Monday, November 23, 2009

Thankful

Over the past few weeks, it has felt like I have turned my life over to stress. With a draft of my thesis due this week, the continuing frustrations of job-hunting, and the realization that being unemployed means that the holidays this year will require a painful stretching of the already stretched budget, I find myself exhausted, yet tossing and turning, unable to fully rest.

Job hunting accounts for probably 90 percent of my stress. Researching and writing are tasks that I not only can do, but enjoy doing. Finding a job on the other hand is, in a word, awful. Trying to find a job that is enjoyable but still pays enough to justify grad school tuition is, in another word, impossible.

Job hunting is exceptionally stressful due to its utterly dehumanizing nature. I think this is particularly true in New York, where there are TONS of people all vying for a limited number of jobs. When there are thousands of applicants, the applicants are treated like just a number, rather than a person.

The way I see it, there are seven key steps in job hunting.

First, you must sum up all of your accomplishments in an approximately one page resume; any longer than that and you bore the prospective employer. Second, you must construct a cover letter to complement your resume, but again, be sure not to bore the employer with your silly little life experiences. Third, you wait. If by some miracle you are chosen from the thousands of other one-page-people for an interview then, step four, you dress yourself in a suit, remember to pick a "neutral" color so that you look just like everyone else, and be sure to study and prepare answers to the standard interview questions: Why this company? Why this job? What are your greatest strengths/weaknesses? Blah, blah, blah.

Step five, the interview. Interviews are awkward for both potential employer and potential employee. Typically either you click with someone, or you don't. If you don't, brace yourself for a very painful half hour. You spend the interview dancing along a tightrope between bragging, and selling yourself short, between describing yourself as perfect for the job and the company, and blatantly sucking up. Never, under any circumstances, do anything to upset or upstage the interviewer. If the interviewer scoffs at Burkina Faso, the country you called home for a time, asking "Are you sure it's a country?" and being entirely serious, smile, grit your teeth, and explain, again, that it is a nice little country in West Africa. You must have your life boiled down to one to three minute anecdotes, and be prepared for an interviewer to not ask or care about something you may have considered to be your greatest accomplishment.

Also, you know all of those little things that make you human? Your family, friends, joys, fears, etc? The interviewer does not care about that. The interviewer often does not care that your sister is your best friend and you talk to her on a daily basis, or that you have a husband who beats you at Trivial Pursuit and can almost always make you laugh when you've had a rough day, or that you admire and hope to become like your grandmothers, or that you are someone's daughter, someone's best friend, someone who means something to another person, someone who is part of a family, someone who is loved. They will see you as a piece of paper, a time slot, a monkey to dance for them. And you have to be okay with this.

Sixth, you wait again. You send follow up emails, thanking the person for allowing you to dance your monkey dance for them. Depending on the company, this may be the last contact you ever have with them. If you are lucky, sometimes you will get a form email to "Dear Applicant", along with all the other monkeys, er...candidates, they interviewed, telling you that they have chosen the monkey that can disappear into a top hat while twirling a baton. Sometimes they will ask you to come in for a second interview, or a third interview, or will fly you across the country for an interview, so you can go through the same process in a different city. The result is the same either way - you never hear from them again, you get the form email, or if you are very lucky, the job.

Seventh, if you have not gotten the job, you start the whole process over again, feeling like you have lost a little bit of your humanity at every step.

This process makes me feel very small, helpless, and insignificant. I sometimes wish that I could say to the interviewer "Hello. I am a fellow human being. Please don't treat me like a number." But I fear that kills any chances of getting the job. This, in a nutshell, is why job hunting is at the root of my stress. Why I toss and turn, and why writing a 70 page thesis is not that daunting to me.

The holidays are swiftly approaching, and as I make travel arrangements, and think of gift ideas for my family, I can't help but worry about not having a second income. Thanksgiving is right around the corner and instead of visions of turkeys, mashed potatoes, and cranberry sauce, I am still worrying about resumes, cover letters, and networking.

Thanksgiving, however, is not a time for being stressed, it's not a time for thinking of everything that we want, and everything that we don't have. It is not a time for self-pity and worrying about the things that we have not yet done. Thanksgiving, as its name implies, is a time to be thankful. A time to remember and appreciate what we do have, in spite of all the things we don't.

I may not have a job yet, but I am thankful that I have had the opportunity to work in the past, and thankful for all of the lessons I have learned from these jobs. I may not live in a swanky Park Avenue penthouse, but I am thankful that I live comfortably in my cozy Brooklyn apartment with my husband and puppy. I am thankful that even though I am not working, that my husband has a good job - there are complete households who are unemployed and we are so lucky that is not the case for us right now. I am thankful that we have heat and hot water as the winter comes - every day we see people sleeping in the subway, and yet it is so easy to take for granted that we have a home. I am thankful for the fact that we have food for breakfast, lunch, and dinner, when more than 20,000 people die every day because they don't. Even though I toss and turn because of stress sometimes, I am thankful that I get to do it in a warm bed. I am thankful for my education, and that I had the chance to attend graduate school, as I know that the majority of the world's citizens do not even get to attend university, let alone grad school. I am so privileged and yet I take it completely for granted as I pity myself during the job hunting process.

Most importantly, I am thankful for all of those things which are so often not seen by interviewers, and which are not written on my resume, for all that makes me human. I am thankful that I can talk to my sister, my best friend, on a daily basis; for my intelligent, funny husband; for my parents, my grandparents, my wonderful family and loyal friends; for the fact that I am loved, in spite of my flaws. No matter how many dehumanizing interviews I go through, no one can ever take this away from me.

For all that and more, I am thankful.

Monday, October 26, 2009

Healthcare has gone to the dogs...

Unless you live under a rock (or perhaps have been out of the country with no access to interwebs) you are probably aware that there is a proposed bill making its way through the Senate dealing with an issue near-and-dear to Americans: health care.

According to the 2007 Census statistics, there are around 47 million Americans without health insurance. This number is surely much higher now due to the economic downturn and rising unemployment - often losing insurance is an unfortunate side effect of losing a job. Health insurance is not, in my view, a privilege for those worthy enough to receive it, but is a basic human right. It is shameful that in a country as wealthy as America we still have people who cannot go to a doctor, or pay for an operation they may desperately need.

For those of you groaning "Enough! I am sick of hearing about this health care reform bill!", fear not. I believe there is sufficient coverage of the bill without my two cents and, unless you are an aforementioned rock-dweller or interwebs-avoider, I think you'd agree. My primary concern lies not with the bill, but with the high cost of health care in general, which I actually think the bill fails to address anyway.

Whether you favor a donkey or an elephant, you surely have noticed that health care in America is in dire need of reform. We pay more in health care costs than any other developed country - in 2009 alone our health care expenditures are expected to be $2.5 trillion - almost 18% of GDP. And while our wallets are emptier, we are not necessarily healthier for it - our system consistently ranks at the bottom of other developed countries' health care systems in terms of quality, access, efficiency, equity, and healthy lives.

Two recent episodes of "This American Life", one of my favorite NPR shows, address this issue of rising health care costs and attempt to clarify how we have reached an age of six-or-seven figure medical bills. They are truly the most entertaining two hours I have ever listened to about health care and I urge you to download them: they were aired the weeks of October 11 and October 18, 2009. They forced me to take a good look at what my health care actually costs, and evaluate where there may be problems.

