Thursday, December 30, 2010


Hello, two versions of the books are uploaded, both in separate post. The first post is how the book actually appears. But unfortunately the preview does not allow the text to be read. The second post is a PDF which has some display problems but is readable. Please, if you find any mistakes please let me know so that I can correct it before I order a print.


Book 1

Malawi Computer Version


Sunday, December 19, 2010


“Hey man, how’s it being back?” Or my personal favorite, “how was Africa?” Shit, I don’t know. Not exactly the response most people are expecting, especially not medical school interviewers, so I fabricated answers. As time went on I developed talking points that fit with what people expected; a nifty collection of stories and insights that portrayed a challenging but positive experience…blah, blah, blah. Not exactly prevarication, but not exactly candid. The truth is, I don’t know how to encapsulate the experiences of an entire year in a terse narrative. Ignoring this challenge, a larger obstacle remains: I'm not sure what aspect of my time in Malawi was meaningful. No doubt the experience felt impactful, but the stories I have been telling about power outages, matola rides, and cold showers are superficial. Day to day occurrences of this sort, though novel at first, have a way of fading into the background and becoming normal. Taking cold showers did not define my Malawi experience; it just makes easy conversational fodder.

In the five months since my return to the United States I have struggled to untangle the mess of experience and emotion which surrounds Malawi in my mind. I have tried to distill the elements of Malawian life which were meaningfully unique and which transcend the superficial descriptors to which travelers so often digress. It was, and is, a personal question, one which I hope to communicate here with as much clarity as my mind allows.

At many times throughout these blog post I have commented on the opportunity which Malawi afforded me to think and, in retrospect, this was one of the most meaningful parts of the past year. I didn’t fully appreciate this until I had been back in the United States for several months. Even without the help of a full time job I still managed to fill nearly every second of my day, be it constructively or otherwise. There is always a new book to read, a friend to see, an email to respond to, or some other industry of life. Malawi is a far less stimulating environment than the United States but more importantly it is a different environment. There are different ways to spend ones time and they were not endeavors to which I was accustomed. Given several years I expect that I would have filled my life with commitments analogous to those I have in the United States, but in just eleven month my time remained remarkably unrestrained. Mr. Mtemangombe, a fellow teacher, once commented that I had more time than him because I didn’t have a real life, an astute observation which he intended without judgment. When Mr. Mtemangombe returned home he had a business to run, a family to take care of, a house under construction, and an active role in his community. I had none of these things. For the first few month of college I had noticed a similar phenomena; a plethora of free time arising from the fact that I had not yet chosen where and how to exert myself. Since life in Malawi represented an even larger departure from normality than beginning college, my idle time was even more abundant. Remove, family, friends, Gmail, television, and facebook from your life and you save a prodigious amount of time. Just as the novelty of Malawi was affording me an idleness I had never before experienced, it was also presenting me with a cornucopia of challenging and thought provoking ideas. Although the majority of my time in Malawi quickly became “ordinary,” with uncanny frequency Malawi’s many idiosyncratic quirks would emerge from the mundane and leave me scratching my head. The result was a year of engaging philosophical thought and learning that differed markedly from the type I had experienced during my formal education. Without the accountability of a teacher or an assignment I could take the time to allow questions to appear, rather than forcing them to do so. I could spend an hour entertaining an idea in the hammock; take the time to read several book on a topic; write down my thoughts and ideas without the need for a conclusion or the exigency of a deadline. The blogs provided an outlet for some of what I was thinking, but for every page posted online there are countless pages on my hard drive written without purpose or intent. It was learning for the sake of curiosity with a lack of deliberateness in which I had never before had the pleasure to indulge. It changed my day to day experiences in a way that remained novel, even as the more superficial parts of Malawian life faded into the background. These periods of introspection and contemplation defined my time in Malawi in a way that is personally meaningful up to this day.

I left Malawi with grand aspirations to continue this new found intellectual diligence. In most ways, I have failed. It is no coincidence that this blog post comes more than 5 months since my return to the United States and more than 6 months since my previous post. I kept telling myself that I wanted to give my feelings from Malawi time to “sink in” before I put them down on paper. In reality, continuing the introspection and contemplation I valued in Malawi has been much more difficult than I expected.

I am realizing how important the novelty in Malawi was to sparking my thinking. Since Malawi, I first felt compelled to write a blog post after I began temping in the seedy world of Chicago construction. Although quite different than Malawi (well, the corruption is a striking parallel), I was once again operating in a foreign environment and interacting with people from entirely different backgrounds. Just as in Malawi, an offhand comment by a coworker would give me something to ponder for the rest of the day. There was nothing inherently stimulating about Malawi; except in the sense that it utterly ravaged my autopilot and forced a clean break from the regimen of routine. This opportunity allowed for a change in perspective that was very stimulating and, I think, enabled the presence of mind I enjoyed in Malawi.

Retaining my Malawian mentality was also mired by the manner in which I returned to the United States. For better or worse, I didn’t have time to transition from Malawi to America. Literally days after arriving home I began a marathon of stressful medical school interviews. Nothing fosters genuine reflection less than the combination of severe jet lag, coffee jitters, and a medical school administrator asking you to summarize the most meaningful aspect of an entire year in Africa in one minute or less. Now that the dust has settled, my year in Malawi feels dislocated in my memory. It is as if my brain compartmentalized itself into American life and Malawian life. This made my transition back to the United States almost too effortless, since I essentially left much of my Malawian persona behind and slipped back into the person I was a year before. I became involved with friends and family, and also the daily distracters such as email, computer games, television, and facebook. With the benefit of hindsight, I now recognize that when I left Malawi I also left behind a part of myself, a part that I hope to, with time and due diligence, incorporate back into my life.

