Time and Space

The other day, I was talking to a friend about my concept of the hourglass. Basically, when you move to a new place, your hourglass is full on top with tiny grains of optimism and rage. Over time, those grains slowly trickle away until there’s nothing left. Different places make the sand fall at different rates, but your hourglass is always active. The grains are always falling.

Once your sand is gone, you’re burned out. You have no rage to fuel a passion for change, and no optimism that you can be part of making things better. You may put in your time going through the motions of your job, but it’s minimal. You have no spark. No drive. No willingness to go beyond your job description. Your work may be good enough, and it may not.

When you move to a new location, you flip the hourglass. You start over with your energy and optimism and righteous rage. You’re on fire once again, not burned out. Self-aware people with choices in their lives recognize when their hourglass is getting low. They stay ahead of job options and plan their lives so that they move before they’re out of sand.

I have believed in the metaphor of the hourglass for a long time.

I realized today, though, that the whole hourglass idea doesn’t match my own experience, or the things I’ve argued before on this blog.

This afternoon I walked down the street by my office to get an afternoon snack. (Breastfeeding takes calories. Feed and water your nursing moms, people.) I was thinking how nice autumn in Central Asia is, with the cool nights and the way the light comes in across the horizon. Eleven years ago when I moved to Uzbekistan, I thought this region didn’t have fall. How could it be a different season when it was still 85 degrees out? But I recognize autumn now, and I love it.

Ten years ago I didn’t know why the holiday meals in this region are so similar to the everyday meals. I didn’t know which kind of canned potato chip tasted better, and I didn’t know that their availability depends on the size of the city you’re in, not the size of the store. I didn’t have Soviet transport structures memorized. I couldn’t taste the difference between regional varieties of plov.

Today, I can tell what capital I’m in by the smell of the dust. I’ve talked to farmers and teachers and doctors and factory workers from Bokhara to Bishkek to Turkmenbashi. I’ve swum in Issy-Kul and the Caspian, mountain streams near Dushanbe and the underground lake just outside Ashgabat. I’ve thrown up in every model of Soviet airplane still flying. (I’ve spent two full pregnancies here.)

That’s got to make me better at my work.

Ten months from now, my contract and my husband’s end. We don’t know where we’ll be next. It could be another stint in Central Asia – we’ve never lived in Bishkek, after all. But odds favor some other part of the world. I have no shortage of transferable skills; I’m not worried about that. I’ll find a job. (Email if you’d like to give me one.) A job I love, even.

But will I ever again stay long enough to know what the fruits of the cedar trees look like, or memorize the sunset on New Year’s eve? Will I be as good at what I do if I can’t?

(photo credit: OpenDemocracy)

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.

The Field

man in a corn field

Recently, the IPA blog and the Ghana Diary blog brought up an interesting discussion about the term “in the field.” They questioned its appropriateness. The core of the argument was that the phrase creates a sense of otherness. Specifically, if you’re a local partner in a development project, how do you feel when your own home is referred to as “the field”? What does that say about the true nature of your partnership?

I think I agree with Noompa at Ghana Diary. It’s hard to disagree with the scenario that he lays out: it is alienating in the word’s truest sense to hear your own territory referred to as the intimidating unknown.

It has always seemed silly to me when people refer to my own “field experience.” I’ve spent eight out of the last ten years of my life living in Central Asian capitals. I’ve spent more of my adult life in Tashkent than any other city. And let me stress that I have been living in capitals. I’ve been in houses and apartments, often nicer than anything I lived in as a grad student. I’ve had heat, hot water, and even air conditioning on a mostly-regular basis. DC felt a whole lot more like roughing it than Central Asia ever has.

Calling time in the developing world “field time” implies two things to me: that it is temporary, and that it is difficult. Both of those are often false.

But  is “the field” a problematic term that serves a useful purpose? Are there other, better ways to convey the idea? I think there are. I suspect it’s one of those catch-all terms that serves less purpose than we think.

I mentioned a while ago that I no longer use the word “beneficiaries” unless I am contractually obligated to do it. It has been a hard transition, as a writer. There’s no real synonym for beneficiaries.  Instead, every time I am writing, I have to stop and think about who the person or group I am referring to really is. Someone who has benefited from an intervention? Partner NGO? A physician we trained? It takes time, but I think the thought and effort has made me better at what I do.

Dumping the term “field” might work the same way. Julian Jamison’s field research in North Gulu has nothing to do with my cushy life in Dushanbe or Ashagabat. Lumping the two things together is intellectually lazy. Doing the work to think of better vocabulary wouldn’t hurt.

So, for me, it comes down to this question: is there a non-lazy use for the term “in the field”? If so, what is it?