Here's a snapshot of the most recent doctor's bill for me, a healthy twenty-something, living in New York City with health insurance:

Doctor's visit: $325
Lab microbiology: $110
Lab microbiology: $110
Lab cytopathology: $90

My total responsibility: $35
My health insurance company's total responsibility: $600

This was a routine 15 minute visit and routine testing. Results: I am 100% normal. And the total cost for someone to tell me this was $635. Preventive care is important so I am not knocking the idea of having regular check-ups, but if I did not have health insurance, I certainly would have foregone this exam.

Now here's an example of a medical bill from a time when I was not as healthy. Last year, I was sick and put on antibiotics. Here's a rough breakdown of the medical costs:
Doctor's visit #1: $200
Lab microbiology: $110
Antibiotics: Unknown actual cost, cost of co-pay $15.00

After visit one, my symptoms returned, which leads to:
Doctor's visit #2: $200
Lab microbiology: $110
Antibiotics: Unknown actual cost, cost of co-pay $15.00

My symptoms then became much, much worse and I developed a high fever. This leads to:
Doctor's visit #3: $200
(Two blood samples)
Lab microbiology: $110
Lab microbiology: $110
C/T Scan: $2,300
Radiology fee: $300
Antibiotics: Unknown actual cost, cost of co-pay $15.00

My total responsibility: $45 in antibiotics, $15 for C/T scan, $30 in doctor's visits
My health insurance company's total responsibility: $3,595

The result? I was allergic to the antibiotics and needed different ones. This was determined after every single test came back negative and I had a phone consultation with my sheepish doctor.

The way our health system is currently set up, doctors are paid more for performing more tests. People who have health insurance, like myself, may undergo a battery of tests merely to "be on the safe side". Some of these tests, while extremely cool (seeing how kidneys function = sweet) are not always necessary. If I did not have health insurance, I certainly would not have agreed to a $2,600 C/T scan, but because my insurance covered most of it, I thought "Ok, the doctor must know what he is doing." This is explained in quite a bit more detail in the first of the This American Life segments.

One more medical bill example from, shall I say, an uninsured member of my family who recently injured his foot pretty badly. There was crying involved, limping, and the foot looked bent at a funny angle.

Doctor's visit: $60
Pain medication (optional): $20

Total cost to me: $80

This visit was far cheaper than a normal family doctor visit, even without insurance...because this particular family member is a dog. We opt to not insure him because he's a healthy little guy and the cost of insurance would currently outweigh his yearly vet bills.

Animal health insurance is a relatively new phenomenon, but in the multi-billion dollar pet industry age of doggy clothing (or "Snuggies"), spa and hotel services for pets, and countless other areas to waste money on, it just makes sense. In the October 18th episode of This American Life, they outlined a question posed to pet owners, a sort of threshold cost of what might they pay to keep their pet alive called a "Stop Treatment" level. In 1997, this threshold cost was around $576. Then in 2007, it was $1451. With people willing to spend so much more on pet healthcare, the pet health insurance industry practically created itself.

During my dog's visit for his injured foot, the vet said that we could do an X-Ray...buuuut she'd "...hate to order a bunch of really expensive and traumatic tests if they're not entirely necessary." Seems reasonable. Not something I am entirely used to from health care. Without pet insurance, I am forced to look at exactly how much each service at the vet costs: a routine visit, a vaccination, an X-Ray. I am much less likely to force my dog to undergo a possibly optional test if I am paying a couple hundred dollars for it.

If my dog's symptoms had not gone away, however, this is where the case for pet insurance comes in. I love my dog and cannot bring myself to identify a "Stop Treatment" level, but I also have student loans and am loath to spend a couple grand on a hurt paw. The pet health insurance system is actually pretty reasonable. The reporter covering pet insurance for This American Life interviewed an economist with the Financial Times asking him about pet health insurance...the economist said that pet health insurance actually gave him hope for our human health insurance debacle. Here's why:

Pet insurance is not tied to pet employment but purchased on the open market. The TAL program likened the logic of employer-provided health insurance to employer-provided groceries. In this system, you would have unemployed people worrying about being able to provide food for themselves, and campaigns dedicated to universal food coverage. Why should an employer take interest in what foods you have? How much you pay for them? And how much food coverage you have? Perhaps you want a few more tomatoes this month because you feel like having some salsa...sorry, that's not covered under your plan. It's asinine. It's become a similar system with human health insurance with employers deciding what your coverage is. With pet insurance, you can purchase as much or as little as you may need. Further, owners do have to pay part of pet surgeries, even with health insurance, meaning that they actually have to think about what the costs are. This system helps to keep costs under control because people are not so far removed from the bills, unlike the system where you pay $20 for a surgery that your health insurance company might pay $20,000 for. With cost control built in, even if you don't have pet insurance you will not go bankrupt because your dog needs to be neutered.

Obviously even this pet health insurance system is not perfect. If we were to implement a pet health insurance system today, our medical costs are so out of control that people could go broke paying even a part of their surgical bills. I just think that the program made an interesting point. Our health care costs have gotten completely out of control. Our current health insurance system does nothing to address this problem, and leaves far too many people uninsured and vulnerable. Perhaps we can learn a lesson from our furry friends.

Friday, October 23, 2009

I'll take the earth, please

I often find myself on a soapbox. Being in the realm of academia, this has meant that I am surrounded by others on soapboxes as well. They do not judge me for having strong beliefs, but encourage and support this tendency. "You're so right! More people should care about developing countries! We don't do enough!" And "Of course global warming is a problem! Everyone should make efforts to cut their carbon footprint!" Academics love to pat themselves on the back for having everything all figured out, should-ing all over people, all the while wondering why the real world does not follow their advice. No matter...as long as they take the high road the rest of the world will someday follow. Trouble is, the academic world is just a wee little microcosm and what happens in the real world does not just matter, but defines the world's direction. The view from the academic bubble is quite different from what I see when I venture outside of it.

I have been thinking about this a lot lately because I am soon to be kicked out of academia and forced into this real world. Once my thesis is finished I no longer have an excuse to hang out on campus, or drag my soapbox around with me. It's too heavy to cart around while wearing a suit.

My path to entering the real world is defined by two awful little words: job hunting. The days of being recruited right out of grad school seemed to end with the collapse of the financial system (what perfect timing on my part). Now I must beg...send out resumes, "network", write cover letters, and attend fancy functions where my soapbox(es) must remain hidden away...their discovery would ruin my chances at getting a job. The real world does not much care for soapboxes.

Recently, the job hunt took a fortuitous turn. I was invited to a reception at a prestigious company, to be followed by an interview the next day. My husband, who has some experience in fancy-schmancy events, gave me just one piece of advice "Do NOT say anything controversial." Sounds easy enough. Until, that is, I found myself chatting with an employee who had this to say about the climate-change bill (Waxman-Markey or Boxer-Kerry) going through Congress: (paraphrased) "Oh, with all those Democrats, they'll probably get their stupid way." Gulp. "And climate change...how much do we really know about it?" GULP. GULP. "(Nervous laughter) I'm just going to get some more water..."

Without even both feet out the door of academia, I already miss my soapbox. My poverty and underdevelopment soapbox is fairly uncontroversial. Most people generally agree that poverty is bad. This does not mean that people want to do anything about it, but they typically admire any efforts to alleviate poverty. I can safely discuss my time in Burkina Faso and the response is admiration rather than controversy (or confusion, in this case "Burkina Faso...is that in Asia?" and "Peace Corps...is that like study abroad?"). Climate change, however, is somehow more controversial. Why?

