Archive for the ‘cynical rants’Category

Uninformative paper titles: “in Africa”

When I saw a new NBER working paper titled “Disease control, demographic change and institutional development in Africa” (PDF) pop up in the NBER RSS feed I thought the title sounded interesting, so I downloaded the paper to peruse later. Then today the new-ish (and great!) blog Cherokee Gothic highlighted the same paper in a post, and I finally took a look.

Unfortunately the paper title is rather uninformative, as the authors only used data from Burkina Faso. Sure, economics papers tend to have bigger, less formal titles than papers in some other fields, but I think this is particularly unhelpful. There are enough search frictions in finding applicable literature on any given topic that it helps to be somewhat more precise.

For reference, here’s Burkina Faso:

And here’s Africa:

Not the same.

It’s unclear from the data and arguments presented how these results — for a regional disease control program, but only using data from Burkina Faso — might generalize to the quite diverse disease environments, demographic trends, and institutional histories of various African countries. The paper doesn’t answer or even give much grounds for speculation on whether onchocerciasis or other disease control programs would yield similar results in countries as diverse as (for example) Senegal, Ethiopia, Uganda, and Angola.

A quick thought experiment: Virginia’s population is about 1.5% of the total population of North America, just as Burkina Faso’s population is about 1.5% of the total population on Africa. Can you imagine someone writing a paper on health and institutions using data from Virginia and titling that paper “Health and institutions in North America”? Or writing a paper on Vietnamese history and titling it “A history of Asia”? Probably not.

Jul

27

2013

Do they know it’s Christmas? No, because it isn’t.

Remember “Do they know it’s Christmas?” That’s right, the 1984 hit song intended to raise money for famine victims in Ethiopia.  If that’s not ringing a bell (See what I did there?) then here’s the video:

You probably didn’t get very far, so here are some of the inane lyrics:

And there won’t be snow in Africa this Christmas time
The greatest gift they’ll get this year is life
Where nothing ever grows, no rain or rivers flow
Do they know it’s Christmas time at all?

In addition to reinforcing all sorts of stereotypes about Africa, this video gets one very important thing wrong: Do they know it’s Christmas time? No, they don’t, because Ethiopians are Orthodox Christians and don’t celebrate Christmas until January 7th. So next time someone says they love this song, you now have an annoying know-it-all response to shut them down — which you can consider your holiday gift from this blogger. Merry Christmas!

[On a more serious note, Ethiopia has made huge strides on food security since the fall of the Derg. If you want to read more on that, MoreAltitude (an aid blogger who recently relocated to Addis) has this take.]

Dec

21

2012

The greatest country in the world

I’ve been in Ethiopia for six and a half months, and in that time span I have twice found myself explaining the United States’ gun culture, lack of reasonable gun control laws, and gun-related political sensitivities to my colleagues and friends in the wake of a horrific mass shooting.

When bad things happen in the US — especially if they’re related to some of our national moral failings that grate on me the most, e.g. guns, health care, and militarism — I feel a sense of personal moral culpability, much stronger when I’m living in the US. I think having to explain how terrible and terribly preventable things could happen in my society, while living somewhere else, makes me feel this way. (This is by no means because people make me feel this way; folks often go out of their way to reassure me that they don’t see me as synonymous with such things.)

I think that this enhanced feeling of responsibility is actually a good thing. Why? If being abroad sometimes puts the absurdity of situations at home into starker relief, maybe it will reinforce a drive to change. All Americans should feel some level of culpability for mass shootings, because we have collectively allowed a political system driven by gun fanatics,  a media culture unintentionally but consistently glorifying mass murderers, and a horribly deficient mental health system to persist, when their persistence has such appalling consequences.

After the Colorado movie theater shooting I told colleagues here that nothing much would happen, and sadly I was right. This time I said that maybe — just maybe — the combination of the timing (immediately post-election) and the fact that the victims were schoolchildren will result in somewhat tighter gun laws. But, attention spans are short so action would need to be taken soon. Hopefully the fact that the WhiteHouse.gov petition on gun control already has 138,000 signatures (making it the most popular petition in the history of the website) indicates that something could well be driven through. Even if that’s the case, anything that could be passed now will be just the start and it will be long hard slog to see systematic changes.

As Andrew Gelman notes here, we are all part of the problem to some extent: “It’s a bit sobering, when lamenting problems with the media, to realize that we are the media too.” He’s talking about bloggers, but I think it extends further: every one of us that talks about gun control in the wake of a mass shooting but quickly lets it slip down our conversational and political priorities once the event fades from memory is part of the problem. I’m making a note to myself to write further about gun control and the epidemiology of violence in the future — not just today — because I think that entrenched problems require a conscious choice to break the cycle. In the meantime, Harvard School of Public Health provides some good places to start.

Dec

17

2012

Alwyn Young just broke your regression

Alwyn Young — the same guy whose paper carefully accounting for growth in East Asian was popularized by Krugman and sparked an enormous debate — has been circulating a paper on African growth rates. Here’s the 2009 version (PDF) and October 2012 version. The abstract of the latter paper:

Measures of real consumption based upon the ownership of durable goods, the quality of housing, the health and mortality of children, the education of youth and the allocation of female time in the household indicate that sub-Saharan living standards have, for the past two decades, been growing about 3.4 to 3.7 percent per annum, i.e. three and a half to four times the rate indicated in international data sets. (emphasis added)

The Demographic and Health Surveys are large-scale nationally-representative surveys of health, family planning, and related modules that tend to ask the same questions across different countries and over large periods of time. They have major limitations, but in the absence of high-quality data from governments they’re often the best source for national health data. The DHS doesn’t collect much economic data, but they do ask about ownership of certain durable goods (like TVs, toilets, etc), and the answers to these questions are used to construct a wealth index that is very useful for studies of health equity — something I’m taking advantage of in my current work. (As an aside, this excellent report from Measure DHS (PDF) describes the history of the wealth index.)

