I've put together a list of tips and suggestions for travelers, drawing on advice from colleagues and friends. It's geared towards public health or development folks who work in and often travel between low-income countries, as opposed to backpackers, tourists, etc. The document is in Google Drive so I can continuously update it with suggestions -- feedback is appreciated. Another good resource is How to work in someone else’s country by Ruth Stark, which is written with global health consultants in mind, and contains useful packing advice and good general rules for cross-cultural work. Chris Blattman has written quite a bit about this; see especially his posts on air travel, air travel pt 2, packing, and packing pt 2.
Jay Ulfelder, of the blog Dart-Throwing Chimp, recently wrote a short piece in praise of fun projects. He links to my Hunger Games survival analysis, and Alex Hanna's recent application of survival analysis to a reality TV show, RuPaul's Drag Race. (That single Hunger Games post has accounted for about one-third of the ~100k page views this blog got in the last year!) Jay's post reminded me that I never shared links to Alex's survival analysis, which is a shame, so here goes: First, there's "Lipsyncing for your life: a survival analysis of RuPaul's Drag Race":
I don’t know if this occurs with other reality shows (this is the first I’ve been taken with), but there is some element of prediction involved in knowing who will come out as the winner. A drag queen we spoke with at Plan B suggested that the length of time each queen appears in the season preview is an indicator, while Homoviper’s “index” is largely based on a more qualitative, hermeneutic analysis. I figured, hey, we could probably build a statistical model to know which factors are the most determinative in winning the competition.
And then come two follow-ups, where Alex digs into predictions for the next episode of the current season, and again for the one after that. That last post is a great little lesson on the importance of the proportional hazards assumption.
I strongly agree with this bit from Jay's post about the value of these projects:
Based on personal experience, I’m a big believer in learning by doing. Concepts don’t stick in my brain when I only read about them; I’ve got to see the concepts in action and attach them to familiar contexts and examples to really see what’s going on.
Right on. And in addition to being useful, these projects are, well, fun!
Here's a quick digression from global health that I thought might be interesting to to tech-minded folks. nsnippets, a fascinating link blog (found via Blattman) has a post called "China's 65 dollar smartphones" that caught my attention, because I (sort of) have one of these phones. That post is highlighting a Technology Review piece: "Here's where they make China's cheap Android smartphones." And here's more on even cheaper phones.
Before moving to Ethiopia I was stuck in a Tmobile contract that was poor value for money with a glitchy phone. Since I'm only back in the US for about 5 months finishing my last semester of grad school I resolved to get an unlocked phone that I could use in the US or abroad, on whatever network I liked, and at a grad student price. I bought one on Amazon from "China Global Inc." and shipped by some third party directly from China. The exact model isn't available anymore but you can find similar phones by searching on Amazon for "Unlocked Quad Band Dual Sim Android 4.0 OS." It gets some incredible double-take reactions because it looks almost exactly like an iPhone in front, but on the back it has the Android logo and just says "Smartphone":
It cost just $135, and I use a $30/month prepaid plan (also Tmobile) with 100 minutes of talk (which is about right for my usage), unlimited text, and unlimited data -- and I'm not locked in at all. My annual cost for this Android smartphone: $495. If you buy an iPhone 5 on Verizon your annual costs are, depending on your contract, in the $920 to $1400 range! I'm sure for some the differences between what I have and a brand new iPhone 5 with 4G (my phone is 3G) are worth $500-1000 annually, but it works for texting, email, search, Twitter, music, games, and so forth -- everything I want.
I can't imagine that everyone with the latest smartphone actually 'needs it' -- in the sense that if they knew there were good alternatives they would think the difference is worth the value. American phone plans are generally incredibly overpriced, leaving you stuck in a cycle of buying premium products -- which are nice -- but ironically being locked into keeping them until they're well past premium. I think what is happening is that as long as most of your friends have high-priced phones with expensive contracts, that's the norm and the price seems less absurd.
The weekend is almost here, and the new year -- so how to celebrate? For a start, here are the results of a mashup meme I tried to start last night on Twitter: #MiddleEarthPublicHealth: https://storify.com/brettkeller/middleearthpublichealth
If the Storify version (which shows all the tweets) doesn't work, you can search on Twitter for the #MiddleEarthPublicHealth hashtag.