Case in point: this article today outlined how only 57% of people believe that the earth is getting warmer, down from 71% last year. More disturbingly, only 36% of people believe that human activities are causing this change, down from 47% last year. Science indicates otherwise. The earth certainly has natural heating and cooling mechanisms, but countless studies have shown that human behaviors which release billions of tons of CO2 into the atmosphere are speeding up heating.

This is having direct consequences. Ice sheets in the Arctic are shrinking and disappearing. The ice this year has shrunk by 25% from the average size between 1979 and 2000. Rising oceans mean disappearing islands as well. Disappearing islands mean millions of people with no homes. This report describes how by mid-century, we will have around 1 billion refugees and internally displaced people who have lost their homes due to climate change. Billions more will face water shortages, severe weather changes, food shortages, and other life-threatening events...all because of climate change. It is not just a scientific issue, but a moral and humanitarian issue...just as much of a humanitarian issue as poverty, in fact.

The evidence for global warming exists and is mounting, so why is American skepticism increasing? My answer is that I think that with acceptance of global warming as reality comes responsibility. A responsibility that many people do not want or are not ready for. Changing an infrastructure that is built on pollution will not be easy...and certainly not cheap.

In the documentary "An Inconvenient Truth", a choice is given to the audience. Here is a whole bunch of gold bars. Lots of them. Tons of money. To spend how you wish. Goooooold baaaaaars. And here is the earth. Which do you choose?

As I walked away from the conversation with the climate-change-doubter, shaking my head, I felt ashamed. I felt like I had chosen the gold bars rather than stick up for the environment. I do need a job, after all. "Do not say anything controversial." My soapbox, which has long withheld all the weight I put on my shoulders, cracked a little at that moment.

Dejected, I walked toward the open bar to switch my drink from water to wine. On my way, however, I was stopped by another employee who I began to chat with. He asked about my interests, and my thesis topic, and my last internship. When I mentioned energy and the environment, in passing, he said "You know, that's really cool. We have a new team dedicated to sustainable energy." I immediately perked up "Really? It's a huge, growing industry! And it's an exciting area for investment, too." He asked me a few questions about renewable energy, a subject he did not know much about, but was interested in, and then said told me that I must interview for this team in addition to the team I was already scheduled for. I beamed and began mentally repairing my soapbox.

I am still very frightened that entering the real world and finding a job, particularly in a job market with very few choices, will force me to choose the gold bars. I do need a job. But I am glad to know that the earth is still on the table.

Wednesday, March 18, 2009

Losing a job...but not perspective

"Amy, do you have a few minutes to have a meeting?"

Gulp. "Um...sure, no problem! I'll be right there!"

I could almost hear "The Imperial March" as I walked through the corridor. Emails had been circulating for the past two weeks, "budget deficit", "downsizing", "expense reductions". My heart began to pound.

"Please, have a seat."

I sat.

"As you know, the financial crisis has placed an extraordinary burden on our organization and we have been forced to make some difficult decisions..."

"Mm-hmm..." I mumbled.

"Unfortunately, your position..."

It was around this point that I decided to put my filters on. I knew what was coming and in an effort of self-preservation I decided to go completely numb. I decided that I was perfectly fine without hearing the rest of the sentence. I nodded politely, forced my face to register surprise and disappointment, managed to muddle through the apologies, discussions of severance, and make it back to my (former) desk in one piece.

Unfortunately, this meeting was not surprising news. All the warning signs were present: I was hired only six months ago, I work only part-time while attending graduate school full-time, and I had certainly not yet reached a point where I had become indispensable to the organization. The moment I heard about the 10% reduction in staff, I began bracing myself to be part of that 10%. This may sound blase, but I assure you, I love the organization I worked for and will miss it dearly. I am just trying to be reasonable.

I am certainly not the only person who has lost their job in the past several months. The US Department of Labor's non-farm payroll employment statistics indicated that the US economy shed 651,000 jobs in February alone and the unemployment rate jumped to 8.1%. Scary. These statistics may not even reflect how dire the situation actually is, as they do not account for people who moved to part-time positions, people who took a huge step down on the economic ladder, or many domestic workers who are not "on the books". For example, when I lost my job, the woman who cared for my dog during the day also lost a portion of her income, as she was no longer needed because I would be home. This does not show up in labor statistics.

It is not just the United States facing rampant unemployment; around the world the shocks of the economic crisis are being felt in declining levels of employment. The United Kingdom today reported over two million people are unemployed - the largest number in 11 years. As the developed world slows consumption, manufacturing export-based economies like China and India also feel the pressures of unemployment from large-scale layoffs. No country has been immune to the ills of the crisis.

The Economist's report this week on "The Jobs Crisis" lays out what impacts the financial crisis has had thus far on employment worldwide. They say, and I doubt there is much disagreement with this, that "...the job losses are starkest in America, where the recession began." One need only glance a newspaper here in the US to find yet another story of a person who has lost their job. One article talks about executives who went from making upwards of $70,000 per year to just $12 per hour. Another traces the story of a woman who received just one afternoon's notice that she would no longer be receiving her paycheck and health benefits. Horror stories are making the rounds. One former employee tells the story of walking into the office to find their security ID de-activated. This is how their employer chose to inform them of their layoff. These stories make me shudder, and also make me appreciate even more how humanely and generously I was let go.

One story I read (from the same article above) had a profound impact on me. A woman making $165,000 per year for about 20 years was forced to take a job making $10-$15 per hour, just to make ends meet. I feel for this woman. I really do. That is an incredibly difficult transition, especially after 20 years of such an extravagant lifestyle. The article, however, goes on to say that the woman was forced to clear out her retirement portfolio: $17,000. Perhaps this woman was invested with Madoff. Perhaps she had a very risky portfolio. Perhaps I am being too critical to wonder why on earth after 20 years of a six-figure salary she has such little savings. I think this woman's story provides an interesting insight into the root of the problem itself - unsustainable levels of consumption. Living in luxury, living only for the moment, with little thought for the future. This same woman describes how taking this lower paying job has led to "parting ways with some friends because she is no longer in their social stratum," and how this situation has been so difficult that "It has really been even worse than the death of my mother." Wow. Again, I do not know this woman or her history, but to read this was shocking to me. When your life reaches a point that your friends are based on your mutually high incomes and the loss of a loved one is less significant than the loss of a job, then certain priorities seem to me to be out of whack. Again, I do not know her, but she seems to be lacking perspective.

Losing your job is never easy. I can now speak these words with the wisdom of experience. But there is a light at the end of the unemployment tunnel. It is impossible to say how long, or rough, or difficult the journey to the end of the tunnel may be, but it is there. And during such a difficult time, it is even more important to keep priorities in order and to keep perspective on things.

Though the recession does not yet show significant signs of slowing (though, thankfully!, the markets have rallied in recent days and continue to rally today), there are still opportunities for those seeking employment. The same afore-mentioned issue of the Economist describes a "renaissance" for entrepreneurs. Counter-intuitively, some of the barriers to entry for innovators have actually been removed as a result of the economic crisis. The mobile phone industry is similarly enjoying unprecedented growth, as landlines become more and more obsolete, especially in developing countries. The recession could also provide a boost for green technology. This could not have come at a better time (except perhaps 20-30 years ago) as our greenhouse gas emissions need desperately to be curbed. Now, the opportunities for those interested in creating environmentally sustainable energy abound. A silver lining, at last.