(photo credit: Diva Eva)

Chosen because it’s a field, and it’s in upstate New York, where I grew up.

A few disjointed thoughts

Some disjointed thoughts that won’t quite grow into blog posts. In no particular order or relationship to each other.

1.       I spent my lunch time in our office kitchen, eating some kind of meat soup, potatoes, and carrots. I listened to my colleagues chat in Russian about minor domestic topics. I finished my meal with black tea and sour Russian bread. I’ve spent the last decade of lunches like this. I will spend 2011 the same way.

2.       People need narrative to make sense of their lives. If you don’t have a story, your life is just a series of disconnected events. If you help someone find the right story, their life will change. Religious people know this, even if that is not how they see things.

3.       I worry about inequality, all the time. I worry that income inequality, in particular, is going to destroy everything good that human beings have managed to build. But I am a health professional, so I focus on inequalities in health and access to health care. It’s what I can do. It is not enough, but it is something.

4.       My brother and his wife are visiting from the US for the holidays. I have lost the knack of relating to non-expatriate Americans and I keep forgetting to give them information. They want to know stuff all the time. What’s for dinner? Who will be at the party we’re going to tonight? Expats just assume that either no one knows or it doesn’t matter that much. You don’t really have to tell them anything except the time of the next scheduled event. I am pretty sure my brother and his wife are the normal ones in this situation.

5.       I worry about water all the time. We are clearly using up and destroying all of our clean water. What happens next?

6.       Some Excel tricks: If you’re dealing with a big spreadsheet full of text, like a workplan or a logframe, it’s always easier to review column by column than line by line. I wish I had learned this years ago. Also, you can spellcheck an excel spreadsheet. And if it has any text in it, you should.

7.       Is everything getting worse now that it has been before, or is it just that we have more information about all the bad stuff? Aside from climate change, which is clearly getting worse.


photo credit: stagewhisper

Five Essential Readings for People Working in Development

These are not the books that teach you about development. These are the books that crack your head open so you can start (or continue) to learn.

1.       Anything by Graham Greene. Doesn’t have to be The Quiet American or Our Man in Havana, honest. The Comedians or The Heart of the Matter will do fine. But his take on the world will help guide your own perspective in a way that’s useful. The Portable Graham Greene, while not actually portable, is a nice start.

2.       Biggest Elvis, by P.F. Kluge. The important thing to remember about this book is that it’s not just the narrator who is unreliable, it’s the author. But read it and if you’re paying attention, you’ll see yourself. It’s a warning and a gift of insight to everyone who thinks they know how to help.

3.       Anything by Nahguib Mahfouz. I actually find his writing a little dry in English – Mahfouz’s true genius as an author is the way he uses the Arabic language. But he also writes deeply felt, emotionally resonant stories about the lives of poor people, set in one of the world’s biggest, oldest, poorest cities. Children of the Alley is a good example, and it’s faster than reading the whole Cairo trilogy.

4.       Prague, by Arthur Phillips. Okay, the Amazon reviews really hate this book. But I think it’s a dark and brilliant reflection on expatriate life and it has changed the way I see my place in the world. (Not necessarily for the better.)

5.       Orientalism, by Edward Said. Surprise! Nonfiction! I’d say about 50% of development programs that go horribly wrong do so because of orientalism on the part of the foreigners involved. Even programs outside the Middle East. Said is writing about the Arab World, but the larger issue is about how we perceive the other, and that’s a universal problem. This book is considered one of the most important of the 20th century, and I totally agree.

Note: these are affiliate links. If you’re going to buy a book, I may as well get a miniscule percentage of its value.

(photo credit: Lin Pernille)

What we can’t do, part II

One person can never do enough. It’s a truism, and a dull one at that, but living that inadequacy is a whole new deal. In the US, you can mostly ignore the pain and inequality in your life. You can go from home to car to office to car to home again, and only encounter other middle class people. You don’t see the sweatshop laborer that made your clothes, or the environmental impact of the pollution caused by your car.

You don’t get a bubble in poor countries. The sick, starving, and unemployed are your friends and neighbors. Kids swarm your car to beg for money in the street. The pollution hangs in the sky and makes you cough black. Your staff members need more days off to attend funerals than you could have ever imagined. There is no way to pretend you’re not living in a world of colossal needs; that everyone is as comfortable as you are.

That never stops being painful for me, and I know I am not the only one. There are a few time-honored ways of dealing with the problem. You can try to tune it out – focus only on your job and refuse to notice all the other needs. That turns pretty quickly to blocking out the entire world you live in. You can refuse to think about it at all, but that turns pretty quickly into refusing to think about everything. Or you can tell yourself a story to help you accept your tiny little place in the world. A story helps give yourself some kind of handle to hang on to when the big eyed children with malnutrition-orange hair beg you for bread and candy.

