Nairobi is a gritty town. Sure, it’s got the shopping malls, the fancy restaurants—but underneath the veneer, Nairobi is a coarse industrial machine, with money and labor pumping through its veins like crude oil through a pipeline. You feel it on the road—black plumes of exhaust, traffic jam, horns blaring, streams of men and women weaving in and out of traffic, some selling things, others just on their way somewhere. Pass by petrol stations, car lots, and factories—cement, foam, tires. Then by an ocean of slums, waves of brown cardboard and tin, and along their periphery, commerce: blacksmiths, spare parts, sheet metal. There are lorries everywhere. From the back seat of my taxi I watch a man seated atop one, riding there in the back in the early evening haze, his shirt flapping in the wind.
***
In December 2007, Kenya held presidential and parliamentary elections. Incumbent President Mwai Kibaki was declared the winner, but his opponent, Raila Odinga, contested the result. The election commissioner admitted he didn’t know who won.
People began to say that the election had been stolen and riots broke out. First in the Rift Valley, they spread like a shockwave to the streets of Nairobi, ripping, tearing, blasting apart the sense of solidity that the country (and the world) had of itself. Buildings were set on fire, demonstrators were shot.
—We locked ourselves in our house for two days.
—I lived across from Kibera [a slum]. Even in the house we had to wipe our eyes from the tear gas police were using outside.
—If the international community hadn’t come in, this place would have been gone.
—Sometimes I don’t even like to remember.
Over 1,300 people were killed and hundreds of thousands displaced. Such things are not easily forgotten.
Which is why Wednesday’s referendum, in which a large majority of Kenyans voted in a new constitution, was monitored so closely. No one wanted what happened in 2008 to happen again.
Reports from international news agencies preceding the referendum suggested that Kenya was on the brink of a descent to violence:
“Kenyans will decide on Wednesday whether to adopt significant changes to their constitution, but the vote may produce violence rather than reform.” —Reuters
There are “heightened fears of political violence ahead of 6 Aug constitutional referendum.” — International Crisis Group
“Once again, many Kenyans fear that the prospects for more violence are increasing as their country heads toward another politically divisive turning point.”—The New York Times’ Jeffrey Gettleman
The reports did not match reality. Most Kenyans felt relatively confident (rightly it turns out) that violence was unlikely. So was this just another example of the press painting African countries as more violent and chaotic than they really are? One more example of cowboy reporters making things sound more dangerous (and exciting?) in the cities where they are based? (Yes, Gettleman, that one’s for you.) Maybe that is part of it.
But maybe the speculation was also borne out of the doubts that appear, like cracks on the surface of an ice-covered pond, when our sense of the inevitability of stability is broken.
***
The constitution contains many landmark provisions—a Bill of Rights, land reforms, and limits to presidential powers. No one is sure if it will usher in a new era, one less riddled by corruption, one defined more by equality and opportunity than sickening poverty side by side with ostentatious wealth. It is, after all, just a document, just words. And we rarely live up to our words.
But words are not meaningless either. They express what we hope for, what what we think we have it in ourselves at our best to be. Maybe that's why, all around Nairobi, in newspapers, on billboards and banners, on the radio, scattered like flecks of gold on the beach, are words like Renewal. Healing. Unity. They are words about leaving the past behind, about bringing fighting to an end and having peace.
Making them real will require effort—mundane, unglamorous work. (For a good analysis of the challenges ahead, see John Githongo’s Fear and Loathing in Nairobi.)
But at least for now, there is a sense of possibility.
"Things change for the worse so quickly. They change for the better more slowly—but they can." --Bono
(With thanks to Matilda for taking the time to talk.)
There was nothing unusual about how it began. Mid-morning, and the skies were as bright as a flower—sunny and clear. Outside, peacocks fanned their feathers on the grass and a crow glided through the air, settling on the perch outside my window. My gaze returned to my computer screen; I scanned the morning headlines, and when I looked up a few minutes later, it was raining. The shower was cool and pleasant, and in April in Tanzania, fairly typical.
But instead of subsiding after an hour or so, it grew stronger and harder, and the drops became thicker and denser, until there were sheets of rain, and the sky was as white as snow and seemed to hover right on top of us. A colleague and I stared out the window in wonder until it was so blurry with water that we could no longer see through it.