For the four and a half million Americans who have lost their jobs since the beginning of the downturn, yours truly included, and for those who only see grey in this silver lining, rest assured that the recession will not last forever, and unemployment will fall again. But in the meantime, try stay positive and keep perspective. Things could always be worse.

Wednesday, March 04, 2009

Etude du Mileu

I recently changed my email address and was digging through some old emails when I discovered this. It is my "Etude du Milieu" from my first three months in my village in Burkina. It is a bit long, but if you have ever wondered what a small African village is like, this is pretty comprehensive. If you do not have time to read all of it, at least check out the "Demographics/Site Description"...interesting information.

Enjoy!

Etude du Milieu: Saouga

I. Demographics/Site Description

The village of Saouga is located in Oudalan province on the road from Gorom Gorom to Dori. It is 12K south of Gorom, 36K north of Dori, and 306K from Ouagadougou. Transportation (mainly in the form of camions or pick up trucks) to and from Gorom and Dori can be found daily during the dry season, but gets difficult during the rainy season as the road is unpaved and often washes out. Travel costs are 250-500 cfa to Gorom and 1,000-1,500 cfa to Dori.

The population of Saouga is nearly 99% Sonrai people, but there are Peuls and Bela who live on the periphery of the village. Accordingly, the language heard most frequently is Sonrai, but occasionally at the CSPS or the Tuesday marche, one can hear Fulfulde or Tamashek. Slight cultural differences between these people aside, Saouga and its surrounding villages are 100% practicing Muslims. There are 12 mosques in Saouga itself and the two biggest and only fetes are for Ramadan and the fete de Tabaski. These are celebrated in village with prayer, food, and a weeklong village dance called the Gumba. It is mostly just the youth of the village who participate, but nearly everyone attends at least once.

There are no official government representatives in village, but there is a definite hierarchy of power players who determine what happens in village. The delegue and the village imam head up this power structure, followed by the conseille and the twelve responsables from each of the twelve quartiers. While it is primarily the men, elderly men to be specific, who call the shots, there are also two elderly women who are well respected and hold some influence in village. One is the former accoucheuse villageoise and the other is an elder woman with no official title but who is always invited to important meetings to speak on behalf of the women of Saouga.

There are approximately 17 groups in village, ranging from agricultural organizations, to parents of students, to elevage, to credit groups, to groups exclusively for women. Although many of these community groups do not necessarily function, they all have representation in the CVGT (which I have been told will soon be renamed the CD – Comite de Developpement), which is quasi-functional. The CVGT undertakes projects concerning village development, such as the building of the literacy/alphabetization school, as well as a tree planting project started by and in collaboration with an Italian NGO. The CVGT used to lend villageois money for development projects (90% of the cost, while 10% came from the project coordinator) and the money came from a caisse kept in each quartier, but the CVGT president, Yacouba, informed me that lending has effectively stopped due to the fact that each caisse contains only a couple hundred CFA. To call a meeting of the CVGT, or any other organization for that matter, one needs to walk around the village to inform each conseille, the village imam, and the other people considered to be influential in village. For smaller meetings, informing the key people will suffice, but for a larger meeting, Yacouba sends out a “town crier” with a tam-tam on the day of the marche.

II. Community Organization and Infrastructure

Saouga is organized into several family compounds ranging in size from 15-30 people in 3-5 houses per shared courtyard. Typically, one family shares a house while several extended families share a courtyard. Houses are generally made of mud brick with sand floors and wooden roofs.

The man is the head of the household and, in line with Muslim rules, can have up to four wives if he can afford it. Polygamy is, thus, practiced, but infrequently, as many men cannot afford more than one wife. In choosing a wife, the man pays a woman’s family 60,000 CFA as a dowry, which the family then uses to purchase a bed and other furniture to furnish the house for the new couple. A man can choose a wife as young as 10 years old, but most are 12 or older when they get married. Child production starts almost immediately following marriage and girls as young as 14 come to the CSPS for prenatal consultations. The number of children per family varies depending on fertility, but many women give birth right up until menopause. Divorce is also practiced here, but the decision is left to the men. The only rule in divorcing someone is that if the man has not fully paid the dowry to his wife’s family, he must do so before divorcing her.

The family compounds are shared not only with large groups of people, but with any and all animals owned by the family. Courtyards are often overrun with sheep, cows, goats, guinea fowl, roosters, chickens…and their wastes. Most people do not see any problem with this; I have even seen children collecting the larger piles of waste by hand and put them in buckets to use for other purposes. I can only hope they wash their hands afterwards, but I fear that they do not.

Latrines can be found in many family compounds, but most people seem to prefer to “faire les besoins” en brousse. I even saw one woman squatting in the field right next to a latrine, which indicates to me that convenience is not a factor in the decision to forego their use. Many children simply are not allowed to use latrines, and thus must go en brousse as well. There are areas of pathway all over village that are avoided specifically for this reason.

Women of each family collect water at one of the several village pumps. There is one at the school, one for the quartier next to the school, two near the CSPS, two on the other side of town, and potentially even more that I have not yet seen. There is also an Italian NGO currently working on building another pump closer to the edge of town for the people who live en brousse. Water is stored in buckets and bidons, both covered and uncovered, and is consumed with no filtration system. Water from the pumps runs relatively clear when water is more plentiful, but during the dry season, the more scarce the supply, the dirtier it becomes. Water is generally available all year, just much more difficult to find during April through the rainy season. A barrage used for bathing (both animals and humans), laundry, jardinage, and I fear sometimes even drinking water, has already dried up.

Along with infrastructure, I feel it is important to mention the apparent lack of it in the center of the village. There is a large sand pit that fills with water every year, making it impossible to leave or enter Saouga. A small “boat” was used last year, really just a plank of wood which floated people across, but has since been broken, so villageois are unsure of what will happen during this year’s rainy season.

III. Economic Activity

Saouga is, in line with the rest of Burkina, mainly an agricultural community. Several different crops are grown, including millet, the staple of the diet. Herding is also practiced more here than in other areas of the country. Animals are raised and sold at the marche: I have seen mostly sheep, but also goats and cows. There is also a specific season for eggs around April, I have been told. The satellite village of Ouro-hesso also contains many camels, which are quite valuable, but people rarely sell them.

Saouga’s marche is every Tuesday, and one can find both men and women selling various items from dried leaves, to millet, to nattes, to canneries, to gateaux, to calabashes. Many items are seasonal, but bike supplies, clothing, fabric, beads, and even generic medication sold out of cardboard boxes are available year-round.

There are several small village boutiques which sell petrol, sugar, rice, noodles, lamps and some other very basic necessities. Despite the fact that they all sell almost the exact same thing, there is no competition among the owners.

Because of the village’s proximity to Gorom, many people sell their goods at the Thursday Gorom marche. Women often walk all the way there and back in the same day with their goods on their heads. Men ride in on donkey carts to sell their items. Both men and women go nearly every Thursday to purchase food that one cannot find in village.

There are several examples of “petite commerce.” Many women have gardens where they grow lettuce, cabbage, tomatoes, and carrots, and sometimes potatoes (although there were no potatoes this year). These items are sold two months out of the year towards the very end of January through the beginning of March. Women do not sell the items at the marche, so to buy them one has to go to the garden. They complain that their reason for not selling items at the marche is that they do not have a French-speaking business partner to do it for them. They also complain that they do not get their seeds on time and thus miss opportunities to grow and sell certain crops (thus the reason for no potatoes). Aside from jardinage, small transactions take place among women at all times, as they often carry around little cherry like items called “jupe-jupes” and sell them for 25 CFA to interested parties. They also sell large sheets that they have sewn patterns onto.
Work and economic activity, like everything else in Burkina, is seasonal. There are large blocks of time when people are not doing much and do not bring in much, if any, income. During December, many men of Saouga leave for the Cote d’Ivoire to do manual labor or to sell second hand clothing and other goods there. Another complaint from both men and women is that work becomes scarce following the rainy season, again because of the inaccessibility created by the large sand pit.