In lieu of observations about Ethiopia, notes from my work here, or discussion of recent news/articles/links, here's a picture of the books currently occupying my time at work (fascinating, I know):
Tomorrow I'm off to Mek'ele, the capital of Tigray region in northern Ethiopia, for work for about a week. If you have blog withdrawal in the meantime, I share links to maybe 5-10 articles or blog posts each day on Twitter.
Power outages in Addis -- at least in my neighborhood -- are short but still more or less a daily occurrence. At the office we have a generator that kicks in, but at home I like to think of these outages as "podcast breaks." Here are two I listened to recently that are particularly worthwhile, even if your power is on:
- Planet Money has a nice, non-technical summary of Oregon's randomized Medicaid program. (Previous post on the same subject with more technical details here. Recent NYT coverage here.)
- Ira Glass spoke in Princeton earlier this year, and he discussed how This American Life has been moving towards more investigative reporting -- they brought down a lousy judge in Georgia, for example. Their latest investigative installation is incredible: What Happened at Dos Erres tells the true story of the long-lost survivor of a massacre in Guatemala that wiped out an entire village. It's a great use of a human narrative to make you care about an important but disturbing story, from the role of the US in that era of Guatemalan history to the role of the investigations in modern Guatemalan politics. The reporting was done in tandem with ProPublica, so there's an excellent prose version you can read here.
(They've also shared some updates on the story here.)
In the language of the Tuvan people, khoj özeeri means not only slaughter but also kindness, humaneness, a ceremony by which a family can kill, skin, and butcher a sheep, salting its hide and preparing its meat and making sausage with the saved blood and cleansed entrails so neatly that the whole thing can be accomplished in two hours (as the Mongushes did this morning) in one's good clothes without spilling a drop of blood.
That's from this National Geographic article, which analogizes lost linguistic diversity to lost biodiversity. Here's the kind of knowledge we might lose:
Smaller languages often retain remnants of number systems that may predate the adoption of the modern world's base-ten counting system. The Pirahã, an Amazonian tribe, appear to have no words for any specific numbers at all but instead get by with relative words such as "few" and "many." The Pirahã's lack of numerical terms suggests that assigning numbers may be an invention of culture rather than an innate part of human cognition. The interpretation of color is similarly varied from language to language. What we think of as the natural spectrum of the rainbow is actually divided up differently in different tongues, with many languages having more or fewer color categories than their neighbors.
It's a busy time of year: this week I'm prepping for a day-long comprehensive exam that covers the core classes at the Woodrow Wilson School, with sections on politics, economics, statistics, and psychology. Next week I'll be starting my actual final exams. And on June 1st I travel to Addis Ababa, Ethiopia, where I'll be working through January 2013. (More on that soon, once I figure out how much - if at all - I'll be blogging about my internship there.) So expect few new posts, other than a couple that are already queued up. In the meantime, here are two papers that I have not yet read but that should both prompt a lot of discussion amongst health and development folks:
Gabriel Demombynes and Sofia Karina Trommlerova, in the World Bank's Kenya office: "What has driven the decline of infant mortality in Kenya?" And here's a discussion of the paper by Michael Clemens at the CGD blog: "Africa’s Child Health Miracle: The Biggest, Best Story in Development." Clemens and Demombynes previously coauthored some excellent work criticizing the Millennium Development Villages' evaluation efforts.
And speaking of the Millennium Villages, Jeff Sachs writes in the Huffington Post: "Breakthroughs in Health in the Millennium Villages." He's highlighting a new study in the Lancet by Sachs, Paul Pronyk, and a number of other authors with this long title: "The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment."
No time to read these now, but I imagine they will paint very different pictures of what is going on with child health in Africa, using different methodologies, and offer contrasting solutions -- I'm looking forward to reading them in the weeks to come and seeing if either paper moves my priors.
How did Phantom of the Opera get to 10,000 (!) Broadway performances? Patrick Healy reports (NYT):
From years of detailed audience surveys, the producers and creators of "Phantom" have honed the ways to maximize its appeal, whether emphasizing the show’s love story in advertising or offering sharp discounts so audience members will return. More than 40 percent of "Phantom" patrons have seen it at least once before, and a majority of "Phantom" audiences in 2011 saw no other Broadway show that year. About 68 percent were women, and nearly 60 percent were tourists.
