My favorite things, all at once!

Yay for old friends, economics, and technology! All at once!

kc wrote a blog posting with her humble ideas on how to use IP address space tax. Wait… there’s a tax on address space? Yes, because it has become a scare quantity, because people are too lazy to move to IPv6, IPv4 address space is running out. The best of all bad ideas about what to do about this is to make an open market for address space, as though network addresses were some kind of useful piece of property with any kind of useful value. (BTW: When the present econolypse is over, and the next bubble starts, it will be an IPv4 address space bubble. Mark my words…) Address space is bits. We can make more bits… Look! I just made some! But because the value of a network exists in everyone who is using it, not just your implementation of the network, you can’t just add bits in your IP stack and get any benefit. So, while bits are free, and address space could conceiveably be free, because we have a network with limited space, we have a scarce asset. And, of course, what do humans do with scarce assets? We make bubbles! Yay for bubbles!

OK, now that we’ve gotten kc and tech checked off the list for this post, what about economics? Well, actually I touched on economics above, but there’s something way more fundamental to economics. Fundamental questions tend to be hard to recognize because they seem so obvious. The world would be a lot more sane place if more people took the time to ask this particular question and understand (no… really understand) the answer:

What is money?

In case you are not following me and don’t see why this is a hard question, see if any of these wrong/incomplete answers are floating in your head:

  • Money is the paper with green ink and dead guys on it. And red discs with the other dead guy on them, but it takes 100 of those red discs to make one of the green papers.
  • Money is dollars, euros, and yen. It’s what you spend when you want to buy something. You can change it to the other kind of money if there’s a different symbol in front of the price on the thing you want to buy.
  • Money comes from the government. The Fed sets the rate and it goes into banks, then I get it from the ATM.

These answers are all wrong. Not just a little bit wrong… they are like “the earth is flat” wrong, or “the sun goes around the earth” wrong.

So what’s the answer? I’ll tell you what… the answer is so hard that I certainly can’t tell you. You could earn two PhD’s and not really know. Money is something that humans invented after we invented trade, but before we invented numbers. That means it’s something that’s fundamental in the human condition, and that it is as human as culture and art. You might as well give up on the money question and work on a nice simple one like, “What is art?”.

But it wouldn’t be very nice of me to bring you this far and dump you with no ideas of what money is. What lead me to write this post is this great quote I found in one of the papers kc linked to in her blog posting. Here’s the quote:

The Nature of Money

My very great teachers (Alchian, 1977; Brunner and Meltzer, 1971) taught that a society uses as money that entity that economizes best on the use of other real resources to gather information about relative prices and to conduct transactions. This makes clear that the common — but wrong — statement of Gresham’s Law about “bad money” driving out “good money” needs to be restated. What we have observed through the millennia is that high-confidence monies drive out low-confidence monies (Hayek, 1976, p. 29; Mundell, 1998).

That’s academic speak, and it’s easier to understand if you read it in context. But what it’s basically saying is that “a culture will chose as money that thing which minimizes the costs for them to participate in the market to find the correct price for goods”.

That is profound. It’s very far removed from what we think about money when we are at the checkout counter at Tesco (which for me is usually “Gee, this yogurt will be 37 pence, I hope I have exact change and can make my pocket lighter”).

Here’s a related story from when I worked as an administrator in Liberia for Doctors Without Borders. A rumor was going around the country that “little head” dollars were no longer accepted by the bank. “Little head” dollars? This is Liberian shorthand to describe the difference between newly designed money with the large heads and other security features in them. The rumor, as they usually always are, was based in fact. When currency circulates outside of its place of origin, counterfeiting is easier to get away with. In Liberia, from time to time, I noticed bills that, if they’d been given to me as change in the USA, would have made me call the manager. But as long as the staff accepts them, it’s not my problem. Why do they accept suspicious money from me? Because they have no fear that the guy selling cement bags at the corner will refuse it. That guy in turn doesn’t know or care about counterfeit US dollars, and so the bill moves on through the system.