IV. Education

Saouga has one primary school: six buildings, six levels. School fees are 1250 CFA per year per child, and this cost includes one meal per day for the kids, sponsored by PAM (Programme Alimentaire Mondiale). The closest secondary school is in Gorom Gorom, but very few students go onto study there. The numbers of girls and boys in school seem to be even, but only about 20% of the children in Saouga attend school: about 40 children are in the lowest level with numbers declining steadily only 7 students remain in the highest level. I have asked repeatedly why more children are not in school and have been given a wide range of responses with no concrete answers: children are needed to work in the fields, the family can’t afford the 1250 CFA, they don’t want their kids to begin speaking French and become pretentious, if girls go to school it will derail their Muslim teachings and they will start wearing “mini-jupes”…the list goes on and on.

I have spoken with the school director and one female teacher of the 2nd level about doing “Sante avant Tout” activities and they are very interested. There are already health subjects taught in school, but they are eager to try a new approach. I have also brought up the idea of doing a Life Skills camp for some of the French-speaking children in village during their summer break. Critical thinking skills are not taught in the schools, but are vital to both development of the child and community. The Life Skills manual has several activity ideas and I plan on using many of the problem solving and decision making activities, as well as some of my own ideas. The teachers are less eager to do this, as it requires a great deal more work, but I would like to find a village counterpart who can keep the project going in future summers. If it is too close to this summer to plan one for 2007, I would at least like to get one up and running in 2008.

Aside from primary school, there is a village alphabetization center that holds classes from March through April. There are 3 teachers: the Coges president, an educated woman, and Ishiaka who runs a non-functioning savings and credit club. They teach villageois how to read and write in Sonrai. The classes are composed mainly of adults, with one separate class for women (taught by the female teacher), and some teenagers attend also. Classes are free, and people come and go as they please. Approximately 60 people are involved in the school, but at any given time there are likely about 20-30 people in attendance.

A small religious school for young boys is run by a village elder close to the gare. It meets around dusk, though I am not sure how frequently, and I am unaware of how many students go there.

V. Health

General Information and Staff: Saouga’s CSPS is relatively new as it was just built in 2002. There are two buildings: a maternity and a dispensaire, as well as a hangar that is rarely if ever used.

The staff is officially composed of an ICP, Alaye Kabore, (who recently acquired the position when the old ICP left to work in the south, but will also be leaving soon to work in a different Sahelian village before also leaving for the south), and an accoucheuse, Blandine, who works primarily in the maternity. Each of them speak only limited Sonrai, but can usually find a way to communicate to patients without having to call in a translator. Usually it is the COGES president who translates when needed.

There is a gerant in charge of medication distribution, and also a manouevre who is in charge of cleaning the CSPS and disposing of hazardous materials. The manouevre also often helps during Prenatal Consultations (CPNs) because the accoucheuse gets too busy to help everyone. He weighs pregnant women and records their weight and (hopefully) growth in their Blue Carnets.

Aire Sanitaire: The CSPS of Saouga covers a large aire sanitaire of 10,815 people, spread out among 9 satellite villages, the farthest being Touka-Agulanabe at 40K from Saouga. Almost half of the district sanitaire (5,130 people, 47.4%) is located more than 10K from the CSPS. Although this distance does not keep some people from frequenting the CSPS, the rainy season does. The previously described sand pit renders it impossible for some satellite villages to access the CSPS for at least two months out of the year.

Prominent Illnesses: The five most commonly reported illnesses, in order, are: malaria, respiratory infections, skin conditions, digestive conditions, and trauma. There were no cases of guinea worm in 2006, but there were 8 cases of tuberculosis and 1 case of leprosy. HIV/AIDS statistics are unknown because the CSPS does not test for it and many people say that they would not get tested even if the service was offered. The villageois maintain that “AIDS has not yet reached Saouga, it is only in Cote d’Ivoire…”

Services Offered: In accordance with national regulations, the CSPS offers the “Paquet Minimum des Activites (PMA)” including:

la consultation curative, la consultation prenatale (CPNs offered Monday and Tuesday mornings), la consultation infantile, la couverture obstetricale, le planification familiale (PF), les activites du PEV (free vaccinations), les activities de recuperation nutritionelle (Thursday morning nutritional consultations, followed by Friday morning enriched porridge making), nutritional activities done in conjunction with PAM and Unicef.

The services most frequently used are curative consultations: in 2006 there were 1,841 patients who came to the CSPS with general illnesses. The other most frequently used services were: 433 CPNs, 136 PFs, 217 accouchements. The costs, respectively, are: 1300 CFA (consultations), 1200 CFA (CPNs), 500 CFA (PFs), 2500 CFA (accouchements). Nutritional consultations are free, but women who are selected to receive the enriched porridge must pay 100 CFA for the supplemental oil and sugar.

The costs for 2007 are to be very different, as I found out at a recent meeting in Gorom Gorom that explained a new set of fees set on a national level for all CSPS maternity facilities. The new price for a delivery is only 900 CFA and CPNs are now completely free because of governmental subsidies that are to cover 90% of maternity costs. The COGES president and I held door-to-door sensibilizations in both Saouga and the satellite village of Ouro-hesso to inform women of the elimination and reduction of maternity fees. Many women seemed excited and promised to now go to the CSPS more frequently, but several women seemed indifferent. I called a separate meeting of village women to try to understand why so many choose not to go to the CSPS for prenatal care and the response was very surprising. All of the women who gave birth at home claimed that the birth had been a “sudden surprise” and that is why they did not go to the CSPS. They claimed that they felt only a moment of pain and then literally “2 minutes later” the baby just “came out.” One women even said that she gave birth to all 11 of her sons thinking that she had only to use the bathroom. I did not want to call these women liars, but pointed out that birth typically takes several hours and there are several clear indications (like water breaking, contractions) that give sufficient warning that birth is about to take place. Natural warnings should give more than enough time for women to get to the CSPS, particularly for the women of Saouga who are no more than 20 minutes away. The women had no response for this and continued to insist that it was a surprise. *I would very much like to get at the real reason for why women refuse to give birth at the CSPS, but I believe that I will have to find a translator who is not a male first. Even then, the truth might be difficult to find.

The poor frequentation of maternity services is further complicated by the existence of an accoucheuse villageoise. Until the CSPS was built only 5 years ago, women came to her for all things related to pregnancy and childbirth. She still holds a lot of influence with village women and many will consult her before they even think of going to the CSPS. Because of this, there is a bit of a strained relationship between her, the ICP, and the CSPS accoucheuse. She would like to be more involved in CSPS activities, but the staff does not respect her role, nor consider her to be of much importance and thus does not include her. Because she feels excluded, she often advises women not to go to the CSPS and continues to do some prenatal consultations in village. The COGES president and I have gone to discuss this wither her several times, but the one time the ICP accompanied us, he fought with her and she left in mid-conversation. *I would like to find a way to improve relations between these two important influences on women’s health.

