The Power of a Sewing Machine in Northern Uganda – Part I

Creating Jobs in Oyam District

Between 1986 and 2006, northern Uganda suffered a violent insurgency by Joseph Kony and his Lord’s Resistance Army. In Oyam District where Global Health Network (U) works, most residents were forced to leave their homes and move into displacement camps. The population today has returned to over 300,000 residents but their outcomes in terms of education,  income, health remain very poor. Below are some examples:

Income – The average income per person is 70 cents a day, while the global extreme poverty line stands at $1.90 a day.

Education – 20,000 children from the district enter the first level of primary school, but only about 6,000 children finish primary school. 141 children complete secondary school.

Health – 191 out of every 1,000 children born die before the age of five.

To remind myself a human face within some of those numbers, I think back to meeting a woman named Molly who was 31 years old the first time I visited Uganda in 2013. She already had seven children and was planning for one more. Molly had been diagnosed with typhoid fever and had been prescribed pills that were offered for free at the nearest public hospital. The hospital was too far away for her to reach on foot, however, and she was unable to pay for a $5 repair that was needed to fix her bicycle. She told me she would wait one month until she had saved enough to fix her bike, then travel to the hospital for her free typhoid medication.

This story is exactly why poverty is so wrong. Five dollars was keeping Molly from free, life-saving medicine. So she would wait a month – while suffering from typhoid – to save up those five dollars. I spend a lot of time in rural Ugandan villages and I’ve met a lot of people who seem very happy. Their lives seem simple, but not necessarily bad. In fact, I often think about how aspects of their lifestyle would be an improvement on my own as an American. But then I visit a hospital or hear a story like Molly’s and I’m reminded about the terrible side of poverty. It’s not always visible, but it is unavoidable for just about everyone living below the extreme poverty line, struggling just to survive.

When Che Guevara traveled around Latin America as a young medical student, he met a woman with asthma and a heart condition but without any access to the required treatment for her illnesses. He concluded that failures in access to health care are the most striking and egregious results of poverty. Witnessing these failures is enough to make someone demand a better system that cares for the people who face them. He wrote about his feelings in his memoir The Motorcycle Diaries:

“It is at times like this, when a doctor is conscious of his complete powerlessness, that he longs for […] a change to prevent the injustice of a system in which only a month ago this poor woman was still earning her living as a waitress, wheezing and panting but facing life with dignity. […] It is there, in the final moments, for people whose farthest horizon has always been tomorrow, that one comprehends the profound tragedy circumscribing the life of the proletariat the world over.”

While I was visiting different villages in northern Uganda during my 2013 trip, the topic of potential income-generating activities came up quite a lot. After all, more jobs would go a long way in improving the statistics listed above – they would raise incomes, pay for children to stay in school, and pay for transportation and medicine for those who are sick. Many of the women I met told me that they would like to learn tailoring. There aren’t many jobs available in a rural village without electricity and with a labor force that is largely uneducated and untrained. But a mechanical sewing machine works just fine in a remote village, and you can even make things that people in rich countries might like to buy. So tailoring seemed like a good way to help these women of Oyam District make some money. The next summer, we brought some sewing machines to Adyege parish and taught women there to make canvas tote bags, which they sold to students at the University of California. Today, we’re making even more tote bags and T-shirts for university students. We’re looking for the right market, the right customers, and the right products to match these women with a job that can be sustained and can earn them money for their families.

Generating incomes can have a major impact that extends to the entire community. Furthermore, a full social enterprise can help fund an organization like Global Health Network (U) while providing jobs that supplement the health services the organization already offers. We’re starting off small, but meeting and working with the women who make these items provides more than enough inspiration to keep moving forward.

What is Going On in South Sudan?

Overview

There is a civil war going on in South Sudan. The war is being fought between two ethnic groups, which puts it at risk of turning into a genocide. The president of South Sudan, Salva Kiir, is from the Dinka ethnic group, while former Vice President Riek Machar is from the Nuer ethnic group. These two men lead the factions that are fighting each other and thousands of civilians who have gotten in the way. President Kiir rose to power in 2011 after a referendum liberated South Sudan from Sudan to the north. Riek Machar was his vice president until July 2013, when Kiir fired him. Civil war broke out in December 2013 and lasted until a peace agreement signed between Kiir and Machar in August 2015. Violence broke out yet again in July 2016 between the government and opposition forces and has continued since.

