The Pleasure and Pain of Writing

I’m finally done with business school applications. It was fun at first – reflecting on where I’ve been and where I want to go, but after writing, re-writing, editing, and re-editing the same thing a couple of times and then adapting it to different schools – it got pretty tedious. You can only eat the same meal so many times in a row before it all starts tasting like mush, and that’s what I felt like by the end of this process. However good I felt about my essays when I first wrote them, they tasted pretty dull last night when I did one last read before submitting. It might’ve been Chilean sea bass at one time, but yesterday it sure tasted like moldy PB&J.

But it did remind me of how much I love writing, the agony of the process, and the victory of emerging proudly with something original and (hopefully) interesting. There’s something personal about writing, the creation of something unique, that isn’t present in other disciplines. There’s something exciting about seeing ideas come together and reveal a deeper truth. It’s why I kept my essays from college and high school, but threw out my math tests and science lab write-ups.

Beyond that, writing is just so different from what I do at work every day. At work, I have a pretty good sense how long something will take me – drafting a strategic plan, building a financial model, developing a presentation. I might be a little faster or a little slower, but I can make a pretty good estimate – and as I work, I move inexorably forward, closer and closer to the goal. With writing, there is no such clarity or guarantee. I could be writing for two hours and be thrilled, or ten hours and be disappointed. Compelling ideas in an outline might develop awkwardly, and after writing and re-writing the same paragraph, I might still be standing in the same place. I tell myself that the dead ends and circles that I go around are part of the process and unavoidable, and that always makes me feel a little better…

In the end though, I’m glad I’m done – and now I can write what I want to write about! Now if only it wasn’t so difficult to get started…

The World Connected

Spending time overseas has shown me how much the world has shrunk. Sitting at my computer in Kenya feels remarkably similar to sitting at my computer in Boston. I type out emails and chat with friends. I read the New York Times online and feed my addiction to Politico. I see the same screens that I’ve always seen – a virtual home that I can come to no matter where I’m physically located.

I remember hiking in the mountains in rural Rwanda last year. I was a two hour drive from Kigali out on a farm with no electricity or running water. We were at the base of the jungle, surrounded by green pasture dotted with thatch huts on one side and a thick, tangled forest rising up the slope of the mountain on the other. A friend's cellphone rang: it was his girlfriend calling from NYC. He excused himself and had a ten minute conversation.

Yet below the surface of this tremendous interconnectedness, there’s still a stark divide. When the internet is down, I suddenly realize how far away I am from home. If I get into a car accident here, help is probably not on the way unless I get out my cell phone and call a friend. If I want to send or receive a package, it takes almost a month to navigate the global postal service – if it arrives at all.

Deeper than that, I see the separateness of this community that I am now a part of from the one that I left. Eldoret is not exactly part of the multinational community. There are no American or European chains here, except for a peculiar, hand-painted sign for a “Marriott Hotel” that probably won’t accept my Reward points. And of course, most people here are not world travelers; they are subsistence farmers who have seldom ventured more than 200 km from where they were born.

The world has become incredibly connected in some ways, but remains incredibly separate in others – an obvious truth. My next thought is how the easy of communication and data flow could make a difference in the lives of people here – a topic that I’m sure a lot of smart people are already working on. More thoughts later…

Living in a Compound

We live in a compound with a lot of other Americans who are working for the same program. Some are long-term (more than 10 months); most are short-term (less than 3 months), rotating through here as party of medical school or residency. There’s safety and comfort being surrounded by the familiar and separated from the rest of the city by walls and watchmen. We eat tacos and spaghetti for dinner. We talk about Top Chef and watch Monday Night Football on DVR. I appreciate all of this, and am happy that we didn’t have to find and furnish an apartment or learn our way around the city on our own.

But the attitude that living in a compound encourages is discouraging to me. I feel more expat, more foreign, and more separate. It’s easy to retreat to this island community, but I want to get outside of our gates. Maybe I’ve read too many Peace Corps books where the isolation of being the only American in a tiny village in Togo forces you to learn the language and get to know the community. Or maybe it’s just an idealized expectation of being overseas – to cross the divide of being a foreigner just a little bit.

In any case, I hope that we can get to know more Kenyans and that eventually, our time here will feel less like time away from home and more like time in a second home.