It continued all afternoon and into the night and though the ferocity of the downpour let up, the rain itself carried on for three days. Paved roads became rivers. Dirt roads became thick with mud, impassable, with craters filled with filthy water.
Traffic jams lasted for hours. The day before the storm hit was a national holiday in Tanzania, and since most people took the day off, the roads were empty—it took about 12 minutes to get home. On the first night of the storm, it took nearly three hours to cover the same distance.
The next day at the office, colleagues compared traffic horror stories and tried to outdo each other with who sat in their cars the longest. Some asked: what will happen in the city next week, when Dar es Salaam hosts the World Economic Forum on Africa? How will the city cope with the extra traffic it will bring, plus the rain? Others shook their heads and said: the question is how this city will sustain itself at all, with more traffic, and more cars and more people every year (Dar es Salaam is one of the ten fastest growing cities in the world).
Meanwhile, we were informed that piped water in the city had been cut off because of damage to the pipes. It was not caused by the storm, but fixing the problem was made more difficult because of it. We went without water for two days at the World Bank, with acrid fumes of urine emanating from the bathrooms.
But at least we had satellite internet. While the storm raged and the taps went dry, much of the rest of the city also experienced disruptions of internet service because of a breakdown of the fiber optic cable that brings high speed internet to East Africa. It was like the whole city was on the blink, malfunctioning, haywire.
***
That was how about 30 percent of Dar es Salaam experienced the storm this week. The other 70 percent also experienced a storm, but differently.
Seventy percent of Dar es Salaam’s four million or so people live in unplanned settlements: no proper roads, no sanitation systems, no link in to water or power systems (less than 15 percent of the country is connected to the grid). This seventy percent didn’t lose power or internet because they didn’t have it to begin with. The roads in front of their homes became mud, and many neighborhoods were flooded. My three-hour commute was bad, but try doing it in a dala dala (i.e., a small Tanzanian bus)—squished, standing between five people, hunched over so your head doesn’t hit the roof, with no AC, just the choice of leaving the window open and letting rain splatter in, or shut, and letting the bus become a humid, foggy mess. For those who walk to work, the walk became harder and dirtier, and for those who sell vegetables, toilet paper and other sundries at little shops on the side of the road, business slowed.
The seventy percent don’t live far away, either—they live right next door. In the canyon between Kimweri road and Wonderwelders (a shop where expats go to buy gifts for friends and family back home) there is such a settlement, a community built along narrow alleyways; a sea of corrugated iron, of kids running barefoot in torn shirts. At night, little flames glow in the dark lit by tiny kerosene lamps.
The settlement is about five minutes down the road from where I and many of my colleagues stay, on Slipway Road, in million-dollar homes with lovely views of the water.
***
Two sets of people in one city, side by side practically, living different lives. One goes to eat and get her nails done and works out at places with generators, so most of the time, she isn’t even aware of how fragile the power supply is in this town. The other spends her nights in the dark. One treats herself to a 15,000 shilling sandwich and coffee at the sleek, urbane Kempinski hotel, and pays 10,000 shillings for the cab ride home. The other spends 1,500 shillings on a lunch of bananas and rice, and 200 for the dala dala home. One wears pretty scarves that she bought in New York. The other cleans them. One rents an apartment on Dar’s peninsula for $1,500 a month, while the other pays a kind of rent to the guy who “runs” the slum where her and her children live, except she doesn’t think of it as a slum.
The rain began to let up, but it was still sprinkling on the ride home from work yesterday. The director general of the Tanzania Meteorological Agency told The Citizen newspaper that the rains “might start to clear tomorrow” or “the situation might persist.”
A year before coming to Tanzania, I had dinner one night in Dupont Circle with a friend. Both of us worked in development—him from the program side in southern Africa, and me from the policy side in Washington. Seated at an outdoor cafe, a bottle of red wine between us, we teased each other:
—Still trying to fight poverty by thinking about it in Washington, he asked? —Still traipsing around Africa pretending you’re Jesus, I shot back?
While discussing development, my friend was as full of optimism and hope as a spring morning, but when the conversation turned personal—when we began to talk about our families—his mood darkened. He stared down into his plate, moving bits of fried calamari around with his fork.
Uncomfortable with the lull, I said brightly: I think I’ve figured out how we can change our lives.
My friend’s eyes lit up like a struck match. He asked:
—Do you think our lives can change?