Banks who do international business don’t feel the same way about counterfeiting. Afterall, if a Liberian bank sends some counterfeit currency to London or New York, it’s not going to get passed on. It’s going to get subtracted from their total deposit amount. It won’t be investigated as a crime if it’s just one bill here or there, because it’s a drop in the ocean and the trail to the original counterfeiter has already gone cold — it was likely introduced by North Koreans into Kenya by way of India and made it’s way across to Liberia overland. There’s a certain cost of accepting money from areas with endemic counterfeiting. It’s perhaps 0.1%, but it’s there. That’s $1 per $1000, and it adds up.

Banks don’t just eat costs like that, they pass them on. One place that cost has showed up is in the exchange rate between USD and other currencies. The exchange rate between USD and Euros is different depending on the bill. Little heads low rate, big heads full rate. I don’t know who actually takes the fall for the fake bills — who’s account is debited when they are removed from circulation. But whoever loses that money is not bothered, because they’ve already covered the cost (and more) on the spread between their “little head exchange rate” and what the true exchange rate should have been that day.

OK, so back to Liberia. When the Liberian banks started charging a differential exchange rate (the same as their partner banks were doing in London), that reality-based fact morphed in the street into “the banks don’t take little heads”. The US Embassy put out a press release to try to stop the rumor. It said, “Dollars are dollars, big head or little. Every dollar anywhere on the planet can be exchanged for any other, and they are all dollars.” Which would be true, except it’s not. If you try to bring $10,000 from Liberia and spend them in the US, the odds that you have a counterfeit bill in there someplace are high enough that you’ve probably brought (on average) $9994 instead of the $10000 you thought you did.

In any case, a press release from the embassy certainly wasn’t enough to stop this story. Whether because they believed the rumor, or because they just didn’t want to be the only one not believing it (the musical chairs effect), within a few days the vendors stopped accepting little head notes. This was a few days before payday, and several staff brought the story to me, worried I would pay them in little head notes that they could not spend in the local market. I showed them the newspaper, and told them a dollar is a dollar. They told me, “a dollar I can’t spend isn’t a dollar”.

I’m going to repeat that, because it’s part of the answer to the question, “what is money?”

A dollar I can’t spend isn’t a dollar.

So, what to do? I called my boss in Monrovia, who’d had the same complaints. She made a quick decision: starting that moment, little head dollars no longer existed in the MSF system in Liberia. I was to find every little head dollar I had (a few hours work, in the end it was about 50 notes totaling about $550) and send them to her. She would send me back big head ones (thereby balancing our books). She’d send all of the little head dollars from the entire mission back to Geneva, and we’d change them there into francs and put them back into the budget at headquarters. Presumably she only chose non-suspicious bills to send back to Geneva, lest “MSF counterfeits dollars” were to show up in the newspapers the next day!

Problem solved. The staff loved me because I paid them in big head dollars. And I learned, first hand, a little bit more about what is money.

PS: Think rumors are funny? Managing rumors and knowing when to give up and get out of the way is serious business for humanitarian aid workers. Here’s an article about 3 Red Cross workers killed due to a rumor. My boss didn’t make the decision she made because she’s a nice lady. She decided this wasn’t a rumor that we were going to kill, and we needed to get the heck out of the way of it.

The New Yorker on Aid Work

There is a really excellent article on aid work in The New Yorker.

Though this is pretty much a write-only blog at this point, and I don’t really know if anyone cares, here are my reactions to the article:

  • It is remarkably candid, but…
  • it is too hopeless…
  • because it focuses too much on the UN and not enough on independent actors.

Of course, any reader of mine know my biases: I am a cynical humanist capitalist from Silicon Valley (engaged to be married to a practical humanist socialist from Switzerland), who chose to work with MSF due to it’s independence. Because this article speaks to the core of my identity, of course my biases are going to be the key to my understanding of it.

