this kind of behavior. I thanked her for her honesty and passion, and gave her the contact information for Human Rights Watch.
Until today, that was the worst story anyone had ever trusted me with. I’d heard worse things in the media, of course. But that was the worst story some had asked me to help with.
What really got to me was that it wasn’t her uterus she was carrying around. (And, it turned out, she took it everywhere, for fear the government would steal it and she’d lose her evidence.) It belonged to a stranger. But this pathologist saw a systemic wrong, and she wanted to change that.
I don’t think anything has changed in that country. I think she is still carrying that uterus in her purse.
That woman is my hero. She’s more than a little bit nuts at this point. She sleeps with a human organ under her bed. She’s Don Quixote with a scalpel and a supply of formaldehyde. But she’s not complacent.
And that’s why I’d like to slap both Bill Easterly and Jeff Sachs upside the head. There are human lives at stake here. There are people suffering and dying and risking their lives to help others. And nothing the big guys are saying right now is useful to me.
I want to know how to do my work better. I want to know whether it’s useful to have the EU pull its funding from the country whose name I won’t mention or if it’s more effective to keep pushing small changes and hope they add up. I want to know if supporting democratic institutions actually leads to democracy.
The high level debates about theory and the middle-aged guys mud-wrestling about African aid do nothing for me. You are very, very smart. You know more about aid than just about anybody. Please, give me something useful.
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photo credit: caro’s lines
Chosen because the jar is somehow sad.
Why Easterly? I’ll give you Sachs, but Easterly seems to be more often the voice of compassion and studied reason in international development theory debates, reminding us that this is daily reality of people we’re dealing with, and that failed experiments have human consequences.
It continues to amaze me that the practice of medicine and psychology — anything that eventually requires human subjects to be “tested” in pursuit of knowledge and scientific advancement, even if the sample size is 10 healthy and well-insured university kids, is extremely regulated, but running international development pilot programs can be done without basically any oversight outside of the implementing organization, with direct impact on thousands of people and even regional economies affecting millions, even billions of people’s livelihoods.
Easterly is good on what we do wrong, but not so great on what we get right. His prescriptions on what makes program work tend to be really vague. Community ownership is all well and good, but how do we make that happen?
Yeah, the whole back-and-forth between Easterly/Moyo/Sachs has gotten my head spinning. Maybe they should get together, figure it out, and then report back to the public? :O
“And nothing the big guys are saying right now is useful to me.
I want to know how to do my work better. I want to know whether it’s useful to have the EU pull its funding from the country whose name I won’t mention or if it’s more effective to keep pushing small changes and hope they add up.”
Thank you.
I’m pushing for the small wins myself, but it doesn’t seem to be getting any easier with all the talk.
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Lovely post.
Sachs is ridiculous, but I agree with earlier points made about Easterly. There is some value in pointing out what doesn’t work, especially given that this debate involves billions of dollars and euros in wasted aid.
Community involvement in health care and education is part of what I study. Believe me, we’re trying to figure out what works and what doesn’t work so it will make your job easier. It is really complicated (the difficulty of measuring “effectiveness” keeps me up at night), but I hope I’m making a tiny contribution that will help you understand why it’s better to partner with some organizations rather than others.
Thing is, it’s a lot easier to focus on what doesn’t work at the macro level than it is to do the slow, micro level studies in places that are difficult to live. So that might explain it.
Yeah. not much to say to that.
the courage of ordinary people who realise something is wrong. it is hard to look at such a person and tell them ‘there is nothing I can do’.
Alanna, I will have some (hopefully helpful) responses to your questions soon.
[…] questions from Alanna Shaikh Jump to Comments Alanna recently wrote a disquieting post about the worst story someone ever trusted her with in the field until now, implying that she just […]
In my currently sleep-deprived state, I attempted a quick response to your democratization questions. It’s up on my blog now. As I was trying to fall asleep in the wee hours of the morning yesterday, I kept imagining a jar with a healthy uterus and fetus in it under my bed.
I think what Moyo, Easterly and Sachs are doing is noble. There are no simple/black & white solutions to the world’s ills. It would be much easier to ignore and ‘live and let live’ like much of the world is doing but these and a few other people have chosen to think through and present us with their opinions. The debate is now in the public domain. Let’s use the best from both angles and move, knowing that the alternative is maitaining the status quo.
I think what you’re after is a management specialist rather than an academic. Remember academics are hiding from the real world.
It’s a couple of years after you posted this, but the debate on Sach’s MDVs still rages on, and I still can’t find anything useful stemming from it. I don’t think that they have many relevant ideas to contribute (and no, Easterly saying “lots of this is wrong” is no longer a relevant idea if it ever was).
J-PAL has some good stuff, designed for an audience of practitioners rather than book-buyers. If you’ve found useful findings elsewhere, would love to know about it!
[…] It’s one of those moments when you see that Alanna was dead on when she wrote (several times, actually) about how projects work, while grand theories and ivory tower pontification and abstracted debates.. er, not so much. […]
[…] Original post date: May 28th, 2009 Permalink: http://bloodandmilk.org/2009/05/28/a-request-for-useful-information/ […]