Month: July 2013

Poverty alleviation and healthcare need more people, not more technology


Atul Gawande writes eloquently, about why certain advances are taken up very quickly. and some aren’t. Seven pages of crisp prose full of stories, examples and personal experience mixed with science later, I (re)learned a couple of important lessons.

via Atul Gawande: How Do Good Ideas Spread? : The New Yorker.

 

One

This has been the pattern of many important but stalled ideas. They attack problems that are big but, to most people, invisible; and making them work can be tedious, if not outright painful. The global destruction wrought by a warming climate, the health damage from our over-sugared modern diet, the economic and social disaster of our trillion dollars in unpaid student debt—these things worsen imperceptibly every day. Meanwhile, the carbolic-acid remedies to them, all requiring individual sacrifice of one kind or another, struggle to get anywhere.

The nature of the problem being fixed is important. Issues not immediately apparent to human perception, and which require human behaviour changes to fix are difficult.

We’re infatuated with the prospect of technological solutions to these problems <snip>As with most difficulties in global health care, lack of adequate technology is not the biggest problem. <snip> Getting to “X is what we do” means establishing X as the norm. <snip> To create new norms, you have to understand people’s existing norms and barriers to change.

Two, clearly, inventing new technology/interventions is only second or third in a series of steps needed to actually solve a problem. We often laud the technological aspect, awarding prizes for new inventions and new science, while ignoring the much more challenging human dimensions to changing behaviour and norms.

What would happen if we hired a cadre of childbirth-improvement workers to visit birth attendants and hospital leaders, show them why and how to follow a checklist of essential practices, understand their difficulties and objections, and help them practice doing things differently. In essence, we’d give them mentors.

We are going in the opposite direction. Government spending, especially on hiring people to solve difficult problems over a medium-long term is now almost taboo. Take poverty, for example. Yesterday, there was a report of a groundbreaking study confirming that, contra the billions of dollars spent trying to win the “war on drugs”, poverty is much more harmful to children than their mothers’ cocaine usage. Clearly, Canada has enough money that no one has to suffer from poverty. Yet, my wonderful “heaven on earth” province BC has Canada’s worst child poverty. The BC government is running headlong in the opposite direction, consolidating services, and making assistance services almost impossible to reach.

We know what to do, give people money to live, give them cheap and accessible child care, help people with acute and chronic physical and mental health issues including substance use, and employ people they can talk to and learn from, mentors and more. Take the uncertainty out of their daily lives, take out some of the incredibly taxing daily decisions they have to make every day, and see what happens.

Instead, it is easy politically to spend billions on shiny cars, bazookas, drones, heat sensing equipment, computers, and more for cops to police poverty. My city’s cops ride around in cars that seem ridiculously over-designed given the city’s speed limit of 50 kmph, and Victoria is not even close to being excessive. Yet, it is impossible to spend money on the harm reduction workers that can actually provide the support services people need. We routinely criminalize poverty and hope that we will somehow solve it by harassing people for being poor.

Real poverty reduction starts with giving more money to the poor, unconditionally and non-judgmentally. But it also involves hiring many more people to act as advocates, teachers and mentors for people who will greatly appreciate and benefit from this increased social connection. If we want change, we need more people whose job it is to make the change happen.

 

The India Pakistan Partition in Indian Textbooks

Partition_of_Punjab,_India_1947Via Kafila, Shivam Vij on how India’s National Council of Educational Research and Training (NCERT)’s history curriculum for 12th graders (They publish the entire curriculum on the web for free, read/download) addresses the violence that accompanied India and Pakistan’s independence from British rule (the partition), and its aftermath.

I’m startled to see that a government textbook has progressed so much that it begins talking about Partition with oral narratives, that too from 1992 and not 1947. In one go, it has told 17-year-olds the importance of oral history, introduced them to the idea of Partition as a continuing event and showed them how their own family narratives about Partition have a mirror image across the border. The chapter’s last four pages discuss oral history and its limitations in understanding the past.

What I learned about Partition – The Express Tribune.

Class12 IndianHistory3 Unit14 NCERT TextBook EnglishEditionIndiaPakistanPartition

Read embed here.

Wow, oral histories, neutral points of view, narrative and people-based history, this is definitely not my history textbook. The history I learned in school (10th grade and below) was simplistic, date and event based, and painted Jinnah and the British as caricature villains dividing South Asia on religious lines during the partition. I remember the year the Brits massacred thousands of unarmed meeting attendees in Jallianwala Bagh (1919), not what it led to, and why it happened. Divide and Rule was all you needed to know about the partition.