A History of the Conflict

The conflict between the northern and southern regions of what used to be Sudan began before the country had even gained independence. Egypt and Britain gave up their joint rule in 1956 and a new government was established in Khartoum. While the north embodied a Muslim/Arabic identity, the south continued to follow traditional beliefs of its 64 ethnic groups. The north ruled according to its Muslim/Arabic identity, and the south fought back in a civil war that lasted from 1955 to 1972. The Addis Ababa Peace Agreement of 1972 awarded Sudan’s southern region some autonomy, but that autonomy expired in 1983. As a result, another civil war broke out and lasted until 2005. This war was fought by a group from the south called Sudan People’s Liberation Movement (SPLM), of which Salva Kiir is now the leader. 1.5 million people were killed in the conflict. The 2005 Comprehensive Peace Agreement brought an end to the civil war and scheduled a referendum vote for secession of the south in 2011. The new nation of South Sudan was created as the outcome of this referendum in July 2011.

Civil War in the New South Sudan

The country’s president, Salva Kiir and vice president, Riek Machar did not get along and fell out in July 2013 when Machar was officially fired. Civil war broke out a few months later in December between Kiir’s Dinka ethnic group and Machar’s Nuer ethnic group. The violence was bad enough for the UN to make a rare decision to authorize peacekeepers to use force in order to protect civilians. The violence also prevented farmers from harvesting crops, which led to the worst food crisis in the world by July 2014. One third of South Sudan’s population (4 million people) were affected, and 50,000 children faced death by starvation.

The Latest Developments – As of December 2016

It seemed the conflict might end in August 2015 when President Kiir and Vice President Machar signed a peace agreement. Machar returned to the country in April 2016 and was once again sworn in as vice president. Unfortunately, violence erupted yet again in July 2016, Machar fled after he claiming that Kiir’s forces attempted to assassinate him, and Kiir replaced Machar with an army general as the new vice president. The fighting has spread into the southern region of the country. Kiir’s government is seemingly mobilizing militias to target civilians from particular ethnic groups there and throughout the country. The United Nations has sent in expert observers who have warned of an impending genocide.

Solutions

Adam Dieng, the UN Special Advisor on Genocide Prevention suggested an arms embargo to the UN Security Council as a measure to keep weapons out of the hands of the fighters. In December 2016, Samantha Powers from the US put forward an arms embargo proposal to the Security Council, but the proposal failed with eight abstentions. Other possible solution are sanctions against South Sudan, a regional protection force in addition to the UN’s 14,000 forces, and a hybrid court to hold those involved accountable for crimes committed.

Casualties

Before South Sudan was even created, all of Sudan had endured Africa’s longest running civil war. Today, things are as bad as ever in the 5-year-old South Sudan. 200,000 people are seeking safety in UN emergency protection camps. 3 million South Sudanese in total have been forced from their homes. 600,000 of these have fled across the southern border to Uganda. It is estimated that 17,000 children are fighting in various militias. The unrest has led to very poor health outcomes, with 10% of children dying before the age of five. Rape has been recorded on a massive scale, with 1,300 cases documented between April and September 2016 in Unity State alone. There have been 50,000 total deaths since 2014.

Side Issue –  UN Peacekeepers’ Failure

When the fighting broke out in July 2016, there was a particularly gruesome attack on Terrain Hotel in Juba. On July 11, government troops entered the hotel and began killing, torturing, and raping victims inside. Victims included western aid workers, UN staff, and other civilians. There was a UN peacekeeping camp less than a mile away, but the UN troops never came to the rescue. The failed response led to the firing of the Kenyan commander of the UN troops after less than six months in charge.

Updates on Conflicts in Syria and Yemen and an Economic Overview by Jeffrey Sachs

By Evan Pye

This week I read news articles on Middle Eastern affairs, including the crises in Syria and Yemen. I also read an overview of the United States’ economy by Jeffrey Sachs. To begin with the Syria, it was a significant week because the US and Russia negotiated a cease-fire between Assad’s forces and the rebels. The purpose of the cease-fire was to allow aid supplies into the areas in greatest need. ISIS was not involved in the agreement, however, so there was no guarantee of safety for aid groups. The US and Russia agreed to take the time during the ceasefire to jointly target ISIS forces and an Al Qaeda affiliate group called Jabhat Fateh al-Sham. Meanwhile, the United Nations is making attempts to negotiate a settlement to the entire conflict with Syrian leaders in Geneva. The United States and Russia deeply disagree about the causes and potential solutions to the conflict in Syria. While Russia blames terrorist groups for destabilizing Syria, the US blames Assad and his mistreatment of his people. The common belief is that Russia is supporting Assad because he is a former-Soviet ally. While this may be true in part, this Foreign Policy article explains that Russia’s greater concern is a power vacuum left by Assad’s ousting. Russia sees a power-sharing solution in which Assad is still a leader a possibility, while the US does not. Other countries have more skin in the game than either the US or Russia. Turkey is fighting to stop ISIS from creeping up on its border and to restrain the Kurds from gaining too much power. Saudi Arabia and Iran are also engaged in a proxy war with very high stakes in Syria.