I stared out at the sidewalk crowded with people on their way home from work, at the L2 bus zipping up Connecticut Avenue.
—Yes, I said, our lives can change. Tomorrow can be different from today.
***
The development business isn’t (ostensibly) about changing our lives. It is about changing other peoples’ lives. The question is to what extent those of us in the business (or anybody for that matter) believe that is possible.
But change how, you might ask? What is “development” anyway? Is it a moral duty, to save peoples’ lives, or help them live longer if we can? Is it increasing the number of choices people have? Is it transitioning entire economies and countries? Or is it simply a business—what aid agencies do?
Owen Barder, in his recent blog post Aid Policy Vs. Development Policy, identifies two types of development. On the one hand is the view that “development assistance should help to accelerate economic and institutional change in developing countries. The idea is that temporary support from the outside can be a catalyst for permanent changes.” This is what Owen calls development as transformation and it can be achieved with help from donors who support migration, trade, climate change, and other policies that help instead of hinder developing countries.
Another objective of development is what Owen calls solidarity. It consists of trying to improve peoples’ lives today (by, say, providing aid for health programs or schools) while we wait for the bigger, more fundamental and mysterious transformation to take place.
“I personally have my doubts,” Owen writes, “that aid makes much difference to the prospects for economic and social transformation. Countries change from within, through long, slow, organic processes, and it is hard to see how money and advice from outside can make much of a difference to that.”
***
My mobile phone says 8:02 a.m., and I wonder if the taxi driver will show. I’m always ready by 7:55, brimming to get out of the house, to get to the office, to have a cup of coffee and open my Gmail and the New York Times.
I grab my bag and walk down the dirt driveway to the road. There, another commute is taking place. Old women and young women, old men and young men, on foot, on bicycles, are on their way somewhere—to guard houses or clean them, to see a friend, or maybe to work at the hotels further down the road. I wish I could walk, like them, I think. I used to walk everywhere in Washington, DC—I’d walk for hours, even in the heat. But here when I walk I feel like a target, I’m always watching my back.
The ride in is quiet—I’m relieved the driver doesn’t want to talk. After seven months, I still know practically no Swahili, which I am both embarrassed about and resigned to. In the silence, I can just stare out of the window at the sea, which we drive by each morning on our way to town. The tide is swept out, so far it seems to recede all the way to the horizon. The tankers parked offshore seem to float just above the water, which is so dazzling, so glittering in the morning sun that it smacks me back into the reality that I’m in East Africa. That I came here because I wanted to come.
At the office a friend, a nutrition specialist, hands me a pamphlet put out by Uwazi, Tanzanian NGO, describing the state of nutrition in Tanzania. Though food fortification is a cheap and (relatively) simple way to save lives, the Tanzanian agencies responsible for moving the process along have spent most of the last decade in meetings and trainings, equivocating and delaying. So, this year, 43,000 more children will die in this country because they are malnourished, it says.
Later in the afternoon I meet a new colleague.
—What work do you do, I ask her?
—Private sector development.
—Oh really, how interesting. What’s happening with that?
—Not much.
And over dinner, a friend tells me that an agriculture program she is involved with, to help poor farmers purchase inputs like seeds, is in a shambles. “It’s just not working like it should. But obviously that doesn’t mean we’re going to stop it.”
***
That evening, I sit down on the couch and turn on the BBC. Headlines flicker across the screen: a funeral; an election; a flood; a truce. Then two advertisements play, one after the other. One is a general pitch for Africa, full of those familiar, sweeping panoramas of the Serengeti—a giraffe, some smiling Maasai, melodic tribal singing. The other is more somber. An NGO is encouraging viewers to donate money to their cause by panning in on a frail African woman lying on a cot beside a cement wall in a bare room. She is being fed by a nurse in all white, and we are told that this woman is sick but that she will get better. Because she has medicine, which costs only a little, she will live.
As I watch I think: oh yes, I remember. That’s how I used to feel about development.
***
No matter what you think development is, one thing is certain: it is hard. When we say change ultimately comes from countries themselves, what we really mean is that change ultimately comes from people themselves, and people are a messy lot, slow to change, a bit shabby sometimes, if well-intentioned.
