Nick Wadhams

The Kiva Konundrum, Part 2

New studies suggest that micro-lending isn't all it's cracked up to be. Researchers at MIT have found that microlending may make poor people's lives a little easier, but doesn't lift them from poverty.

One of the big problems with micro-lending is that no one really seems to know exactly how effective it's been, and the above Boston Globe story acknowledges that researchers had to come up with creative ways to figure out the metrics. To me, the takeaway paragraph is:

"And once an aid organization or philanthropically minded corporation, won over by powerful success stories, commits to an antipoverty tool, whether it’s microcredit or bed nets or building rural schools, they tend to lose interest in funding research that could suggest that it doesn’t work."

That seems to be a big problem with aid programs. If well-intentioned aid workers invest a ton of time and money in a project, they probably won't particularly want to know whether it succeeded or not.

A sign of the times

I just started Emma's War, a Nairobi bookstore staple about a young, idealistic aid worker who married a South Sudanese rebel leader. One hundred and forty one pages in, I'm most struck by the passage in which author Deborah Scroggins writes: "It was my first foreign assignment for the Atlanta Journal-Constitution. The newspaper had embarked on a long-term project looking at famine in the Horn of Africa."

The Atlanta Journal-Constitition embarked on a long-term project? |Looking at famine in the Horn of Africa? AJC reporters actually went on foreign assignments? To places like Sudan? I almost burst out laughing at how nonchalantly those statements were written. The idea of it now sounds so far-fetched!  Think of the bills that Deborah Scroggins must have racked up! 

The AJC is owned by Cox Newspapers. Three years ago, Cox was considered a good string because it paid the occasional expense; travel was out of the question by this point, of course, but Cox would at least chip in for a taxi ride or a couple of phone calls. Then there was Foreign Editor Chuck Holmes, a wonderful guy. Now Cox has been nuked to near oblivion by the financial crisis. It closed its Washington bureau and canned its foreign staff. Chuck moved on to NPR.

People often ask if it's not boom time for freelancers _ the theory being that newspapers may cut their foreign correspondents but will still need foreign reporting. In the United States, anyhow, that's not the case. Papers have opted to do with the wires, or do without. (The San Francisco Chronicle, once another freelancer stalwart that is now even closer to oblivion, just scratched its foreign service too.) 

Journalists often talk about all the stories that are not being written anymore because no one is willing to pay for them. Here is an example of a fine book that never would have been written if Cox had not been willing to pay for the reportage that forms its core.

More on the female condom

Anna Forbes, the deputy director of the Global Campaign for Microbicides, responds to my post on the female condom:

I hear your suspicion but I can tell you from first hand experience that you are just plain wrong. Women in Uganda do want female condoms – desperately.  We have met with over two dozen organizations serving women living with HIV and/or at high risk of HIV in eastern Africa in the last year and talked with women in all kinds of settings.  Most of them have heard of female condoms but, as one educator told me, “I have never seen one, and I do trainings on them!”

My colleague and I visited five different pharmacies one weekend trying to buy a female condom, just to see if it was possible.  Only one had them in stock. Suddenly, I had a deeper understanding of why guidelines exist for how often you can wash out and reuse a female condom.  The answer is five times before you start seeing significant damage.  Reuse is not recommended but its better than nothing.  And be sure to re-lubricate it, even if you have to use cooking oil.  Does this suggest to you that women do not want female condoms?

The Ugandan situational analysis released last February shows that 65% of new HIV infections are occurring among married people; 60% of all newly infected Ugandans are women (more like 75% if you look just at the 15-49 age group) and that the rate of extramarital sex between 2001 and 2005 increased from 2% to 3% among women and 11% to 18% among men.  So who do you think is actually bringing HIV into the relationship most of the time?  And what on earth makes you think that women don’t want to protect themselves?

One woman told us, “as a woman, my private part belongs to my husband and he is the decision-maker in the relationship.”  Would you like to be the woman trying to negotiate male condom use in that relationship?  Or getting into bed knowing that you may be infected with HIV before morning, as so many of your friends have been?

Here in Washington DC (during the Bush administration), a Congressional staffer I was lobbying once said to me, “I have no respect for a woman who can’t make her man wear a condom.”  I am sorry to say, Nick, that you sound a lot like that guy when you write, “Do they really think that women need the female condom?”  In speaking to you, I did not get the sense that you are so lacking in compassion.  I wish you had taken my suggestion that you speak to some of the Ugandans I spoke with – as that might have clarified your view of the situation somewhat.

One educator told us about doing a presentation on the female condom from the back of a truck. It was market day and she was explaining the device in the hope that it would someday be available to this community.  At the end of the presentation, she was mobbed by women wanting female condoms.  But she only had her demonstration model, and she couldn’t give it away.

What it the tables were turned, Nick?  What if over 99% of the 10 billion condoms distributed globally each year were female condoms and fewer than 1% were male condoms.  What if you had reason to think you were being exposed to HIV every time you had sex?  Might you be crowding around the back of that truck begging for a male condom when someone finally showed you one?  Or would you still be as inclined to suppose that men in your area didn’t really want male condoms, and that promoting them was just part of someone’s money making scheme?

I slightly resent the remark that I'm lacking in compassion, and I didn't mean to suggest in my previous post that I don't feel compassion for women who want access to female condoms. Otherwise, this strikes me as fair criticism from someone who knows a great deal about the issue.

Female Condom Redux

In a story for Time.com, I revisited the story of Uganda bringing back the female condom. Partly this was because I got some more interesting reporting after submitting a story I wrote for The Lancet. The big issue for me is this: How much credibility you ought to give nongovernmental organizations that demand a particular initiative? Do they really think that women need the female condom? Or do they see a potential female condom campaign as a source of revenue?

My suspicion in the case of Uganda's female condom initiatve is that it's the latter. It's difficult to imagine a product that is poorer suited to fight HIV/AIDS in Uganda, chiefly because the virus is spreading most quickly among people who have more than one longterm partner. Those are the people least likely to use any form of protection at all.

Now there's more literature coming out that lends credence to something it's impossible to ignore when you're on the ground. Local NGOs are often a way for their founders to make a living, and the altruistic part comes later. The people who run them are entrepreneurs more than anything else, skilled in the ways of grant-writing and development-speak. This has been going on for years and ought to come as no surprise -- one of the key indicators of a charitable group's efficiency these days is the percentage of your donation that actually gets to the person you wanted to help. It is hard to fault someone who has the initiative to make some cash, but as in Uganda's case, the trouble comes when the campaigns they preach may actually hinder development or the fight against HIV/AIDS.

I have been thinking about this a lot lately as I wait for various strings to publish stories I wrote about jatropha curcas, a wild plant that has been hailed as the next great step in the biofuels revolution. Overzealous advocates of jatropha (who in many cases have a financial stake in the plant's success) persuaded poor farmers to plant jatropha based on claims that would be impossible to meet. It turns out jatropha isn't all it's cracked up to be, and smallholder farmers are the ones paying the price.