Feeble frequentation of the CSPS is not just limited to prenatal care and childbirth. The Microplan for 2007 listed “Faible participation communautaire” as the priority problem to work on. One source of this problem is the existence of traditional healers, which are much less expensive, but can sometimes aggravate a health condition rather than help it. *I heard about a “traditional healer formation” that takes place in Gorom and am actively searching for more information, although nothing has come of this project idea yet.

Another problem is that people claim to have no money to afford health services (no one saves “for a rainy day”, and one man actually laughed when I asked if anyone set aside money for health emergencies). This lack of available funding means that people wait until the last possible minute, until their condition is as bad as they think it could possibly get before finally coming to the CSPS. The best case scenario that results from this is that the services are exorbitantly expensive, but sadly the worst case scenario is often death because they just waited too long. The other volunteers in the region and I have discussed the possibility of setting up a savings and credit club just for pregnant women so that they do not have to rely on their husbands to pay when they are ready to give birth. We would like to collaborate with the CSPS or maternity of each village to perhaps keep a caisse at the health facility to be contributed to and used exclusively by women who will give birth at the maternity. A similar idea of a savings and credit club for health purposes could be implemented at the dispensaire that would be non-exclusive. In a neighboring village, the ICP mentioned that there are several families that have a card that works similarly to a caisse at the CSPS. They give 10,000 CFA to the CSPS to be used only for their family and each time a family member visits, they simply write it on the card. That way they do not have to pay each time they come in, because they have paid in advance. The CSPS also gives them a subsidized rate for paying in advance, so in the long run, health care works out to be cheaper and the 10,000 CFA goes to cover a lot more than it ordinarily would.

The strategy listed in the Microplan to increase frequentation of services at the CSPS is simply “sensibilizations.”

COGES: Although I have referred several times to my COGES president, I am sad to report that the COGES of Saouga is only marginally functional. There are 5 members, all male, and I have only met 4 of them in my 3 months in Saouga. One lives in Saouga, meme, and the rest only come in on marche days from their respective satellite villages. All of the members have held their positions since the COGES formation in 2002 and there has been no talk of a new election. The only activity COGES members are involved in, and even then it is only 4 out of the 5, is the mandatory meeting that takes place the first Tuesday of every month. This meeting is generally just a synopsis by the ICP of the previous month’s activities at the CSPS and adjourns quickly so that members can go to the marche.

Despite the lack of functioning of the COGES as a whole, the president seems to have a strong sense of his role as a liason between the CSPS and the community. He has been very helpful in scheduling the sensibilizations that I have done so far and assures me that he will help with any activities I want to plan in the future. In fact, I work more with the COGES president than with my counterpart because his relationship with the villageois is much more positive.

VI. Perceived Village Needs

Aside from the simple information collection I have already explained, I wanted to find out what villagers themselves thought of as their priority problems (ie: what they might actually be willing to work on). I called a meeting of 30-40 members of the CVGT, several women included, to discuss their perception of their own needs. We brainstormed several areas that are a good place to begin work on secondary projects aside from health sensibilizations.

The number one problem determined by the villagers themselves is the inaccessibility of the village and of health care in general because of the previously mentioned sand pit that fills with water. The next four, in order, are: lack of educational opportunities for children (even the very few kids who make it past the 6th level in Saouga rarely have the means to continue to secondary school in Gorom); the lack of water or difficulty in finding it, especially for people living on the periphery of the village and for everyone in the months right before the rains start; the lack of opportunities for women in terms of commerce; and the lack of credit for village organizations trying to undertake projects.

The villagers came up with several other problems, but these top five give me a good place to start, and at least an idea of what they might be motivated to work on. The number one problem of the large sand pit proves to be something that stunts development in all areas: health, economic activity, etc, so this is what I am hoping to begin to work on.

Friday, October 24, 2008

The mirror has three faces

This week my wedding dress arrived. The best way I can describe the feeling of seeing it and trying it on for the first time: sheer glee. After a moment or two, the glee gave way to pragmatism, and I began the inspection that any female undertakes when trying on an article of clothing. I tend to do this without much ado when trying on jeans or sweaters or everyday items, but for such a momentous purchase I scrutinized. I turned, shifted, stood up straight, slouched, tugged, lifted, and craned my neck to see my dress from every angle. A kind woman in the boutique complimented me on my choice, and I politely smiled and thanked her, and promptly continued about my dress vetting.

I love, cannot emphasize this enough, love my dress. But this did not stop me from criticizing my appearance in it. I cursed my love of fine cheese and wine, harangued myself about my frequent trips to Chelsea for my favorite Mexican food, and damned the falafel stand close to the library that is amazing post-studying. "Why must I love food so much?" I lamented, as I vowed to cut back in the remaining months before the wedding.

This week, in addition to being my "week of the wedding dress", also happens to be a week of fun-filled events hosted by the Action Center to End World Hunger, which is celebrating its official opening this week in Battery Park City. The opening was intentionally scheduled close to the UN Food and Agriculture Organization's World Food Day on October 16th, which brings attention to issues of hunger and poverty worldwide. As an NYU student, I am bombarded with emails about events around the city related to my field, so I heard about the Center's opening and registered for a couple events.

The first event happened to be a comedy show. The notion that you have to suffer a bit to do something good for humanity, or that if it is fun it is not philanthropic is completely false. It was a wonderful event - we laughed, socialized, and raised a ton of money to assist hungry and impoverished people around the world. A number of entertainers from Saturday Night Live provided the comedy acts for the night: Seth Meyers, Horatio Sanz, Rachel Dratch, and that guy who does MacGruber...what is his name? Anyway, the main reason I decided to go (aside from the cause) was because Chevy Chase was the headliner. As a child who watched the Griswold family trek across the country, weathering storms, accidental death, and other mishaps, only to arrive at a closed amusement park where a furious Clark punches Wally the Moose in the schnozz approximately 1,452,897 times, seeing Chevy Chase was an event not to be missed. For readers who have never seen this film, it is called National Lampoon's Vacation and it is also not to be missed. Classic.

So we stood in a packed hall and watched the SNL cast, psyching ourselves up for the real humor of Chevy Chase later in the show. After about an hour and a half, he finally took the stage. The crowd went crazy, cheering, whistling, I even heard giggles of anticipation of future laughter. He walked to a podium, removed a few pieces of paper from his jacket, put on a pair of eyeglasses, and began to speak soberly into the microphone. His speech started out with a few statistics about world hunger. Some people, caught off guard, thought it was part of an act and began to laugh and cheer. But Chevy Chase looked up, seemed surprised even, and said "No, no...just listen." He cited a statistic that I have heard and read before, but it is still shocking every time I hear it: 1.2 billion people live in extreme poverty, earning below $1 a day, unable to properly feed or care for themselves or their family. 1.2 billion. It is a daunting number. Mr. Chase compared this statistic in a way that I had not heard: this is three times the population of America. Imagine every single American living below one dollar a day. Then imagine adding 300 million more Americans. Then 300 million more. It is unfathomable to think of this many people living in such abject poverty, yet it is reality.

Though Chevy Chase eventually did provide the comedy we had come to hear, I have an enormous amount of respect for him for remembering the reason the event took place, and reminding all of us, too. It may not be typical comedian behavior, but it is socially responsible and commendable behavior.

The second Action Center Opening event I attended was a panel discussion with representatives from the UN's World Food Program, Professors from NYU, the Food Bank for New York City and, the person who drew me in to the event, Nicholas Kristof. If you have not read him, his column appears every Sunday and Thursday in the New York Times. He writes eloquently and passionately about current affairs, mainly those taking place in developing countries. His prose transports you to these poverty stricken areas and forces you to look the problems squarely in the face. He introduces you to people who live in conditions that you likely cannot imagine, and makes it impossible for you to just write those problems off as inevitable or too distant to care about.

