Author: Alanna Shaikh

Six things I know about medical training

By Alanna Shaikh | | 1 Comments |

picture of nurses being trained

1.       When you train a doctor, it doesn’t trickle down. It stops, right there, with her. That’s why you need to train nurses and the rest of the clinical team.

2.       If you teach new skills from a book and don’t include hands-on practice, it won’t stick. People will go right back to the old way of doing things.

3.       If you train clinicians and you don’t change the rules that govern their practice, it won’t change their behavior.

4.       Invest in good practice models. Better to break a mannequin than a newborn baby.

5.       Finding – or developing – good trainers isn’t easy, but it is essential. If you don’t make sure local trainers can continue the program after you leave, you are wasting a massive opportunity.

6.       Don’t develop your own training curriculum. Odds are overwhelming that there is already an evidence based curriculum out there that’s been developed by someone else. Spending your time finding, translating, and adapting the curriculum to your local context.

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(photo credit: ORBIS UK)

Answering a Question

By Alanna Shaikh | | 1 Comments |

 

While I was on my way to my new home in Baku*, someone left this comment on my blog:

Well…., great blog. I appreciate your contribution to the field of I/D. I go to know about this from Chris Blattman’s blog. Just one issue- Why would you charge anyone (students) for career advise, though? I don’t even pay for journal articles while writing my thesis for God’s sake!!!

”It’s $2/month and well worth the cost”—If you can charge only 2 dollars, then you can as well afford not to.(it wont have any implications on your mortgage) I know there’s time invested here but then again, even the busiest, craziest academics give career advise gratis, just saying:)

Also, It’s ironic that you’re involved with international development. I would understand if it was someone in the field of investment banking- we know they don’t give a *@?%

This reminds me of some guy in Kenya (my undergraduate) who used to give information and advise on scholarships in developed countries at a fee. You know in Africa, where I grew up, many bright kids miss out on opportunities just because some people control information that they can not afford to access. Imagine if those people took it upon themselves to make sure everyone gets that juicy information regardless of their background. Hope you understand:)

I’m glad this reader asked. I did a lot of thinking before I set up IDCL, and I’m happy to share that thinking here.

I give career advice for free to people I know. I have rewritten resumes, helped with job searches, and done practice interviews for dozens (possibly hundreds) of friends and colleagues. I have a knack for this, and I’m glad it can be useful. I love helping people do great things.

But I have this blog, and a lot of people read it. I get emails just about daily asking about international development careers. It takes me at least 30 minutes, sometimes more, to answer an email like that. I used to answer as many as I could, anyway. Because I really do want to help. I should probably note here that the vast majority of people who write to me aren’t from the developing world. They are entitled, hyper-focused Georgetown undergrads**. (I was one, so I know of what I speak.) 99% of the time, I never heard back from the letter-writer. No “thank you,” and no update on how it turned out.

It was frustrating. My post on Peace Corps includes an explicit promise to anyone who wants to write to me. To date, about 20 people have written. I have replied to every single one. One of them has written back  to say thanks and let me know how the situation turned out. This frustrates me.

My original plan was to just stop answering the emails.  It took a lot of time and had no discernible effect on the world. I was sick of it. In other words, when I placed a low value on my time, other people placed a low value on it too. That helped no one, because it made me want to stop offering my time at all.

So, the careers list. Having to sign up for something knocks out the people who aren’t serious, and two dollars was chosen on purpose to be a price low enough not to create a financial barrier. Being able to share responses with a whole group makes me feel like the time spent answering questions is well spent. And user fees have a long and studied role in international development.***

You’re right, though, that I don’t want anyone to miss out on useful information because of their background. I’ve amended the Career Advice page to explicitly state that if you can’t pay, contact me anyway. And I am saying it here, too. If you can’t pay for career advice and need help, email me anyway. We’ll work something out.

 

*Do you live in Baku? Have suggestions for settling in here? Email me!

**Yes, okay, sometimes they attend other schools, and sometimes they are grad students. But Georgetown (and BYU) are way up there.

***Among other things, they tend to reduce access to health care, which does in fact solidly undercut my point.

 

(photo credit: dan)

Yes, that is an Azerbaijan air plane, much like the one I arrived on.

