Author: Alanna Shaikh

Briefing: Tuberculosis

By Alanna Shaikh | | 4 Comments |


I recommend that before you read this entry, you go here. Right click, open it in an another window. Then come back here, and read.

Tuberculosis (TB) is mostly an illness of the poor. It is caused by a bacterium called Mycobacterium tuberculosis. It’s hard to get tuberculosis if you have a fully functioning immune system and a nutritious diet. It’s easy to get tuberculosis if you are sick, hungry, or have HIV. People who have HIV in developing countries are very likely to also get TB. There are three kinds of tuberculosis. All are equally infectious, but some are much more fatal once you are infected.

1. Regular, which can be cured with a standard regimen of drugs, most often the regimen recommended by the “directly observed therapy short-course”, or DOTS. If your get proper treatment, it is pretty easy to survive regular tuberculosis. (And training doctors to use the DOTS drugs will ensure that the largest percentage of TB patients get better.) People in the developing world are often afraid to go for treatment, but tuberculosis can be cured, and treatment is free in many countries.

2. Multi-Drug Resistant Tuberculosis (MDR TB). This is a TB infection that cannot be cured with the usual drugs. Doctors must prescribe second-line drugs to cure this form of TB. There are two ways to get MDR TB. You can get regular TB, and be prescribed the wrong combination of drugs, or fail to take your drugs. This will mean that the weak bacteria in your body are killed by antibiotics, leaving the stronger ones to breed and take over. These survivor bacteria cannot be killed by the usual drugs. You may also get tuberculosis from someone who has gone through this process and has MDR TB; your bacteria will therefore be the stronger, survivor bacteria even at the beginning of the infection.

CDC MDR TB fact sheet

Wikipedia entry on MDR TB

3. Extremely Drug-Resistant Tuberculosis. (XDR TB) This is the worst kind of TB to be infected with. It cannot be treated with the normal, first-line drugs, or the less common drugs used for MDR TB. It requires rare, third-line drugs to cure it. These drugs are more expensive, harder to store, and may have severe side effects. 50-80% of XDR TB can be treated or cured.

Medical News Today on XDR TB
The WHO on XDR TB
The Stop TB alliance on XDR TB

For a long time, drug companies didn’t bother to research and develop new antibiotics. They were cheap and didn’t make a huge profit margin, and so effective that new ones were not really necessary. When drug-resistant TB first showed up, there were no second and third-line drugs. Doctors used veterinary drugs never used for people, and old-fashioned antibiotics that had been discontinued because of dangerous side-effects.

We can stop TB by improving the availability of good TB drugs, reducing the incidence of HIV/AIDS, or making poverty less common. Your money is well spent on any of those things.

This entry was inspired by James Nachtwey, and his TED Prize wish.

(Photo Credit: Saad Akhtar)

International development blogs

By Alanna Shaikh | | 0 Comments |

My Google alerts have been good to me. I have been heartened to discover more and more blogs which touch on international development in interesting ways. You may have seen my blog roll expanding; I’m trying to create something like a comprehensive list. Check it out and explore.

Here are a few highlights:

NGO blogs

Oxfam and Refugees International both have great organization blogs, which showcase deep topical knowledge and passionate writing. Medecins sans Frontieres has a whole compendium of personal accounts by aid workers. Project HOPE has a blog all about (and by) their field volunteers, which would be a great resource for someone who wanted the nitty-gritty about medical volunteering.

Individual blogs

Vasco Pyjama has amazing, amazing posts about life abroad doing international development work. She is the real thing; full of insight on the work she does and with a wry and engaging voice. Chris Blattman is a famous development economist (insofar as there is such a thing) and one of my personal heroes. The Road to the Horizon, by Peter Casier, is dense with interesting information, personal observations, and lovely storytelling.

Jargon of the day: FSN

By Alanna Shaikh | | 4 Comments |

Jargon: FSN

Translation: This is a US embassy acronym that stands for “Foreign Service National.” It’s the term for someone from the host country who works for the US Government.