Arrival and Beginnings

My wife and I arrived in Eldoret, Kenya yesterday morning, running on a little sleep and a lot of excitement. We’ve both been jumping across the US for the last three weeks, including my terrible 24 hour Seattle to Boston trip that included sleeping in the Dallas-Fort Worth airport to the soothing sound of vacuum cleaners, floor scrubbers, and a two year old who was much too awake for 2am in the morning. Arriving in Eldoret has been like clearing that last hill and then realizing the destination is suddenly upon us. We’re here.

There have been many thoughts and feelings to process, but I’ve been most struck by a sense of arrival. I’ve talked about being overseas for a long time, and I’ve worked in global health and development at the strategy level while being based in Boston. But knowledge is a funny thing, and English seems limited in its ability to describe different kinds of knowledge. I “know” something about global health and development – from research papers, news articles, blogs, conversations with experts and friends in the field. But I don’t “know” much first-hand. I can talk about the randomized controlled trials (starts at 8:50, or transcript here) that show that giving away insecticide treated mosquito nets for free is more effective at preventing malaria than charging a nominal fee (at least under the trial conditions). But I haven’t run a malaria prevention program, or seen one in action, nor do I know much about how it affects a community beyond the top-line prevention numbers.

Arriving has meant crossing this distance between knowing in my head, and seeing with my eyes. I’ve had a lot of studying the forest in the last three years and now I’m ready to be in the trees. And I know there is a lot to learn from the trees that you can’t see from the air. What do people really want? How does the community interact with the program? What difference is the program making in people’s lives? This is a big part of what I hope to immerse myself in.

On a more guttural level, arrival also feels like a bit of a test. I’ve often imagined what it would be like to live overseas and to work in global health and development. Now I’m here, and I wonder if my experience will meet my expectations. I don’t have naïve hopes for dramatic impact or sweeping change – I’ve been deep enough in this work to know that the ten months we’re here is short, barely enough time to ramp up and become effective. But will I thrive here, not just doing good work, but finding life in Eldoret life-giving and sustainable?

I have high hopes, and am looking forward to wrestling with all that will be challenging, depressing, frustrating, joyful, exciting, and amazing.

The Trouble with Short-Term

I've long harbored a mild distrust of the expanding interest in social enterprise in the young business school community as exemplified by blogs like NextBillion. This distrust is probably magnified by a sense of my own hypocrisy since I'm more a part of that community than I would like to admit - young, (ostensibly) well-educated, living in the United States, and with limited experience in or relationship with the very communities that I would like to help.

A recent post in NextBillion confronts this dilemma - how can young, Western idealists make a difference for poor communities when the problems are so complex and the local context matters so much?

This is simple to ask, but difficult to answer. For example, it’s incredibly important that people in the wealthy world understand the living situations of their brothers and sisters at the base of the pyramid. The only way to help someone with technical skills to be an effective innovator for the poor – who has grown up in a place where electricity is reliable, bankruptcy laws protect people from multi-generation debt bondage, and it is uncommon for babies to die – is to provide them with experiential education in places where this is not the case.

But how possible is it to design learning environments in which college students are the guinea pigs and learn from the people they hope to help, rather than vice versa? How can testing a new device, the design process for which is intended to teach students how to be socially-responsive engineers, truly be a test for the students rather than a test on the community in which they are embedded? There are no base of the pyramid Hollywood sets to practice on.

It's the underlying limitation of my own short-term commitment that makes me cringe. I don't speak the language, I don't know the culture, my skills were built up in a different world, and by the time I learn enough to be useful, I'll probably be shipping back to the U.S. In the long-term, when my wife has finished medical training, we plan to make a commitment to being overseas, but until then, here I am - rooted in Boston. I talk to so many people who are in the same position, with a deep desire to engage on global issues, but planted on the wrong continent.

During my senior year in college, a friend told me that it was dangerous to try to help people who you aren't in relationship with, who are more part of a problem to be solved rather than people to be loved. I've struggled with that and have felt the strain of working on global health and development issues from a computer in Massachusetts. It's the driving reason I left a tremendous job and wonderful colleagues and am now working at Boston Public Schools. I wanted to be doing something that is more local.

Nathan at NextBillion believes "that there are enough problems in the world that there must be room enough for everyone to take part in solving them." Surely that's true - but I sometimes wonder if we oversell our role in the solution given our priorities. If I want to help small holder farmers in Western Kenya, but I'm unable or unwilling to go live in Western Kenya and get to know some farmers and see a) if they're interested in my help, and b) if I can actually BE of any help, then I'm probably better off just giving money to One Acre Fund.

