the moodle is trying to kill me, or "what i did on my summer vacation"

Studying the trials and tribulations of underdevelopment is all well and good, but I never understood the importance of practice as much as when I had to use the moodle (the internal website for my graduate program) on a low-speed internet connection. 

The impatience I felt last fall for the global classroom (connecting the entire network of MDP programs around the world) from a Columbia user point-of-view is nothing compared to what it feels like to try to open a single page on the moodle from anywhere that doesn't have high-speed internet--even using the "low bandwidth" setting is not enough to keep my blood pressure from soaring and the vein on my forehead from popping out a little more. My sympathies go out to all those who were connecting with us during the global classroom.

Nonetheless, in terms of getting through the day, the Internet and its connection speed are the least of our worries, as rationing water and power come before we even begin to think about how painfully long it takes and how many tedious steps are involved in accessing the moodle.

The four of us working for Millennium Villages in Rwanda this summer opted to live in Nyamata, the "biggest" town near the actual MV village, Mayange, and where the MV Rwanda office is located. In the seven weeks since we arrived, the dry season has progressed and we are feeling it at home. 

We are supposed to have piped water at the house every Tuesday and Wednesday morning and every Friday evening—though I found out today that this has been cut to twice per week. For the last four weeks, we've had problems of not being able to fill the house's water tank because the water pressure was too low, or the water that was supposed to arrive on Tuesday morning at 7am didn't start until 5pm or 10pm or even 4am the next morning, which means Daniel, our house guardian, has to stay awake until the water is on so he can fill the assortment of jerry cans, 5-liter water bottles, plastic buckets, and cooking pots we’ve assembled to store extra water. We've had to buy extra jerry cans of water (at 150 RWF a pop) to carry us through to the next time the piped water came on.

I taught Le, one of my housemates, the phrase "if it's yellow, let it mellow," and we've all become very strategic about trying to use the toilet somewhere besides home as much as possible in order to avoid running out of water for things like washing dishes, flushing the toilets, and performing our own limited ablutions.

(Having grown up in Southern California during a looooong drought, I'm no stranger to water conservation behavior change campaigns and I'm pulling out all the stops in our house this summer. So, yeah, like thanks, California Board of Education, I, like, totally learned something, I guess.)

The sink in my bathroom is like the canary in the mine—each time I turn the knob is like a check on the gauge, I can tell by the water pressure how much is left in the tank and the smaller the trickle, the closer we are to running out; I’m always anxious that this turn will be the one that releases only a gurgle of air and perhaps a melodramatic final drop or two. 

This week we ran out of our last jerry can on Monday morning and the tank was completely empty by the next morning. The water came at 3am and today we woke to a full tank, a platoon of water containers at the ready, and Daniel fast asleep despite the late hour because he’d been up all night first waiting for the water to come on and then filling the containers.

Also, I don't know how or if this is related to the water problem, but for the last few weeks, nearly every night we have had a power outage that lasted anywhere from 2 to 4 hours. This is only inconvenient in that it usually happens right in the middle of our dinner preparations, so we've become connoisseurs of half-cooked pasta topped with olive oil and soy sauce (75% of us are East Asians, after all). When it happens in the afternoon and the back-up generator is out of gas, the office empties, and work grinds to a halt.

Bitch, moan, rinse, repeat. 

As annoying as the water and electricity problems we're having are, they are not really much more than that—simple (temporary--for us) annoyances. I remind myself that even complaining about these problems is a sign of the relative luxury we are living in compared to most of the people in the community we serve and the neighborhood we live in.

Every day, we see kids and adults pushing bicycles heavy-laden with full jerry cans up and down the inclines that give Rwanda its "Land of A Thousand Hills" namesake. Electric wires and poles crisscross the Rwandan countryside, but at night, houses are as likely to be lit by kerosene lamps as electricity as “cash-power” is too expensive for most despite their technically being “on the grid.”

All this has made me wonder, at the end of this summer, are these three months much more than just adult camping? Are we the ultimate summer poverty tourists,“slumming it” for the novelty of seeing development in action? I'd like to think not and I'd like to think that, just like with what CA’s Board of Ed taught me about water conservation, I'm, like, totally learning something along the way.

While the three months of summer initially seemed like they would stretch lazily across twelve long weeks, I can’t believe we’re already more than half-way through. It seems like we’re only now getting settled and it’s already time to start preparing for our goodbyes.

Professionally, admittedly, I’m not making a lot of progress. I've come to realize that given the language barriers and the heavy involvement that the CHW program has with the Rwandan Ministry of Health (read: bureaucracy moves slooooowwww) and the hesitation (read: we are explicitly forbidden) I have to "go rogue" at the Mayange site (read: strike out on my own with an interpreter in tow), I'm probably not going to get very much accomplished with my project this summer. 

To make up for that, I’m trying to learn as much as I can about Rwanda's culture and society (with some very interesting observations! More to come on that in a later post.) and how these influence the country’s development challenges. I do this by tagging along for site visits even for sectors that aren't explicitly under the health sector purview, talking to people I meet on the bus to and from Kigali, and asking people why they think things are the way are or work the way the work or what they would keep or what they would change about Rwanda’s development progress.