So what you must believe, if you're going to be a part of the development business, is that your own life, that is, that you, can change. An enterprise, tired from false starts and disappointments, needs some new energy, and hope that we can be stronger and braver and better than we are. That's why a movement like Twaweza, a brand new citizen action initiative in East Africa, has caught fire so quickly: because it embodies this kind of optimism. Maybe its popularity is illustrative of the fact that, despite our collective fatigue, deep down we still believe change is possible. Who would have thought?
An American I know who works in southern Africa had girl trouble recently. The trouble wasn’t so much the girl as it was him: he’d pursued her hard, emphatically, then just when she’d started to warm to him, he backed off suddenly, dropped out of sight. The girl was understandably pissed, and in an attempt to explain his careless behavior, he told her this:
"Intense things take hold of you here in Africa when you least expect it or are prepared. You can say 'wow, I'd never do a thing like that' and you do."
***
It’s Saturday night, and everyone’s out, drinking at a local dive. Around 2 a.m. we gather to leave. In the parking lot, a young American girl stumbles in high heels to her car, fumbles for her keys, cheeks flushed from the heat and too many beers. She opens the door, gets behind the wheel and, laughing, says: “Man, I would never do this at home.”
***
Some friends and I are having brunch at a local café when an old expat couple walks in and stops to say hello. When they pass we exchange furtive glances and smile. The couple are friendly but quirky—they seem to have abandoned all the formalities associated with their former life in the West. Like other “lifers” they sometimes seem slightly unhinged, paranoid, and just plain weird. My friends and I joke about it: “That’s what happens when you stay in Africa too long.”
***
In his January 14, op-ed The Underlying Tragedy, New York Times columnist David Brooks, discussing the development failure of Haiti, suggests that the culprit, the thing that keeps some poor countries poor, is culture.
“It is time to put the thorny issue of culture at the center of efforts to tackle global poverty,” he says. “Most of the world’s poorest nations [suffer] from a complex web of progress-resistant cultural influences.”
Brooks’ solution is to find, “self-confident local leaders who will create No Excuses countercultures…surrounding people…with middle-class assumptions, an achievement ethos and tough, measurable demands.”
Could this be true? And is it this culture that drives us, expats, to such strange behavior when we’re here?
***
The danger is that we’ll say no too quickly. None of us wants to suggest that a country’s culture is somehow responsible for poverty, to imply that something about the culture is wrong, not as good as our own. Moreover, donors, painfully aware of the meager impact of much of our aid and effort, are keen to take the blame for development failures.
But even as our instinct is to take the blame, we are also just as quick to point the finger. Our constant griping about the frustrations of living here, for example, contains implicit criticism of culture.
—I walked into the post office and the woman at the counter just stared at me. I had to practically harass her to get her to help me…why’s it so hard to just do your job?
—I know what you mean. We’ve been trying to schedule a meeting with the Ministry for months—they don’t respond, they delay, they equivocate. It’s like we’re the only ones who care about this project.
—Don’t even get me started. My driver was an hour late today, and that’s just the tip of the iceberg. Tanzanian incompetence!
—At least you have a driver. With taxis, it's constant negotiation no matter how loyal you are to them. All I am is a dollar sign to these people.
—Yes, but what do you expect? It's just another form of corruption, and corruption is part of the culture.
We shake our heads in resignation, we huff and puff—but press us on the issue and most of us will tell you the same thing: if you need someone to blame for development failures, throw a rock in the air. You’ll hit someone guilty.
***
Brooks wasn’t wrong to point the finger at developing countries. They are as responsible for their own development (and its failures) as donors, and it’s a good thing to puncture a hole in the chorus of donor knee-jerk self-flagellation.
But even if there are things about living in developing countries that expats (rightfully) find troubling, it does not excuse our own mistakes. Donor aid that is unpredictable and inflexible, redundant in some areas and feeble in others, driven more by the political/PR/security/economic interests of rich countries rather than by the needs of poor ones, under-evaluated and sometimes wasteful—and expats who are reckless, who feel above the rules of the countries they live in, who are arrogant and careless—all these things are still our mistakes and we have a responsibility to address them.
Moreover, talk of culture, that amorphous word dripping with generalizations and contradictions, is often a sign of desperation, the thing you blame when you don’t know what else to do, when you’ve given up, when you’ve resigned yourself to ineffectiveness and failure. Culture is an excuse, in other words, for not dealing with the troubling fact that there are many things rich countries could do today to address poverty but are not. (For an idea of some of these things, see a blog post by CGD president Nancy Birdsall that offers ten actionable ideas for global development—practical things rich countries can do now to improve global equity and prosperity.)