Jeffrey Sachs wrote this article on why ISIS persists in Syria, which explains the confusion that is going on there. With so many actors and so many enemies, it seems that nothing is really getting accomplished. Sachs explains that ISIS has only 25,000 troops in Iraq and Syria, and only 5,000 in Libya. Compared to fighting forces in the hundreds of thousands in Iraq, Syria, Saudi Arabia, Turkey, and Iran, it’s a mystery why ISIS hasn’t yet been thwarted in the Middle East. Sachs goes on to explain that ISIS persists because the countries involved in the Syria conflict have other priorities that are distracting them from eliminating ISIS. Israel considers the removal of Assad a greater priority than ISIS, because Assad helps Iran support Hezbollah and Hamas, both of which are paramilitary enemies of Israel. The US also prioritizes ousting Assad in Syria, because he is the last of the Soviet-friendly regimes in the region. The US has been fighting against these regimes since the 1990s (Iraq, Libya, Afghanistan). Saudi Arabia wants to oust Assad to weaken Iran as well, just like Israel. Turkey is equally concerned with weakening the Kurds, ISIS, and Assad. Russia is primarily concerned with removing ISIS, but they have also been targeting rebel forces trying to oust Assad. The United States could partner with Russia and Iran to eliminate ISIS in Syria, but the US refuses to lose focus on the fight against Assad. This multi-targeted approach is the reason Assad and the rebels are stuck in a stalemate in places like Aleppo, and why ISIS hasn’t yet been defeated despite its small fighting force.

Yemen was also in the news this week, because more civilians were killed by Saudi Arabian air bombs. So far this summer, 40 civilians have been killed. MSF hospitals, a potato chip factory, and a school have all been targeted so far by the coalition of Sunni Arab nations. The United States is also selling weapons to Saudi Arabia for this mission, which is drawing significant criticism. The article argues that the US is simply trying to mollify Saudi Arabia, because it is not happy with the release of sanctions resulting from the American nuclear deal with Iran. Saudi Arabia is attacking the Houthi rebels, who have taken over the capital of Yemen, Sana. The Houthis are Shia, and likely close with Iran.

Finally, a Jeffrey Sachs article about the US economy provided some reasons for pessimism as well as some solutions. America is experiencing a low annual growth rate (about 1.4%) and increasing inequality. In 2016, the top 1% of earners took home 22% of income. He is also pretty pessimistic about unemployment, despite the fact that the unemployment rate is a very low 4.9%. He provides another statistic, which shows that the ratio of overall employment relative to working age (25-54) is at 77.2% now, compared to 81.5% in 2000. Sachs also says that the budget deficit is contributing to a harmfully high debt and that the big ideas we’re coming up with (Internet, smartphones) aren’t having as much of an impact as previous big innovations (steam engine, automobiles). The two solutions he offers are a renewed focus on sustainable development (people, planet, and prosperity), as well as public investment in order to spur private investment.

Online Courses on World History & Sustainable Development

By Evan Pye

Over the past few weeks, I’ve been taking several online courses to learn more about world history and the sustainable development goals. I’ve been learning world history with John Green’s CrashCourse World History 2 on youtube. The course is based on theme rather than chronologically or geographically. Themes featured include war, disease, water, Islam, climate change, and money. I went through the entire first course on world history offered by Crash Course this time last year. I learned so much that I had missed in high school, and this second course taught me just as much.  

The most interesting lesson I learned from the second half of the “World History 2” course, and the lesson that may be most relevant to international development, is that democracies may not be the most effective (economically) form of government for developing countries. John Green points to Singapore and China as examples for his argument. The architect of Singapore’s new government was Lee Kuan Yew, who leads a very dominant political power that has the freedom to focus on long-term development objectives without any interruption. As a result, Singapore has very strong health, education, and social security systems. The country has emerged as an economic success story over recent decades. Of course, China is another example of tremendous economic growth under a non-democratic political system. Deng Xiaoping and the Chinese Communist Party implemented 5-year plans that allowed the Chinese government to appoint executives in China’s biggest corporations. This state-run industrial model is successful in some sectors, and not so successful in others. For instance, China is very good at building infrastructure, but not very good in entertainment or innovative industries such as filmmaking or software/tech. John Green explains that the state-run model might be helpful to developing countries that need to foster industry and infrastructure, but should maybe be replaced when a country is ready to transition to a service-based economy.