I still have hope that, ultimately, I’ll be able to produce and deliver something that the MV health office here will find useful, but, so far that seems as likely as a full tank of water on a Tuesday.

from WTF to talk of a cure in 30-ish years

Today I wrote a long post about HIV for my Global Heath class. I'm reposting it here because the links I found are great. I realized that one of the reasons why looking at the timeline of this disease is so interesting to me is that we are almost the same age--my life has run its course alongside much of the lifetime of HIV and it's amazing to me to see how this disease has progressed in our shared lifetime. 

My post was in response to a classmate of mine's posting of this article from The Telegrah that talks about the possibility of a cure in the next few years and already this year we've seen several stories in the news about a baby being "cured" and other people who's viral load is so low it's virtually non-existent. We've come along way fast. My health post is below.

It's amazing to me the medical and social progress that has happened around HIV since the early 1980s. 

In the 1990s, I was pretty heavily involved in an HIV/AIDS youth peer education program that the American Red Cross was piloting in a few areas around the country. Unfortunately, it never took off nationally, but I personally thought it was a great and effective preventative intervention. 

I was teaching not long after Magic Johnson announced that he was HIV positive and had directed a ton of his personal wealth to HIV research/education. Around that time, the HIV phenomenon was just coming out of the really, really dark days of the late 1980s and early 1990s when institutional and general public lack of knowledge and understanding about the biology of the disease as well as the social implications of the disease left everyone of a certain age or of various social groups feeling unanchored and that the act of loving someone or being lazy about condoms could mean death or severe illness. 

This was when the entertainment industry was maybe the most human I've seen it be in my lifetime and I'd highly recommend watching these movies and tv shows if you have time (like over the summer) to get a sense of how far we've come both medically and culturally in the discussion around HIV. It will be interesting to see how HIV as a disease is treated and how people who are HIV positive are treated in this country today versus how these were addressed in the 1980s and 1990s, and how addressed in other, developing countries, with different social and development contexts.

1. And The Band Played On -- HBO film about the early days of HIV and the social and medical responses to the disease. This was the first film I ever saw about HIV and it's heartbreaking and eye-opening. Watch the full film here: http://www.youtube.com/watch?v=DIHy4_31Db4
2. MTV's Real World: San Francisco (the first time) -- Pedro Zamora was the first openly HIV positive gay man to be featured on national television. The Real World television reality show was a totally different animal in its early days compared to what it turned into in its later years and Pedro and his story is one of the reasons why. I was talking to Sarah about Pedro's story a few weeks ago and it made me choke up just thinking about how important he was in changing a generation's perceptions of people with HIV specifically and maybe even people's empathy toward other diseases, racial or socio-economic differences, etc. (to relate it to today's lab). The entire season is available for viewing here: http://www.mtv.com/shows/realworld-season3/video.jhtml (ps there's also lots of other crazy, more typical "Real World" stuff that makes the show fun for summer viewing [esp. crazy Puck]... and, hello, the clothes! It was the '90s!!!). He was 22 when he died shortly after the final episode aired in 1994. MTV put together a tribute to Pedro: http://www.youtube.com/watch?v=KA4ZZImS4Qs.
3. Philadephia -- Probably the most famous of the HIV-story offerings. Tom Hanks won an Oscar for his performance in this film as an HIV positive man and watching the process that Denzel Washington's character (as Hanks' lawyer) goes through in terms of his personal beliefs about homosexuality, HIV, human rights, etc., is powerful. 

In the 1980s, it seemed like HIV was as contagious and deadly as ebola, so many people were dying. Then they figured out ARV therapy, but it was expensive.

In the 1990s, it seemed like affordable, accessible treatment would never arrive. Then it did and people across the developed and developing world were able to live with some measure of disease management, but it still seemed like an incurable disease--after all, illnesses that had been around for much longer and that are politically less sensitive still didn't have cures, why should HIV be any different?

In the 2000s, we've seen the costs and unwieldy aspect of HIV meds decrease considerably and in 2013 there has been a lot of talk around cures and vaccines--even if we're still 5+ years out from a "cure," it's still incredible to me the medical and social changes we've seen around this disease. Although it seems like a long time since HIV came on the scene, the character of the (medical/social) treatment around it has progressed, in my opinion, very quickly considering that we've seen significant changes/advances across countries and cultures in HIV-related personal behavior, personal perceptions, research, medicine, patient-doctor communication, education, etc. 

a price too high

I didn't grow up around guns and I'm not from an area with lots of hunting that might have made me more familiar with guns even if they weren't in my house. In fact, my father is from one of the most, if not the most, gun averse country among developed countries, which surely had some influence on my opinions. I admit to my bias or, at the very least, ignorance, around gun culture in America.

What I do understand is words, reasoning, and legislation. I am not going to argue with the 2nd Amendment of the US constitution that says I have the right to bear arms--the right is there, enshrined in the Bill of Rights for hundreds of years, and repeatedly supported by US Supreme Court decisions. It's there to stay, at least for the foreseeable future.

What the 2nd Amendment does not say is that I have the right to fatally wound dozens of people (including children) on a psychotic whim.