"Based on all our data, we’re able to predict, for virtually each week of the year, what the demand for seats will be, what types of people will be coming and how to price the seats," said Alan Wasser, the production’s general manager.
One of my classmates drove from Los Angeles to Princeton and set up his camera to take photos along the way. He edited the results into this video:
In his words: "California to Jersey, 5,000+ photos, 2,800+ miles, 45 hours of driving, 0 speeding tickets, 1 driving hero." And yes, they stopped to sleep (though maybe not enough).
Things to watch for include the moon, the palms trees at the beginning, the changes in lighting (including sunrise around 1:40), and how many tractor-trailers they pass. But what strikes me the most is the uniformity of the road system -- the two-lane interstate highway, the road markings, the signs, the road-side stops. As outdated as our transportation system is, it's still a phenomenal public good when you compare it to what came before. It took Lewis and Clark a lot longer and they didn't even go as far.
Charles Mann wrote the wonderful book 1491, a summary of research on the Americas before Columbus, as well as 1493 (which I haven't read yet), a sequel of sorts that takes on the post-Columbus exchange of ideas, tools, plants, and germs. He's also written an article titled "How the Potato Changed the World" (which I imagine covers some of the same material as 1493) in the latest Smithsonian. One of the most arresting sections of the potato article is actually about a forgotten commodity. Today we take nitrogen fixation for granted, but its industrial perfection enabled a massive increase in world agricultural output, and more darkly the use of chemical weapons during the First World War. But prior to all that one of the best source of nitrogen was guano, or bat and bird dung:
In 1840, the organic chemist Justus von Liebig published a pioneering treatise that explained how plants depend on nitrogen. Along the way, he extolled guano as an excellent source of it. Sophisticated farmers, many of them big landowners, raced to buy the stuff. Their yields doubled, even tripled. Fertility in a bag! Prosperity that could be bought in a store!
Guano mania took hold. In 40 years, Peru exported about 13 million tons of it, the great majority dug under ghastly working conditions by slaves from China. Journalists decried the exploitation, but the public’s outrage instead was largely focused on Peru’s guano monopoly. The British Farmer’s Magazine laid out the problem in 1854: “We do not get anything like the quantity we require; we want a great deal more; but at the same time, we want it at a lower price.” If Peru insisted on getting a lot of money for a valuable product, the only solution was invasion. Seize the guano islands! Spurred by public fury, the U.S. Congress passed the Guano Islands Act in 1856, authorizing Americans to seize any guano deposits they discovered. Over the next half-century, U.S. merchants claimed 94 islands, cays, coral heads and atolls.
Read the rest of the Mann potato history article here. A related academic paper is Nathan Nunn and Nancy Qian's "The Columbian Exchange: A History of Disease, Food, and Ideas" (ungated PDF).
And while the idea of this blog post was simmering in my head I came across another piece by Charles Mann in Vanity Fair, this time on air travel security and how so much of it is theater to reassure the public. It's called "Smoke Screening":
Remember the fake boarding pass that was in Schneier’s hand? Actually, it was mine. I had flown to meet [TSA critic] Schneier at Reagan National Airport because I wanted to view the security there through his eyes. He landed on a Delta flight in the next terminal over. To reach him, I would have to pass through security. The day before, I had downloaded an image of a boarding pass from the Delta Web site, copied and pasted the letters with Photoshop, and printed the results with a laser printer. I am not a photo-doctoring expert, so the work took me nearly an hour. The T.S.A. agent waved me through without a word. A few minutes later, Schneier deplaned,compact and lithe, in a purple shirt and with a floppy cap drooping over a graying ponytail.
The boarding-pass problem is hardly the only problem with the checkpoints. Taking off your shoes is next to useless. “It’s like saying, Last time the terrorists wore red shirts, so now we’re going to ban red shirts,” Schneier says. If the T.S.A. focuses on shoes, terrorists will put their explosives elsewhere. “Focusing on specific threats like shoe bombs or snow-globe bombs simply induces the bad guys to do something else. You end up spending a lot on the screening and you haven’t reduced the total threat.”