 

Things I don’t believe in – handicraft projects

By Alanna Shaikh | | 6 Comments |

I don’t like handicraft projects. They seem to be very popular with private donors and small NGOs, but they’re mostly a bad idea. Here’s why:

It always seems to be women who are targeted with these efforts. Do you really empower a woman by sitting her in a room to knit all day?

Not every person is actually good at making handicrafts. You need a certain level of skill to make anything someone will buy. Not all women will get to that point, and being able to badly paint a trinket isn’t a transferable life skill.

Handicraft income is extremely unreliable. You need a market – generally tourists – for your product and that market is heavily influenced by global economic conditions. If the market fails and you’re stuck with 120 embroidered eyeglass cases, they don’t have a lot of intrinsic value. If you were, say, growing broccoli as a cash crop for foreigners you could eat least it yourself or sell it domestically if all the tourists went home.

The rhetoric about self-reliance from selling your own handiwork is all well and good to read, but linking people to one of the most fluctuating parts of the global economy isn’t precisely self-sufficiency. If you want to teach people to make and sell something, make it useful. Not trinkets.

That doesn’t mean we should never support anything made by hand. There is plenty of work to be done that is genuinely helpful.

You can support better market linkages for existing artisans. This might involve helping rural artisans sell directly to the capital without an intermediary, helping artisans gain access to international markets for their goods, or teaching them how to research current international tastes so they can make their products more sale-able if they choose to. You can help artists and artisans share their techniques, through helping them train others or documenting their work.

Handicraft projects always look like low-hanging fruit, but they’re more like low-hanging branches, getting ready to whack you in the head as you go by.

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photocredit: knittymarie

Dementia and other disasters

By Alanna Shaikh | | 0 Comments |

A couple of people have pointed out that my approach to Alzheimer’s, as I outlined in my TED talk, looks an awful lot like disaster preparedness. That’s not by accident. My job shapes my personal life all the time, and since Alzheimer’s is a disaster waiting to happen to me, I took a disaster preparedness approach. The first draft of my speech explicitly referenced earthquakes, but June didn’t like it.

In a nutshell, here’s the disaster preparedness approach:

  1. Figure out what the most likely disasters you’re facing are.
  2. Take what steps you can to prevent them
  3. Estimate what kind of damage they could do
  4. Create resilience to help you respond to and survive that damage

If you’re worried about earthquakes, then you identify the most seismically active areas in your location, don’t live there, study up on the damage done by past earthquakes, and then pre-position first aid kits, emergency food supplies, and get training on search and rescue.

(That is the deeply simplified version; you can get a better explanation here.)

If you’re worried about Alzheimer’s – well, that’s your disaster right there. It’s the most likely one in my old age. I am eating low fat and exercising for 30 minutes a day as my prevention effort. (And I guess this blog counts as keeping mentally active.) I’m estimating potential damage by watching my father decline. He was always my teacher; this is his last lesson for me. And I’m developing resilience by trying to shape my body and mind into a person who will be happy and loving, even with dementia.

If you look at the TED.com comments on my talk (For the love of summer days and fuzzy puppies do not look at the youtube comments.), you’ll see a lot of people arguing that it’s insane to prepare for something that may never happen. You get that response when you’re trying to get ready for disasters, too. People think it’s a waste of time and money to get ready. (Yes, I’m talking to you Army Corps of Engineers.) They say that life is for living and probably it will all be fine.

People are always going to say that. Human beings are wired to hate thinking about future risks. If you prepare for a disaster that never comes, everyone makes fun of your wasted efforts.

In my own case, I answer this with the argument that my efforts toward dementia resilience are also enhancing my life right now. I like origami. I like drawing. I like yoga. I could have decided to needlepoint or juggle, but that sounds horrible. You can draw the same parallel to community disaster resilience. Seismically sound buildings also handle storms better, and they last longer. First aid kits are useful for more than just earthquakes. So is search and rescue.

You can build a life today that prepares you for a whole range of tomorrows.

What does this have to do with development? Well, global warming is going to bring us a massive increase in natural disasters. Disasters that will hit poor people the hardest, and keep low income countries from developing. Done right, poor communities can build resilience for the natural disasters of the future and improve their lives right now.