I really enjoyed reading this more nuanced and sophisticated treatment and look forward to reading more of the curriculum on Indian history, all the textbooks are online for free. Well done, Indian government!

Only Indians choosing the “arts” stream would be exposed to this curriculum. The overwhelming majority of those who take science or economics streams would not see this at all. I wonder what kind of history is being taught to 13-14 year old kids taking required social science courses, hopefully, better that what I was exposed to.

Is BC’s agriculture Minister Pat Pimm a climate denier?

pimmFrom Minutes of Wednesday’s Committee C meeting, to me via Torrance Coste on facebook (can’t link), some disturbing words.

 

N. Simons: Does the minister agree that climate change is human caused?

[D. Plecas in the chair.]

The Chair: Minister.

Hon. P. Pimm: Thank you very much, and welcome to the discussion this afternoon.

The Chair: Good afternoon.

Hon. P. Pimm: I think there are many varying opinions on climate change, and we all have our opinions. I’m sure you have your opinion, I might have my opinion, and I think we’ll just leave it at that.

via Hansard — Committee C Blues — Wednesday, July 17, 2013 p.m..

Very troubling if true. Climate change will have many impacts on agriculture in BC and worldwide and a minister who thinks climate change is a matter of opinion doesn’t belong in positions of power regardless of portfolio.

Stay tuned. I hope this is some kind of transcription error.

School Meals and Child Death in India

Hunger

Like most, I am appalled and saddened by the death of 20+ (and rising) children in Bihar, poisoned by pesticide in their state-provided school lunch. This guardian article has a good run down on the issues that beset the program.

The fear is that attention is being diverted from what is an acute problem in many of India’s state-run or state-assisted schools. While the ruling party in the state looks for excuses, the harsh reality is that food provided to children all over the country is often substandard, and sometimes not even fit for human consumption.

Indias deadly problem with school meals | Kishwar Desai | Comment is free | guardian.co.uk.

What is missing from the analysis is the magnitude of the hunger problem India is trying to solve. It is estimated that over 40% of children are undernourished in IndiaSchool meals have large public health benefits if done right. So it is vitally important that this program work, as this Indian teacher so eloquently details in her blog post.

It’s this absence of monitoring, I believe, that’s sabotaging a scheme that’s helped bring millions of children into school. The scheme was originally envisaged as government-run, but community aided and supervised. In practice, because parents and teachers are both busy, the whole system lacks anyone to ensure hygiene and quality.

The entire post is worth a read.

India reduced its global hunger index by about 24% since 1990. But note that Bangladesh’s percent reductions have been higher. As The Week points out, the last thing you want is for parents to pull their kids out of school because their kids will get poisoned, and for this program to end because it cannot be implemented without poisoning the kids.

What is especially egregious in this case was that the children noticed something was amiss, and alerted authorities, who did not listen. India’s authoritarian school institutions do not abide any feedback from children, especially the children of low/no privilege that attend government schools. Hunger and lack of choice probably played a part as well. There’s also early evidence that the school administrator ignored warnings from the cook about the cooking oil, calling it “home made”.

In the end, like everything else in India, it comes down to institutional quality and money. For all the complaints about excessive “regulation”, programs like Food Safe in BC are designed to ensure that people working with food know how to handle food, what to avoid, and how to identify and prevent dangerous situations. It takes effective institutions to ensure that quality and safety are maintained consistently and the people involved do the right thing most of the time. India’s performance in providing reliable services for its poor is also complicated by vast state-to-state disparities in institutional quality. India’s so called growth has also been top-heavy. People living in villages and the urban poor have not been a part of India Shining (or its new incarnation Bharat Nirman).

Can regulations on food safety, quality and delivery be enforced in the absence of a good monitoring and accountability system? Can India use the money it gets from “developing” to provide better services for its people? It will take time, and hopefully, eventually tragedies like the one above will be less frequent.

Canadian Citizenship Oath in Court, and Royal Baby!

royalbabyA number of Canadian immigrants want the right to NOT swear allegiance to the Queen (of Canada). Their reasons are varied, they don’t believe in a monarchy, they moved from recently decolonized countries where atrocities were committed in the name of the queen, their religion doesn’t permit it, and more. They have lost their case at every step, and the originator of the case, Charles Roach, passed away recently, but they persist, and it is now going back to court. The globe and mail reports rather breathlessly with a heavy handed dose of editorializing. 