Saturday, November 21, 2009


I made a personal promise to myself at the beginning of the year that I would not let these blogs digress into a commentary on my gastrointestinal tract. If you have appreciated this goal then read no further. For those of you who are still with me, welcome to my level. During my first few months in Malawi being prepared meant carrying toilet paper in my back pocket. I never had serious intestinal problems, but I never knew where or when Malawi’s microscopic populace would hold a party in my gut. As time went on one of two things happened. Either my body dominated the locals or, as is more likely, the locals setup shop inside my intestines and decided to exist in a continual state of asymptomatic parasitism.

The problems which marked my first few months in Malawi had nearly faded as I entered the home stretch of my time in Africa. Aside from the heat, which drenched my shirt everyday by 8am, things were going well. I had discovered that my neighbor Ayub had the best fan in a 20km radius and had consequently taken to absconding to his house in the afternoon. On one such afternoon I was basking in the afterglow of a huge afghani meal when I began to feel a dull ache in the gut. I initially passed off the pain as the result of overstuffing my shrunken stomach, but later that night the pain returned. After dinner I laid down on the bed and began massaging my abdomen and complaining to Jes who was taking her customary pre-bed shower. “When did it start?” She yelled over the shower water.

“This afternoon at Ayub’s… I think its just gas though,” There was a pause in the conversation as Jes rinsed her hair.

“Where does it hurt?” I moved to the left side of the bed so that I was visible through the open bathroom door.

“Right here,” I said, jabbing a finger in my lower right abdomen.

“Huh, weird,” said Jes as she turned off the water and began toweling off. I went back to massaging my abdomen for several minutes until Jes walked by on her way to the kitchen and said in an offhand way, “isn’t that where your appendix is?” My heart did one of those sudden big lub-dubs that is followed by near normal heart beats and a feeling of anxiety flowing from your heart to your extremities. I had actually already noticed that the pain coincided with my appendix but somehow having another person make the same observation added to the credibility. The pain was pretty minor though and I convinced myself that it would probably subside by morning. It didn’t.

The dull ache in my abdomen continued throughout the next week in both a very reassuring and disturbing way. The pain didn’t get any worse, a fact that I used to rationalize to myself that I was okay. The pain also didn’t get any better, a most unsettling detail that provoked worst-case-scenario dramas to play out in my head as I tried to sleep.

My medical options were slim; I could try to get the problem looked at locally or I could go to one of the private hospitals in Blantyre. When Jes had gone to Koche, the local clinic up the road, the young man examining her had proudly announced that he was going to be taking his MSCEs soon. The MSCEs are high school performance exams so Koche was obviously not a good option. The Mangochi District hospital was a little bigger and a little farther away but also did not have much to recommend it. Mangochi District Hospital serves 50,000 people and has three doctors. An American medical student who worked there once recalled to me that he had seen ants crawling inside an IV tube attached to a person. I had heard good things about the hospitals in Blantyre, but they were a 5 hour bus ride away, a journey not to be taken lightly. I didn’t feel justified going to Blantyre since the pain was, admittedly, pretty minor. I had heard horror stories from a friend in college who had had appendicitis and my lackluster symptoms didn’t seem to compare. I decided to hold out a while longer and hope for the best.

I woke up Sunday morning and the pain was worse. I tried to tell myself that it was worse because I had spent the last week pushing and prodding my abdomen, but the time for rationalization was quickly passing. It was at this moment that I realized how nominal my ‘health insurance’ really was. Jes and I had both purchased catastrophic travel insurance before we left the states. The policy, aside from having a high deductible, was pretty good. It would airlift you out in case of emergency and would pay up to two million dollars. Yet before you can be flown out of country you need to find a plane, that means Blantyre or Lilongwe. Both cities are hours away on bad roads and I sincerely doubt a leer jet is standing by. As comforting as those travel insurance plans feel, I suspect Jes and I were, and are, at the mercy of local medicine in nearly all emergency scenarios. As I faced the prospect of acute appendicitis, my options were really no greater than a well to do Malawian.

I decided that I had to act now as it would take a considerable amount of time to access medical care. I talked to Jes and we made the decision to go to Blantyre if it was appendicitis. Mr. Sibale, the director of MCV, was at the campus on Sunday and we discussed my options. He knew a doctor at a local private clinic that I could probably see Monday morning with little delay. ‘Little delay’ was key since a visit to the district hospital could mean waiting the better part of a day. Every time I walk past the district hospital I see a meandering line of people emerging from the entrance, baking in the blistering sun. The line moves so slowly that people can be seen sitting or sprawled on their backs as they wait. I resigned myself to the fact that I would have to wait till Monday for any answers. Much of the country closes down on the weekends and this, to some extent, includes transportation and medical services.

Monday morning came and the pain was worse. As I went to the breakfast table I felt my abdomen jarred by pain from the movement of walking. Jes joked that it was probably because I was so heavy footed, but her teasing manor couldn’t mask the nervous edge in her voice. I didn’t feel like eating so I drank a protein shake while Jes picked at some bread and mangoes. Sibale arrived at 8am. I stepped gingerly into the front car seat and bade farewell to Jes. We had both decided she should stay and pack incase we had to go to Blantyre. The 30 minute drive to the clinic was mostly paved but bumpy dirt patches caused me to rise off the seat in a vain attempt to shield my abdomen from the rough road.