First, above all, it is remarkably candid about the reality of our work. There’s a funny-if-it-weren’t-so-sad explanation of how UNHCR field people are reduced to writing reports about reports, and how in N’Djamena, they are compiled into reports about reports about reports and sent to Geneva. He found someone candid enough to tell him the MMM theory of relief workers. He hinted at, but unfortunately did not discuss at length, the fact that many (most?) international UN humanitarian workers are African expats who are doing it for the money as much as for love of the work. There is fertile ground (full of landmines) to be explored there: What does it do to the UN’s effectiveness that many of it’s field people don’t like their job but are trapped in it by economic forces? How can international workers be effective when their primary motivation is not solidarity with the beneficiaries, but with their family (and it’s bank account) back home? What’s the solution?

Next, I say the article is too hopeless. At least one reason it is hopeless is that the situation in Darfur and along the Chadian border with Sudan is so hopeless. It’s a political/economic situation, a proxy war between the West and China. It puts into opposition China’s need for resources and disinterest in international norms with the international humanitarian principles the west stands for. No big surprise what wins out: as usual, follow the money.

The other reason it is hopeless is because the journalist got the UN side of the story. The MSF side of the same story has its roots in our very reason to exist, the MSF charter. MSF is in Chad the same reason we are in any country: because patients need us. MSF has hundreds of stories to tell about people in Chad (refugees, citizens, rebels, soldiers, it doesn’t matter who) who needed help and MSF had the capacity in place to give that help, when and where it was needed. There’s something beautiful in that, and the journalist let the heat, the walled compounds, the driving sand, and the rebel attacks divert his attention from the beauty and the power of what it means to just be there, and to be human, alongside other humans. He came close: he personally experienced the pain we all feel when you can’t do enough for one, let alone for everyone. That’s human, and that’s the hard part of the job.

He missed reporting on the the humanitarian imperative, which is too bad. Did he miss it because his hosts at UNHCR and WFP also are missing it? Or was it there, and he just blew it as a journalist? I suspect the answer lies somewhere in the middle, and I don’t blame him one bit.

Which brings me to my final critique, which is that he doesn’t cover the story from outside the UN bubble enough. But there’s enough other brilliant journalism about MSF and other actor’s work, so perhaps it is valuable just to have the UN story.

Go, read. This article has won a place in my bibliography of humanitarian aid stuff.

PS: The headline is “Lives of the Saints: International hardship duty in Chad”. Headlines are often picked by editors long from the story, and I hope this one was. The people the author talked to undoubtedly told him that aid workers hate to be called heros, saints, or anything other than simply their job title (e.g. log, nurse, protection officer). Our work is too important and too dangerous for us to tolerate show-off heros as colleagues for very long. The professionals in the highest leagues of humanitarian aid (and he met some of them) know they are neither saints, nor heros and they never allow someone to call them one.

The OC

(Good lord is this a day for blogging. I suppose sometimes the dam breaks and the thoughts spill out…)

Today I got a question from Jon:

What is OCA and OCP? MSF is getting into the acronym business like everyone else!

The simple answer: OC = Operating Centre, or Cell depending on the person.

  • OCB – Brussels
  • OCA – Amsterdam
  • OCBA – Barcelona/Athens
  • OCG – Geneva
  • OCP – The mythical Parisian OC, which does not exist as far as I know

An OC is supposed to be a reflection of the difference between the hosting section, which has a responsibility to communicate with the people of the country for temoinage and fundraising, recruit, etc and the OC, which has a responsibility to all of the donor sections that contribute to it to get the work done, and report back what got done, so that the donor section can explain to their constituency what got done with the $$.

MSF France, of course, rejects this model, because along with being fundamentally logical and democratic, it would also result in them having to actually listen to what MSF USA and AU think. The donors to OCB sit on a board and control the work plan of the OCB — MSF Belgium only has one seat on the board, just like MSF USA, MSF, Canada, and the other donors.

So, as far as I know, OCP is a figment of the imagination of whoever wrote it. People who don’t fundamentally understand the governance change with the rise of the OC’s often make the mistake of thinking that the OC’s are just new names for the operations departments of the hosting sections. In the case of “OCP”, that’s true — it is a new name for business as usual.

Baby Season

Marina is doing a project right now in her Public Health class where she has to make a project proposal (the whole thing, with the Gant charts, the budget, etc) for a Maternal Health project in a fictional health district in a fictional country in Africa.