(Here is something to know. FSNs very often have serious authority. Not soft power, or unofficial power, or the ability to influence someone. Real job-based power to make major decisions about your project. If you are the kind of jerk who assumes that you should focus on the American and not the FSN, I guarantee you will regret it.)

How to write like a person

By Alanna Shaikh | | 2 Comments |


Writing a good report is an under-appreciated art. You don’t want to be dry and overly technical, but you don’t want to sound like Sally Struthers asking for donations, either. You want to present your work in a way that makes your impact clear and also makes everyone want to keep reading. It requires a careful balance, but here are a few tricks that may help.

1) Don’t ever use the word individual. It’s not an individual, it’s a person. More than one person is people (not individuals).

Compare “Individuals who visited the clinic reported greater satisfaction with quality of care,” to “People who visited the clinic…” People get your attention. Individuals are meaningless.

2) Keep your paragraphs short. Reports are so often big blocks of text that short paragraphs are refreshing to look at. It subtly makes your materials seem easier to read, which makes people more likely to read them. By the same logic, use bulleted lists whenever you can.

3) Use acronyms sparingly. Some acronyms are so common that they will read like words to most people; those are okay. Acronyms that are specific to your project or organization, however, will drive readers away. Avoid them. If you use a special kind of pit toilet designed by your own engineers, do not call it the Improved Insect-Negating Ground Facility (IIGF) and then go on to refer to the IIGF throughout your document. Just call it the new toilet design.

4) Change up your sentence length. Let some sentences be long; go ahead and use subordinate clauses. Others should be short. Varying the rhythm will keep people engaged.

5) Be careful with adjectives. Calling something terrible doesn’t really make your point. Describing the terrible conditions does. Saying a school is in “a condition of despair” (yes, that’s a quote from a report I read) is much less effective than saying that the school has leaky plumbing, no roof, and a rat infestation.

6) When you’ve finished your last draft, read it out loud as a final check. Any awkward phrasings will leap out at you in full awful glory. (Thanks to Ryan Briggs for this tip.)

(photo credit: genewolf)

Jargon of the day: CTO

By Alanna Shaikh | | 2 Comments |

Jargon: CTO

Translation: This is a USAID term, as far as I know. CTO stands for cognizant technical officer. The cognizant technical officer is the representative of the contracting officer and responsible for the day-to-day management of a grant or contract. The CTO approves your workplan, approves your key personnel, and manages the various types of bureaucracy that affect your project. As a rule, you can assume your CTO is on your side and wants your project to succeed and look good doing it. Considering how much time and energy they will put into managing your project, he or she will be as emotionally invested in its success as you are. They will be your advocate with the other actors in the USAID bureaucracy.

Things I believe in #14 – writing all your documents in clear, simple language

By Alanna Shaikh | | 0 Comments |

There are two big reasons that clear writing is important. First of all, it lets as many people as possible understand what you have to say. Secondly, writing clearly forces you to think clearly; it improves the quality of your ideas.

Using jargon-free writing appeals to the largest possible audience. Experts in your field can still comfortably read your reports, but non-experts can understand them, too. It takes a little more work to find understandable terminology for technical ideas, but doing your best is well worth it. Your donors, staff members, and the people you serve probably don’t have the background to read a jargon-dense article, and these are your most important audiences. There may be a few highly-targeted documents that need to be heavy on technical terms, but even then you can still write well.

Using jargon-free writing also forces you to think about what you’re saying. Jargon makes people’s attention – even your own – slide away. If you write that you are going to “include stakeholders in decision-making,” you don’t have to stop and think about who, exactly, you will include or how you’ll make them part of your decisions. Jargon is an obstacle to good planning. Clear, specific language, on the other hand, leads to clear, specific thinking and plans.

(Here’s a tip: if you are so far into the belly of the beast that you can’t tell what is jargon any more, read your writing out loud. Anything that stumbles off your tongue should be removed.)