What Young has done is to take this durable asset data from many DHS surveys and try to estimate a measure of GDP growth from actually-measured data, rather than the (arguably) sketchier methods typically used to get national GDP numbers in many African countries. Not all countries are represented at any given point in time in the body of DHS data, which is why he ends up with a very-unbalanced panel data set for “Africa,” rather than being able to measure growth rates in individual countries. All the data and code for the paper are available here.

Young’s methods themselves are certain to spark ongoing debate (see commentary and links from Tyler Cowen and Chris Blattman), so this is far from settled — and may well never be. The takeaway is probably not that Young’s numbers are right so much as that there’s a lot of data out there that we shouldn’t trust very much, and that transparency about the sources and methodology behind data, official or not, is very helpful. I just wanted to raise one question: if Young’s data is right, just how many published papers are wrong?

There is a huge literature on cross-country growth ‘s empirics. A Google Scholar search for “cross-country growth Africa” turns up 62,400 results. While not all of these papers are using African countries’ GDPs as an outcome, a lot of them are. This literature has many failings which have been duly pointed out by Bill Easterly and many others, to the extent that an up-and-coming economist is likely to steer away from this sort of work for fear of being mocked. Relatedly, in Acemoglu and Robinson’s recent and entertaining take-down of Jeff Sachs, one of their insults criticisms is that Sachs only knows something because he’s been running “kitchen sink growth regressions.”

Young’s paper just adds more fuel to that fire. If African GDP growth has been 3 1/2 to 4 times greater than the official data says, then every single paper that uses the old GDP numbers is now even more suspect.

Dec

11

2012

“As it had to fail”

My favorite line from the Anti-Politics Machine is a throwaway. The author, James Ferguson, an anthropologist, describes a World Bank agricultural development program in Lesotho, and also — through that lens — ends up describing development programs more generally. At one point he notes that the program failed “as it had to fail” — not really due to bad intentions, or to lack of technical expertise, or lack of funds — but because failure was written into the program from the beginning. Depressing? Yes, but valuable.

I read in part because Chris Blattman keeps plugging it, and then shortly before leaving for Ethiopia I saw that a friend had a copy I could borrow. Somehow it didn’t make it onto reading lists for any of my classes for either of my degrees, though it should be required for pretty much anyone wanting to work in another culture (or, for that matter, trying to foment change in your own). Here’s Blattman’s description:

People’s main assets [in Lesotho] — cattle — were dying in downturns for lack of a market to sell them on. Households on hard times couldn’t turn their cattle into cash for school fees and food. Unfortunately, the cure turned out to be worse than the disease.

It turns out that cattle were attractive investments precisely because they were hard to liquidate. With most men working away from home in South Africa, buying cattle was the best way to keep the family saving rather than spending. They were a means for men to wield power over their families from afar.

Ferguson’s point was that development organizations attempt to be apolitical at their own risk. What’s more, he argued that they are structured to remain ignorant of the historical, political and cultural context in which they operate.

And here’s a brief note from Foreign Affairs:

 The book comes to two main conclusions. First is that the distinctive discourse and conceptual apparatus of development experts, although good for keeping development agencies in business, screen out and ignore most of the political and historical facts that actually explain Third World poverty-since these realities suggest that little can be accomplished by apolitical “development” interventions. Second, although enormous schemes like Thaba-Tseka generally fail to achieve their planned goals, they do have the major unplanned effect of strengthening and expanding the power of politically self-serving state bureaucracies. Particularly good is the discussion of the “bovine mystique,” in which the author contrasts development experts’ misinterpretation of “traditional” attitudes toward uneconomic livestock with the complex calculus of gender, cash and power in the rural Lesotho family.

The reality was that Lesotho was not really an idyllically-rural-but-poor agricultural economy, but rather a labor reserve more or less set up by and controlled by apartheid South Africa. The gulf between the actual political situation and the situation as envisioned by the World Bank — where the main problems were lack of markets and technical solutions — at the time was enormous. This lets Ferguson have a lot of fun showing the absurdities of Bank reports from the era, and once you realize what’s going on it’s quite frustrating to read how the programs turned out, and to wonder how no one saw it coming.

This contrast between rhetoric and reality is the book’s greatest strength: because the situation is absurd, it illustrates Ferguson’s points very well, that aid is inherently political, and that projects that ignore that reality have their future failure baked in from the start. But that contrast is a weakness too, as because the situation is extreme you’re left wondering just how representative the case of Lesotho really was (or is). The 1970s-80s era World Bank certainly makes a great buffoon (if not quite a villain) in the story, and one wonders if things aren’t at least a bit better today.

Either way, this is one of the best books on development I’ve read, as I find myself mentally referring to it on a regular basis. Is the rhetoric I’m reading (or writing) really how it is? Is that technical, apolitical sounding intervention really going to work? It’s made me think more critically about the role outside groups — even seemingly benevolent, apolitical ones — have on local politics. On the other hand, the Anti-Politics Machine does read a bit like it was adapted from an anthropology dissertation (it was); I wish it could get a new edition with more editing to make it more presentable. And a less ugly cover. But that’s no excuse — if you want to work in development or international health or any related field, it should be high on your reading list.

Nov

15

2012

Obesity pessimism

I posted before on the massive increase in obesity in the US over the last couple decades, trying to understand the why of the phenomenal change for the worse. Seriously, take another look at those maps.

A while back Matt Steinglass wrote a depressing piece in The Economist on the likelihood of the US turning this trend around:

I very much doubt America is going to do anything, as a matter of public health policy, that has any appreciable effect on obesity rates in the next couple of decades. It’s not that it’s impossible for governments to hold down obesity; France, which had rapidly rising childhood obesity early this century, instituted an aggressive set of public-health interventions including school-based food and exercise shifts, nurse assessments of overweight kids, visits to families where overweight kids were identified, and so forth. Their childhood obesity rates stabilised at a fraction of America’s. The problem isn’t that it’s not possible; rather, it’s that America is incapable of doing it.