I’m a storyteller, myself. A good story about what I am doing and why it’s worth doing it can take me through a long of dark nights of the soul. I define my project, and its immediate impact. Then I try to think about the ripples it may have, spreading out into the world. It’s not that my work is necessarily the most important work, or the only work that matters. But it does matter. Insert your metaphor of choice here: starfish on beach, candle in darkness. Sisyphus and his rock, by the way, are not a good metaphor choice.

I have other types of stories for other types of projects. International development is powerfully complex. Everything is linked, often in ways you wouldn’t expect. Situating your little effort into a large whole is easy. Education projects are essential because educated people improve economic growth and are healthier. Agricultural development efforts can prevent small farmers from starving and improve GDP. Even something as technical as land reform ties into state stability, agricultural support, and individual empowerment. I tell myself a story for every project I work for. I find a reason to love my work, and I hold to that reason.

So I had an answer for my office manager – I had my own story. I told him you can’t change the world when your child is sick. You can’t start a business, run for political office, or form a community association. All you can do is try to save your child. That’s just the nature of the human heart. And by helping the children of Uzbekistan be happy and healthy, we were freeing up a lot of human energy to make the country a better place.

The office manager accepted my answer. At least, he seemed calmer after we talked. He kept going. He didn’t do anything drastic like quit his job or emigrate to Russia. But I am willing to bet he’s still haunted by the problems he can’t solve in Uzbekistan. Just like I am.

What we can’t do, part I

Thdepressing picture of a muddy streetere have been an awful lot of people I haven’t been able to help. My career feels, sometimes, like a long list of things I haven’t been able to do, punctuated by the occasional success.

I know that isn’t unusual. When you live in a poor country, you are constantly assaulted by the terrible need of the people around you. Our ability to respond is limited by so many things – program scope, funding, human capacity and host country conditions – just to start. There is never enough money to do everything, or you need to branch out into some new area you know nothing about. Sometimes the problem is caused by destructive traditional practices or bad government regulations.

At times, you can’t help people because you failed. Your program just got it wrong. You trained doctors but they didn’t change their behavior afterwards. You wasted your money and their time and no patients benefited. Or the broiler chickens turned out to cost more to raise than they earned when you sold them. Or your families sold the vegetables from their kitchen gardens and used the money to buy sugar and children’s nutrition actually got worse.

You can make bad choices with the best of intentions, you can discover your every choice has unintended consequences, and you can just be flat out stupid. Luckily, we’re not houseflies. We have the capacity for learning. And if we’re willing to genuinely examine our failures, we can avoid making the same mistake twice. It’s hard, but it’s possible.

I’m not saying that failure is a good thing. No one wants to waste their limited resources – time, money, and community commitment. And most of the time failure isn’t failing well – it’s just an ugly mess. But you can learn to fail well, and over time most of us learn how to.

For me, at least, it’s not failure that devastates. It’s the sheer scope of the problems we face and the tininess of our ability to help. Even the most holistic project has its limits. You simply can’t tackle everything all at once. But as you live your life, everything all at once is what you see.

When I was living in Uzbekistan in 2005, there was an incident in a conservative city, Andijon, in the Ferghana valley. A protest got out of hand, leading to a break-in at the city jail and a massive demonstration in the main square. When the police got involved, it ended in violence. Somewhere between 169 and 700 people were killed. The Uzbek government holds that those who died were terrorists; NGOs in the country report deaths among innocent civilians, including women and children. It’s been a source of a lot of controversy.

Nobody, however, denies that it was bloody, terrible, and heartbreaking. The deaths in Andijon left the whole country stunned. My office manager came to me in tears; he was thinking of quitting his job. What is the point, he wanted to know, of running a health project when there were so many other things going wrong in his country? Training pediatricians struck him tiny and useless.

He had a point. Most of what we do is tiny and pointless in the grand scheme of things. One average-size project isn’t going to have much impact on an entire country. That is brought home to us every day, all the time, as we live and work in the developing world.

If you’re working for an HIV project, helping people access anti-retrovirals, you know you’re saving lives. If you visit a clinic that is giving out the drugs, you can actually watch people get healthier over time. But what about all the people who don’t have AIDS? What about your neighbor, whose mother has cancer and there is no treatment available in the country for it? What about your friend’s son, who has no way to pay for university? What about the woman down the street, who always has bruises and you can hear the shouting in her house? And the children begging in the street, or the local school which has no windows or books?

(photo credit: me)