Friday, August 29, 2008

After a summer of clicking my heels together occasionally after multiple days of rice, beans and greens, conversations with non-english speakers and more bugbites than I could ever dream to count, I'm finally back in New York City. (Sadly?) I'm not sure that my life in New York is so exciting that all of you would care to read about it once or twice a week.  

Monday, August 11, 2008

That sounds about right

It is my newfound use of this phrase that inspired someone I work with to inform me that I'd officially been working in South Sudan for too long. It's a phrase that conveys agreement, while at the same time expressing a disinterest in any sort of precision relating to what you're talking about because whatever it is is the norm to such an extent that it isn't questioned. For instance "My flight hasn't started boarding and we were supposed to leave an hour ago" "That sounds about right", or "We're out of tea and there are ants in the sugar" "That sounds about right" etc, etc.

So the question then becomes whether the phrase is an expression of complacency on one hand, or an understanding that nothing can be expected to work perfectly here, so that close enough is often your best choice. I'm not sure to be honest. There's a great song that begins with "One of my friends taught me the most glorious lesson, that in this life there is no need to ever be complacent." If complacency is "smug and uncritical satisfaction with one's self or one's achievements" then perhaps the sentiment I've described is the opposite of complacency. It is the recognition that no matter how hard or long you work, there is so much to be done here that it feels like you're wading through waist-deep mud no matter what approach you take. For instance, Unicef distributes drug kits to organizations that support Primary Health Care Centers and Primary Health Care Units. These drug kits contain all the basic medications needed to diagnose and treat basic diseases, and without them the health centers are essentially impotent. So after months of organizations informing Unicef that stocks were getting low, the kits were finally delivered. All at once. All in Juba. So now you have literally thousands of tons of drugs sitting in NGO compounds because the drugs are, in fact, mostly needed in the field, not in Juba. But the roads are terrible and hiring a charter to fly your tons of drugs out to your site (if your site has a landable airstrip) is incredibly expensive. The UN Humanitarian Air Service (UNHAS) has kindly donated 80 hours of flight time a month to INGOs for shipping supplies. But they won't take anything of this weight or bulk. So Unicef distributed life saving medication in such a way that no one is using them and the medication is sitting on shelves slowly moving towards its expiration date? Sounds about right.

There are many more humorous examples of how this phrase is applicable to daily life here. For instance, " This beer is warm" "Ahh sounds about right", or "There's a goat giving birth outside our front door", "Yup, sounds about right". If nothing else, it just goes to show you how much you can get used to, some of that is positive - like not being phased by everyone you meet saying "morning" regardless of the time of day. On the other hand a friend of a friend told me a story the other day about being asked to name three pivotal events of the past week, one of which was having an AK-47 held uncomfortably close to his temple at a traffic stop. Rather than being frightened or vowing to get out of Juba, he began asking his friends how many lbs/inch of pressure it takes to fire an AK-47, so that the next time it happened he would better be able to gauge how close the finger on the trigger was to firing the gun. That's not normal. But normalizing things that would ordinarily offend, scare or repulse you is part of life. Rats darting out from underneath giant piles of trash is normal in New York City, goats tiptoeing among piles of burning trash is normal in Juba.

Many people have asked me what it's like here, they want to know details about everything from the day to day to the extraordinary. And even after two and a half months I still stand by my original assertion that it's not all the different from many other places I've been. Manhattan it's not, but then again nor is it a place that would be beyond the imagination of anyone. So either I am particularly adaptable, or the world is smaller than we've all been led to believe.

Wednesday, August 6, 2008

A numbers game

It is easy to become accustomed to the contradictions present every day in Juba. Then all of the sudden I remember I'm not only in Africa, but am also in one of the least developed countries in the world, with what is estimated to be one of the highest maternal mortality rates and infant mortality rates in the world. It's estimated because no one has concrete or reliable statistics, and sadly the statistics that do exist must be negotiated with the government before they can be made public. I've been slowly coming to the conclusion that, of the things I have learned so far in school, some of the most valuable have been from stories I've heard from professors or other students. Not that learning the meaning of p-hat and the difference between specificity and sensitivity isn't useful. They are (hopefully) what will help me get a job upon graduation. But it's the stories and experiences in countries, often terrible and heartbreaking, that have really stayed with me.

For instance, to paraphrase a particularly poignant one, we had a professor who works in nutrition and only taught one class but told a story about working in the earthquake in Bangladesh many years ago. He was given a week to lead an assessment of the housing and nutrition status of the entire population to determine the need for aid in the immediate aftermath of the disaster. The only way to access many of the areas was by helicopter so he and a team of surveyors would drop into entirely isolated locations, do a rapid survey and get pulled out again. At the end of the survey they estimated that (I don't remember the numbers here, so these are just examples) 2/3 of the population did not have adequate housing. They determined whether housing was adequate by the presence of walls and a roof, as long as the basics were present to protect people from weather it was thought to be enough. He brought this data back to his organization and they looked at it and saw they simply couldn't meet the need, there wasn't enough money or staff. So rather than let everyone see that the organization was underfunded and couldn't help all the people who needed it, they insisted he change his definition of adequate housing to anything that provided shelter from rain, ie a tarp, a house where all the walls have fallen down that the reports about the disaster that came out of Bangladesh claimed that 1/3 of the population was in need of support.

When you think of it as simply shifting a few numbers on a spreadsheet, it doesn't seem like such a hard thing to do. But when you consider that you're deciding that tens of thousands of people won't have access to shelter and will therefore be more likely to die of exposure and a litany of illnesses, it's shameful. But that is apparently the case with most statistics. I've been told that in some countries infant and child and maternal mortality rates that are reported by many organizations are negotiated with the government before they are released. The rates are decreased or increased depending on whether the government wants to display progress to satisfy one set of donors, or a decline to increase aid funding. It's a sad state of affairs and could make some people lose faith in the nonprofit/aid industry. My reaction is just the opposite. Call me an optimist but I think it can only get better and if nothing else there is a recognition of how important the work of NGOs is, as well as the importance of engaging the local community to make the progress and change sustainable. Sounds like rhetoric to anyone involved in this work, but I actually believe it. And I figure if South Sudan couldn't knock it out of me, maybe nothing will.