What’s Killing Us

 

People ask me – a lot – how to start learning about global health. I never have a good answer. Usually I send them to Karen Grepin’s blog and suggest they take a look at the various textbooks on Amazon. It’s not a satisfactory answer. Karen Grepin is fantastic, but a blog’s a very different format from a book. And a textbook is no one’s idea of a good time.

Just about twelve months ago, I got an email announcing the new TEDbooks series – short, opinionated ebooks meant to be read in a single sitting. I messaged the TED folks immediately, offering to write the book I’ve been wishing existed. They took me up on it, and I’ve spent the last year writing, re-writing, and picking out some fabulous pictures from Glenna Gordon.

It came out this week. “What’s Killing US,” is a brief guide to major global health issues. It is meant to be both an overview and a starting point. If you’ve been thinking you should probably know more about global health, I wrote this book for you. The book is part of the TEDbooks ebooks imprint, and it’s available for Kindle, Nook, and the iPad. You can find the links to buy it here.

As you might expect, I am very, very excited about this. To celebrate, I want to give away a few copies of the ebook. (It’s only $2.99 – I can afford it.) Leave a comment with a suggestion for how I can promote the book, or a link to your tweet about it – and I’ll enter you into the contest. I’ll pick one comment out of every ten that I get as a winner.

Not giving money

 

 

 

 

 

 

If there is one question I get asked most often by people who don’t work in international development, it’s what can I do beyond just giving money?

First of all, there is no “just” about giving money. Money is the lifeblood of international development. We can’t run programs without money. And improving international trade and supporting economies in the developing world – also all about money. So we could stop right here. Giving money is fantastic.

I suspect that people want to do something other than donate for three reasons. First, they may just not have money — which is unarguable. Second, they may have money and don’t trust NGOs. Third, they may want to feel a personal connection to what they are doing.

If you don’t want to give your money because you can’t afford it, or you don’t trust people to use your money well, I would suggest connecting to local groups. Volunteer in your own community where your expertise is valued and you can choose an organizational partner that you trust. Your time is most valuable closest to where you or your area of expertise. Therefore, you are most useful volunteering in your neighborhood with a community group, or doing your professional work pro bono for an organization you believe in.

The third case is the one that really intrigues me. People want meaning in their lives, and in their philanthropy. They want a sense of belonging and meaning that doesn’t come from their Visa card. Change.org and Jumo were efforts to capture this desire for connectedness and meaning, but I don’t think either one quite hit the mark. Eventually someone is going to find the magic sweet spot of doing, giving, and belonging, and they will have an incredibly powerful source of support and funding. (Maybe the Obama 2008 campaign is an example?)

If you want to feel like an actor as well as a donor, you can fundraise. Reaching out to people, advocating and bringing in money is more active than handing over your credit card number. Many organizations have networks of fundraisers, and if you develop a long term relationship with one group you become an insider, not an outsider.

If fundraising is not your thing, I can suggest you do is become an ethical purchaser. A middle class consumer in a wealthy country has a lot of buying choices to make. You can choose sustainable, ethical products and you can refuse to do business with companies that harm the world.

It’s nearly impossible to pressure governments. See our current Syria mess as an example. Governments have taxes and armies and therefore the power to coerce. But you can pressure a corporation. In the end, corporations need customers, one way or the other. The fear of losing those customers is a motivator for corporations. No matter how big a corporation is, a big enough media mess and the threat of customer boycott can scare them. Any one of us can make that mess. Think of Molly Katchpole, the Bank of America card fee woman.

Yes, big business is, well,  big. And there is a global capitalist system pushing us all in single-profit maximizing direction. But there are levers, and if you’re reading this blog you have the internet skills to find and push them.

So, if you want to make a difference, the first thing you need to do is give money to professional aid agencies that run programs that actually work. Doing that is enough. But if it doesn’t feel meaningful, then become a fundraiser, volunteer in your own community where your time is most valuable, and become an active, ethical consumer.

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(photo credit: nickyfern)

Announcements, Products, and Pretty Pictures

The Announcement

As some of you may know, I am a Senior TED Fellow. As such, I am going to the TED conference in Long Beach, CA at the end of the month. I am also going to visit a friend in San Francisco and then to SXSWi. It’s going to be a really amazing trip, and I am already bouncing around in excitement. (And some despair, at leaving my infant and my kindergartener.)