***
Everyone who works in development will from time to time have to face the colossal disappointment of ineffectiveness. It's easy to be mesmerized by uncertainty, to sink into resignation and finger pointing, but we must move on. There are many things we—donors and developing countries both—can do now to improve the lives of poor people in poor countries—the question is whether or not we will try.
Keep walking, though there’s no place to get to Don’t try to see through the distances That’s not for human beings Move within, but don’t move the way fear makes you move Today, like every other day, we wake up empty and frightened Don't open the door to the study and begin reading Take down a musical instrument Let the beauty we love be what we do There are hundreds of ways to kneel and kiss the ground
There’s a scene in Out of Africa where Meryl Streep and Robert Redford are trekking across the Kenyan wilderness, tracking lions, when one of them suddenly bursts out of the bush with a ferocious growl and charges them. Streep instantly lifts her rifle and shoots it dead, then turns to Redford and watches in stunned silence as he comes to her side and gently wipes the blood from her mouth, where she had bit her lip in exhilarating terror.
Our safari was not like that. To start with, we did not carry rifles, nor did we wear khaki (I wore jeans—which are, it turns out, not an ideal clothing choice for safari). But it was an adventure nonetheless.
With my friends Kevin and Jean, I left Dar es Salaam Saturday morning in a spunky Rav4 (the expat car of choice—tougher than a sedan, but not as neocolonial as a Landrover), drove through the outskirts of town and up the Morogoro Road towards Mikumi National Park, a lesser sister to the grand game parks of the north.
Mikumi offered instant gratification: from the highway we saw an assortment of wildlife: elephants and giraffes, baboons and gazelles. We took some photos, went to the lodge, had a hearty dinner of macaroni and cheese, and went to bed, full of food and anticipation of the safari to come.
Early the next morning, freshly showered and optimistic, we set out into the park. With a map that identified points of interest, which helpfully corresponded to numbered markers on the road, we made our way 10 kilometers or so to the “hippo pool,” and saw, as you might have guessed, hippos sleeping in a crater-like pool of water. When we discovered that sleeping hippos don’t do all that much (and also that they smell), we returned to the car and set off down a road that lead 30 kilometers out and before looping back around to the main gate.
The sky was patchy blue and gray, the air was warm. The valley, dotted with acacia trees, swept out for miles, and far out on the horizon, mountains shown like shadows in the haze. With the windows rolled down, we watched with wonder as elephants led their young across the veld, giraffes stretched their necks to the tree tops, gazelles pranced and zebras grazed. Birds as colorful as a kaleidoscope flitted through the air and buffalo covered themselves in mud to fend off the midday heat.
Further along the road began to change. It became jagged and littered with tall, sharp grass, and the plains were swallowed up by high bush that surrounded us on both sides. We stopped seeing animals, and other cars, and the air outside was suddenly thick with horse flies. We stared out the windows, saying little, until Jean finally broke the silence:
—Dudes, this is BORING.
Kevin and I heartily agreed, but before we could find a place to turn around, we lumbered around a bend and were confronted with a steep embankment that led down to a muddy river. (Okay, river might be a bit of an exaggeration; let’s call it a healthy creek.)
Discussion ensued—to cross or not to cross. We decided to cross.
Now, looking back, one might say that there were various Signs that, had we paid attention, might have helped us to avert the fate that I am about to describe. There was the carcass on the side of the road near the hippo pool, the vulture, grim as a hangman, perched on a dead tree that watched us as we drove by, and the ash gray thorn tree that had fallen into the road, blocking our path (which we decied to drive around). Yes, perhaps the less adventurous traveller would have been deterred by these Coincidences—but not us!
We buckled our seatbelts, held our breath and descended into the water and up the steep rocky climb on the other side. Relieved and emboldened by our good decision (we made it!), it took us a second to notice that the “road” on the other side of the river/healthy creek was nothing more than grass and bush. So we turned around and crossed back, but this time, hit the water at too steep an angle, lodging our front tires in the mud.
Kevin stepped into the muddy water and tried to push the car to no avail. I got out, threw a branch across the water, crossed over and offered to push. (Kevin was hugely relieved to benefit from my added strength and resourcefulness.) We got down on our knees, braced against the oven-hot hood, and listened as the engine clicked, whimpered, and died. The battery was dead.