The MacArthur "genius" grants this year went to -- as always -- some awesomely creative people. It's exciting to see this award given to those you already admire because it's $500k in absolutely no-strings-attached cash; they'll be able to do a lot more of the good stuff they're already doing. One recipient is Jad Abumrad, of the show Radiolab. If you're not already listening to the show it'd be a disservice to just say it's a radio show about science. A better take comes from Ira Glass in this appreciation of Radiolab:
Take the opening of their show on the mathematics of random chance, stochasticity. The first aesthetic choice Jad and Robert make is that they don’t say you’re about to listen to a show about math or science. They don’t use the word stochasticity. They know those things would be a serious turn off for lots of people. In doing this, Jad and Robert sidestep most of the conventions of a normal science show – hell, of most normal broadcast journalism.
Or try the recent short episode "Damn It, Basal Ganglia."
Another recipient is author/journalist Peter Hessler. He's written three books on China: Country Driving (which I haven't gotten to yet) which was preceded by Oracle Bones and River Town, his first book. The best thing about these books is that they convey (as nothing else I've read has) the incredible pace of change in China. Hessler picks and chooses stories and builds them into a narrative arc that would make a novelist weep for joy. In this post-MacArthur interview Hessler says his next step is to learn Arabic in Egypt and write about the Middle East. This bodes well for fans of long-form journalism.
So who will win it next year, or in years to come? MacArthur's tend to go to folks who are decently well-known within their own field, not for being the best at a traditional discipline but for pushing the boundaries of that field in some way. My picks for people who might win in the next 10 years include:
- Jonah Lehrer, science writer extraordinaire. (Proust was a Neuroscientist, How We Decide, blog).
- Sheri Fink (MD/PhD) is a journalist currently working for ProPublica. She won a Pulitzer recently for her reporting on deaths at a hospital following Hurricane Katrina, but I think her best work today is still her first and only book, War Hospital, which tells the story of the people (and half dozen doctors) trapped in the Srebrenica enclave during the Bosnian War. It's incredibly under-appreciated.
- Siddharta Mukherjee, obviously.
- Honorable mention: David McCandless of Information is Beautiful (if he just moved to the US he'd be eligible...)
Who else do you think -- or hope -- might win?
Our lonely little sliver of biosphere on our sole habitable planet (so far) has its limits. But what are they? How can we know? From the September 2009 edition of Nature:
The framework presented is an attempt to look holistically at how humanity is stressing the entire Earth system. Provocatively, they go beyond the conceptual to suggest numerical boundaries for seven parameters: climate change, ozone depletion, ocean acidification, biodiversity, freshwater use, the global nitrogen and phosphorus cycles, and change in land use. The authors argue that we must stay within all of these boundaries in order to avoid catastrophic environmental change.
... But even if the science is preliminary, this is a creditable attempt to quantify the limitations of our existence on Earth, and provides a good basis for discussion and future refinement.
The actual article, "A safe operating space for humanity" is worth a read if you have access. Interesting concept, even if the numbers themselves are incredibly preliminary.
Outer space and rockets were what first sparked my interested in science. My 4th and 5th grade GT teacher, Wanda Holland, taught a summer model rocketry camp for 5th grade science students in my hometown in Arkansas. I went to the camp, fell in love with rockets, and built so many in the next year that Mrs. Holland invited me back as an "assistant" the next year. I kept assisting, then co-teaching the camp through 9th grade and along the way acquired an immense knowledge of mostly useless trivia about astronomy and rocket science. By the time I reached 9th grade I had a collection of hundreds of rockets -- including multiple stage rockets, gliders, scale models, and onboard cameras. I even remember asking a friend once why he would spend money on clothes when he could buy another rocket kit. Needless to say, I was cool. At some point in high school I discovered interests in travel, in playing guitar, in cars, and in girls. Rocketry slowly fell by the wayside. In 10th grade I was building a greater-than-full-scale model of the AIM-9 Sidewinder missile in the family garage (the real thing is 9 feet tall, mine would have been 14'). I had already done the composite reinforcement on the main airframe body tubes when I calculated out how much the construction supplies, avionics, and solid fuel motors would cost, and I realized it would take much more money than my part-time job as a grocery bagger would provide. Then good fortune struck: I won $500 in a regional grocery bagging competition (seriously) which would have let me complete the rocket and buy the fuel to fly it once. But by that point my priorities had shifted and I chose to use it towards a trip to Ghana. That decision is one of many small steps that led me from wanting to be a rocket scientist or astronaut to an interest in global health. The experiences I had in Ghana, and later in Zambia and South Africa, led me to my current interests, and rockets have been a sideshow ever since.