I have a few questions: Are any of you in LA, SF, or Austin? Should we try to have a meet-up? My blog stats seem to imply all the Americans come from the east coast, but I am not sure if that’s true or some data issue I don’t understand.

Also, what kind of blogging would you like to see from TED and SXSWi? I don’t plan to live tweet unless something epic happens, because I hate live tweeting but I do want to blog a bit.

The Products

I’ve been getting friends and colleagues set up on Twitter for a while now. I’ve got lists of good people to follow by subject, a whole process for identifying what you want from twitter, and etiquette and best practice notes. I have now codified it all into two different Twitter jump-start packages you can purchase from my online store. If any of you aren’t on twitter already, it’s a useful way to start.

The Pretty Pictures

I am finally putting together an e-book based on this blog. I need a picture for the cover. Please vote in the comments for the picture you like best. Two  are from Tajikistan and the last one is from Lebanon.

Picture A:

 

 

 

 

 

 

 

Picture B:

 

 

 

 

 

 

 

Picture C:

Book Review: Damned Nations, by Samantha Nutt

I didn’t mean to read this book. I am in the middle of another book I’m reading for review – Ed Carr’s Delivering Development (which I am really enjoying, but it’s new enough to me that I am also carefully taking my time). But I picked Damned Nations off my to-read pile the other day because I was on my way to the bank and needed something while I waited. About five days later, I’m done.

Everyone new to aid and development should read Damned Nations. It didn’t have a lot in it that was new to me, but it’s a fantastic overview of almost every major issue in relief and development aid. Health, conflict, rule of law – packed into 200 well-written pages. I’m going to recommend this book to pretty much everyone who writes to me wanting to know more about aid, and I’m going to give it to my entire extended family next Christmas. Professors should be assigning this to their undergrads.

This is the book that explains the why and how of what we do. It’s about the issues that make aid necessary, the ways to do aid right, about being a better aid worker and a better donor. From SWEDOW to the Paris declaration to .7%, it’s all in there. And that’s woven in with compelling personal anecdotes and powerful imagery. This is a book my cousins will actually read. It is a beginner book, but it’s an amazing beginner book.

Like pretty much every book on aid, Damned Nations does a better job of identifying problems than solutions. The last chapter, in which Nutt talks about better aid, is by far the weakest of the book. I think that’s a forgivable flaw. These are giant problems and we’re still figuring out how to do things right. Nutt doesn’t have a set of handy prescriptions to fix aid because nobody does.

Now that I’ve finished my copy of Damned Nations, I’m ready to give it away. Leave a comment on this blog entry telling me one of your favorite books on aid and/or development and why, and I’ll enter you in the drawing. I’ll give you one entry for each comment. I’ll close comments on the 14th, and I will mail the lucky winner their book at the end of the month when I am in the US for the TED conference.

(Amazon links in this post are affiliate links. I will earn a tiny pittance if you click them.)

Where are the interesting aid thinkers?

In mid-November, Paul Currion wrote a pointed blog post asking why we see so few interesting thinkers in the aid sector. I tracked him down on skype to talk about it a little more. It turns out we were on slightly different tracks in thinking about this, and it was a useful conversation for me (and I hope Paul). Here’s a recap:

Alanna: The system as a whole doesn’t reward individuals with interesting or innovative ideas. If you think in an unusual way, you’re not perceived as a visionary or a useful contributor. You’re seen as wacky or a complainer. Not a team player. Since we all have to be aware of our next job, we can’t afford to be visionary. And you don’t get to be the kind of senior person who’s allowed to have big ideas by being an interesting thinker. You get to that level by being a good team player.

Paul: The aid bureaucracy is fundamentally a mechanism of control. A civil service mentality. hence the layers upon layers of task forces, working groups, etc. Which doesn’t leave us in a good place, at a time when the sector is really struggling with a massively changed external environment. It’s not just that people don’t care, it’s just that the lack of vision runs so deep that most people don’t even realize it’s a problem.

Alanna: Based on my interactions with people at senior levels in aid, that does tend to be true. I know plenty of front line aid workers who know we have a problem, but they aren’t able to affect things. And the people who can, don’t see a problem.

Paul: The next question is, what do we do?