After finishing the World History II course, I signed up for a free online mini-course on the Sustainable Development Goals from Jeffrey Sachs and the Sustainable Development Solutions Network. The course gave an overview of the Global Goals and explained their origins. It begins with a 1972 UN conference in Stockholm, which was the first time development and the environment were discussed together. 20 years later, in 1992, the Earth Summit in Rio set goals to protect biodiversity and mitigate climate change. And then in 2012, the Rio+20 conference set the stage for the SDGs to replace the highly-successful MDGs in 2015. Sachs goes onto explain how the goals are highly inter-connected, how every country is responsible for creating its own tailored plan for achieving the goals by 2030, and how businesses and universities should serve as allies in this endeavor. While discussing the role of universities in the United States, Sachs refers to the 1862 Morrill Land-Grant Act, which allocated land in each state upon which to build public universities. This investment was meant to reap benefits by stimulating local economies and producing research and development to spur American progress.

I am particularly interested in the roles that universities have to contribute to global health and development. I think that for all the research that is conducted, there should also be an action component. Universities are filled with thousands of energetic, passionate, and curious students from the full range of academic departments – equipped with knowledge, expertise from their professors, and resources from their universities – capable of making a real difference. I think most of this potential is so far untapped, but could have a very significant impact on the developing world when it is.

Thoughts on Land Privatization and Community Creation

By Evan Pye

I’d like to talk about two things today: private land ownership and how to create “community” in today’s society. The first issue comes from a Crash Course World History video I was watching and taking notes on about Europe in the Middle Ages. The host, John Green, explained that until 1500, most land in Europe was shared by everyone and was known as the “Commons.” When monarchs began to distribute plots of land to the wealthy class, the new landowners removed peasants from their land, which drove the peasants into the city to beg or work menial jobs. These conditions reminded me of what I saw in Uganda during my summer trips there in 2013 and 2014. My classmates and I visited rural villages in the central district of Oyam. The villages were quite remote and consisted of small huts separated by large plots of land. When we asked the villagers if they owned all the land we saw, they told us that most of it was communal grazing land. No one necessarily owned it, but for generations the land was shared for animals to graze. The plots of land that the villagers we met owned were usually about one or two acres near their home. We were all struck at how much land was going un-farmed. Furthermore, the vagueness about who owned the land seemed to mean that no one could use it for growing crops and making a profit. This seemed very inefficient, but the communal land we saw can’t be utilized for agriculture unless it is legally owned and sold by specific families. It seemed that the legal structure is not set up to handle that kind of land distribution policy.

John Green explained in the Crash Course video that land privatization in Europe during the 1500s was harmful to the peasants who were removed from the land, but it led to great advances in agriculture. Green notes that since you no longer had to worry about someone else’s cow stepping all over your crops and eating them, you could focus on carefully planting seeds in rows. Land privatization gave farmers incentives to make more efficient use of their land and “experiment with new methods of food production.”

This history lesson reminded me of another article I read the other week about the purchasing of land in Africa by urban dwellers. Although legal systems have a long way to go, it seems many Africans have been able to buy up large plots of land that was previously known as communal grounds for local communities. They are unhappy with the upswing in “land grabs,” but it reminds me a lot of the land privatization that occurred in Europe. Perhaps the concept of communal land has been inhibiting African economic development, because it promotes an inefficient use of fertile land. If so, there could be a race in the next few years to “grab” fertile African land from communities that have had it for many generations. This may upset the social order but pay off in terms of agricultural output. And if a traditional lifestyle really is at odds with the most financially lucrative use of land, is the new system really worth it to improve economic conditions?

This question leads to the second topic of creating communities in today’s society. I was watching an interview with Louis Cole from his Youtube channel Funforlouis. I’m a big fan of his daily vlogs, so I was interested to hear his answer to the question of what he’s learned from traveling around the world and visiting so many different cultures. Louis told the interviewer that the biggest takeaway from his travels has been the difference between the communal/familial/tribal lifestyle of less developed regions of the world and the individualistic, high tech lifestyle of the developed Western world. Louis and the interviewer conclude that Americans and other Westerners have created a culture in which we don’t really need each other for very much, because nearly everything is available to us at our fingertips. The interviewer makes the case that communities only form when people truly need each other for some reason or another. And in the West (especially in cities), as the need for others diminishes, our connections with others diminishes. But we look around at our lives and realize something is missing. It’s that sense of communities that humans have lived with and valued for our entire collective history.