Because Kristof was the "big name" of the panel discussion, I had to listen to several other speakers before his turn. Unlike the comedy show, however, I found myself not simply waiting for the headliner to come out, but becoming deeply involved with each speaker's presentation. The first person to speak was from the Food Bank for New York City. I know that there are hungry people in New York City; I pass them every day on my way to work, sometimes sit next to them on the subway, and generally avoid eye contact with them at all cost. I feel absolutely horrendous about doing this. I wish there was something I could do, but aside from handing over my carefully packed lunch, or giving them money, I am at a loss. The Food Bank actually does something more productive than both of these things.

The Food Bank recently passed its 25 year mark in the city fighting hunger. This is not a milestone that they are happy about. The representative said that when they began the Food Bank, they had hoped that it would be a simple short-term solution to a hunger problem, but they have continued to exist because there is a desperate need for it. A statistic from 2007 showed that 1.2 million people in New York City relied regularly on the emergency food aid they provide - this is a number that has increased by 24% since 2003, and has likely increased again over just the past year. More people are going hungry than ever before. The cost of food, already high in New York City, has increased by 20% in just a year, but wages have not risen to match. The representative said that we have to do something to address this before the problem becomes a crisis, but policymakers do not seem to pay sufficient attention to the marginalized. They sit next to them in the subway and avoid eye contact...

The Food Bank representative also mentioned a term I had not heard before, but makes a lot of sense: food poverty. It is important to note that hunger, in most cases, is not a result of a shortage of food, but of poverty and inability to access food or provide food for your family. This is a very important distinction, as it lends itself to solutions that may have nothing to do with food.

The next speaker was the former Director of the World Food Program and she spoke about hunger on an international level. She described three "answers" to hunger typically provided by the international community. One is food aid: most of this typically goes to war-torn countries and the US actually does this quite well. However, food aid is really only appropriate in a crisis situation, like a conflict or a natural disaster. Constant food aid can lead to dependency and dimishing incentives to grow their own food, as exemplified by the case of Ethiopia. In accordance with the implications of solution number one, solution number two is basic agricultural development: teaching people how to grow their own food so they do not need to rely on food aid, or on imports. Despite the preeminence of agriculturalist societies, most developing countries are net food importers because subsidies abroad make food from the Western world actually cheaper than their homegrown food. Though developing countries may have a competitive advantage in terms of land, their agricultural infrastructure does not come close to rivaling the West, and this is something that needs to change in the future; all countries must have the power to feed themselves. Solution number three is educating girls and women: 80% of the farmers in Africa are women, and those who spend their days farming do not have time to invest in an education. Developing countries cannot afford to leave more than half of their populations uneducated. Combatting food poverty, and poverty in general, requires investing in education...and not just for the males of the family.

I greatly respect the World Food Program; for all its flaws it does actually manage to get food to some of those who need it. Remember my "The road to the Sahel is paved in good intentions" blog? It has some first hand observations of the impacts of PAM (Programme Alimentaire Mondiale, or World Food Program) on my small village in Burkina Faso. After the panel discussion, I took advantage of the opportunity to talk with the representative about some of my concerns for the future of WFP programs. She had mentioned the importance of food aid, but did not discuss the implications for those reliant on it in the face of the current economic crisis that will certainly have a negative effect on foreign aid. Though food prices have finally begun to drop again from their spike in early 2008, the freezing credit market will still severely limit the availability of funds for poverty alleviation in developing countries. I told her that I agreed that agricultural development is a long-term solution, but in the meantime, what is being done? Does the WFP have a back-up plan when rich country donors slow down their support? She shrugged apologetically. "The only answer I have for you is the same old thing. We need to do more." Though it was not a satisfying answer, to say the least, I do not blame her for this, I only wish there was something more to be done.

After a couple more panelists who were interesting but unremarkable for my purposes, Nicholas Kristof had his turn to speak. I was extremely pleased to find out that his amazing ability to captivate in his writing translates well into his public speaking. He has travelled extensively throughout regions many people have never heard of or could not even imagine if they had heard of. He has spent time in refugee camps in Darfur, witnessed the atrocities committed in the Democratic Republic of the Congo, attempted to liberate teenage prostitutes in Cambodia, and has shared all of these incredible experiences with his loyal following in the West. These experiences also expose him to some of the deepest poverty and extreme hunger cases on the planet, which is why he was speaking at such an event.

Kristof said that through these experiences, he has come to understand that there are "three faces" of hunger and extreme poverty. The first of these, which has haunted me, is that it is expressionless. It literally takes too much energy for people who are dying of hunger to display emotion. They do not smile, they do not laugh, they cannot even cry in pain. He described walking through a refugee camp and children barely batted an eye at the strange white person. I drew a comparison between his description and my own experiences in West Africa. In my time there, I saw many malnourished children, to be sure, with swollen distended bellies, brittle and broken patches of hair, and tiny bony little arms with not an ounce of fat. But in most cases, these children still could not contain their excitement about seeing a foreigner; their eyes would light up as they began to yell "N'sarah!" or "Obroni!" or "Tubaku!" To think of these children not being able to register excitement, or fear, or anything is heartbreaking.

Hearing Mr. Kristof describing the void of emotion reminded me of an experience I had early on in my time in Burkina Faso, an experience that I sometimes wonder if I dreamt or sometimes forget about all together. It was a trip to a hospital for malnourished people in Ouahigouya, one of the larger cities. As callous as this may sound, I try not to think about it much, and it is only when something triggers the memory that I allow myself to remember it. It was a somber, depressing, painful experience. We were led through various wings, and introduced to patients, mainly women with arms that seemed they would snap if they tried to lift themselves. There were also tiny skeletal children laying motionless on beds, hooked up to IVs, staring blankly, seemingly not even noticing us. This was the one place in Burkina where the presence of strangers did not seem to matter. It was a hospital full of, as Mr. Kristof described, the expressionless face of extreme poverty and hunger.

The second face of extreme hunger is filled with skin rashes. This was another thing I noticed at the hospital for the malnourished. When a person is slowly starving to death, their body develops many ailments as their immune system shuts down. The skin rash is one of these ailments.

Mr. Kristof's third characteristic of the face of starvation is that it is female. In an earlier posting, "The Third Gender", I described that in traditional societies, it is always the women and children who eat last. Though they often work the fields to grow the food, harvest the food, and prepare the food, they reap the least amount of benefits from the food. This is why part of the solution to combat hunger worldwide must be to empower women. Though men also starve, women are the most deeply affected by poverty and hunger.

The events of this week were a glaring reminder to me of how crippling extreme poverty can be and how important it is to remember how fortunate I really am. It was a reminder of those three faces, three human faces, that I have seen firsthand, and those three faces that so many people will not look in the eyes. The expressionless face of starvation will never be overjoyed at the arrival of a dress. The face of starvation suffering from horrible skin rashes will never be eager to try on clothing. And the female face of starvation will never stand in front of a mirror in a fancy gown wishing that she had eaten less.

I am not saying that I am not allowed to be ecstatic about my wedding, or that it is not normal for me to stare scrutinizingly at my reflection in my wedding dress. But I must remember to keep all of these things in perspective. While I curse food, others have none to eat, let alone to curse. I know that it is relatively impossible for me to understand their plight, or to empathize in any real way...this is why it is so hard to look these three faces in the eyes. But they must still be considered.