The clinic was part of an Islamic charity that has a large compound with a school and a large garden. The school and the garden looked well maintained and I became hopeful that the clinic was equally cared for. It was, but unfortunately quality does not go unnoticed in Malawi. Several men were sprawled out on the front steps and every available seat and patch of floor was occupied by sick looking people. I was ushered over to the check-in desk where the attendant promptly asked to see my health book. A health book is a small notebook used for medical records. It has things like your weight, age, sex, and notes from past clinic visits. Never having visited a Malawian clinic in a patent capacity, I had no health book. Every clinic is pretty strict about patients having their health books and seeing as I have chewed out patients for not bringing them I really couldn’t blame the attendant’s instance. Fifty cents later and I was the proud owner of a Malawian health book, yahoo, only $2499.50 more until I satisfy my insurance deductible. I was then ushered over to a line of chairs against the back wall. After several minutes of waiting someone came out of the door to the right of the chairs and the person seated next to the door rose to enter the examination room. Immediately, every other person in line shifted to the next seat with amazing speed, considering most were probably sick. I was reading at the time and kind of missed the cue so was leapfrogged by the woman behind me. ‘Oh well, I’ll get it next time,’ I thought.

After five or six more seat changes I was the one entering the examination room. I was pretty thrilled; the queue had only taken about a half hour. Inside, there were two women, a small bed, a scale, and an old-school blood pressure machine. I immediately realized this was not the doctor’s office, just the pre-doctor screening. I guess there are hoops to jump through in every country. I was weighed (147lbs, okay I have lost some weight on the beans and rice diet) and had my blood pressure taken (120/80 – pretty good numbers, guess I am not dying yet). I was then ushered to the next, longer, line of chairs. To my relief, the door at the end of this line read, “doctor’s office.” Forty minutes later and I was face to face with a doctor with just enough gray hairs to exude a reassuring and competent manner. I had done some research on appendicitis and so tried my best to convey actual symptoms without imagined or embellished details which always occur after one reads what they are ‘supposed’ to be feeling. The doctor asked me some questions and did all the physical appendicitis tests. “Well,” he said, “I think you have acute appendicitis.” He started writing in my health book. Reading his scrawl upside down I saw the entry: refer to Mangochi District Hospital for management. “So you think I should go to Mangochi District Hospital?” I asked. He looked up, a bit startled that I had been reading his notes.

“Mangochi is where we refer appendicitis cases,” he said in a voice that sounded like he used this line frequently.

“So they can treat appendicitis at the district hospital?”

“Well it where we refer patients for appendicitis.”

“I heard that,” I said, “but would you recommend going there?” He stopped writing momentarily and fixed me with a gaze that for the first time suggested he was pulling out of automaton mode.

“Well, if you need surgery you may want to go to Blantyre,” he said.

“Do you think I will need surgery?”

“In my experience most appendicitis cases are surgical.” He paused again, and then said in a rather frank voice,

“You should go to Blantyre.”

“That’s what I needed to know,” I said, and thanked him for his assistance. He gave me some useful information on hospitals in Blantyre and within minutes I was on the phone to Jes. “We’re going to Blantyre,” I shouted into the phone as the SUV bounced along the bumpy road. Jes had spent the morning wrangling transport and had serendipitously been connected with Octavio. Octavio is the former ambassador of Portugal and I had spoken with him on several occasions as he often stays at his lakeshore chalet near MCV. He happened to be returning to Blantyre with his wife, and upon hearing about my medical predicament, had moved up his departure time.

I decided to remain in Mangochi since it was on the way to Blantyre. I waited on the dusty steps of Peoples, the local quickie mart chain. The sun was overhead and the temperature was steadily climbing into the mid-nineties. I pushed on my abdomen to see if the pain had gotten better. Ouch! Still there. After about a half hour of imagining a gruesome death on the steps of Peoples, Octavio’s gleaming Toyota Land Cruiser arrived. Octavio was dressed in a smart polo and the air conditioning was blasting. As I stepped into the car I felt as if I was also stepping out of Malawi…well, at least out of Mangochi. In just two and a half hours –a full three hours faster than the bus – we arrived in Blantyre.

Jes and I had decided upon the 7th Day Adventist hospital which came with good reviews from everyone we talked to. Their slogan is: we care, god heals. I secretly hoped the hospital also healed, but was prepared to accept intervention on my behalf from any source. After proving that we had adequate financial resources (in my case, being white was enough), I was ushered back to a waiting room that was so cold I was shivering within minutes (in retrospect the room was probably in the 70’s, but these days anything below 80 is too cold).

My doctor was a young and very nice Chinese man with an American accent. He became excited upon hearing that I was here volunteering for the year. “That’s how I started out in Malawi too,” he said, and then with a sheepish look added,” and I never left.” After a bit of poking a prodding he said, “I am going to admit you and call the surgeon for a consult, it does present like appendicitis.” The doctor seemed worried about my condition and before I left the examination room the surgeon had been called and was on his way. I was promptly put in a wheelchair and wheeled to the ward, a trip that actually involved going outside and down an alley. Nice to know I am still in Malawi. As I was taken down a barren but very clean hallway I couldn’t help but feel as ifI was in the 50’s. Nurses (all female) walked up and down the corridors wearing white dress uniforms with little white hats. My room was painted white and was barren except for a curtain and an old-style iron frame bed. Behind the curtain was my roommate, an older and well-off Malawian man.