While rocketry hasn't been my primary interest in years, I still try and keep up with my rocket blog, especially when I get around to flying one of my own projects. The old urge to be an astronaut, still strikes now and then. I was a bit bummed that I didn't make it down to the last ever Space Shuttle launch since I always told myself I'd make it to one of them. So this weekend I indulged myself by re-watching Apollo 13, one of my all-time favorite movies.
Apollo 13 holds up surprisingly well 16 years after its release. The casting, the acting, the writing -- it's all excellent. The special effects hold up well too. The soundtrack fits the movie perfectly, especially the triumphant horn riffs during the launch sequence (which I used to watch over and over for hours when I was in junior high). The movie manages to sneak in a surprising amount of jargon, but it works because it's a compelling human interest story focusing on the astronauts and their families. And director Ron Howard managed to infuse the movie with considerable suspense despite everyone knowing how it ends.
Since this is a blog (mostly) about international health and development, I feel it's my duty to draw a few extremely tenuous connections between space flight, this movie, and my current interests:
- Computers are older than I often think. I mean, they're relatively new in the grand scheme of things, but in my head I often date the importance of the computer to the wide availability of the personal computer. The first Apple home computer I had access to in the early 90s had an operating system contained entirely on a floppy disk, and a separate drive for another floppy disk on which you could load programs and files. Computers have come a long way since then, but even that little Apple was an incredible advance over the computers of the NASA era. Still, they were good enough to take us to the moon in the 1960s. Though you do get the distinct impression that Lovell sure could have used a USB thumb drive to transfer the 'main operating program' from the command module to the LEM at the height of the crisis.
- Organization as technology. Part of my summer reading is Charles Kenny's optimistic take on global development, Getting Better. In an early section describing the history of theories of economic development, Kenny discusses how some economists have argued that institutions are as important for development as any given technology. Example institutions include specialization of labor, "double-entry bookkeeping, just-in-time management systems," etc. There's an early scene in Apollo 13 where Jim Lovell (Tom Hanks) is giving a tour of the massive Vehicle Assembly Building and describes astronauts as only the most visible part of a massive system. Having just read about institutions -- and economists' attempts to predict national growth rates -- I couldn't help but think of the massive specialization of labor that allowed us to go the Moon. One of the delights of being a hobby rocketeer is that you can do it all, at least the fun parts, yourself. But real NASA engineers are part of massive systems that work together to do much more than any individual could. That's one reason that disasters like Columbia and Challenger are almost always ultimately traceable to problems in how those systems of people work together, rather than a single failure in materials or a single mistake by an individual. The question "what caused the Challenger disaster?" can be answered on as many different levels as "what sparked the recession?"
- Why did we win the space race? Relatedly, if economists or engineers had tried to predict who would win the race to the Moon in 1950 or 1960, there would have been any number of reasons to pick the Soviets over the Americans. Both sides had natural resources, large numbers of engineers, and rocket scientists poached from the Germans after World War II. While we got the better German, the Soviets had an early lead in rocket development. Then the 60s were particularly rough for the Soviet rocket program (see the Nedelin catastrophe). Arguments abound as to why the US eventually got to the Moon first, but my impression is that US institutions, and especially the engineering systems (not just the particular technological fixes) developed by the US played a significant role.
- Rubella. Astronaut Ken Mattingly (Gary Sinise) was supposed to be on Apollo 13, but he was exposed to a virus and bumped to the flight lest he become sick on his back to the Moon -- his removal from the flight set the stage for Jack Swigert (Kevin Bacon) to take the third spot just 72 hrs before launch. In the movie they just say "measles," but in reality it was German measles -- a synonym for rubella. The other astronauts had natural immunity because they had had rubella as kids, but Mattingly hadn't, so he got bumped. The rubella vaccine (see graph at right) wasn't introduced until the 1960s, so Mattingly's kids would have gotten the vaccine, but he hadn't. Oops. Rubella is also one of the few vaccines not developed my Maurice Hilleman. OK, that's a slight exaggeration, but Hilleman did invent vaccines for eight diseases: measles, mumps, hepatitis A, hepatitis B, chickenpox, meningitis, pneumonia and Haemophilus influenzae bacteria. Incredible.