Friday, October 10, 2008

Bleeding Hearts...and bank accounts

A basic principle of economics dictates that people primarily respond to incentives. Helping others is nice and all, but the question one asks first is "What's in it for me?" This unfortunately explains why so many of the world's problems go unnoticed, unaddressed, and unsolved. There is no fame or fortune to be gained by lending a helping hand to those less fortunate in largely forgotten corners of the world. There is only the warm, fuzzy feeling that you have done something selfless to help fellow man - though, as I have found, sometimes there is not even this feeling to reward your good deed.

Despite the lack of incentives, and in many cases, even disincentives, people still dedicate their lives to the cause of helping others. It is for this reason that I have always had veneration for the non-profit sector. Non-profits go places no one else will, risk their lives in dangerous countries, and deliver food and supplies in harsh conditions, all the while writing grants, begging for donations, and "singing for their own supper", if you will, to ensure that their, largely free, services can continue. They respond not to incentives, but to need. They are an economic enigma.

When I moved to New York to start graduate school, I was immediately drawn to the non-profit world, despite warnings about (very) low pay and long hours. Concerns about paying rent aside, I was thrilled by the idea that I could do something to help humanity while still getting paid (albeit not well). Within a couple of weeks, I had landed a job at a small non-profit working with Liberian refugees in the New York City area.


The first few months were what you might expect at a non-profit. I felt a sense of accomplishment working at such a selfless organization and felt both pride and admiration for our work. I also, as you might expect at a non-profit, performed duties that I had never done before, and was arguably unqualified to perform, simply because they needed to be done and we had no funding to pay a specialist. I took on the role of grant-writer, bookkeeper, human resources department, capacity building consultant, and even mover when the organization needed to relocate. At times, I took on the role of social worker, assisting in providing direct services to refugees (something that could potentially create, yikes, legal troubles) again, simply because it needed to be done and we had no funding to pay someone to do it.


I was alarmed to witness all of the difficulties faced by refugees in America - from issues related to general poverty to deportation notices to a need for basic health care - it is no wonder that high blood pressure was rampant in the community. Seeing everything firsthand proved to me that there was definitely a need for a space like ours to help. It did not take long for me to notice, though, that even though the organization was perceived as needed within the community, we had a very hard time maintaining our ability to operate. The few employees we had were so busy trying to maintain a semblance of infrastructure that it was difficult to focus on the primary purpose of the organization.


Fortunately for both us and the refugee population, we had several collaborating non-profits that used our space to provide free legal assistance, health screenings, food pantry services, and youth activities. These organizations comprised the majority of our programming, providing invaluable help to both us and, more importantly, to the refugee community. Unfortunately, their ability to assist is limited. Their loyalty and obligation lies first with their own organization and any assistance they provide to us is secondary. However, without these collaborators, there is simply no way that we could accomplish what we are trying to. There is neither the manpower, nor the funding. Even with the extra help they provided in terms of programming, it felt at times like a constant struggle just to keep the organization afloat.


This case at our non-profit points to a larger issue in the non-profit world: the need for greater and more tangible collaboration. Every non-profit wants to be original; everyone with an idea wants to be a director. Where's the entrepreneurial spirit in joining up with an existing non-profit when you can just create your own? The problem is that it seems that organizations could be much more efficient if they worked together instead of vying for the title of "Best Non-Profit" in their field. With respect to the organization I worked for, there were several non-profits on the ground already, performing similar tasks, and rather than trying to join up with them, the directors created a brand new organization. I admit, the organization did have an advantage in terms of location; it filled a void left by other non-profits in the area in being directly on-site for the refugees in the neighborhood. However, my novice opinion is that the organization could have been more effective as a branch-off of an existing organization - the location could have been the same, but simply done under a different and recognized name. The countless hours currently devoted to administrative, managerial, financial, and fundraising duties would be the responsibility of a well-established parent organization, allowing the founders to focus on what they were trying to do in the first place - assist refugees.


Without a parent organization and parent staff performing these essential functions, we had to rely on others to do the work that we wanted and claimed to do, because we were simply too busy drowning in paperwork to perform it. My role was to assist in capacity building, developing new programs and finding ways to improve existing ones. Instead, I ended up paying bills, balancing the checkbook, dealing with non-profit legal issues, and desperately seeking funding. I spent the majority of my first few months working on grant proposals to secure operational support, without which, we could not pay the bills, let alone our staff. When (Hallelujah!) funding was secured, I spent the majority of my time drafting and submitting reports to funders, tracking spending, and trying to stay within strict funding guidelines.


It must be noted that flexibility is not typically a characteristic of grants. When you request funding for a specific purpose, funders expect you to spend it only for that specific purpose and to provide documentation proving that you did what you said you were going to. It is not necessarily convenient, but those are the rules, and in order to be a successful non-profit, you have to follow them. Consider the similar situation of getting a loan from a bank (albeit one that you do not pay back) - if you say you are building an ice cream shop and instead use the money to go on a shopping spree for cars or clothes, you will likely not get any more loans. And you will even more likely get into trouble.


I paid close attention to the rigid grant regulations, carefully monitoring every check I wrote for the organization, scouring the bank statements for discrepancies with our grants...It did not take much scouring before I noticed discrepancies.


Thousands of dollars in office supplies, books, office repairs and upgrades, a new phone line...it seemed others were not monitoring the grant monies as closely as I was. I made a point of mentioning "You know that those monies are for *xyz*, not for *abc*, right? We have to be careful about that or they will take away our funding..." And "Hey, maybe this upgrade should wait a while until we have specific funding for it...?" And "If you purchase something that is 'related' to the organization, you have to have a receipt for the funder. And it cannot be a receipt from an unspecified restaurant..." All to no avail. Funds flew out of the organization faster than you can say "Account Overdrawn."


Non-profits are sometimes accused of corruption and mismanagement - not every non-profit is full of bleeding hearts and helping hands. Like any other industry, there are bad apples. One specific study showed that an estimated 13% of non-profit funds go to fraud and embezzlement. These are the donation environments in which our funders operate, so it is no wonder they are strict about their funds. You can imagine my concern about trying to report these numbers to them.


Environment aside, in the case of this organization, I genuinely do not believe that the funds were being embezzled, or used for extravagant purchases unrelated to the organization. I know that the people I worked with badly wanted to help the refugee community we were working in. But it seems the euphoria of receiving so many grants at once led to extremely irresponsible spending. As much as I nagged about "Please be careful about spending!" the words seemed to fall on deaf (or euphoric) ears. The behavior may not have been ill-intentioned, but it will inevitably lead to ill consequences.


This situation might have been avoidable. Though no organization is perfect, there were other non-profits functioning in the area, and even in the specific capacity we attempted. It is wonderful for people with great ideas and willingness to help to be involved in non-profits. But not necessarily to start new ones..."too many cooks in the kitchen" if you will. More specifically, cooks that may have great ideas for meals or great tastes, but not know the intricacies of the kitchen well enough to function effectively. Perhaps collaboration at the start could have potentially offset these current financial troubles. But perhaps not. There is no way to be certain.


What is certain is that if these sorts of behaviors continue, the organization will not survive. As you can likely tell from the past-tense language, I no longer work there. It is obviously in part, but not entirely, due to the messy financial situation. I strongly believe in what they are trying to do, and sincerely hope that they can pull it together, for the sake of the organization. But more importantly, for the sake of the refugee community they are trying to help.