Author: Alanna Shaikh

Things I’ve been thinking 6/17/2014

By Alanna Shaikh | | 0 Comments |

 

“Don’t think about where the lines are drawn, think about who draws the lines.” I rarely agree with The Last Psychiatrist, but it’s my go-to source for question assumptions and making the world look different. I found this post especially thought-provoking. 

This long blog post about disease diagnostics got me wondering if we’ve been prioritizing all the wrong things when we talk about improving laboratory skills. 

And, then, finally, these two pieces about children in the US just flat out devastated me. It’s conclusive evidence that we cant go around doing development work as though the US is the top of a pyramid we want everyone else to ascend in a similar way. 1) One American child in eight will experience maltreatment (abuse or negligence) in their lifetime that is confirmed by authorities. ONE IN EIGHT. and 2) One American child in four is born into poverty.  There is something deeply, deeply wrong in the way the US values (or doesn’t) children.

(photo credit: me)

Baku, a Snapshot

By Alanna Shaikh | | 2 Comments |

1244 Some of you may have noticed I started using all my own pictures in this blog a while ago. I pull them from my Instagram, which is reasonably active. I have found taking pictures helps me think in new ways about the places I live. I always worried that photography would turn me into an observer instead of a participant, but it seems to be making me a better participant, instead.

I am going to start highlighting some of the pictures I’ve taken that really helped me do that. Not necessarily the nicest ones I’ve taken, but the ones that helped me think.

This photo, of the metro stop closest to my home in Baku, is one of about about twenty I took of that same place on different days. It just perfectly encapsulated the Baku experience for me, so I kept taking pictures. The metro, first. Because Baku is genuinely urban in a way that not all cities are. It’s dense, busy, and and full of traffic. It’s expensive, hard to drive in, and people live in apartments, not standalone houses.  It’s exactly the kind of place you picture when you think abstractly of city. The metro represents that to me.

Next, the minaret peeking out. Because Baku is a Muslim city, and forgetting that doesn’t help you understand Azerbaijan.

The construction, because Baku is a city in the middle of an oil boom.

And finally, the fountains. The Soviets were obsessed with building fountains in dry places, to display their generosity and the value of being  a citizen of a Soviet Republic. If you were part of the USSR, you got fountains in the desert. (And, for that matter, excellent public transportation.)

Things I’ve been thinking about: May 1st, 2014

By Alanna Shaikh | | 1 Comments |

1. Can Elinor Ostrom’s work help us understand what to do about antibacterial resistance? I’ve been reading a lot of Ostrom in an attempt to develop an opinion, but it’s tough going for me.  Econ was never my strong suit. Anyone smarter than me want to chime in and explain it?

2. How do we balance the importance of innovation and learning from our mistakes with the importance of not wasting our finite? Leaving room for failure is important, but people get hurt when we fail. It’s a confusing and ugly dilemma and it’s much less clear-cut than anyone wants to admit. Here’s one interesting take on failure.

3. Worms. The good and the bad. I am now the proud owner of a worm box for composting, which brings me a genuinely embarrassing amount of joy. I have also been thinking about helminthes – the intestinal worms that can lead to malnutrition or even death. I suspect we’re going to find out they matter a lot more for children’s health than anyone ever realized.

4. The new David Roodman / GiveWell report that finds that reducing child mortality does not lead parents to have fewer children. When I was writing What’s Killing Us, I looked for research linking reduced child mortality to a decrease in fertility rate. I assumed it was true. It seems true. Heck, it seems obvious. But I couldn’t any definitive research indicating it was true, so I left the claim out. Interesting to see that backed but by someone who did a serious study.

(photo credit: me)

By Alanna Shaikh | | 0 Comments |

Expat_Cover_Final-1

All the cool kids have already written about this, but there’s a fun new book out on being an expat. It’s called Expat Etiquette: How to Look Good in Bad Places, and it was written by Michael Bear and Liz Good. They sent me a preview copy, and it’s a short, clever book that’s both fun and useful.

The first nine sentences make it clear what to expect:

 “Going overseas is hard. Leaving friends and family behind. Traveling to a country where you probably don’t speak the language, and definitely don’t understand the culture. Foreign foods, foreign diseases. Loneliness.

Of course, it does have its compensations. Smoking. Casual sex. Functional alcoholism.”

How can you not enjoy that book?

I particularly like the advice on haggling with taxi drivers:

“He – it’s invariably a he – will charge too much. Far too much. You have two options:

1. You can accept this with a zen-like state of calm. Counter-offer with half the fare. Settle on something like one-half to two-thirds of the original price.  Consider the overpayment your small contribution to the local economy. Smile.

2. Alternatively, you can get indignant. Let the cabbie know that you know that he’s overcharging. Say that you live here, that you know how much the cab fare should cost. Raise your voice.  Counter-offer with half the fare. Argue. Settle on something like one-half to two-thirds of the original price.  Spend the balance of the ride fuming over the fact that you were ripped-off.

Of course, none of this applies to your favorite cabbie – the one with whom you’ve developed a relationship, the one whose phone number is on speed-dial in your phone, the one who drives you around on a regular basis.  He’s still over-charging you, but his services are, on the whole, worth more than gold.  It is always important to find this favorite cabbie, and then be stingy about sharing his number with other expats. If you are too generous, within a matter of weeks he will be too busy to pick you up on time anymore, and you will be forced to find a new favorite.”