I think there’s a really important point being made in this interview. I think they’ve identified an issue that leads to so much of the mental illness that is present in our society and in our cities. Technology and advancement has satisfied so many of our needs, that the role of other people in our lives is becoming less important. This is, of course, a terrible consequence of high-tech convenience and social media. I think it’s a problem that has to be addressed and figured out, or else our entire society will suffer greatly at the hands of the technology we’ve created to “improve” our lives.

What I Learned from “Requiem for the American Dream” featuring Noam Chomsky

A few months ago, I watched and took notes on this documentary from Netflix. It features Noam Chomsky discussing his “10 Principles of Concentration of Wealth and Power.” These ideas are centered around the relationship between money and power in American politics. Chomsky’s thesis is that greater wealth leads to greater power, because elections are very expensive and American political powers need to appease their funders. In turn, greater power leads to greater wealth, because lawmakers create legislation that concentrates wealth for those who already have it. Legislative tools for this sort of behavior include tax policy, deregulation, and corporate governance rules.

In his “10 Rules” Chomsky refers often to civil participation and recounts the 1960s as the heyday of popular activism. People organized themselves and protested for the rights of women and minorities, and environmental protection. In response, the “masters of mankind,” (ie, the business and legislative sectors) worked to “financialize the economy.” This was accomplished through deregulation of the banks and the offshoring of production. During the 1950s to 1970s, there were no financial crashes, perhaps because regulatory systems placed checks on the financial sector and commercial banks were separated from investment banks. Also during the 1950s, Chomsky points out that the US was “the great manufacturing center of the world.” Indeed, manufacturing made up 28% of our GDP, while finance made up only 11%. In 2010, manufacturing accounted for 11% of our GDP, while finance made up 21%.

The reason that manufacturing accounts for so much less of our economy is free trade. American workers suddenly had to compete with lesser paid factory workers in the developing world. Chomsky paints this as a bad thing, although it seems to me it an inevitable outcome of globalization. It is easy to see, however, how unfair it is that low-paid workers are faced to compete as a result of free trade, while highly paid workers in the financial sectors remain protected from international competition for their jobs. Chomsky also points out that this job insecurity resulting from free trade makes it more difficult for workers to unionize or bargain for better conditions/higher wages. While I don’t think global competition for manufacturing is wrong, I see what Chomsky is saying about how harmful it is for American workers and how convenient it is for the “masters of mankind.”

The documentary has a section on taxes, in which Chomsky explains that taxes on wages and consumption has mostly stayed the same since the 1950s, while taxes on dividends and capital gains (which mostly go to the rich) have steadily decreased. Since the 50s, the marginal tax rate for the highest earners has decreased from about 90% to about 40%. Capital gains taxes alone have decreased from about 35% in 1970 to 18% in 2010.

Principle #6 really highlights the hypocrisy of neoliberalism in America. For the majority, market principles were encouraged to prevail. The government should help as little as possible, because the government is the problem, not the solution. However, in the 1970s, lobbying in Washington increased and deregulation of the banks began. Reagan furthered the policies of deregulation until he was forced to conduct the biggest bank bailout in history. Reagan left office with a major financial crisis that the next government had to bail out again. In 1999, commercial banks were separated from investment banks. The Bush and Obama administrations both had to conduct bailouts of their own, and the next financial crisis is looming, according to Chomsky. The point he is making is that a truly free market wouldn’t let the government bailout the banks when they fail – they would just fail and make room for new actors. The deregulation and subsequent series of bailouts highlights Chomsky’s argument that “there’s one set of rules for the rich, and an opposite set of rules for the poor.”

Principle #7 talks about the problems with our electoral system from a historical lens. The 1976 Supreme Court case of Buckly v Valeo determined that money is a form of speech. About a century before that, corporations were afforded personal rights. So in the 2010 Citizens United Supreme Court case, corporations’ rights to spend as much money as they want on elections was upheld. This is obviously really harmful for elections, and is the subject of Lawrence Lessig’s Republic, Lost, which I am planning to read soon.

Principle #9 has a similar message to Fight Club, which is that consumerism is harmfully distracting us from the important issues in our society. Chomsky notes the power of public relations and advertising firms to distract us with exciting consumer products that are just barely within our financial reach. These products, mixed with entertainment from television and other technologies, make us feel fulfilled and more likely to ignore more significant matters. Even elections are run in this way. We are encouraged to follow a candidate for their character or their ability to inspire us, but we don’t often bother ourselves with the nitty-gritty details of their platform. In fact, the general population’s will has very little to do with what actually happens in our legislating process. We are completely disconnected from the laws that are made. We have no idea which laws are passing on a daily basis, and the majority of Americans would likely disagree with a great deal of them.