America’s national governing ideology is based almost entirely on the assertion of negative rights, with a few exceptions for positive rights and public goods such as universal elementary education, national defence and highways. But it’s become increasingly clear over the past decade that the country simply doesn’t have the political vocabulary that would allow it to institute effective national programmes to improve eating and exercise habits or culture. A country that can’t think of a vision of public life beyond freedom of individual choice, including the individual choice to watch TV and eat a Big Mac, is not going to be able to craft public policies that encourage people to exercise and eat right. We’re the fattest country on earth because that’s what our political philosophy leads to. We ought to incorporate that into the way we see ourselves; it’s certainly the way other countries see us.

On the other hand, it’s notable that states where the public has a somewhat broader conception of the public interest, as in the north-east and west, tend to have lower obesity rates.

This reminds me that a classmate asked me a while back about my impression of Michelle Obama’s Let’s Move campaign. I responded that my impression is positive, and that every little bit helps… but that the scale of the problem is so vast that I find it hard seeing any real, measurable impact from a program like Let’s Move. To really turn obesity around we’d need a major rethinking of huge swathes of social and political reality: our massive subsidization of unhealthy foods over healthy ones (through a number of indirect mechanisms), our massive subsidization of unhealthy lifestyles by supporting cars and suburbanization rather than walking and urban density, and so on and so forth. And, as Steinglass notes, the places with the greatest obesity rates are the least likely to implement such change.

Nov

07

2012

Our future selves will mock this (I hope)

Smiling people holding hands. Walking on the beach. Inexplicable doves flying through blue skies. Terrible side effects discussed cheerily by a honey-voiced narrator…. That’s right, this post is about direct-to-consumer pharmaceutical advertising.

Niam Hardimh, writing at Crooked Timber, shares one of the odd things about living in the US — for those who aren’t used to our TV:

One thing that is striking, compared with European TV, is what is advertised and how. In particular,  I don’t think you see ads for prescription medicines in Europe, certainly not in Ireland or the UK. They seem to be all over American TV.

I am particularly struck by the way these ads are made. The visuals  typically show someone having a happy and trouble-free life while using these drugs, overlaid with soothing music and a reassuringly bland voice-over. But clearly the US FDA requires advertisers to include all the small print in their ads as well.

Do you read all the known downsides of the medicines you take? Don’t…

It’s easy to become habituated to these since they’re everywhere, but it hasn’t always been that way, and in most places it still isn’t — the US and New Zealand are the only two countries that allow direct advertising of drugs. Here’s an exemplary ad for Vioxx, which was pulled off the market because it caused health problems (which Merck systematically lied about):

Ice skating. A minor celebrity. Inspiring music. They even note that “Vioxx specifically targets the Cox2 enzyme.” How many Americans can even define what an enzyme is? I’m sure consumers are more likely to remember that than the mentioned side effects (“bleeding can occur without warning”)… Other lovely examples include this other ad for Vioxx, and one for Zocor.

For more examples and some background on how the ads came to be, check out “Sick of pharmaceutical ads: here’s why they won’t go away” on io9.

May

09

2012

Facebook’s brilliantly self-interested organ donation move

How can social media have a big impact on public health? Here’s one example: Facebook just introduced a feature that allows users to announce their status as organ donors, and to tell the story of when they decided to sign up as a donor. They’re — rightly, I think — getting tons of good press from it. Here’s NPR for example:

Starting today, the social media giant is letting you add your organ-donation status to your timeline. And, if you’d like to become an organ donor, Facebook will direct you to a registry.

Patients and transplant surgeons are eager for you to try it out.

Nearly 114,000 people in this country are waiting for organs, according to the United Network for Organ Sharing. But there simply aren’t enough organs to go around.

It’s an awesome idea. Far too few Americans are organ donors, so anything that boosts sign-up rates is welcome. As Ezra Klein notes, organ donation rates would be much higher if we simply had people opt out of donating, rather than opt in, but that’s another story. (And another aside: I hope they alerted some smart people beforehand to help them rigorously measure the impact of this shift!)

Call me a cynic, but I think the story of why Facebook chose to do this — and in the way they did it — is more interesting.Yes, there’s altruism, but Facebook is a business above all. Maybe they’re just trying to cultivate that Google ethos of “we sometimes spend lots of money on far-sighted things just to make the world a better place.” Facebook will certainly garner lots of public good will from this.

But I think, even more importantly, Facebook gets magnificent cover for introducing new modules on health/wellness. Check out the screenshot from their newsroom post on the new features:

That’s right — in the new Health & Wellness section you can enter not only whether you’re an organ donor, but also these categories: “Overcame an Illness,” “Quit a Habit,” “New Eating Habits,”Weight Loss,” “Glasses, Contacts, Others,” and “Broken Bone.”

All life events some people may want to share, of course. But Facebook makes money off of advertising, and just think of how much money Americans spend on weight loss, or on trying to quit smoking (or more usually, continuing it), or on glasses and contacts. Then think how much more advertisers will pay to show ads to segments of the billions of Facebook users who have shared the fact that they’re actively trying to lose weight.

Maybe Facebook has seen this sort of health data as a major growth area for some time, but was wary of introducing such features in the wrong way. On any other news day the introduction of these features would have triggered a new outbreak of the “Facebook feature prompt privacy outcry” and “Why does Facebook need your health data?” stories. Sure, we’ll get some of those this time, but I think any backlash will pale in comparison to the initial PR bump.

I don’t think there’s necessarily anything wrong with the move, and I certainly welcome any boost in organ donor registration. It may just be that this is a case where Facebook’s business interests in inducing us to share more of our personal information with them just happens to happily coincide with a badly needed public good. Either way, the execution is brilliant, because so far I’ve mostly seen news stories talking about how great organ donation is. And I just updated my Facebook status.

May

01

2012

Before you get all excited about male birth control

When you’re a public health grad student and something related to health hits the news, your friends make sure you see it. Since there’s a lot of bad science writing on the internet this can be rather frustrating. In the last few hours I’ve seen several people post this  to Facebook, and another emailed me with the subject line “Woh” and asked if this was too good to be true….