The surgeon also poked and prodded me and after asking several questions said, “I don’t think this is appendicitis; wrong place wrong symptoms. It could be an infected caecum. We will give you IV antibiotics tonight and if it doesn’t get better we will operate tomorrow.” The surgeon left and I picked up War and Peace and prepared for a long night in the hospital.

A small placard on the wall said, “Visiting hours strictly enforced. Patients will be billed for unauthorized visitors present outside of visiting hours.” The approved visitation times were very short and I thought the stipulation seemed rather strict. Visiting hours were also maintained at the hospital I worked at during college, but the rules were pretty lenient and almost anyone could visit at anytime if they checked in. The rules at the Adventist hospital also seemed at odds with the attitude of my doctor, who had encouraged Jes to stay with me, even through the night. The rationale behind the visitation rules became clear when, at 5:30, the hospital was besieged by an army of visitors. The halls were suddenly filled with a mass of talking bustling people darting in and out of rooms. My roommate had about 30 visitors crowed around his bed. Visitors entered the room single file dressed in their Sunday best. They all spoke with my roommate briefly, then relegated themselves to the far side of the bed and stood in respectful silence while others took their turn. Visitors entered in phases, and although there were never fewer than 20 people in the room, it was obvious the different visitors belonged to different parts of my roommate’s life. Some groups interacted with the intimacy and familiarity of family, while other groups were clearly professional associates. Many visitors, upon noticing my glaring lack of visitors, came over to talk to me. It was quite nice to have the company and I ended up meeting the author of the biology textbook Jes uses in her class. As much as I have bashed Malawian textbooks in past posts, his is one of the better ones. Upon hearing I was from Oregon he became excited, exclaiming that he had done his undergrad at Whitman, small world.

After the half hour visitation period had passed I gained a full appreciation for the strict rules enforced by the hospital. All the people are nice, but very exhausting. United States hospitals can escape with lenient visitation policies because no one comes to visit. Okay, that’s a bit of an exaggeration, but in the entire year I worked at Penrose St. Francis Hospital in Colorado Springs I did not see as many visitors as I saw in just a half hour in the Blantyre hospital. I have come to the opinion that everyone and their uncle, their neighbor, and their distant cousin visits hospitals in Malawi. Seeing the positive affect these visits had on my roommate really made a strong case, in my mind, that we need to step it up in the old USA. The visitors even improved my mood since my roommate, in true Malawi style, shared his extra visitors with me.

My first night in the hospital (or any hospital for that matter) strangely reminded me of trying to sleep on a long airplane flight. People kept waking me every 3 hours to tale my blood pressure and refilled my IV. Jes, feeling guilty about sleeping in my bed in the presence of sisters (all the nurses are nuns), had been sleeping on the cement floor but after several hours of fortitude was overcome with weariness. The nurse, upon entering the room to find Jes in my bed, made a comment along the lines of: “what took you so long.” Morning came slowly but was punctuated by another half hour of visitation when my roommate once again entertained dozens of guests.

I spent the following day in the hospital in a manic cycle as my abdominal pain fluctuated from better to worse to better. By the end of the day the pain was a bit better and the surgeon decided that my problem was actually an intestinal block which should pass with proper medication. I was pretty stir-crazy by this point so was very in favor of being discharged. The surgeon agreed that I was probably safe to leave but recommended I stay close by until the symptoms completely disappeared.

I am feeling completely better now and am back in Mangochi. The experience made me appreciate how accessible quality medical care is in the United States. I was in one of the best hospitals in Malawi and there were no CAT-scans, no MRIs, and I suspect, few specialists. There was a poster on the wall advertising the visitation of a neurosurgeon to Blantyre. Apparently a neurosurgeon from South Africa spends part of his year visiting, for several days each, seven sub-Saharan African countries. The poster listed the dates he would be in each country and stressed he was only doing consults. While this neurosurgeon is shared by seven countries, my home town of 50,000 people has two neurosurgeons to itself. The level of care available in Malawi, even at the best institutions, is limited. Imagine having access to care only as sophisticated as a community clinic in the United States. Who do you know who would be suffering? Who do you know who would be dead?

Sunday, November 8, 2009

It’s the Economy Stupid

In Malawi, one has a lot of time to think. I think while I pump water (Jes and I pump all our water with an MSR hand-pump), I think while I walk down the road, and I think with quite little distraction when the power goes out every night at 6pm. What has come as quite a shock is that my mind has chosen to occupy itself with economics during these moments of monotony. In college, Adam Smith was about the only economic theorist I read. Over the last several months I have been kicking myself for never taking an economics class. I am sure many people share my regrets based on the recent bamboozling financial quagmire. However, being cutoff from all but the most superficial and inane news, my impetus for economic learning has been quite different.

Malawi provides a unique perspective from which to observe economics. I can literally watch the flow of goods as they move from farmers to market, and as they are distributed from wholesalers along a chain of increasingly smaller, more expensive, and more remote shops. When I walk into the market and see only one stand selling tomatoes, I know the price will be steep. A haggling system also makes painfully clear that prices are motivated, not by value or cost of production, but by what someone is willing to pay. In the United States, although the same forces of competition and scale are at work, they are shrouded from view by an economic system so large and complex that it operates beyond public perception.