In turn, this disconnectedness leads to a distrust of our government. Conservatives take advantage of this distrust by espousing “small government” because “government creates more problems than solution.” The great thing about America, however, is that we are supposed to get together and decide on which rules we want to follow. Taxes and elections are our chance to support those rules. Unfortunately, we have grown to resent taxes, and to some extent even government, because we don’t know what’s happening to our taxes and we know we probably wouldn’t like it if we did know.

The answer isn’t smaller government, it’s just better government. This documentary offers a few solutions, like political activism of the masses the way they used to do it in the 60s. Another solution is reforming our electoral process. Yet another is staying informed about legislation that is being passed and the lawmakers passing it. We might not be taking full advantage of this “experiment in self-government” that Alexander Hamilton and Barack Obama talk about, but we do have the means to improve it. We’ve improved it so many times in so many ways previously, so we only need to become informed enough and organized enough and inspired enough to demand change where it is needed.

Global Affairs from “The Economist”

By Evan Pye

This week I read articles from various online sources and from a few recent issues of The Economist. I have access to an online version of The Economist through my university library account, and I decided to look through some of the articles for the first time in a while this week. I was really surprised at the quality of articles and range of subjects that the magazine covers, so I think I will spend at least the next week reading and taking notes on Economist articles.

I covered a lot of different articles and subjects this week, but they can be grouped into the categories of poverty alleviation, AIDS, and international politics. First, I learned about the current mobile phone market in Africa. Its rapid growth has led to 500 million mobile phone subscriptions, although the rate of growth is slowing. The mobile phone market contributed $153 billion to Africa’s economy in 2015, which accounts for 6.7% of Africa’s GDP. The biggest phone markets are in Nigeria, South Africa, and Egypt, but growth in the next 5 years will be concentrated in Tanzania, Nigeria, and Ethiopia (Source 1). In addition to mobile money, mobile phone chargers are serving as a gateway into solar charger companies such as M-Kopa, which has sold 400,000 solar power kits in Kenya, Uganda, and Tanzania (Source 2).

Next I looked at poverty through the lenses of hunger and land ownership. The World Food Programme estimates that $265 billion are needed annually to eliminate poverty and hunger worldwide, the majority of which must be spent in rural areas. 800 million people in the world still suffer from hunger today. The WFP highlights social protections and rural/agricultural development as the keys to increasing the incomes of the extremely poor (Source 3). In terms of land ownership, The Economist wrote about how city-dwellers all across Africa are buying up rural land for lucrative farming businesses. Agriculture, if well-organized and done with large quantities of land, can earn more money that urban jobs or public sector jobs in Africa. For this reason, as much as ⅓ of Tanzania’s farmland is currently owned by city-dwellers. This new trend brings benefits as educated and legally-savvy urbanites are demanding more from their governments in terms of legal systems and infrastructure to support agriculture, many communities are pushing back against the large purchases that outsiders are making in their traditional, communal land (Source 4).

My global health news came in the form of an article explaining how much work the world still needs to do to eliminate AIDS worldwide. 16 years after a momentous AIDS conference in Durban, another conference was held in South Africa in July to examine the progress made. The good news is that 17 million people are now on AIDS treatment. The bad news is that 38 million people still have AIDS worldwide and 2 million people are still getting infected with HIV each year, down from about 3 million per year back in 2000. Progress has been good, but not good enough to make the goal of eliminating AIDS realistic any time soon (Source 5).

Finally, I read articles about politics in Zimbabwe and Brazil. In Zimbabwe, 92-year-old President Mugabe is being challenged through protests in the streets and online by a clergyman named Evan Mawarire. The public is joining in the protests, thanks to a terrible economy and a large number of public sector workers (teachers, police, army) whose paychecks are being delayed or even lost. The looming transition that will occur when Mugabe dies could be messy there. And in Brazil, I watched a Vox documentary about favelas, which were formed by slaves and immigrants. They are home to lots of crime and drugs, but also to creative examples of self-governance, as the government has basically abandoned these communities. Speaking of the government, I read that former President Luiz Lula da Silva will face trial soon regarding his bribery scandal with the state-owned oil company Petrobras. The scandal involves many other politicians, including Brazil’s current President Dilma Rousseff, who has been impeached and awaits trial as well. Da Silva was president from 2003-2010, and was popular for reducing poverty and overseeing strong economic growth during that period.

