Archive for October, 2012

Friday photo: Wenchi Crater Lake

Wenchi Crater Lake is a long-ish day trip from Addis Ababa. The former volcanic cone is filled with a lake and hiking trails, and there’s even a monastery on an island in the middle of the lake. Here’s a panorama shot from near the top of the trail, made from five photos stitched together (click for higher resolution):


10 2012

On efficiency

A friend of mine who is working in public health in a South American country writes great email updates about the specifics of her work, which often end up illustrating something universal. I thought this note — about the latest delays in accomplishing a relatively simple task that has taken weeks when it should have taken hours, or maybe half a day at most — nicely illustrates how much time can be wasted through the accumulation of minor inconveniences or annoyances. No single act is backed by poor intentions, but the final effect is that no one can get much done. Shared with permission:

Today’s visit to the Municipality of […] was particularly silly.

It went like this: I arrived at 10:45am and went to the Budget Office. The Budget Office sent me to Provisions Office, which sent me back to Budget Office, which sent me backed to Provisions Office accompanied by a secretary.

The Provisions Office sent us to the Head Administration Office, which sent us to a different Administration office on a different floor, which sent us back down to the Provisions Office, which sent us back up to the Administration Office, which sent us back down to the Provisions Office. This all took an hour.

Then, I waited in the Provisions Office while they looked for the resolution that was supposed to be attached to my project, and they all blamed a different secretary in the office for why they couldn’t find it. After an hour of waiting in the Provisions Office, I got tired and hungry and had to pee, so I made up an excuse for why I had to leave and I asked when I should come back and where I should go.

They told me to come back in two days, which is what they always tell me. So, I’ll go back in two days.


10 2012

Friday photos: Meskel

Last week Ethiopia celebrated Meskel, a major holiday that commemorates the discovery of the “one true cross” on which Jesus was crucified. Meskel Square in Addis is the place to be — “meskel” means cross in Amharic.

Orthodox priests and actors surround the cross (yes, the thing that looks like a Christmas tree to American eyes):

Everyone brings candles, and at dusk they’re lit in a slow wave moving across the square:

The roar of the crowd grows until the cross is lit:


As the fire dies down the crowd scattered — but this drumming and singing circle stuck around for quite a while:


10 2012

Bad pharma

Ben Goldacre, author of the truly excellent Bad Science, has a new book coming out in January, titled Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

Goldacre published the foreword to the book on his blog here. The point of the book is summed up in one powerful (if long) paragraph. He says this (emphasis added):

So to be clear, this whole book is about meticulously defending every assertion in the paragraph that follows.

Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects. Regulators see most of the trial data, but only from early on in its life, and even then they don’t give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion. In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, colleagues or journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are even owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all. These are ongoing problems, and although people have claimed to fix many of them, for the most part, they have failed; so all these problems persist, but worse than ever, because now people can pretend that everything is fine after all.

If that’s not compelling enough already, here’s a TED talk on the subject of the new book:


10 2012

Monday miscellany


10 2012