So what’s the story? Techcitement has a breathless article titled “The Best Birth Control In The World Is For Men” by Jon Clinkenbeard, which he followed up with “Could This Male Contraceptive Pill Make a Vas Deferens in the Fight Against HIV?“ The first article starts with this hook:

If I were going to describe the perfect contraceptive, it would go something like this: no babies, no latex, no daily pill to remember, no hormones to interfere with mood or sex drive, no negative health effects whatsoever, and 100 percent effectiveness. The funny thing is, something like that currently exists.

Clinkenbeard is describing RISUG, or “Reversible inhibition of sperm under guidance.” Wikipedia explains:

RISUG is similar to vasectomy in that a local anesthetic is administered, an incision is made in the scrotum, and the vas deferens is tugged out with a small pair of forceps. Rather than being cut and cauterized, as it is in a vasectomy, the vas deferens is injected with [a] polymer gel and pushed back into the scrotum.

Sounds awesome? Why don’t we have it already? Clinkenbeard continues:

The trouble is, most people don’t even know this exists. And if men only need one super-cheap shot every 10 years or more, that’s not something that gets big pharmaceutical companies all fired up, because they’ll make zero money on it (even if it might have the side benefit of, you know, destroying HIV).

Before you go injecting something in your scrotum… not so fast! Yes, in one sense it exists. But on the other hand we don’t really know how well it works, and we don’t really know how safe it is. Clinkenbeard makes it sound like it’s a done deal, and claiming that Big Pharma is standing between you and the cure for babies (not to mention HIV!) certainly helped the article go viral. He then links to a bunch or articles and a few petitions.

While pharmaceutical companies do all sorts of things to manipulate data (start here if you don’t believe that), I think they could actually make TONS of money on this if it worked. The price of medicines isn’t usually based on how much they cost to manufacture but on how much they can be sold for, and I think there’s clearly a market for male contraception: just think how much men would pay for the insurance to both avoid pregnancy and not have to use condoms. A drug company could conceivably make a lot of money off this product by getting it to market first.

Guha’s initial studies were very small. A Phase II clinical trial published by Guha et al in 1997 featured a grand total of 12 men (PDF). (It also contains this humorous understatement: “Objective data on posttreatment frequency of intercourse could not be obtained.”) In another study 20 men received an injection, but one man’s partner still got pregnant.

Before a drug can (or should) go to market, it needs to be tested for both efficacy and safety, and everything needs to be done up to certain standards. Guha’s original work wasn’t. From a Wired article on RISUG by Bill Gifford, published this time last year:

In its report, the WHO team agreed that the concept of RISUG was intriguing. But they found fault with the homegrown production methods: Guha and his staff made the concoction themselves in his lab, and the WHO delegation found his facilities wanting by modern pharmaceutical manufacturing standards. Furthermore, they found that Guha’s studies did not meet “international regulatory requirements” for new drug approval—certain data was missing. The final recommendation: WHO should pass on RISUG.

These barriers can be overcome, if the researchers can get the investment necessary to make high quality product and run clinical trials. The Wired article describes how they’ve made progress and are now running clinical trials in India — but the results are still a few years out. In the same article we get this:

“Pharmaceutical companies are not interested in one-offs,” Weiss says. “They’re interested in things they can sell repeatedly, like the birth control pill or Viagra.”

But that’s not as true as it used to be. These arguments used to explain why pharmaceutical companies didn’t invest in developing vaccines, but then they realized they could charge obscene amounts for individual doses — orders of magnitude higher than what they charged before. They’ve managed these high prices because 1) there are always new cohorts of kids needing the vaccine (as there would be with men needing RISUG) and 2) because the health benefits are so large that even at the higher prices the vaccines are cost effective.

So are pharma companies just disinterested in male contraception? No. For quick and dirty evidence check ClinicalTrials.gov, where US clinical trials must be registered. I find 436 studies on contraception, of which 84 are specifically about male contraception. There’s a disparity there, but it’s explained in part by the fact that many of the non-male contraception studies are about delivery methods (like this one involving text message reminders) and you can’t even start do this sort of research on male birth control before we have effective methods. Maybe they’re under-investing a bit — drug R&D is risky, as firms spend an average of $1.3 billion on research for every one drug  brought to market — but it’s not being ignored.

In closing, that Wired article from last year has some of the same breathless new-techthusiasm as the new Techcitement piece, but it’s a lot better at explaining where things stand today. Clinical trials in India are ongoing, but it will be another year or so before we hear any results. If those are considered high quality and they’re successful, it might spur the drug behemoths to up the massive amounts required for clinical trials in the US.

Generally, getting your science news from the coauthor of “The Pirate Treasure of the Himalaya” does’t seem like the best idea. Drugs and treatments fail at every stage of the clinical trials pipeline, and that’s a good thing because it means consumers will be less likely to spend money on ineffective or unsafe drugs. If everything works out with RISUG, it could be an incredible success story and a great public health tool. There might well be hope on the horizon, but contrary to Clinkenbeard’s assertions we don’t yet know very well if this works, and we don’t yet know if it’s safe. For that, we need good ole clinical trials, not petitions.

Apr

03

2012

Values and humility in economics

Greg Mankiw is a Harvard economist, former chairman of President Bush’s Council of Economic Advisers, and currently an advisor to the Romney presidential campaign. He teaches a large introductory economics course at Harvard and writes both the widely used Principles of Economics and a blog that displays the same crisp, eminently-readable prose as his textbook. In a show of solidarity with the Occupy Boston movement, some of his students walked out of that class earlier this year. Much has been written about the walkout  (Update: here’s the students’ open letter and a response that outlines why walking out of this particular class isn’t the most informed move.) Still I wanted to highlight Mankiw’s column in yesterday’s New York Times, titled  ”Know what you’re protesting.” I share some of his reaction:

But my second reaction was sadness at how poorly informed the Harvard protesters seemed to be. As with much of the Occupy movement across the country, their complaints seemed to me to be a grab bag of anti-establishment platitudes without much hard-headed analysis or clear policy prescriptions. Ironically, the topic of the lecture that the protesters chose to boycott was economic inequality, including a discussion of recent trends and their causes.