Choosing to Visit Haiti

by Evan Pye

In the last week of June I traveled to Haiti with an organization called Team Tassy. I had developed a very strong interest in the country after six months of reading about Haiti and writing research papers on global health issues in Haiti for school. In terms of books, I read Paul Farmer’s Haiti After the Earthquake, Jonathan Katz’ The Big Truck That Went By and To Repair the World, which is a collection of commencement speeches delivered by Paul Farmer. The speeches cover his philosophy on global health and his work building health systems for the poor in developing countries. I had also read Mountains Beyond Mountains, which is a book by Tracy Kidder about Paul Farmer and his organization Partners in Health. Paul Farmer and his work in Haiti has always inspired me, and he’s always served as a role model. Since my first global health class at USC as a freshman, I’ve heard his name and learned about his philosophy of quality health care as a human right. I even got to meet him when he gave a talk at USC. Regardless, I never felt compelled to visit or work in Haiti until the last semester of my graduate program in public health at USC.

Then I read some more of these books and worked on a very intensive research project for a class on global health and human rights involving the cholera outbreak that followed the 2010 earthquake in Haiti. I had never realized that Haiti was the poorest country in the western hemisphere, nor that it was so close to the United States, nor that its history is so epic and rich. I was turned off by the fact that Haiti is often referred to as the “republic of NGOs.” If so many people are working there, then wouldn’t it be too crowded to make a difference. Or perhaps effective aid and development is just too hard there. Another influence that sparked my interest in Haiti was an interview I conducted with a global health professional for class who told me that nothing her organization did there seemed to stick. She had been very discouraged after working there. While I was in Haiti, I heard other stories of aid workers “burning out” after working there for a few years and never wanting to return.

So I had become fascinated with Haiti and it had another characteristic that drew me towards working there, or at least visiting for an exploratory trip. It is so geographically close to the United States that it would be much easier to work on a university-based program there than in a low-income country in sub-Saharan Africa or Asia. For students or staff working in Haiti versus the other side of the world, distances or shorter, air travel is cheaper, and help is relatively nearby in the case of an emergency. I had experienced a health emergency while leading a trip of 20 students in Uganda, and it was very complicated and scary. In short, Haiti needs as much help as many of the poorest countries on the other side of the world, but it also happens to be our neighbor.

Book Review: “Poor Economics” by Abhijit Banerjee and Esther Duflo

by Evan Pye

Abhijit Banerjee and Esther Duflo, both professors of Economics at MIT, released their book Poor Economics in 2011. It is the best book on poverty that I have read, because it relies entirely on evidence that the two authors have discovered themselves through the use of randomized controlled trials (RCTs). They do not rely on sweeping theories of poverty and development, but they point out many other authors who do – Jeffrey Sachs, Paul Collier, and William Easterly in particular. They breakdown many of the myths and theories surrounding poverty alleviation and usually offer an RCT that has either proven them, disproven them, or exposed some previously-unappreciated nuance to them.

Because their background is in economics, they tackle questions of poverty as generalists, covering health, education, finance, entrepreneurship, and governance. The book gives the reader a sense of the holistic nature of poverty as a challenge, and the myriad of solutions that must be understood and implemented in order to combat poverty. I have experience in global health, but it was really good to learn about interventions and strategies to help the poor when it comes to health insurance and financial services. Furthermore, the authors explain what lucrative businesses there are in the developing world if people can figure out how to provide health insurance or provide loans for medium-sized enterprises (the ones too big for microfinance, but too small for traditional banks.)

The book ends with five overarching lessons that I’ll list and describe here.

  1. “The poor often lack critical pieces of information and believe things that are not true”
    1. Ex: benefits of immunizing children, the value of early education, how much fertilizer to use, the easiest way to get infected with HIV, activities of their politicians.
  2. “The poor bear responsibility for too many aspects of their lives”
    1. Ex: Unlike many rich communities, they worry about purifying their water, supplementing their children’s food with nutrients, saving money without a bank system
  3. “There are good reasons that some markets are missing for the poor”
    1. Ex: loans have very high interest rates, no market for health insurance
  4. “Poor countries are not doomed to failure because they are poor”
    1. Ex: There are small interventions that can improve conditions
  5. “Expectations about what people are able or unable to do all too often end up turning into self-fulfilling prophecies”
    1. Children give up in school when they are told they are not smart; fruit sellers don’t pay back debt because they believe they will soon fall back into debt; nurses stop coming to work because no one expects them to be there

Haiti’s History

By Evan Pye

This week I began to prepare for a trip I am planning to Haiti at the end of June by studying the country’s history. I have been interested in Haiti for a long time, having read Mountains Beyond Mountains by Tracy Kidder and Haiti: After the Earthquake by Paul Farmer. Most people probably associate Haiti with a high level of poverty and the earthquake that caused so much destruction in 2010. Yet, its history has been extremely rich and intriguing since before it even became a country in 1804. It’s a story full of violence, accomplishment, and misfortune; and it is very much in the middle of its own history today. My sources of information this week were Haiti: After the Earthquake, a BBC timeline, and a long article written by Paul Farmer in 2004.