Poverty is probably the most visible economic phenomena in Malawi. The last time I saw poverty as severe was on a school trip to India several years ago. I remember wondering why people, who appear to contain the same intelligence and ability as Americans, have so much less wealth. The question seemed simple enough, and I asked several of the economic majors on the trip. Their answers were never satisfying and seemed to explain the poverty simply by restating it. “Indians are poor because the country has a low GDP,” and, “people are poor because their wages are low,” were common responses. The response concerning low wages progressed my question, but simply shifted the quintessence of my query to wages; why are wages low? After returning to the United States and school my thoughts were diverted to more immediate concerns.

In Africa, however, the question resurfaced, and I once again started asking people about the cause of poverty. Malawians usually have two responses to this question. First, they claim that Malawi is not poor, only its people. Now this sounds nonsensical at first, but it is really a statement about wealth distribution. Malawians see BMWs drive down the road, they see wealthy resort owners, and they assume that the wealth is there and that they aren’t getting their share. As appealing as this explanation is, it is utter hogwash. In a country where there are few natural resources and the per capita income hovers around 500 US dollars, even the most egalitarian economic distribution would still leave Malawi, and its people, poor.

The second rationalization I get from Malawians is that the country is lazy. This explanation is really a statement about how hard and how much Malawians work. It is true that the country enjoys a more relaxed professional culture than America. People take long lunch breaks, take mid-day naps, and work far fewer hours than Americans. However, when I see a Malawian tirelessly building a house in 100 degree heat, or carrying lumber for 10km on foot, I can’t believe Malawians are categorically lazy. Even if Malawians do work less than Americans, say 4 hours instead of 8 hours per day, the pay differential should be one half, not one orders of magnitude greater.

Although the laziness argument is a bit of a scapegoat, it did make me think about how much Malawians really accomplish with their labors. I was recently provided with a rather illuminating example at a roadside basket stand. An elderly woman sat on the ground, surrounded by stacks of woven baskets, mats, and little miniature cars targeted at tourists. I asked the woman how long it took her to weave one of her mats and she replied that it took about a day and a half. A person working in a factory in the United States could probably produce 100 or more such mats in the same amount of time. It was at this moment I realized the answer to my question. Wealth is simply the result of productivity. A person who creates 100 mats will have 100 times the wealth and purchasing power as a person who creates one mat. The man who hauls lumber on his back will probably work harder than a man transporting lumber with a truck, but he will transports far less lumber and therefore have far less wealth. At the rate Malawians weave mats and transport lumber, a considerable number of people are required to satisfy the country’s need for mats and lumber transport. In the United States, those same people are free to pursue other endeavors of production. They make cars, make television, build houses, and create the multitude of things we associate with wealthy societies.

Overall, Malawi’s human capital is probably held tied up most by its unproductive agriculture. Malawian farmers till their fields by hand and, as a result, cultivate far less land than a mechanized farmer. The national statistics are staggering; 87% of the population is employed in farming, not because Malawi is a prodigious agriculture exporter (although they do export food), but because unproductive farming necessitates massive human capital. In a developed country only 2-3% of the population is needed to produce sufficient food.

It seems clear that Malawians are poor because their overall productivity is low, however, within specific sectors of the economy the productivity argument appears to break down. What about teachers? Malawian teachers provide an inestimably valuable product and produce it at productivities roughly equivalent to their higher paid American counterparts (In some instances the teachers in Malawi may actually be more productive due to larger class sizes). If compensation is related to productivity, why then are Malawian teachers paid 2,500 dollars a year while American teachers receive more than ten times as much. I only saw the reason after I accepted that teachers, like other service professionals, don’t really produce anything. Now this seems harsh, especially given my current occupation. But to admit that teachers (and people in other service professions) are unproductive is not to say their labors are without value. Education and other service sectors are like oil to the economic engine; it aids the productivity and functionality of the engine, without actually providing the power or means of movement. The educational sector trains workers and develops production technologies. The health sector keeps everyone alive so that they can continue to work. And the financial sector determines how to distribute capital so that it best increases productivity and growth (at least in theory). Nowhere in these activities are the material goods associated with wealth produced. Therefore, the compensation of individuals in the services sector is inextricably tied to the wealth of the industrial complex that surrounds it. The teachers in Malawi are paid by student fees which are collected from families that are employed unproductively. The teachers can only charge what families can afford to pay and this fact limits the wages of Malawian teachers as well as all other service professionals.

Even from the examples of the basket weaver and the lumber transporter the root of Malawi’s low productivity becomes obvious, technology. The basket company in the United States uses machines to construct the baskets. A transport company uses trucks driven on paved roads, a practice far more efficient than carrying freight by hand over rough ground. Observing the consequences of low productivity in Malawi has given me a new appreciation for the touchy issue of automation in the United States.

Whenever a new machine or process eliminates jobs in the United States there is public outcry. Generally such occasions are viewed as evil companies maximizing profits at the expense of workers. I don’t really care to debate the morality of businesses, but looking at the end result of automation is instructive. Lets assume a new machine is created that eliminates the need for bank tellers (okay this has already happened, but it is a good example nonetheless). The most visible consequence is lost jobs and this is unfortunate indeed. However, people often fail to follow the less visible consequences of automation. Some of the money once paid to employs will pay for the ATMs, which will inevitably fund new jobs in the growing ATM-making industry. The bank, at least in the long term, will also realize an increased profit since the ATMs must cost less than humans to justify their use. The bank can then use that profit in three different ways: it can lower bank fees (effectively raising the income of everyone that uses banks), it can reinvest in the company (creating more jobs), or it can invest the money outside the company (creating jobs in other industries). Even if banks choose to lower bank fees, jobs will be created because consumers will now have more money to spend or invest in different areas of the economy, growing employment in those areas.