I like where the blog post ends up - a call for Americans who want to help to connect with African entrepreneurs and innovators who are much more capable of making a difference and being committed for the long-haul. But I remain skeptical about what kind of a difference a spring break trip can make. With limited exceptions, short-term trips tend to be of more benefit for the traveler than the host. The ultimate prize is converting travelers into residents who can be like grafted branches onto the local flora - rooted in the communities they seek to serve.

*Picture: Kigali International Airport, with an Air Ethiopian plane

The Robin Hood Tax and First vs. Second (or Third) Best

The Robin Hood tax being proposed in the UK is a really interesting policy idea. It would tax certain speculative financial transactions in order to raise hundreds of billions of pounds to fill gaps in government budgets and fund international good deeds such as climate change and global poverty. My first instinct is it's a paradise for liberals! Punish bankers and fund progressive causes at the same time? Sign me up!

But honestly, I have little idea whether this idea makes good or bad economic sense, or where the tax will ultimately fall. Will the UK be taking a chunk out of Goldman's bonus pool, or will it be hampering the growth prospects of its own struggling pension funds? From the various news articles that have come out, it feels like there are plenty of smart people on both sides and like in most public debates, the truth feels clouded by people's ideology with enough evidence to make a great argument either way.

More interesting to me is some of the more wonkish debate about whether this type of tax is the right means to the ends of funding greater global efforts to make the world a better place. Owen Barder writes:

My reservation is not that the Robin Hood tax is too ambitious or that it cannot be negotiated. It is that it is the wrong way to address these problems...We need to build a consensus that there are minimum standards of living below which no person anywhere in the world should be allowed to fall, and that those of us who are fortunate to live comfortably should all make a modest contribution to that. This should be part of the social contract in a democratic society, and it should be part of the mainstream system of taxing and spending. Robin Hood stole from the rich and gave to the poor at a time when we lacked institutions to tackle poverty and redistribute income. A Robin Hood tax is no more a lasting solution to financing poverty reduction than was the approach of Robin Hood himself.

Duncan Green at Oxfam responds:

[Owen] wants to join battle with those who oppose aid, win the argument for ‘good aid’, and then get people to willingly cough up the money needed. On the one hand, that’s a strong ‘social contract’ kind of argument, stressing the importance of the political and financial links between citizens and state, (albeit in this case limited to the donor countries), and it forces the aid industry to take issues of quality and accountability seriously. But on the other, it seems a little extreme/purist. Do we just tell the millions around the world they will have to wait for schools, hospitals and relief from climate change until we convince every last tabloid reader (and even more difficult, their editors and owners) of the effectiveness of aid? Of course we need to continue to work on public opinion and the quality of aid – and we do. But presenting this as a choice between supporting the FTT and everything else we do on aid is entirely false – we are, believe it or not, capable of working on more than one thing at the same time!

I think I agree with Duncan more here. Good policy and politics is about the art of the possible, and if we can agree that there should be more government funding for things like climate change and global poverty, and the means to raise that money is merely non-ideal rather than ineffective, I can get behind that - even if it's not the first-best option. I'll leave the debate about what the real costs of the tax are to the economists, but the money has to come from somewhere, and I think the banks can probably take a hit for the team on this one. As many activists have accurately pointed out, it seems like we took a pretty big hit for them recently.

I also worry about what it means to try and build a broader societal consensus for the agenda of "minimum standards of living below which no person anywhere in the world should be allowed to fall, and that those of us who are fortunate to live comfortably should all make a modest contribution to that." Perhaps this is the troubled part of my idealism but I wonder whether such things are possible in the near-term. People will gladly agree with the broad concept, but ignorance, misinformation, and lack of interest will cripple ambitious intentions, however good.

I don't know about the UK, but in the US even a baseline of common knowledge cannot be counted on: the US spends less than 1% of its budget on foreign aid excluding military assistance while past surveys have the median American believing we spend 20% and should reduce it to 10%. Those survey results are rather old (2001) and I think attitudes have shifted a lot in the last ten years, but I don't think we're looking a revolution on the horizon. In the meantime, we should do what we can. If there are better ideas that are feasible, let's talk about that, but otherwise, let's go with what we can get.

I do share a concern with Owen though. The critical driver for aid is a need for more money, but deeper than that it's making sure that aid is being used effectively. Dropping billions of dollars into global poverty efforts without building stronger infrastructure for delivering aid and developing initiatives to measure and improve effectiveness would be a disaster. This message shouldn't be lost in advocacy efforts.