Alanna: I think the problem at heart comes from the menage a trois, as J put it. The donor’s the customer, and as long as your donor is happy, there is no real drive for change, no matter how much the beneficiary is getting screwed. Which is actually what happens with civil servants, too. And I don’t know how you upset that triangle. For development you can talk about moving away from an aid model, but relief’s pretty much got to be aid.

Paul: It doesn’t seem to me that this is the only problem, or even a substantial problem if other things were fixed. But we can assume that those “other things” won’t get fixed. My argument in the blog post was not so much that the beneficiary is getting screwed but that the sector is just being overtaken by events, and everybody is standing around going “humanitarian reform blah blah blah” without realising that they aren’t wearing any pants.

Alanna: If it’s being overtaken by events, what happens next? Answering my own question: dyncorp, maybe.

Paul: The good news: newly empowered and middle class affected communities. The bad news: military and private contractors. The mixed news: diaspora communities and local political interests. Or maybe nothing happens next, and aid organisations just become increasingly irrelevant because they’re simply failing to meet the challenge.

Alanna: And no one responds to crisis?

Paul: Not in the way that we’re used to seeing. Imagine if there had been a third megadisaster after Haiti and Pakistan. We simply wouldn’t have been able to mount a response. You could see a “hollow” humanitarian sector in the same way as you see hollow states. Activity at the core that makes it look like things are happening, but increasingly little capability outside the core.

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It was a thought-provoking conversation, and it’s been on my mind ever since. Two things really stick out for me.

The first is the role of local political interests in providing aid after disasters. We’ve seen that many times – Hizbullah providing aid in Lebanon, Islamic groups in Turkey after the Van earthquake last year. There are plenty of non-altruistic reasons to provide aid, and those will not go away if the humanitarian sector as we know it hollows out. It will mean a very different – older – model of aid comes back into practice, though.

The second is the fact that aid bloggers aren’t really addressing the failure to think in an interesting way. We’re not doing the interesting thinking, and we’re not calling people out. I think it’s because most of us are part of the aid establishment, and we all have our next job to think of. We don’t want to be known as wacky troublemakers any more than the next aid worker does. What we really need then is aid journalists. Outsiders, with no vested interested in the system. Tom Paulson can go to the Pacific Health Summit and bug people all he wants. That’s what he’s supposed to do. J from Tales from the Hood can’t do that. J can’t even comfortably tell the truth and use his/her own name.

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Some questions to end this post. Is Paul right about the lack of interesting thinkers? Can you recommend some? For me, Ben Ramalingan and Edward Carr come to mind. And some of the most interesting thinkers that are relevant to aid don’t actually write about aid – now I am thinking of Dave Snowden, JP Rangaswami, and Tyler Cowen.

 

And, finally, an administrative notice. My housing for SXSWi seems to have fallen through. Does anyone need a roommate?

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(photo credit: sskennel)

circus, circus

Last week I took my son to the circus. Specifically, a traveling troupe of Chinese acrobats. It was quite clearly the troupe that plays Dushanbe, not the troupe that plays Moscow. They attempted the big stunts, but they didn’t always make it. Spinning plates got dropped, a human pyramid crashed, and one tumbler tumbled right off.

This is what interested me: it didn’t affect the show. They were ready for failure. They had spare plates standing by for quick replacement after droppage. The ribbon twirlers had fresh ribbon at hand in case of tangling. The air acrobatics had truly fantastic spotters. Everyone who fell had at least one person gracefully rush up to soften their fall. They responded to errors so quickly and smoothly that it was like a dance.

Ever since I saw the show, I’ve been wondering how we can build that kind of resilience into development interventions. How can we make sure our errors don’t wreck our work? One thought: maybe ongoing monitoring is the equivalent of those dedicated spotters who saved the falling acrobats. Collecting implementation data will let you know if your human pyramid is going askew, or keep the guy on the springboard from bouncing onto hard ground. Another: you have to be profoundly humble and honest to prepare for failure that way. You have to admit, up front, that mistakes are possible. If your spotters are hiding in the back room, they won’t catch the tumbler in time. You can’t seamlessly replace a knotted ribbon if the new one isn’t right next to you.

It’s a beautiful analogy. Would it be allowed in real life? True, some people do call this industry a circus. But do our donors actually want us to be honest and humble? Would people think we were just incompetent if we visibly prepared for failure? And what, exactly, would preparing for failure look like?

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Photo credit: Don Fulano

Now picture that top girl falling, and landing in the arms of a costumed spotter