So there we were, three safari adventurers, up to our knees in mud, with a car nose down in a river/healthy creek with nothing but our wits to save us.
***
Our wits AND cell phones. Now you would think that the park paperwork (receipt, map, permit for the car) would have in-case-of-emergency telephone numbers on them, but you would be wrong. There were no telephone numbers. Our Tanzania guidebook had a generic Mikumi number, which we tried, but there were two challenges: first, reception was spotty and two, when, for a fleeting moment we connected, no one answered.
So we called a hotel instead, and got through to a receptionist who said she would send help. As a backup we also texted a friend in Dar, letting him know where we were and asking him to “do something” if he didn’t hear back in an hour and a half, since by then we wagered we would either be rescued or our phones would be dead. (*Handy survival tip: before heading out into the African wilderness make sure your phone is fully charged, and that you have credit.)
Assured that help was on the way, we had only to sit and wait. So we did the things that everyone does when they're stranded in the middle of a Tanzanian game park. We applied sunscreen and mosquito repellent vigorously. We found spots to go to the bathroom that weren’t too embarrassing. We made peanut butter and jelly sandwiches. We told ourselves it could be much worse. We played games, drank water, and reflected on the meaning of life (ok, that last one not so much). We sunk into various stages of delirium.
After two hours, I asked the question that we had been trying to avoid: So guys, what if no one comes?
Silence.
Just as we began contemplating our options (walk back through the park and take our chances with all those cuddly animals we'd passed hours earlier, or stay in the car overnight), a white Landrover turned the corner, and out came two park rangers who valiantly resisted the urge to smack us upside the head for getting ourselves stuck in a river/healthy creek on a road that was clearly impassable.
They jump started the engine, dragged the car out of the water and escorted us to the main gate. It was unclear if the escort was for our own good or for theirs.
***
Based on our safari adventure, I would like to offer my fellow travellers three handy survival tips:
When you encounter a steep embankment with a muddy river at the bottom and a high grassy impassable road on the other side, DO NOT attempt to cross, not even for adventure’s sake.
Try not to take too many photos of your safari breakdown adventure when the park rangers come to rescue you. They find this a tad annoying.
And finally, don’t test Africa. Africa always wins.
We hit rough weather thirty minutes out from Bujumbura. A jolt and I could suddenly feel the speed at which we were hurtling through the sky—was suddenly aware that there was nothing beneath us but miles of air.
The man sitting next to me, with whom I’d exchanged pleasantries before take off, saw me clutch my seat and gasp. He looked at me, and feeling his gaze I turned, biting my lip.
—Do you believe in God? he asked. His eyes were as still as the ocean floor.
I shot back instantly: Don’t ask me that, please! And then I turned my head towards the window so he wouldn’t see my tears.
***
I had just left the central African nation of Burundi where I spent a week at a global health conference. The theme was performance-based financing (PBF), a new(ish) idea for improving health in poor countries by, in the case of Burundi, awarding bonuses to health facilities that achieve certain results, such as increasing the number of children they immunize. This is in contrast to the traditional approach of paying for inputs such as equipment and medicine and hoping that better health will automatically follow. It hasn’t always done so. Despite decades of effort and billions of dollars (and some great successes), some health woes persist. Burundi’s maternal mortality rate, for example, continues to hover at about 1,100 per 100,000 live births—one of the highest maternal mortality rates in sub-Saharan Africa.
There are all sorts of ways to explain tragedies like this. PBF says that the reason so many are still sick and dying is that health systems are weak, and health workers underpaid, under-motivated and unaccountable. The answer is incentives: a modest bonus, along with scrutiny of their work, will enable/force health workers to act on the motivation they already have, or inspire motivation if it is lacking.
A small group of young, mostly European men presided over the PBF workshop. They are old friends mostly, who like to talk about their early days in the “trenches” working for Medicins Sans Frontiers in places like Cambodia. There is a lot of camaraderie among them, a lot of shared excitement about their work. None of them would say PBF is full-proof, a silver bullet, but they were confident (almost Certain), that these programs can and will work.
“Evangelists,” is what one observer called them. Just like the man who sat next to me on the plane, they have an answer.