Fair. But later in the piece Mankiw says something that really rankles (emphasis added):

I don’t claim to be an economist of Paul Samuelson’s stature. (Probably no one alive can.) But like him, I have written a textbook that has introduced millions of students to the mainstream economics of today. If my profession is slanted toward any particular world view, I am as guilty as anyone for perpetuating the problem.

Yet, like most economists, I don’t view the study of economics as laden with ideology. Most of us agree with Keynes, who said: “The theory of economics does not furnish a body of settled conclusions immediately applicable to policy. It is a method rather than a doctrine, an apparatus of the mind, a technique for thinking, which helps the possessor to draw correct conclusions.”

That is not to say that economists understand everything. The recent financial crisis, economic downturn and meager recovery are vivid reminders that we still have much to learn. Widening economic inequality is a real and troubling phenomenon, albeit one without an obvious explanation or easy solution. A prerequisite for being a good economist is an ample dose of humility.

I’ll preface my reaction to this with my own dose of humility: my studies at the Woodrow Wilson School this semester are my first exposure to serious economics, and I’m realizing every day that I have ever more to learn. I think it can be helpful to approach a field with fresh eyes so I hope my thoughts here won’t be entirely discredited by my fresh arrival to the dismal science.

That said, No! This seems like denial, pure and simple. My impression is that one of the areas where economists have most often failed to display humility is when thinking of and talking about the interaction of their values and methodologies.  Yes, economics has epistemological limitations, but these are equaled or surpassed by its axiological limitations, and may be more consequential because — unlike with the more readily acknowledged methodological shortcomings — economists themselves don’t always make clear the values implicit in their worldviews. I think economists and those who are impacted by their views (ie, everyone else) would benefit from clearer statements of how values impact economics.

Mankiw’s textbook does very briefly address the political philosophies underlying views on income redistribution, from utilitarianism to liberalism to libertarianism (pages 442-3 in the 5th edition). But this is halfway through the text and only in the context of the chapter on “income inequality and poverty.” In reality, your views on maximizing utility for all versus (at another extreme) only caring about how policies affect the poorest have an impact on pretty much every piece of welfare economics. Here from what I can tell Mankiw is quite mainstream — when considering the effects of a particular policy using the tools of welfare economics, the underlying philosophical preferences are almost always assumed. The conclusions of those studies are then touted as positive statements (“Policy X is bad for the economy”) when that may or may not be true, depending on whether you share the same fundamental normative roots.

Prof. Mankiw spoke at Princeton on October 20 (you can view the lecture here) and it was a well-presented talk. His remarks were broad and intelligent, though maybe a bit constrained by the fact that he is associated with a presidential campaign and thus can’t rock the boat too much (even with a disclaimer that his remarks were his own). In that talk Mankiw similarly began by emphasizing the need for economists to show greater humility in light of recent failures; he then proceeded to discuss a good number of specific policy recommendations with quite a bit of confidence. My biggest question coming out of the lecture was how to square the Mankiw who calls for greater humility from economists with the Mankiw who makes policy prescriptions. If we don’t know with certainty what the impacts of particular policies will be or how to do more than tweak the performance or recovery of an economy, why not start with the policies least likely to do harm to the most vulnerable members of society? That would generally be my preference, growing out of my own nascent political philosophy.

In his textbook (5th edition page 35) Mankiw evenly explicitly notes that ”Economists give conflicting advice sometimes because they have different values.” This is true, and if anything it is under-emphasized. Elsewhere Mankiw has been more direct, contrasting the philosophies of Nozick and Rawls and noting how those might result in very different policy prescriptions on taxation. Mankiw ends up closer to Nozick and so it’s no surprise that his policy prescriptions are for lower corporate taxes (re-emphasized in the Princeton talk as one of the things on which he very strongly agrees with Romney).

How is this anything but a heavy dose of ideology being injected into economics? How can we square this with the Mankiw who says he doesn’t see the study of economics as “laden with ideology”? Part of the problem is that there are figures such as Mankiw who are concurrently serious researchers on scientific questions within economics and proponents of normative preferences in the political sphere. Can the outside observer tell when an economist is being one and not the other? Can economists realize this in themselves? When you couch these preferences in the language of economics without making the underlying values explicit, it’s hard to believe that the field is not laden with ideology. To the extent that he doesn’t even recognize how these value statements pervade the field, Mankiw is — in his own words – as guilty as anyone for perpetuating the problem.

Dec

04

2011

Machine gun roundup: the story gets worse

Machine Gun Preacher opens widely today. I wrote a piece for Foreign Policy that went up last night titled “Machine Gun Menace.” It’s mostly a summary of what I’ve written before on Childers (here, here, and here) but with some new material — including Childers’ denial to me of ever having sold arms — and some further thoughts on the perils of armed humanitarianism. It starts with my favorite quote from Childers’ book: “The Lord I serve is the living Lord Jesus. And to show you he’s alive, I’m going to send you to meet him right now!” You can read the full article here. Thanks to Joshua Keating at FP for the chance to take the arguments I’ve made here to a broader audience (and to my friend Jesse for editing help).

Dave Gilson brings the story to another audience at Mother Jones and Scott Baldauf at the Christian Science Monitor, who expressed early interest in the story, also writes about it there.

But the biggest new information on Sam Childers comes in this Christianity Today story by Mark Moring (with reporting in South Sudan by Uma Julius and Esther Nakkazi). I’ve been a bit frustrated by this whole Childers story since I first started writing about it, as I don’t have the resources (or time, as a full time grad student) to travel and do the research necessary to address all the doubts raised by Childers’ stories. Since I started writing on him I’ve received several emails from folks who previously or currently work in South Sudan, expressing a range of doubts — but most of them did not want to be quoted by name for various reasons.