But we’re going to have to actually think about it first.

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Don’t build in a flood plain

image source: Andrew Ciscel

what we can’t do

By Alanna Shaikh | | 6 Comments |

 

 

 

 

 

 

 

I was at TED Global last week, and I gave a talk at TED U. (That’s the stage where a few attendees are selected to speak.) I talked about something I hardly ever mention on this blog – my dad, who has Alzheimer’s disease. The video went up on the web today. It’s intensely personal for me, but it now has 13,000 views. So it’s probably time to talk about it here, too.

Caring for my dad is an awful lot like aid work. I stare down a heartbreaking problem that’s far too big and complicated for me to solve. I divorce my emotions, quantify the situation, identity the things I can help with and learn to live with the pain of the rest.

My dad was diagnosed in 2005; I’d already been working in aid for seven years by then. I was ready.

For my dad, I hired an aide to keep him company when everyone else was at work. Then a night aide so he never had to be alone. My mom and I found soft clothes for him that he liked to wear (Dad was a college professor; he still doesn’t approve of jeans or t-shirts). I hired a massage therapist to come weekly. Last week, I got him a special apron that has zippers and Velcro and buttons to give him something to do with his hands. (He likes it, I hate it. It makes him look sick. As sick as he actually is.)

None of it really makes a difference. I love my dad and he is still dying of the disease he feared most.

Learning to live with the pain of what I can’t do is the hard part – in aid work, and with my dad. I always want to do more. And there are always limits to what I can personally give, and what can actually be done.

In my work, it’s all the people who don’t get helped. The woman who told me a doctor killed her baby. The people who aren’t in our target districts. The people who are in our target districts and get missed anyway. There is much more pain in this world than anything I can do to help, just like an activity apron and a massage aren’t going to make my dad get better.

I figure out the shape of the problem. I do what I can. I hurt like hell and try not to think about the rest. At home and at work. It’s life, right?

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As long as I am getting personal, that’s a picture of my dad and my son, from a few years back

because this is my life now

By Alanna Shaikh | | 6 Comments |

Today I bought a giant can of Nescafé just to get the free sugar bowl that came with it. We already have a whole set of Nescafe mugs I acquired the same way. My husband thinks I’m crazy and he keeps hiding the mugs in the deepest recess of the kitchen cupboard. But I like the Nescafé mugs. I am genuinely thrilled by our new sugar bowl. It’s a cheery red and says Nescafe across the top. I like the Nescafe stuff and I like Nescafe.

You all think I’m crazy now. I mean, Nescafé’s not just instant coffee, it’s mediocre instant coffee made by a giant conglomerate. Some people will argue it’s the most disgusting coffee on earth. Why, exactly, would I want it to decorate my kitchen?

The thing is, Nescafé is a symbol for me. When I started my aid career, I didn’t drink coffee at all. It was bitter and unpleasant and I usually got enough sleep that I didn’t need the caffeine. Then I moved overseas for my first aid job, and now I don’t just drink coffee. I drink Nescafé. And I like it. (1) It might be the most disgusting coffee on earth, but it’s available everywhere. You’re never without caffeine if you can tolerate Nescafé. (2)

Every single time a health official, a nurse, a community member or a colleague breaks out the coffee to welcome their American guest, I can pick up my cup and keep a smile on my face. Every cold morning in a guesthouse with no heat, Nescafé can keep me warm and alert. In the beginning I needed cream and sugar. Now I can drink it black. Because I learned to do that. Because this is my life now.

I don’t drag coffee beans around in my suitcase. I don’t grind my own anything. I drink Nescafé, because I’ve spent 12 of the last 15 years in places where the water gives you giardia. Because I wanted this career so badly I took an internship that left me too poor for Coca-Cola or tomatoes. I’m not a visitor. I can’t be carrying all my creature comforts with me. I live here – in Ashgabat, in Tashkent, in Cairo, in Dushanbe. I’m an aid worker. So I drink Nescafé.

 (photo credit: GianCayetano)

(1)    For a given definition of like

(2)    Think I should pitch that to nestle as a new marketing slogan?