Children from Sandy Hook Elementary School being led by police after the Newtown shooting. These kids are the same age, size, cuteness, maturity, adeptness of throwing embarrassing tantrums, and humanness as the 6- and 7- year old victims of Friday's shooting.

Off the top of my head, I can recall at least 6 other mass shootings committed by people who were mentally unstable with access to legally purchased weaponry: Columbine, Virginia Tech, the DC Sniper, the shooting of Rep. Gifford, the Colorado movie theatre shooting, and this one in Newtown. I don't even want to do the total on the number of victims in all of these; if it's more than 1 (and it is), it's too many.

The price for the right to bear arms as it exists in practice in our daily lives is TOO HIGH: I am not willing to trade the life of a child (or any human being, for that matter) for my right to shoot at a hypothetical future intruder or attacker.

Because that's what this is, a trade. For every gun that's legally purchased and in the public sphere for no other reason than just because it can be is a trade of one or more innocent lives against the chance to shoot a hypothetical future intruder or attacker in an effort to save myself. I would not trade my own life for a beloved neighbor or friend or relative to have that right, so why should any gun owner feel at liberty (I choose that word intentionally) to trade the lives of twenty children for that right?

Maybe that makes me a dirty hippie, tree-hugging liberal. (Liberal? Guilty. Tree-hugger? Guilty! Dirty? Not guilty!) Maybe that makes me economical--what was the earning potential and social contribution that those 20 children and 6 adult victims could have made to our society? Maybe that makes me risk averse--I'm betting that the odds of me getting attacked are much lower than me not getting attacked. Maybe that makes me human. Maybe that makes me cheap on "liberty" or "freedom" that I'm not willing to sacrifice lives for a constitutionally-mandated right--would I not sacrifice lives for the right to freedom of speech? (I would.)

It definitely does not make me un-American--how much more American is it than to want to prevent the unnecessary and senseless deaths of the most vulnerable among us? Or even the least vulnerable--hell, I don't want anyone shot!! How much freer can we be than to live without fear of such senseless and wasteful death and sadness?

The assault rifle and handguns that were used on Friday were not meant for hunting--at least, not for hunting animals. I won't get into what I think about hunting (though it's probably not what you'd expect). This is about basic safety and sanity--that is, the sanity and reason among those of us who are fully mentally capable and in charge of shaping legislation and regulating, manufacturing, selling, and distributing guns.

There are people in my life that I love, that are part of my family either by blood or experience, for whom I would literally trade my life to protect their right to speak freely and live without fear of retribution for who they are or what they believe, people who I know to be absolutely, unquestionably responsible enough, smart enough, mentally stable enough, trained enough, and valuing of human life enough to entrust with gun ownership. These are not the people I am worried about having their access to guns coincide with their access to suburban strip malls and elementary schools.

Regardless, I am not willing to trade the life of any innocent person for these responsible and sane people who I love and trust's right to own a gun as easily as they can now.

"Firearms regulation" does not mean "firearms ban." It does, admittedly and, in my opinion, rightly, mean making it very difficult for everyone and impossible for the people who should not have access to get access.

POTUS has taken flack for not using strong enough words in his statement on Friday. But I think he was putting everyone on notice: "meaningful action... regardless of the politics" means the human lobby is stronger than the gun lobby, and things are about to change.

To close (because, aptly, I have to get back to writing a paper about post-conflict security...), here is the email I sent my parents after I learned of the shooting on Friday:

I have my Econ final in a few hours and have been pretty calm about it ever since I had that freak out a few weeks ago. I'm definitely not going to do well on the test,* but, more importantly, I understand the general concepts from the semester and, frankly, at the end of the day, it's just really not that big a deal. I've been saying that to people all week--just calm down, at the end of your life, you're not going to look back and be like, if only I'd gotten a B+ instead of a C+ on the microeconomics final. 

I've been working calmly all morning just preparing my cheat sheet and working through practice problems. Some time between when I last listened to NPR this morning while getting ready for school and about an hour ago, some maniac went into a school an hour's drive from NYC and shot and killed at least 27 people, including 18 children. Literally, while people around me spent those hours freaking out about some relatively inconsequential grade on a relatively inconsequential test, children in a place we could drive to within an hour were having their opportunity to flake out on studying or do badly on a test taken away from them forever. 

Thanks, mom and dad, for raising me to (sometimes) remember to keep things in perspective and for being the ones to remind me of this when I'm being ridiculous and freaking out about stuff that in the long run just isn't that big a deal. 

Love
Miki

I want to engage in this discussion with perspective, civility, reason, and respect, and get to a place where everyone can be safe.

So, can we talk?

 Children in Karachi, Pakistan light candles early in the evening in memory of the Sandy Hook Elementary School shooting victims. 

This is all close to home which is why it's easy (and lazy) of me (all of us) to get so worked up about these deaths over ones that take place in other places, but maybe this is the place where this conversation will be able to take its next step and will help Americans be better friends with our global neighbors and their children.

* In case you're wondering, I think it actually went pretty well, much to my relief and surprise. Even more reason to not freak out about things that just aren't that big a deal... sometimes they turn out to be just fine.