However, the most important effect of the ATMs is an increase in productivity. The banks continue to operate at the same capacity but with fewer employees. The laid-off workers (or to say it nicer, “liberated human capital”) can now be employed in new fields that provide new products to society. Imagine if all those people were employed at a new electronics company that produced wristwatch televisions. Everyone could have a wristwatch television; wouldn’t that be great? Well, maybe not. But some of the people could also become therapists and spiritual leaders to help people cope with the societal consequences of ubiquitous wristwatch televisions. My point is, is that liberated human and physical capital can be used in new endeavors to improve everyone’s quality of life.

This process of ever increasing automation, efficiently, and productivity is what has allowed the United State to enjoy such a high quality of life. The absence of such a process in Malawi has left the country devastatingly poor. In the developed world, the effort we spend castigating companies for improving efficiency at the loss of jobs would probably be better spent helping the now unemployed workers retrain and retool. If you question whether this process of ever-increasing productivity is worth the turmoil caused for employees and their families, I have one bit of advice: come to Malawi.

Most Malawians (almost 80%) live a rural subsistence lifestyle, largely due to 30 years of economic and social policy under President Banda. Because of Banda’s policies, Malawi represents the starting point of economic development. The humanitarian costs inherent in such a state of existence are staggering. The low productivity and ensuing poverty means that many are malnourished, healthcare services are appalling, and the education system is accessible to few. I think few Americans would find the standard of living in Malawi acceptable.

The economic question de jour then becomes: how can the quality of life in Malawi best be improved? One approach is outside humanitarian aid. Malawi receives so much outside aid that it accounts for 15% of the country’s nominal GDP. The money certainly assuages some human suffering, but after a year as an aid worker I question its long-term effectiveness. Fifty years of aid-culture in Malawi has bred significant dependence and done very little to progress people’s standard of living. There are of course pockets of success, but by most social measures the country has stagnated for the past 50 years. Much of the humanitarian aid that enters Malawi also has the downside of being unsustainable, a fact that was painfully revealed to MCV (and many other NGOs) during the latest economic recession.

Another way to increase quality of life is to increase productivity. This inevitably involves moving people away from a traditional lifestyle towards a more productive and developed economic system. For this to be realized you need technology, you need the tractors, machines, and factories that fuel affluent lifestyles. Unfortunately, Malawi lacks the capital for the significant internal investment needed for development and consequently requires external input. In short, the economy needs to become more open to investment. Before coming to Malawi, this investment-economic approach to achieving humanitarian aims always gave me pause. It always struck me as exploitive. International companies extracting huge profits while the locals receive a pittance. I was also concerned with the reports of cultural disintegration and the dilution of traditional beliefs with the popular culture of the western world. My angst with both criticisms of development has been tempered, though not eliminated, by my time in Malawi.

Let me begin with the argument that development and globalization destroys traditional culture. Every night outside my house I am serenaded by the singing and drumming of the female boarding students. Their performance is nearly always prompted by the nightly hour-long brownout. In the unlikely event the Malawi Power Board avoids a blackout, the girls remain inside and the air is silent. The other night, as I sat listening to their performance in my sweltering hut, I began to wonder how much singing and dancing is afforded nationwide by the regular blackouts. What effect would just one more hour of electricity have on the culture heritage of Malawi? Who knows, but I suspect the singing outside my window would stop. As people’s lifestyles change it seems inevitable that beliefs and behavior will follow. However, I doubt that this cultural change will morph Malawi into a nondescript country without any semblance of locality.

The missionaries who came to Malawi started the process of globalization over 150 year ago and still the religious character of Malawi remains as unique as ever. Yesterday I was relaxing under our school’s baobab tree with other teachers in a vain attempt to escape the mid-day heat. As the conversation turned to religion (as it so often does when a heathen such as myself is present) I asked what effect they thought Christianity and Islam had on their traditional religions. I thought the biology teacher had an interesting point; he said that the evangelical religions brought new options that were relevant in some, but not all, situations. He appreciated both his Christian and traditional beliefs and embraced both ways of thinking without any apparent contradiction. People in Malawi are always on the prowl for new religions to try; religions are almost viewed as an a la carte offering. Jes is constantly being asked to start up a Jewish group and half the teachers hold strong convictions that I should start a congregational church so they can have a go. Religion here is a smorgasbord of options and even the imported religions like Christianity and Islam have a strong local flavor. Overall, I would describe the religious culture here as more interesting and unique because of outside influences. As more culture and technology is imported into Malawi I do see some traditional culture disappearing, but just as often I see new ways being blended with old to make a culture that is uniquely Malawi. Last night I saw a group of students singing and dancing around the tinny drum beat of a cell phone speaker, giving me hope that the bane of development will fail to usurp the vivacious character of Malawi.