To start with the present day, Haiti is in the midst of an election cycle which will have taken over a year to complete. President Michel Martelly completed his term in February 2016, but the first round of presidential elections in the previous October had been marred by fraud and corruption. He therefore was unable to welcome the new president and Haiti has appointed an interim President until they are able to re-do the contested elections, which are now scheduled for October 2016.

Haiti’s encounters with Europe began as early as 1492, when Christopher Columbus landed on the island of Hispaniola during his first expedition to the Americas. The island was inhabited by a native people known as the Taino. The first European settlement in the Americas was the city of Santo Domingo in what is now Dominican Republic, a city which I have visited without realizing its historical significance. After only 100 years, all of the Taino people were wiped out by disease or violence, both on account of the European settlers. Spain controlled all of Hispaniola (little Spain), but ceded the western third of the island to France in 1697. France called this colony Saint Domingue, which would later come to be known as Haiti. France wasted no time bringing over slaves from Africa and had transported 30,000 of them via the Columbian Exchange by 1540. As a result, Haiti became an extremely brutal, efficient, and productive colony for France. It provided ⅓ of the tropical products to Europe and was the world’s leading exporter of coffee and sugar, making it more valuable to France than all of its other colonies combined.

In 1791, a freed slave named Touissant L’Ouverture led a rebellion that conquered the country that was 85% slaves by the point and declared himself ruler over all of Hispaniola. In response, Napoleon sent his brother-in-law Charles LeClerc with an armada of 40,000 troops to quell the uprising. L’Ouverture had already been captured and taken to France, where he died in prison. But Jean-Jacques Dessalines replaced him as leader of the rebellion, defeated Napoleon’s army, and declared Haiti an independent nation on January 1st, 1804.

Although Haiti had succeeded in freeing itself from France, the country was surrounded by hostile Caribbean colonies of European superpowers and America, which was afraid of the influence the slave revolt would have on the South. America wouldn’t recognize Haiti’s sovereignty until the 1860s. In 1825, France demanded reparations from Haiti for its lost land and property (meaning the slaves) of 150 million Francs. With its Navy surrounding Haiti’s water to threaten recapture, Haiti had to comply and begin paying the debt, which they would continue to pay until the 1950s. The total in today’s dollars would become $21 billion, and severely limit their their economic growth for more than a century.

In 1915, the United States invaded Haiti and occupied the country for 19 years, after disbanding the Haitian military and seizing control of the treasury. America’s reasoning for these actions were fears over the conflict between Haitian blacks in the North and mulattoes in the South. The US removed their troops from Haiti in 1934, but maintained fiscal control until 1947. It wasn’t long before more poor leadership would seize power in the form of a voodoo physician named Francois Duvalier, known as “Papa Doc”, in 1957. Duvalier was a corrupt and oppressive ruler. He was succeeded after his death in 1971 by his 19-year-old son, known as “Baby Doc.” Haiti finally kicked the Duvaliers out of power in 1986, and immediately drafted a new Constitution with changes such as making Creole the country’s official language.

After several failed and corrupt elections, Jean-Bertrand Aristide won the country’s first free and peaceful elections in 1990. He was ousted in a coup just one year later, but he would return in 2000 and be elected as president once more. He took over for Rene Preval, who served peacefully between 1995-2000. Aristide was a very pro-poor, socialist leader who President and Bush did not approve of. Bush decreased development aid to Haiti’s government and got the rest of the world to do the same. Haiti’s budget shrunk, leaving their education, health, and security systems to suffer. There was an increase in gangs and crimes, and Aristide was exiled in 2004 with the help of the Americans and the French. Aristide claims he was kidnapped by these foreign powers, who airlifted him to the former French colony, the Central African Republic. The rest of the 2000s were marked by gang violence, several contested elections, and deadly natural disasters. Rene Preval became president again in 2006, and was replaced by Michel Martelly in 2011. In January of 2010, the 7.0-magnitude earthquake killed nearly 300,000 people and led to an international pledge of $5.3 billion in aid money, most of which has not arrived or not been well-spent.