Andrew Sullivan's Daily Dish is one of my favorite blogs. One feature I've grown to love is the daily "View from your window," and today he featured a shot I took on Sunday looking out my apartment window here in NYC:
I keep hearing complaints from both New York residents and visitors alike that the city smells. You get used to it pretty fast, but it's true -- especially during the summer. In the two other cities I've lived in (Washington, DC and Baltimore) I would put the trash out in a specially marked bin or garbage can for pick-up. My apartment in the East Village has a designated bin on the sidewalk, but we seem to be an exception rather than the rule. Most people just stack their trash bags on the sidewalks, like so:
This contributes to the smell, and probably to the rat problem as well. So why doesn't New York require trash to be placed in bins like at least some other American cities?
This brief history of trash collection in NYC is fascinating, but it doesn't really offer an answer. So I'm stumped for now, but my best guess is that sidewalk and building entryway space are at such a premium that space-consuming trash bins have never been popular. If you have another explanation I'd be happy to hear it.
I had this post saved as a draft for the last week or so -- oops: ------
It's a great summer to be in New York City. I was watching the news on same sex marriage pretty closely, and as soon as the religious exemptions amendment passed -- signalling that passage of the bill itself was just a matter of time -- bloggers started noting that crowds were gathering in front of the Stonewall Inn in Greenwich Village. I live about a mile east of there in the East Village, so I headed out immediately to be there at the historic moment.
This may come as a surprise for gay rights advocates -- or for pretty much anyone who didn't go to an extremely conservative university -- but I hadn't heard of the Stonewall Riots until a year or two ago. The Stonewall has been on my long list of historical sights to see in New York but I hadn't been there yet, and what better time to visit than on this historic occasion?
Sure enough, there was a big crowd gathered and quite a few media outlets on hand. I snapped this shot of an endearing older couple being interviewed:
And here are two NYPD officers doing crowd control, chatting amiably with the celebrants:
While the pace of change can often seem glacial for those eagerly advocating (as they rightly should) for justice now, it struck me that on a grander scale this progress has come impressively fast. Just a little over 40 years ago -- half a lifetime -- the police were systematically oppressing and raiding the few gay establishments in New York. Their actions were hardly inconsistent with popular will either, as there really was no gay rights movement yet. And now, in 2011, there the officers were, guarding a peaceful and spontaneous celebration by New Yorkers -- male and female, gay and straight -- of marriage equality, something that was probably inconceivable to the Stonewall rioters. Yes, the law is not yet perfect and we still have far to go, but for that night it felt right to pause and reflect on just how far we've come.
One of the best things about XKCD is that the mouse-over text (simply rendered using the title attribute in the <img> HTML tag) will almost always give you a second laugh or an interesting thought. This comic isn't his best, but it has this great mouse-over text:
Wikipedia trivia: if you take any article, click on the first link in the article text not in parentheses or italics, and then repeat, you will eventually end up at "Philosophy."
- Bradford-Union Street Historic District
- Plymouth, Massachusetts
- Plymouth County, Massachusetts
- County (United States)
- U.S. state
- Federated state
- State (polity)
- Social structure
- Social sciences
- List of academic disciplines
- Natural science
- Property (philosophy)
- Modern philosophy
According to the Wikipedia page on the phenomenon (of course there's one, which also of course already referenced the XKCD mention) the longest known link chain is just 35 links back to philosophy, so my random find is way up there.
It's interesting to observe how the selections work back from entries on specific, literal things to broader categories. The selections go from place to categories of place to knowledge to a meta-description of what knowledge. I imagine that if you grouped Wikipedia entries by category you'd see similar chains leading back to philosophy. For instance, I think all place names should follow a similar trajectory to my example.
I also wonder what the distribution would look like if you took a list of all entries on Wikipedia and graphed them by this philosophy index number. I think all articles listed together would be messy, but a list of articles weighted by web traffic would yield a a logarithmic distribution with the bulk of the entries being people, places, or things that are far from philosophy but eventually link there. Also, the distribution of any single category (places in the United States, for example) should be more similar to a normal distribution, and the narrower the category is the more true that would be. Now if someone will just build a computer program to test my hypothesis.