Expat Etiquette does have a certain self-published feel about it – I think one more edit could have tightened it up and made it read more smoothly. But it’s a useful, funny, little book and you can purchase it for just $3.49. Go buy it.

One final note: the book swings back and forth between sincere, useful advice and terrible satirical advice. I trust your ability to know which is which, but at least one Amazon reviewer did not.

Disclaimer: If you buy the book through my links, I will earn approximately 2.5 cents on your purchase. I promise not to spend it all on one place.  

Language, Power, and Global Health: the privilege of speaking English

By Alanna Shaikh | | 30 Comments |

picture of a window with graffiti that says F+2=love

 

My first couple of overseas jobs were pretty much just being the native English speaker on staff. Right after undergrad, I was an intern with the American University in Cairo. I drafted or edited every piece of writing that came out of our office. Later on, after my master’s degree, I was an intern again. And I drafted and edited, again. My international health degree was all well and good, but what they really needed was someone to make their grant applications sound good. My experience isn’t uncommon; I’d argue that it’s even the norm.

In other words, young Americans get jobs because the language of global health is English. Through nothing more than luck, we – literally – speak the language of power, and we can use that to get jobs.

I’ll repeat that, because it sucks so much. We get jobs because of an accident of birth.

Most of us go on to get jobs where we’re useful for other reasons. I’ve got a decent set of technical and managerial skills now; I am pretty sure I could get hired on those alone. But I don’t have to be hired on those alone. This makes me a direct beneficiary of global inequality, even in a field that is committed to eradicating inequality.

Because of the way the field is designed.

My Russian is seriously ungrammatical, my Uzbek is irrelevant in most countries, and my French is much better written than spoken. But hey, I speak English, so none of that matters.

On the other hand, I had a colleague once. A genuinely brilliant woman, with a PhD and an MD and fluent in three languages. Her English wasn’t great, though. So most people thought she was kind of silly.

Tech tools may help this. There aren’t a lot of global health problems with obvious (rather than complex) technical fixes, but the language problem is one of them. It seems to get better every day.

Google translate is breaking down a lot of barriers. There are people I email in English and paste the Russian google translate text underneath my original letter. They reply in Russian with the machine English below. I can read the auto-English and use it as a guide to the original Russian. That’s a huge step forward for everyone.

Lingvo is very popular among my Central Asian colleagues. It helps everybody make their way through unfamiliar English vocabulary, and it really seems to help people with writing. There are a few errors in Lingvo, especially with medical language, that I have seen so many times that I recognize them. But it’s a great start.

Software tricks are just the start, though. Helping people get better at using the language of power is a short-term fix. What we need is a system which doesn’t treat English speakers like they’re smarter than everyone else – a system where every language is a language of power.

(photo credit: me) 

Wednesdays are for jargon – Budget words

By Alanna Shaikh | | 0 Comments |

NICRA – Negotiated Indirect Cost Rate Agreement. An agreement with the USG government identifying the amount an organization spends on indirect costs. It has to be developed annually according to documented spending and approved by whatever USG agency an organization is working with. USAID’s NICRA guidance from 2013

LOE – Level of Effort. The number of person hours required to complete a task or project. You might refer to one staff member’s LOE for an activity, or a project’s overall LOE for staffing it.

Burn rate – A project, company, or organization’s average monthly spending.

What we call home

By Alanna Shaikh | | 2 Comments |

Before I came to Kyrgyzstan, I spent three months in Central New York, within a hundred miles of where I was born.  It was the longest time I’d spent there since 1993 when I left for college, and I left with no intention of ever returning. Syracuse isn’t a bad place to be a kid, but I never felt like I belonged there and I left without tears. I can’t say I’ve ever really missed it. Central New York is decayed factories, small, barely profitable farms, and Syracuse University college sports[i]. Gorgeous landscape, yes, but that’s about it in terms of quality of life.[ii]

I thought I’d feel weird being back. Out-of-place, at the very least.

But I didn’t. I felt like I was home. I knew how to dress, what makeup to wear, how to talk to people. It doesn’t matter that it’s 20 years later and things have changed. They don’t change that fast, and knowing the territory intimately meant it was easy for me to identify new things and react correctly to them. I found myself craving flannel shirts. My accent started to come back.

It doesn’t matter that I don’t like Central New York that much, and it doesn’t matter that I was gone for two decades. I spent the formative years of my life in Syracuse. That’s where I learned to navigate the world. That knowledge sticks with you, like it or not.

All of this got me thinking about what it means to be an expat. It’s easy to convince yourself that you know as much as someone who has grown up there. You’ve studied the data, read the journal articles, lived there for a year, or two, or seven. What does a local know that you don’t?

As it turns out, everything.

When your whole life depends on understanding your context, when your toddler brain is young and malleable and absorbent, when you learn to read from children’s books or when you’re a hyper-sensitive adolescent, you take in information in a different way. You don’t just learn that in your brain. You learn that in your bones.

Even the best possible expat doesn’t have that kind of intimate knowledge. Expats bring lots of useful stuff to the table,[iii] but we really ought to spend most of our time shutting up and listening to local knowledge. Because we’re outsiders, and we always will be.

(photo credit: me)

[i] You know, if you trade the college sports for club soccer, you’ve got an accurate description of most of Central Asia. That explains a lot…

[ii] This poem is a pretty solid description of life in the ‘Cuse

[iii] Ideally, anyway