As we were discussing it, I came up with a question… what is the variation in pregnancy over the course of a year? Is it seasonal? If so, in which cultures yes and which cultures no? Why?

It’s important because if you expect 52 complex births a year and each mother needs 7 days in a bed, do you need one bed in your hospital or three? At that scale, it doesn’t matter so much, but add a zero or two onto the end of the figures, and the question of “10 or 30 beds” makes a great deal of difference to budget, logistics, HR, etc.

So you can imagine how I chuckled when this came into my mailbox:

HAITI. The team is struggling to respond to needs of women giving birth these days, as it is the yearly peak resulting from Carnaval festivities in February. For example, yesterday 158 women were in labor at Jude-Anne hospital (60 bed hospital). This means that women were giving birth in every available corner of the hospital property, from the rooftop and stairwells, to the triage space outside. The family caregivers could not enter the hospital due to lack of space and frenetic activity. Also local health structures in Port-au-Prince are still not fully functional, as they are either without proper medical equipment or on strike. This means that MSF is the only hospital functioning in the city for women giving birth. It also means that MSF cannot refer patients to these structures.

(This is from an internal report that I am not normally allowed to forward. But seeing as this information is not security sensitive, I feel comfortable bending the rule this one time.)

At first glance, the idea of carnavale making so many babies they have to be born on the roof sounds a little funny… you imagine a yearly baby boom and who doesn’t smile at the thought of a hundred cute newborn babies?

But to understand why this situation is sad and dangerous for Haitian mothers, you need to understand this: Worldwide, the vast majority of births are not done in a hospital. They are done at home, or perhaps in a health post. Only complex pregnancies (perhaps 10%) need to be seen in a hospital setting. The maternity ward in a resource poor context is only occasionally a scene of joy with beautiful new babies popping out of healthy mothers. More often, it is a scene of fear, uncertainty, pain, and loss. Women who end up in the hospital as a result of a pregnancy have drawn the short straw and are at risk of losing their baby, their future fertility, or even their own life.

If I’ve rained on your parade too much, go visit The White Ribbon Alliance and watch one of their movies. You can get cheered up by hope and strength and get educated at the same time!

Shame and Aid Work

This is a story a bit like mine from Chad, though we were not faced with bandits/rebels/soldiers directly. The feelings of shame and regret she has are related to the complicated feelings I had on leaving Chad as well.

In my case, we had nothing to be ashamed of — we took good care of ourselves and our staff and were not bad guests anywhere. But it does give you a sense of shame that as an expat you are different: you’re allowed to just go away, and your colleagues can’t.

A Call for Help

Something very wrong is going on on South Africa, and the world is missing it:

“It is better for us to be here than go for reintegration. The South Africans want to kill us and the government is trying to kill us. Reintegration’s a death sentence. We’d rather die here together,” said Johnny Kaka.

MSF is only one voice, and though they are speaking out, the immigrants in South Africa need more people to speak for them.

Shame on the African majority of South Africa that they’ve come to this: dehumanizing the African immigrants in their country. There’s no racism here, just nationalism and the simple human stupidity that comes from fear and greed. People on this planet can be remarkably rude to each other, and it’s just an accident of history or fashion if it is due to racism, nationalism, or tribalism. Until we learn to love “the other” as we love our own brother, we will not be able to stop it.

Wow, that was almost biblical. Perhaps this is where the human instinct for religion came from, not that I believe organized religion is really necessary to understand how to live a just life.

NSA is Spying on MSF

Here’s a story that’s, unfortunately, not a surprise:

KINNE: And over the course of my time, as we slowly began to identify phone numbers and who belonged to what, one thing that gave me grave concern was that as we identified phone numbers, we started to find more and more and more numbers that belonged not to any organizations affiliated with terrorism or with military … with militaries of Iraq or Afghanistan or elsewhere, but with humanitarian aid organizations, non-governmental organizations, who include the International Red Cross, Red Crescent, Doctors Without Borders, a whole host of humanitarian aid organizations. And it also included journalists…

As a foreign-domiciled American, I have suspected for a long time that I’m in the surveillance net. But it is something else entirely to read the words from the whistleblower herself, naming my organization.