From more cultural concerns, I would like to move on to the argument that investment led development is inherently exploitive. When outside companies (usually manufacturers) enter a developing country the rewards of the partnership often seem one-sided. When a company ships manufactured goods from the 3rd-world they attach an enormous mark-up, little of which is seen by those actually making the product. When I walk into an American department store and pay 50 dollars for a new pair of jeans, the thought that those making the jeans are paid less than a dollar a day is a little unsettling. Such measly wages seem almost immoral. However, after living in Malawi for a year that dollar-a-day figure doesn’t have the same shock value it once did. In Malawi, there is nothing insulting about paying a worker a dollar a day; in fact, it is a good wage that many would be happy to receive. I can actually foresee it being socially disruptive to pay factory workers significantly more than the local market income. What sort of harmful incentives would be created in an economy where a seamstress in a textiles plant makes four or five times as much as a teacher or nurse? Is that justice? Regardless of how one-sided the rewards of third world investment appear to be, it is wrong to assume that local communities do not benefit; they actually benefit a great deal.

The MCV sewing program recently made the choice to enter into what is called piece work, basically a compensation system where companies (often international) auction out large sewing orders at very low per item rates. The piece work system is how most commercial sewing is conducted and has a bit of a stigma because it produces a ruthless bidding system that leads to low wages (at least by American standards). MCV is making prison uniforms at 70 kwacha a piece, or about 50 cents. The people working in the sewing program start at 170 kwacha a day (about 1 dollar) and are expected to produce a certain number of uniforms, though I don’t think a quota system is in place. Although piece work has a bit of a stigma, I actually applaud Nettie’s (Nettie is the director of the sewing program) decision to change the sewing program. Previously, the sewing shop was routinely empty as the tourist orders on which the program relied were infrequent. “Piece work” may not have the same cachet as “tourist boutique,” but it has allowed the sewing program to train and employ a roomful of people, giving skills and a dignified livelihood to individuals who previously had none. Even at a dollar a day, employees can save for the future, pay for their children’s education, and appreciate the stability of an income. Now when I walk into the sewing shop there is a positive vibe; people are in a great work environment and proud of their vocation. The biggest complaint I hear in Malawi is that there is no work. People want and need employment.

As long as a humane work environment is maintained, I see nothing immoral with outside companies bringing factories to Malawi. This may feel exploitive, but for all its evils this type of investment-led-development has helped lift millions out of poverty. China, and to a lesser extent India, have both embraced this style of economic development and have seen their incomes and access to basic services increase dramatically. Meta studies have consistently shown that developing countries with open economies and high levels of external investment post much larger economic and humanitarian gains than countries relying on internal investment alone.

I still have reservations about the future of development in Malawi. If wealthy companies enter Malawi, the lopsided power between companies and employees could easily create an environment where workers are exploited in ways far more damaging than low wages. I would be most concerned by inhumane working conditions where a disregard for human dignity could quickly nullify any humanitarian gain offered by increased wealth. I think that Malawi’s development needs to move forward cautiously and deliberately. To not move forward at all would be robbing people of a proven path towards increased productivity and prosperity.

Friday, October 23, 2009

Generosity…in Moderation

Ever since childhood we are taught that sharing is a good thing. The idea is so engrained that just last week I found myself reflexively chastising two toddlers in the nursery for hording the Tonka truck. I think that an ethic of sharing is necessary for a successful society and that people everywhere are taught, in one way or another, that sharing is important. However, after living in Malawi for nearly a year I have come to the belief that Americans are not the world’s most prolific sharers. In the United States there is a sanctity of ownership and a belief that what’s mine is mine and what’s yours is yours. There are certainly many generous Americans (many, I suspect, are reading this blog), but their generosity is viewed as a choice, not an obligation. In Malawi, the culture of sharing is embedded within a system of property ownership that is much more nebulous. The boundary between personal and communal ownership has an equilibrium that is forever moving, ebbing and flowing in response to the changing needs of individuals and communities. I have observed that there is an unspoken rule that when you have something you are expected to share, with the expectation that others will do the same when they are able. I suspect this ethic of sharing evolved from the need of communal societies to temper the ups and downs of a subsistence lifestyle. Even if the generosity of Malawians emanates from the need for a social safety net, the result is nevertheless heartwarming.

When teachers buy sodas or popcorn, they always buy several and surreptitiously place them on other teacher’s desks. During lunch you often see a group of students huddled around a plate, one student sharing their meal with their fellow classmates. Yesterday, I was sitting at my desk grading papers while other teachers ate lunch. I hadn’t paid for lunch, not because I didn’t have the money, but because I couldn’t face another day of nsima and beans. I have nothing against nsima and beans, but the heat compounded with the culinary monotony is sometimes enough to make me skip meals. Peter, realizing that I didn’t have lunch, brought some food over to share with me. Even though teachers pay for lunch separately, the food always arrives in a communal pot and is shared by all. Even when a teacher collects their food separately they quickly surrender it to the big bowl on entry to the teacher’s room. I can never bring myself to eat on days that I haven’t paid, but I am alone in this respect. Probably only 2/3 of teachers pay on any given day, but the communal bowl usually has enough food. Jes and I secretly grumble to each other on days when the communal pot is kuchepa (Chichewa for insufficient), often absconding to our house for a few biscuits to augment the paltry portions. If other teachers share our frustration, it is well hidden. I suspect most teacher do not feel entitled, as I do, to a full lunch simply because they have paid. If you are able to pay, you do, and if you can’t, you don’t. For Malawians it is no more and no less complicated, to suggest otherwise would be uncouth.

For me, this unconditional generosity is one of the most beautiful things about Malawi. Unfortunately, this is often the only perspective taken by outsiders. Visitors nearly always laud the generosity of Malawians, and really, how could you not within the confines of traditional morality. Although I am honestly touched by the generosity of Malawians, I do see consequences of sharing, both societal and personal, which deserved to be acknowledged.