Brief Update on Life

Apologies for not updating more - it's been an eventful beginning of the year. I decided to move on from FSG and am now working for six months at Boston Public Schools. It's been a sad transition to leave such a fantastic organization and wonderful people, and I was privileged to have learned so much over the last two and a half years. But I've hungered for involvement in implementation and operations, and have also felt the strain of working on global health and development issues from the U.S. BPS will be a new adventure (I started on Monday), and I'm very excited to be learning about urban education. This will also help me learn if education is a good fit for me for the many years that Kristin has left in medical training.

The longer-term plan is to hope that we are awarded Fulbright Fellowships to be in Western Kenya, which would ideally start in September 2010 (hence the six month commitment at BPS). Afterwards, who knows - but I'm sure I'll be transformed in a lot of ways during the beginning of this new decade.

Anyway, apologies for not posting more - I've been prioritizing transitioning well from FSG and setting up my teams for success, as well as hitting the ground running at BPS. But lots of thoughts floating around that I want to get down and hopefully will post more in the weeks going forward.

Four (Rather Unoriginal) Thoughts on Haiti

It's been a week since the earthquake in Haiti and I struggle to even comprehend the devastation in Port-au-Prince.

I don't know much about disaster relief, but to those who have questions about where to give and how to give, great advice can be found here, here and here. A few key themes excerpted:

• Don't go volunteer: As one person wrote, "There is no shortage of unskilled labor in Haiti, and Haitians will be a lot more committed than you are to the rebuilding process."

• Don't give in-kind goods: Effective organizations are not asking for material donations unless they are specific medical supplies useful in disaster relief meeting certain conditions. General goods are not useful and will clog distribution channels.

• Do give to organizations that 1) already work in Haiti and 2) have a strong track record working in health or disaster relief: Partners in Health is a good example. Don't give to organizations that have expertise in other areas (e.g., clean water), and don't give to organizations that are just now setting up operations in Haiti.

• Don't rush your donation: There is an immediate need, but there is a lot of money flowing into Haiti. There will be a tremendous need for a long time to come. Choose wisely so that you can contribute toward making a real difference.

There has been so much written about Haiti already, and so I'll just offer four thoughts that have crossed my mind during the past week.

1. Now that there's a disaster, we care about Haiti

It's a great thing that people are responding to such a horrible humanitarian crisis. A compassionate response and a desire to help is the right and admirable reaction to this tragedy. But a part of me always feels sad that a spike in suffering can bring such immense collective action while every day suffering, which is no less acute, can be more easily ignored. If our compassion moves us now, shouldn't it move us always? Can our compassion be more enduring than this one crisis?

2. Do I really believe that we are all created equal?

I was thinking about what would happen if I had been in Port-au-Prince last Tuesday and what my response might have been. Would I have risked my safety to help save other people - even if they were poor Haitians? They certainly have hopes and dreams the same as I do, families and friends who love them. Perhaps the question is too demanding, but certainly that feels like our noblest aspiration - to be willing to risk it all to save another. But I'm not sure what I would do, and that scares me. We say we believe that all people are created equal, but do we practice that principle?

3. The media reporting has struck themes that make me somewhat uncomfortable

I have seen a number of stories about violence and looting in Port-au-Prince as a result of the devastation (in just the New York Times over the last couple of days: Looting Flares Where Authority Breaks Down, Officials Strain to Distribute Aid to Haiti as Violence Grows, and Patience Wears Thin as Desperation Grows). But I haven't seen many stories on how Haitians are confronting the disaster, helping each other, and searching for survivors - just a lot of stories about how outside aid organizations are mobilizing.

Media does have power to shape the story, and I think the present one feels roughly like, "There was a terrible earthquake that has killed and trapped hundreds of thousands, society is breaking down as food and water run thin, and only outside intervention can save Haiti." The same facts on the ground would probably support an alternative story, which might run, "There was a terrible earthquake that has killed and trapped hundreds of thousands, Haitians are rallying to save their family, friends, and neighbors, many people are desperate and there have been instances of violence, but outside intervention is needed to support the country as it tries to pick itself back up again." Perhaps the sorry state of the government doesn't support such a positive framing, but I still wonder how much preconceptions about Haiti feed into the story line.

4. I hope we finish the job and stick around for the rebuilding

This past week has been the height of the disaster response. But one week later, one month later, one year later, people will still be struggling to rebuild their lives. One writer notes that concerning the Asian Tsunami and Katrina, "nine months after those events the majority of the victims were still living in temporary housing and had not yet regained their previous levels of income generation." Interest will inevitably wane and will the world be there for the long-term, or just be around for long enough to patch things up a little bit?