***
Burundi is emerging from a 12-year, ethnic-based civil war. When Hutu president Cyprien Ntaryamira was killed in 1994 alongside the president of Rwanda when the plane they were travelling in was shot down, violence ensued. More than a half million were killed and many more fled to neighboring countries (including Tanzania, where I live). South Africa mediated peace talks and a power-sharing government was set up in 2001. Most of the rebel groups agreed to a ceasefire, and the country has enjoyed several years of relative calm.
But there is a ripple, just below the surface, of uncertainty, a sort of brace for what might happen. You can feel it in the torn up streets, sudden road blocks, the industrial wasteland feel of parts of the city.
Because it is a post-conflict environment, we had to travel with an armed United Nations security detail on our visit to a rural health clinic. The convoy—a small pick up truck packed with bored Burundian men carrying Kalashnikovs, and us following in a Landrover—felt intrusive, menacing on the simple dirt roads. Especially when we passed a procession of mourners carrying a coffin down a steep jungle hill. They pulled close to the edge of the ravine as we passed, including the somber old man who was leading them. He had a small wooden cross in his hand, raised up to the sky.
***
There are other wars too. One broke out just before the conference when one of the attendees, a long-time public health expert, decided not to come, citing, in an email sent to all his colleagues, philosophical objections to PBF. Financial incentives, he said, commercialize health care, induce cheating, and create distrust of and among health workers. And dissent is not welcome—the club of proponents are single-minded, arrogant, and rarely willing to admit the limits of their own theories.
There was a flurry of response. Recriminations, a hardening of views and marshalling of evidence. The cc’d list ballooned, and the Burundian Minister of Health even chimed in.
Then came an email with a decidedly different tone. The writer, a Bujumbura-based donor representative, began his note with the usual formalities, but then he summoned a quote from St. Augustine:
“Hope has two beautiful daughters, anger and bravery. The anger at such things and the bravery required for change.”
The author of the email then said that though he did not endorse the charged comments and personal attacks of the PBF dissenter, he admired his bravery, his willingness to speak up, and suggested that such anger could be constructive, if it is channeled toward more useful enterprises.
It was just a small word of calm, a small word of credit to a man who feels besieged, and it reminded me of another quote, this one from Shakespeare’s Richard III:
“O momentary grace of mortal men, which we more hunt for than the grace of God.”
***
Our wars are low-level—fought amidst the banality of power point presentations, cocktail parties, and networking lunches. But the stakes are high. Our lives might not be in danger, but our reputations are—the way we are viewed by our peers, which affects what conferences we get invited to, what panels we are asked to speak on, what journals we can write for. And through this, our professional success will be judged. And we will judge ourselves too: did what I committed to actually do any good? Did my career matter?
One morning I asked one of the “evangelists”: do you think criticism or doubt ever get drowned out at events like this? He was thoughtful: yes, he said, we should talk more about the limits of PBF, but "look, for years there was no progress, and now something is actually working…and I don't think we should let doubt get in the way of at least trying this. If someone has a better idea of what we should do, fine, but until then, we need to do this, we can’t wait."
***
I got to the conference hall early one morning. It was quiet out, cool. Some attendees were seated around a table watching a televised church service that was being projected on the wall. A choir was singing:
Hallelujah, Hallelujah, He is risen, He is risen
Some say belief in God is comfort for the suffering, order within the disorder, a port in the pitiless storm. Maybe that is part of what belief is about.
But if that’s all it is about then we are bound to be disappointed. And what I had really wanted to say to the man on the plane was that God, whatever that means, is not responsible for tragedy. Nor does the idea that our lives are guided, that everything is part of a Plan, make me more willing to swallow suffering and grief. Belief like that is bound to be sentimental and fragile.
And new gods like PBF can be fragile too (even war-inspiring). A community tired from years of inadequate solutions to massive problems is in danger of holding on too tightly, moving too quickly, and glossing over details that must be addressed carefully if these programs are going to really succeed.
Everyone knows this. No one needs to be told that caution and careful consideration are needed. Despite the confidence we often project, for most of us, there are moments of serious doubt. But there are moments when we really believe too, when, despite our real differences, a common hope is felt—that even though we may not be able to explain tragedy, there are things we can do to fight it.
That's why most of us got into this business in the first place: Because we want people to live. We want people who are poor not to be poor anymore, or sick. We want life to be more fair than it is.
