And so it goes



Yesterday, my office had a retreat. We’re in the middle of a messy, stressful workplanning process, so we took a day to relax in the sun (and finalize some of our logframes). During lunch, after the swimming, my colleague A turned to me. I don’t know if it was the vodka or the Tajik sunshine, but he said to me, “I started doing surgery as a medical student. It was the war, and they needed every hand.”

I was pretty sun-dazed myself, and I answered, “Did you save people?”

“Some people,” he said. “Not all of them. I remember every one I lost.”

After that we took the baby swimming for the first time, and then he lay on a towel in the shade, naked and kicking his feet. About 80% of my colleagues are doctors, and an undressed human being was irresistible to them. They’d walk by, stop, and do a brief physical. I now know his eyes are good, he is properly symmetrical, and he’s big for his age. (Actually, I knew all that already, but verification is always nice.) I was quizzed about my breastfeeding practices, my plans for introducing supplementary foods, and where he sleeps.

That led naturally into long conversations about Tajik children. They tend to fall off their growth curve when supplementary food is introduced; parents give them too much bread and not enough food with caloric value. We brainstormed ways to educate mothers, and grandmothers, about feeding young children. We want every baby to be as chunky and happy as my little guy is.

It was a really good day, the kind of day that reminds you why you choose to do this.

Driving home to Dushanbe, I was suntanned and contented and full of plov. When my husband called, I answered the phone happily. He told me that the Ministry of Foreign Affairs won’t renew the baby’s visa on a technicality. The visa expires Saturday. We need to leave the country by then and reapply for the visa from outside the country.

So now we’re scrambling to find a place two American citizens can get to easily from Dushanbe, without a visa, since the baby doesn’t have any visas yet besides the Tajik. (Odds currently favor Frankfurt, though I am pulling for Dubai since I haven’t been there since I was a kid.) It’s going to be expensive, and disrupt my work, and I’ll miss seeing my older son, who comes back from Iowa on Monday. Plus I don’t know how we’ll resolve the visa technicality even from outside the country.

Up, down. That’s the life. It’s worth it, but this sucks.


(photo credit: Wayan Vota)

Chosen because when I did a Flickr search for “naked baby” and it gave me a picture of someone I know, it seemed like a sign.

Six things I was thinking about while on maternity leave:

1.       Does the success of cash transfers mean that poverty is a result of the capitalist system and instead of working for international development projects I should be an activist trying to change the global economy?

2.       Are we going to look back at 2011 as the year that climate change became obvious in US weather?

3.       Why is it so hard for people to understand breastfeeding? (I just had a woman at a convenience store tell me that she didn’t breastfeed because her milk didn’t come in because she didn’t drink much milk when she was pregnant. I was genuinely at a loss for words.)

4.       Behavior change efforts work best when we remove obstacles and help people do what they already want to do. Is it possible to frame all change programs that way? Or are we stuck always trying to change what people want to do?

5.       I agree with GiveWell’s conclusion that philanthropic money is better spent overseas than in the US (thus my career choice) but wow, the US is awfully bad off in some places.

6.       Premature babies are often born early because of difficult circumstances in the life of the mother: chaotic or abusive home life, poor nutrition, poor access to medical care. Then we sent these fragile babies home to the same situation that made them this way. It’s a vicious cycle.

Stop Trying to Hold My Baby

So, on Monday I had a baby. (He’s healthy, I’m healthy, and he’s the most perfect and adorable baby in the whole world, for the record. And no, that’s not him in the picture; the internet and kids makes me nervous.) We’re home from the hospital now, and returning to ordinary life, which is as you’d guess a lot of work. And lots of well meaning people want to help me. So they offer to hold the sleeping baby so I can get something done.

But holding the sleepy baby is not helpful. Holding a baby while they sleep is the single best part of having a newborn. They’re all sweet and snuggly in your arms, and they look like angels. Holding the unconscious baby = not work.

If you want to help me, offer to make me a sandwich or clean my bathroom or scan my tax documents so I can pay the IRS. Or hold the baby when he’s crying and won’t nurse or sleep or settle down. That’s the help I actually need right now.

I think too many aid projects just want to hold the baby. (In the case of orphanage tourism, quite literally.) They see what they think is a need – a need that’s easy to fill! And they rush to do it. They don’t stop to ask – what do you need?

This is true both of big institutional donor programs that are eager to apply the sexy solution of the day to every situation – microfinance, health savings accounts, results based financing – and small individual donors who create tiny barely-functional NGOs to provide broiler chickens or used clothes to the needy.

The answer is to pause first, and actually find out what people need. It sounds easy, but it’s not. Just asking people generally isn’t enough. I feel like a total jerk complaining about the nice people who want to help me by holding my son, and I am a deeply privileged resident of the wealthy world.

If I was a Bangalore slum-dweller or a Congolese villager, who would I feel comfortable talking to about my needs? Would I talk to a researcher from the capital about what I need and what I don’t? Or would I just be afraid that if I criticized any aid, they’d send it all somewhere else to people who were grateful?

Bad aid isn’t solely the result of laziness or indifference – doing research on people’s true needs is surprisingly difficult. So is designing programs that meet those needs. But taking the time to do it makes all the difference.


(Photo credit: Sinosplice)

Chosen because it’s a guy holding a baby