There’s some great points in that article. If you can bear it, take time to read it all. But above all don’t miss these points:

  • Privacy International rated the United States as a “society of endemic surveillance”.
  • The real culprits are the senators who have utterly failed in their jobs to provide oversight, so much so that really the only conclusion one can draw is that they are complicit in the scheme.
  • The link to the original reporting from Democracy Now with the revelations about spying on NGOs.

This is part of the death throes of a failing empire and democracy. Who knew it would ever get so ugly?

Same conversation, different venue

The dirty secret of aid work… it always comes down to this… the navel-gazing, “why am I here”, “why is it so ineffective” conversation.

Usually it happens around the campfire, over a bottle of locally made beer, or perhaps for the lucky coordination team in the capital city, at the nearby expat-only restaurant over a nice bottle of South African wine. As with everything this century, it’s moved onto the Internet. But the essential tone of the conversation, and the impossibility of resolving the problem remains.

For me the solution is radical. We need to cut the profligate aid budgets and instead put concentrated effort on what’s important: respect for human rights, economic growth, and individual expression and inventiveness. Give a healthy person a chance at education and a stable economy into which to pour his inventiveness and effort, then reward him with results. We know this works. How? Because it’s what happened to Switzerland in the 1800’s, to Brazil in the 70’s, and to Malasyia in the 80’s.

MSF should keep working to put out burning fires — no one is interested in economic growth when there is a cholera epidemic. MSF should cut it’s fundraising and budget down to the point it can only afford do emergency work. (MSF has a lot of make-work projects, where they are looking for and finding an excuse to work in order to burn up the cascade of cash falling on them.)

USAID and DFID should suffer budget cuts of 99%, and should use the remaining 1% to teach good governance. Food aid should be phased out, the WFP should be shut and the core of its expertise should be moved into HCR, another agency that, regrettably, has to keep existing to put out fires.

Places like the Gates Foundation should invest in fundamental advances in healthcare, but should stay out of the field. Their sole work in the field should be along the lines of Mo Ibrahim, who’s foundation rewards good government. Africans need to live in a context of several generations of good government before they will have the confidence to stretch out their entrepreneurial muscles and reach for their dreams.

I am not saying that nothing any of these agencies do is of any value. What I’m saying is that until Africans are living in a world where they are held responsible for their future, and supported on the path, the problem won’t be solved. (And the problem holding us back from universal justice on this planet is Africa, not Asia… watch the videos at Gapminder to be convinced.)

I’ve said it before and I’ll say it again just so no one misunderstands me: Africans are smart enough and hardworking enough to change their continent for the better. Our job, as residents of continents that developed a few 10s or even 150 years earlier is to stand by and support them when they ask for help.

And now a word from your local public health authorities…

Headline from a Scientific American blog posting:

Measles is back, and it’s because your kids aren’t vaccinated

There was a measles epidemic in the canton of Vaud in Switzerland this year. MSF was thinking about intervening and setting up a vaccination site in Place Ripon, but the corrupt, inefficient, and chronically underfunded local health authorities managed to handle the crisis themselves and MSF just monitored the situation from it’s base in Geneva.

Hello parents…. it is not the vaccine that is hurting kids, it’s your stupidity. And, unfortunately, there is no vaccine for stupidity (though turning off the TV certainly helps some).

Crowd control in Ethiopia

My major job in Ethiopia this summer was crowd control. As a log, I am responsible for setting up the facilities where we work — a little bit of pioneering merit badge, architecture, and a whole lot of crowd control.

Here are two pictures from MSF’s interventions in Ethiopia that give you an idea of what my job looked like: the lines, talking to mothers.

MSF training didn’t prepare me for crowd control, which is too bad. There are some simple principles, and learning them by trial and error is dangerous and not very much fun (not for the log, not for the medical team, and especially not for the beneficiaries). The basic principle is “calm people are safe, scared people are dangerous”. Everything else follows from there. Keep people informed, and set up your site so that even if they don’t understand or can’t hear the verbal instructions, they can see what’s happening and be confident that they are waiting for something of value, and that it won’t run out before they get it.