It looks like Moring, Julius, and Nakkazi have done the hard work of asking around to people in the community — moving beyond the sort of trip where journalists only see what the charity wants them to see. If even half of the allegations they convey are true then this whole series of events is an absolute travesty: dozens if not hundreds of media outlets have interviewed, written about, or featured Childers. It seems that very, very few asked any critical questions or presented his story with much complexity. Some of this may be about resource constraints, but the questions are beginning to be asked now that the movie is coming out, so it’s hard to say that’s the whole story. I think one lesson for the future is this: when you talk to a supposed humanitarian making outlandish claims, it is not OK to only talk to them. Their actions affect others, and media should be more than megaphone-holding cheerleaders or fundraisers.

Back to the Christianity Today story. It opens:

Witnesses have said that the children at Shekinah Fellowship Children’s Village are malnourished, unhealthy, and unhappy. Several locals—including pastors, government officials, and a high-ranking member of the military—tell Christianity Today that Childers has exaggerated or outright lied about his work in the African nation.

Community leaders want his orphanage in Nimule—near the border with Uganda—to be shut down immediately, and for local ministries to take over. In a September 2 letter to Childers, 14 local leaders—including the man who says he gave 40 acres of land to Childers to build the orphanage—wrote that Chiders has “dishonored our agreement” to take care of orphans, and that they demand “immediate closure of the compound.” Childers told CT he never received that letter.

So it sounds like Childers may not have the community support you’d expect if he was doing good work. Childers predictably blames the allegations all on a disgruntled former employee. (Careful followers of aid scandals will note the almost exact parallel between that and Greg Mortenson’s reaction to allegations against him — Mortenson at first blamed almost everything on a disgruntled and dishonest former employee). If that was the only source of these accusations there would be plenty of reason to doubt them. But here’s more from an American doctor who visited in 2009:

Wilson said no adults—including Childers—were at the orphanage when his team visited in 2009, but that they left medicine and antibiotics with clear instructions how to administer them. But when they returned two days later, none of the medicine had been given to the children.

“I don’t know what to do,” Wilson said, “but I have to do something.” He ended up asking CT to investigate, and several people we spoke with recently confirmed what Wilson and the nurse observed.

They go on to talk about the health problems many of the children were having. Really, read it. There’s also a claim that echoes a criticism someone in South Sudan emailed to me, that Childers often stages photographs and acts differently when media are around:

Okumu and others said they witnessed Childers staging photographs of himself fighting against the LRA in order to make his story sound more compelling and to attract more donors to his ministry. Okumu said Childers used guards and children from the orphanage to stage the photos nearby. “He claimed to be rescuing kidnapped children from the LRA,” Okumu said. “But it was false. He just took pictures of the children in the bush around the compound here.”

Seth Trudeau, who is involved with another orphanage in Nimule, South Sudan, says that Childers’ orphanage was shut down by the local government last month. If that’s true, it raises the question of why and how Childers is still promoting the movie to raise money for his charity (I haven’t read that the orphanage was actually shut down anywhere else). Seth writes this:

Over the course of the last year, Sarah and I knew extended families who were taking their children away from the home, which surprised us. As the LRA’s strength had waned in South Sudan, this children’s home had broadened its focus from rescued child soldiers to all orphans and vulnerable children – which made it all the more shocking to us that families would be taking their children back: by definition, these children had come to the home because the families were so ill equipped to care for the children in the first place. At CCH, we had families who would lie about their circumstances in order to get their children in, so it struck us as strange that the opposite phenomenon was taking place on the other side of town.

Very strange indeed. If the children had extended families that could take care of them but just lacked the resources, it raises the troubling question of whether an orphanage was an appropriate charity model in the first place. Why not just support the families so they can care of the kids themselves? That — along with the stories of Childers being absent for long periods of time and the lack of adults on site — remind me again of criticism of orphanages as an aid model (here and here) at the blog Good Intentions Aren’t Enough. Hopefully the attention from the movie and these first critical reports will lead to more questions being asked and answered.

Sep

23

2011

How Sam Childers endangers humanitarians everywhere – reax from the web

(For background see my original long post and this update.)

Sam Childers gets back from Somalia (where he’s currently scouting for a humanitarian mission??) on August 10th, and I’ve been asked to contact him. I plan to, as I want to see if he’s willing to answer some of the many questions that potential donors deserve answers to — based on his own prior statements.

In the mean time, several aid/development bloggers have written about the Machine Gun Preacher:

A couple short mentions: Tom Murphy and Ken Opalo both link, while Tom Paulson at Humanosphere calls it all “fascinating and disturbing.”

Tales from the Hood is a long-running blog written by “J.” While the author is anonymous, many aid / development bloggers have met him (including me) or know who he is and what he does — which is how we know that he’s not just talk: he’s a legit humanitarian bad-ass who’s worked in countries your high school geography teacher has never heard of. J’s work is widely respected and his blog is a watering hole for aid and development workers around the globe. He also has a certain flair for description, as you can see in his piece on Childers:

[Childers] has a custom chopper and a movie deal, and when he’s not out busting caps into LRA, Childers pastors a biker-themed church in rural Pennsylvania (but of course). I think my favorite part is where he states that he is after Joseph Kony. Like, to kill him. Like, good old-fashioned cowboys and Africans.

And nothing says, “I worship the Prince of Peace” quite like vowing to kill someone.

While some commenters on this blog have said that Childers’ actions are just “between him and God” — and thus we shouldn’t criticize him — in reality nobody works in a vacuum. Reckless actions today can make future work via more reasonable approaches impossible. This critique, regarding how what Childers does and says can impact humanitarians everywhere, is very important. Here’s J again:

There is already suspicion, in some cases rightly earned, that humanitarian aid workers may not be strictly humanitarian… But thanks to the Machine Gun Preacher, next time I’m stopped and questioned at a checkpoint, it will be even harder for me to make the case that I’m really there (wherever ‘there’ is) for strictly humanitarian purposes. And so that we’re clear, this is true regardless of whether I’m in Killinochi, Erbil, or LAX. His videos and pics (along with those of many others) are up there, out in the open for all to see…

I have colleagues and close personal friends in South Sudan, including exactly the areas where Sam Childers claims to “help where no one else will.” I frequently must make the decision to deploy people who I supervise and for whom I am responsible to places where the ratio of assault rifles to healthy babies in the general population is far higher than it should be…. We very often go into insecure places where our presence and the associated suspicion that we may have ulterior motives puts not only us, but our local colleagues and those we’re trying to help at greater risk, too.