One problem I see with the sharing culture is the entitlement people feel for the possessions of others. The other day at school Jes passed two students quarreling over a book. Finally, one student turned to Jes and said, “make her lend me the book, she should share it.” Apparently the girl owned a biology book but didn’t want to lend it to her class mate. “But madam, he never returns my book when I lend it to him,” said the girl with the book. Jes, bemused by the entitlement of the boy, rebuked his request and explained that the girl could do with the book as she wanted. The boy stared at Jes in disbelief; it was obviously not the response he had expected and probably not the reply he would have received from a Malawian teacher. I don’t think a Malawian teacher would have gone as far as to forcibly take the book from the girl, but they would pressure the girl to share. This may seem innocuous enough –it certainly would be in the United States– but in Malawian culture a recommendation of that sort would be tantamount to an order; it would be deplorable to refuse. I see this type of forced redistribution all the time at school.

In my form 1 class there are about six students, out of 50, who own calculators. During exams and problem sessions these six calculators get passed around the room with seemingly no preference given to the student who owns the calculator. Even during the national exams (test which are extremely important to future of students), I have seen teachers take calculators from students, without asking, and give them to students across the room. It would be comparable to having your calculator whisked away without your consent during your SAT math test. I personally believe that individuals should have a right to their possessions and that forcing students to share school supplies is unfair. However, I am willing to acknowledge that my opinion is colored by my upbringing in the United States. I understand that what is fair and unfair in Malawi is governed by a different covenant than exists in the United States.

Morality aside, I worry that obligatory sharing often does more harm to the benefactor than it does good for the recipient. Many teachers with long commutes ride a bicycle to school and park it in the teacher’s room. Almost daily, a teacher will rush into the teacher’s room with a worried look on their face and exclaim, “where is my bicycle!” Turns out, many of the teachers who commute on foot (and live close by) like to borrow the bikes to nip home during breaks, but don’t think to ask permission. Sometimes the bikes disappear for only a few minutes, but last week one was gone for five hours. By the time the bike was returned the bike owner (who rides 18km to and from school each day) was seriously inconvenienced. The bikes have also started returning with flat tires or broken spokes with no one taking responsibility for the damage. A bike may seem like a minor possession in the United States, but near Mangochi it is often teachers’ only mode of transport. The teachers who bring bikes to school do so because they need to. It is impossible to walk 20 or 30 kilometers each day. Conversely, those who borrow bikes do so only for convenience and, through their actions, cause a large inconvenience for the bike owner.

The manner in which the bikes are borrowed is clearly inexcusable, but one could argue that extensive sharing, even if it causes some inconvenience, would be necessary with scarce (and expensive) items (such as bikes) in poor areaa. Unfortunately, I worry that in many instances the scarcity of commodities is actually amplified by the sharing culture. Pens, which any teacher can afford in copious quantities, are always a scarce commodity around the teachers’ room. Teacher are constantly scouring the room and rooting through desks looking for extra pens. I often find that my personal stock has been pillaged from my desk. It feels like stealing to me, but I don’t think the other teachers see it that way. I suspect they would happily return my pens if I had the need, but are happy to ‘borrow’ in a semi-permanent fashion as long as I still have pens aplenty. There is no reason for a pen shortage among teachers; they are cheap and available at nearly every local shop. I think the scarcity of pens stems from teachers’ assumption that they will always be able to borrow from someone else. The teachers also realize, rightfully so, that even if they came to school with extra pens they would not be reserved for their exclusive use. The sharing culture actually generates a strong disincentive against bringing pens, and in doing so, creates an artificial shortage which frequently disrupts the workday.

I fear the sharing culture causes far more widespread problems than simple pen shortages. Teachers are constantly complaining that they are unable to save for the future because the moment they accumulate any capital, be it goats or money, they are expected to provide for an ever-increasing proportion of their family and community. One employee at MCV was recently forced to rent a personal apartment in a nearby town because whenever he brought money or personal items to his home village, they were taken from his room and ‘redistributed’ within his family. If an individual cannot have personal ownership they cannot rely on their innate ambition to better their condition, they cannot plan for the future or invest prudentially. If capital is dispersed the moment any concentration of it exists, it prevents the type of long term investments that are needed by an economy. Imagine a shrewd farmer who dreams of building a granary or opening a market. Both endeavors require that the farmer save his resources so that he may afford the upfront costs. If the resources are wrested from farmer’s the moment they accumulate, the granary and the market will never be built. The money will instead be spent on smaller items which almost certainly contribute less to the economic development of the region. The economic development of a society and a country begins with the economic efforts of individuals and without an incentive for these efforts the economic progress of the country is stymied. I think this is happening in Malawi.

I am still impressed by the generosity of Malawians. I still believe sharing is a good thing. But within these beliefs I also see drawbacks of excessive sharing. I can appreciate how communal ownership and sharing obstruct the progress of Malawi, and I can appreciate the value inherent in moderate selfishness. Living in Malawi has made me recognize the credence and insight of Adam Smith when he wrote, “it is not from the benevolence of the butcher, the brewer or the baker, that we expect our dinner, but from their regard to their own self interest… Every individual endeavors to employ his capital so that its produce may be of the greatest value…by pursuing his own interest he frequently promoters that of the society more effectively that he really intends to promote it.”