But with a royal baby on the way, and a federal government under Prime Minister Stephen Harper that has dedicated itself to reviving the country’s connection to the monarchy – restoring the word Royal to the Royal Canadian Air Force, among other measures – the dissenters may have their work cut out for them.

Would-be Canadian citizens set to fight oath to Queen – The Globe and Mail.

The hilarity of the Globe and Mail thinking that the unborn Royal Baby(tm) has anything to do with a serious court case should be the topic of a much longer rant on the sorry state of this newspaper. More importantly, this is an interesting and brave protest by the litigants.

Here’s the oath:

I swear (or affirm) that I will be faithful and bear true allegiance to Her Majesty Queen Elizabeth II, Queen of Canada, Her Heirs and Successors, and that I will faithfully observe the laws of Canada and fulfil my duties as a Canadian citizen.

The oath is a strange and anachronistic beast that literally puts allegiance to a hereditary, unaccountable set of people who won a birth lottery in front of duty to the country and its laws. It’s completely understandable that some would balk at swearing this oath. Only half of Canadians surveyed in 2012 supported the notion of Canada remaining a monarchy. It seems unfair to ask a set of people to swear to something only half of the country supports. Would the settlers and descendants of settlers who acquired citizenship through birth like their citizenship to be contingent on pledging allegiance to the British (and Canadian) royal family? I don’t understand how it is acceptable to make one group of people swear an oath, while exempting a whole other group of people.

This troubles me: The notion that the grant of citizenship is a one-way privilege, something that immigrants should be so grateful for that they don’t exercise their charter rights to dissent.

“Canadian citizenship is an honour and a privilege,” spokeswoman Sonia Lesage said.

Immigration is a two-way arrangement, one that benefits the people immigrating and the country. Repeated studies show this, so while immigrants are generally happy to become citizens, the country should be equally honoured and privileged that they chose to stay here rather than elsewhere. A country ruled by the descendants of those who colonized by displacing the original inhabitants of this land through force, spreading disease and attempted assimilation should be more humble in its pledges. It is especially troubling to hear this one-sided understanding of who is privileged by immigration coming from a country with this history.

I swore my oath sincerely because for me, the benefits of being a Canadian citizen outweighed my distaste for the monarchy. As a recent immigrant and recent citizen, my desire to stay socially engaged, commitment to acting for change, and being the best family member, partner, friend, coworker and activist matter way more than an anachronistic pledge, and those are the standards I would want to be held to.

Update: An interesting article on how close PM Chretien came to scrapping the oath and making it something more meaningful.

More Update: My partner pointed out in conversation that the citizenship ceremony’s focus and tone were quite the opposite of all this honour and privilege language spouted by the conservative government mouthpiece. Multiple speakers specifically talked about how happy and lucky the country was to have us become citizens,and how much the country would benefit. They also talked about responsibility and civic engagement, which is as it should be. Multiple speakers specifically acknowledged our presence on Lekwungen and Coast Salish homelands.

Princely Privilege

I recently became a subject of the British (and Canadian) Royal Family, so I guess I should start taking interest in their affairs, as it were. This made me laugh (emphasis mine).

The attorney general said there was a risk that the prince would not be seen to be politically neutral by the public if the letters were published.

“This risk will arise if, through these letters, the Prince of Wales was viewed by others as disagreeing with government policy. Any such perception would be seriously damaging to his role as future monarch because if he forfeits his position of political neutrality as heir to the throne, he cannot easily recover it when he is king,”

Prince Charles’s letters to ministers to remain private, court rules | UK news | guardian.co.uk.

CharlesApparently, writing 27 letters about political issues (in bad handwriting, oh, the shame!) in an attempt to influence policy makers is okay. However, if the public saw them, it would not be okay, so we can’t see them.

I would like to use this defence next time I am a scofflaw.

Officer: I am going to give you a ticket for riding on the sidewalk.

Me: But Ma’am, if you do so, there’s a risk that I would not be seen to be law abiding by the public!! Any such perception would be seriously damaging to my role as future bicycle policy maven!

Officer: Yeah, that makes sense, have a good evening!

Me: Woohoo!

In all seriousness, I think the royals should use their enormous bully pulpit to champion important issues. They should be talking about climate change. They should be lobbying zoning boards! But, they need to do it out in the open just like their subjects.

Image of the prince of Wales used with thanks from Rizzato’s flickr stream under a creative commons licence.