And so every time the inarticulate Machine Gun Preacher packs heat into South Sudan he makes the entire world more dangerous for me and my friends and innumerable real aid worker colleagues. Every time he puts up another video of himself jumping into his white SUV with an AK47 across his lap, he increases the likelihood that I or someone I care about is going to get shot.

Commenter MB adds this:

As someone who spent many years in South Sudan (pre- and post- CPA), who is currently in Iraq (stuck behind T-walls and armored SUVs)… this burns me up!. Any one who portrays us as CIA, military, armed, mercenary, or anything other than trying to help is beyond stupid! And anyone who would do a “reality series” (is that for real??) about them puts all of our lives, the lives of our friend, colleagues and those we are trying to help, in serious danger!…

Later in the thread the same commenter notes:

I think it’s fairly telling that those of us who have worked in South Sudan, over many years and people currently in South Sudan (a friend did an informal poll of people she knows there) knew nothing whatsoever about this guy.

I’ve heard the same sentiment from others, which is telling. I’ve also exchanged emails with two people in Sudan who have raised other concerns about Sam, and I’m hoping that they’ll decide to share those publicly soon. While there are some supporters who will believe Childers is on a mission from God regardless of what I say (or anyone else for that matter), it’s important for anyone who has information or concerns about Childers to share them as the publicity machine for the movie gears up. On that note, it would be great if someone who edits Wikipedia (I won’t because I think I’m too close to the issue) could update his ridiculously one-sided Wikipedia page to have a more objective voice.

Another aid worker who blogs, Erin in Juba, adds some thoughts here. She notes this passage from the Machine Gun Preacher blog:

As we neared Nimule we began to relax but we weren’t out of danger yet.  We rounded a corner and hurtled in a tribal clash between the Dinka and Madi tribes.  4,000 fighters, armed with pangas (machetes), rudimentary bows, spears and clubs, stormed back and forth looking for someone to fight.  In amongst the drunks I saw an elderly man poised for battle and a young woman with a bow in her hand and a baby slung across her back.  As the situation escalated we had no choice but to lock and load.  Shots were fired and we drove through the screaming remnants of the volatile mob.  Luckily, no one was killed.

If that strikes you as outlandish, you may appreciate Erin’s take:

AGGGGHHHHHH.  Tribal violence in South Sudan is a complicated clusterf[***], to say the least. However, most of the violence is in between the tribes. The traditions of violence and cattle raiding go back generations, and are a tragedy for sure, but because of their specific tribal-focused aims, they tend to not focus on targeting humanitarians.  And then this idiot claims he has “no choice” but to go blazing into the middle of a mob? …

Right. She also notes:

It’s also ironic that Sam claims to work with the SPLA to free child soldiers since the army had its very own child soldier branch (the Red Army).

For now the feedback is this: some aid workers who work in Sudan and other dangerous environments think Childers’ stories should be taken with a grain of salt, and say that what he is doing makes this work more dangerous for everyone. All of the supporting statements seem to be coming from people who are associated with his church and don’t seem to question Rev. Childers at all. They shouldn’t expect the same free pass as the movie brings him more attention. Childers has simply said a lot of outrageous things, and if he wants people to trust his judgment and give him money he has his work cut out for him.

Aug

09

2011

More on Rev. Sam Childers

Earlier this week I wrote five posts (combined into one here) on a scary character named Sam Childers. He goes by the name “Machine Gun Preacher” (website) and I concluded that he was either a self-aggrandizing liar, dangerous, or both. His enthusiastic supporters and a PR rep have commented and contacted me, and I wanted to related the new information below. The short version is that the needle is swinging farther from liar and closer to dangerous.

Regardless of the corrections and additions I’ve noted here, I think it obviously stands that you shouldn’t give Childers your money. Childers has been promoting himself as just the hero the children of South Sudan need, and is finally getting a movie based on his life. For the full list of dubious claims (which were not limited to working with the SPLA) see my prior posts, but it’s worth noting again that he’s stockpiling arms at his orphanage and has admitted to selling weapons to unnamed armed factions in Sudan, Uganda, and Rwanda. He’s apparently fighting with or is friends with the SPLA or some faction of it (details are unclear). His organization doesn’t seem up-front enough about what they have done and will continue to do with your donation to deserve it. And now (according to comments here) he may be poised to start raising money for famine relief in Somalia.

If you just want Kony killed, Childers doesn’t sound like your best shot — and it’s simply not true that the use of child soldiers in the region will end if you kill Kony, as the SPLA has used them too, after all. For reasons why contributing more arms to the conflict is a bad idea, start here. If you want to give to a charity that helps children in South Sudan but is not associated with Childers’ violent tactics, try this organization for starters (rec here) – and I’m sure there are many, many others.

The new information:

1. Whoever moderates the Machine Gun Preacher Reality Series Facebook page (possibly the directors of an upcoming documentary on Childers?) posted this document:

It is dated July 12, 2011, signed by a Lt. Gen Mete, and reads:

This is to certify that Rev. Samuel hee Childers has worked with the SPLA for over 10 year he also RUN an orphanage in Nimule, and travels the out South Sudan he has been granted permission to posses and carry a pistol and rifle for personal security while executing his duties. When seen assist where necessary.

This obviously contradicts the prior press release, apparently from the main SPLA spokesperson denouncing Childers. Assuming this new release is legit, it raises questions about the SPLA’s cohesion and communication. That isn’t too surprising, as one former South Sudan resident said they thought there was considerable struggle over control between the center and other factions.

2. Maria Sliwa, Childers’ (update: former) current publicist, commented on this post noting that she was not yet representing Childers at the time she wrote the article I linked to. Thus, I was in error to say she had failed to disclose that, and I’ve added corrections to the appropriate posts.

3. I evidently goofed in saying Marc Forster was on Oscar-winning director — apparently he’s only directed films that were nominated for Oscars. I could care less about the Academy Awards so this distinction isn’t important to me , but some (including Childers supporters who commented here) evidently think this is a big deal that throws my entire credibility into doubt. Sorry?

While I’m at it, here’s a clip of Childers being interviewed by Pat Robertson on the 700 club. In it he says that many US government officials have contacted him, that he’s also fought the Janjaweed (funny how that didn’t make it into his dramatic report of his trip to Darfur), and that he gets his weapons from the government (presumably of South Sudan?) rather than buying them from “the Russians” as he said elsewhere. Again, I’m not against helping children in South Sudan, but it doesn’t seem giving Childers money is the best way to do so.

Aug

04

2011

Who is Sam Childers? (conclusion)

This is part 5 of a longer article on Sam Childers, the “Machine Gun Preacher.” Read part 1, part 2, part 3 and part 4, or view the whole series as one long article.

In the April 2011 Times of London profile (not online), Childers said this:

“I tell you this – and I believe the day is coming soon – if I had the money, I could have Joseph Kony’s head. I could bring him down. And I will have the money, soon.” […]

… Childers insists the film will be a hit: “It’s going to do unbelievable well.” He hopes it will make him famous, so he can raise more funds for his manhunt and his orphanage.

My hope is that more people will think critically about what the “Machine Gun Preacher” is advocating and doing in Sudan, and choose to give to other organizations instead. There are plenty of reasons to doubt his work:

  1. Violence. By his own claims Childers has personally killed people – in the double digits. He is not a man of peace, and it’s hard to see how his claimed tactics bring the situation closer to that. Even if he were the best option for getting Kony (highly doubtful), it doesn’t seem to me that the use of child soldiers in the region would disappear with Kony’s demise. Also, since many of Kony’s troops are themselves soldiers, how does Childers avoid killing them?
  2. Weapons. Again by his own claims, Childers has sold weapons to armed groups in Sudan, Rwanda, and the Congo. There are no happy-go-lucky bands of nice Christian warriors in the area; every group I’ve read about has been accused of terrible crimes at some point. Feeding more weapons into the conflict will only make things worse, and end up hurting the children Childers purports to help. His solutions are woefully shortsighted.
  3. Lies. Childers claimed to be a “white commander” in the SPLA, but the SPLA has publicly denounced him and called for legal action. This apparent falsehood casts some doubt on whether Childers really does the things he claims – the violence and weapons described above – so we’re left choosing between whether he is dishonest or dangerous. Or both. (Update: see Childers’ letter of support from an SPLA general here — but also note that this isn’t the only of his claims that begs skepticism.)
  4. Disrespect. Much of what Childers’ trafficks in – weapons aside – is poverty porn of the worst sort. By only emphasizing the worst aspects of any situation Childers may drive up his donations, but he demeans those he seeks to serve. He goes even further in his report on South Darfur, prompting a commenter who worked in the region to call him out.
  5. The White Man’s burden. Childers’ story is only the latest in a long history of “Whites in Shining Armour” narratives that emphasize the heroics of white Americans and Europeans while downplaying the agency of the people of Sudan and elsewhere in Africa.
  6. It’s a bad model to begin with. Saundra S of the blog Good Intentions Are Not Enough has written extensively on why donors should be wary of orphanages.

What then shall we do?

I realize some people will find these posts and be discouraged because they were moved by stories of suffering in Sudan and just want to give to someone. Don’t respond to the emotion you’re feeling by supporting Sam Childers, as there are – contrary to his claims – many other organizations working in South Sudan that do good work. If you feel compelled to give to a charity in South Sudan you might consider Oxfam. If you only give to Christian groups, consider World Vision. No group is perfect, but these are both reputable charities. My apologies for not being familiar with smaller charities on the ground, and I would appreciate suggestions from those who are more familiar with the area.

Ironically, I think Sam Childers is best summed up by blogger Chris Baron in this review – where Baron obviously believes in Childers. He asks good rhetorical questions, but obviously I think the evidence points to a different conclusion:

There are only two options, he is either an insatiable liar or there is a God in Heaven who has tasked his angels concerning Sam’s work. And how many liars do you know give up everything in order to save children, build orphanages and fight enemies who are not their own? Liars don’t do that. Liars are self serving.

———————

Notes on Angels of East Africa’s finances: The organization’s income has increased in recent years from $309,166 in 2006 (tax PDF), $578,992 in 2007, $446,294 in 2008, and $877,755 in 2009. Vanity Fair reported that the orphanage has an “annual budget of about $600,000, raised primarily through Childers’s speaking fees and donations from a global network of evangelicals.”

I’m not a Form 990 tax expert, so I will leave more detailed explorations to others. The travel costs ($233,717 in 2008 and $216,809 in 2009) seem high to me. Childers certainly isn’t taking a huge salary: the first year his salary was listed was 2008, at a mere $38,900. It’s hard to tell what all they’ve spent money on – all orphanage expenses are listed under line items such as “Wires to Africa.” Presumably some of this money went to purchase weapons as well?

Miscellaneous notes: here are some additional semi-relevant links that I could not work into this narrative but you may enjoy:

  • The FAA fined Childers $28,000 in 2007 for transporting oil and other hazardous materials by plan.
  • A bunch of photos of Sam Childers in Africa.
  • A video interview in which Childers says he joined SPLA, features sick, crying Africans and naked children, and describes him as a “a rebel turned savior called the bearded white man.”
  • An adaptation of a chapter in Childers’ book.
  • It’s not clear to me where the claims in this PDF come from, but they outline some even more grandiose claims supposedly made by Childers – seems less reputable to me.
  • This video is a short documentary on Childers (or maybe a preview for one?).
  • Childers has a second book titled Living on the Edge coming out in a year or less.
  • This long-ish MSNBC story also features Childers. It’s remarkable how uncritical the coverage of him has been by so many media sources. I also find it hard to imagine that they would take his more extraordinary claims seriously if he were an African rather than an American.
Aug

03

2011