Bit of Fundraising

This is kind of a meaningless post (from a blog quality perspective anyways), but we’re well in the midst of EWB’s annual peer-to-peer fundraising campaign. Like everyone we’ve been hit pretty badly by the recession, and contributions from individuals have really helped fill the gap and keep our overseas programs running! Please consider donating. You can both donate and read more on my perspective about our work and why I think it’s worth supporting here:

https://perspectives.ewb.ca/owenscott

Subtle Parasites and Public Health

Last month, while I was home for Canada, I had my first ever stool sample. (Note: picture omitted…this time.) Realistically I should have had one before – I lived for a summer in rural Zambia in 2007, and then have been in Malawi since early 2009. However, I’ve always put it off.

Regardless,the results are in: I have no less than 5 separate intestinal parasites. I have yet to do the research on what these are, or how I got them. They all have long latin-sounding names, and none are particularly familiar. However, one guess I’ll safely hazard: my behaviour is to blame.

Despite working in public health, I’m pretty easy going when it comes to my own exposure. I drink untreated tap-water in Malawi’s cities, and, generally, whatever everyone else is drinking in rural areas. I walk around barefoot in villages, including daily for 4 months when I was living in the village in Chikwawa. (The inspiration for this blog’s title actually, now that I think of it.)

One incident in particular comes to mind. It was the start of mango season, so probably around September of last year. The bus route from Salima to Lilongwe is the best place to buy. During one trip, I got a beautiful grocery bag full for K50 (maybe $0.35) and, having not eaten lunch, I immediately started digging in.

A guy at the back of the bus stops me. “Excuse me. I noticed that you’re eating those mangos without washing them.”

Yes…” (“I’m on a bus. There’s no tap…”)

In Malawi we sometimes think it’s important to wash them first.”

I’m not too worried.” That was my blurted out reply. I’m not too worried. Off the top of my head. The blunt truth.

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Stock photography of mangos from earlier in the season.

And that’s the thing. I wasn’t too worried. See, I almost never get sick. Even as I type this, with 5 parasites inside me (or maybe some of them are bacteria, I’m not too sure actually), I feel fine. And I’ve had them since at least November, maybe much longer – no reaction. I went for a run yesterday. Health = more or less ok.

Therein lies the tricky thing with working in health. I pursue a bunch of risky behaviour, get sick, but my body fights it off and I barely notice. In fact, had it not been for the test, I wouldn’t even have noticed at all. Someone else does the same thing, and gets sick. Extrapolate this to a whole community, and we have a serious disconnect between cause and effect. Behaviours that we know are risky, like not washing your hands, improper disposal of faeces, drinking unsafe water, or, yes, eating unwashed mangos on a bus, don’t always lead to negative health effects. And thus the need to change those behaviours isn’t always that obvious. If it was, I think ideas like handwashing would have taken off long ago, and working in public health wouldn’t be even a tenth as challenging…

The Things We Rely On

Early last week, after an already long day of work, I hopped on a late afternoon bus from Lilongwe to Blantyre, so that I could get to Mulanje district early the next morning to run a half-day training for district government staff there. Because of the mountain of work I was buried under, I didn’t have time to deal with a few key details, like getting to the bank before the trip. Still, I had a plan. I scraped my pockets to find bus fare, then figured I’d just get a taxi in Blantyre to stop by an ATM before taking me to a guest house.

Great plan, in Canada anyways. And a pretty good one in Malawi. Of all the services here, ATMs are one of the most reliable. Still, as I sat at that ATM in Blantyre, waiting for money to come out, I had a thought: “If this doesn’t work, I’ll be pretty screwed.” I might have enough money to cover my cab fare, but not my accommodation, my trip to Mulanje the next morning, or other minor details like…food – not to mention somehow getting back to Lilongwe.

 

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The trip on a map. Pretty far from home to risk running out of money.

You see, things go wrong in Malawi all the time – way more than in Canada. Buses break down. Electricity goes out. The water stops. 3 weeks ago I was having to walk 15 minutes to a friend’s house to use her shower – my water had just randomly shut off for a few days.

Communication infrastructure is even worse. I have what is, ostensibly, the best internet service in Malawi – 3G wireless internet hooked up by USB to my computer. When it works, it’s great. The other half of the time, I may as well not have it. Makes keeping up with email a little more challenging than it needs to be. And cell phones…oh, cell phones. I remember , last time the network cut out, asking a friend: “what do people do in Canada when the cell network goes down?

It doesn’t go down.”

Oh ya…

All of this makes life way harder in Malawi. It also makes business harder. Talk to an entrepreneur anywhere in Africa, and see how long it takes them to mention electricity supply as a major challenge. Not so in other parts of the world.

So what do we do? How do people cope with all this unpredictability? Partially through redundancy. Most people in the country, including me, have SIM cards for multiple cell phone networks – one goes down, you use the other one. Most serious businesses have backup generators. Computers are hooked up to uninterruptable power supplies.

But that’s only part of the answer. The bigger part, the real glue that keeps things going here, is best illustrated by a story – another bus adventure.

Flash forward to my trip back to Lilongwe later in the week. I was still buried under work, so wanted to get an early start and not waste much time travelling. I woke up at 5:50am, aiming to be at the bus station for a 7:00am scheduled departure. First stop though: the bank. Travelling eats up money pretty quick, and once again my cash had run dry.

I get to the machine, and put in my card. I go through the motions – same old same old. Pin. Checking Account. Withdrawal amount. A message comes up: “your provider has declined the transaction.”

Excuse me?

I try again. Same message. I phone my mom in Canada, seeing if she can get VISA on the line and sort it out. But, as she starts trying, I look at the time – even if she sorts it out quick, I’ll probably still miss my bus.

I look at the remaining wad of cash in my pocket. It looks thicker than I initially thought. I count it out. I scrape the bottom of my bag. I’m almost there. Only short K85 for a bus ticket. A meaningless amount. In Canada, less than 60 cents.

Still, less than 60 cents is a significant part of a bus ticket seller’s daily salary – there’s no way I can ask her to eat my shortfall out-of-pocket. And I know that she’s not allowed to give discounts. What do I do?

Not being one to give up without a fight, I come up with a plan. I have K456 in “talk time” on my phone. (On a good day) you can send talk time from person to person via the cell network. So I figure I just go to the bus station, and start asking people if they want to double their money – K200 in talk time for K85 in cash. It’s a good deal, and I’m sure it’ll work.

What I forget though, is that I’m in Malawi. The first person I ask just gives me a funny look (probably at least in part because I was speaking in Chichewa), smiles, and then hands me the money I need. I try to get her phone number to pay her back, and she declines with a laugh. That’s life here.

And that is the answer. The glue that holds things together. People. Each other. When you can’t always rely on services, when the world’s not always that predictable, you turn a little more to the people around you.

Since coming to Malawi I’ve been helped out of a lot of jams by friends and strangers. And I’ve helped out a lot of other people too. It’s not just me. Everyone’s doing it. It’s what keeps the country going. When you can’t rely on the fact that, day in day out, action x will lead to result y, what other choice do you have…

Economic Development in Perspective

Defining what we really mean by “development” is one of the central challenges for humanity in the 21st century. Look back fifty years and it all seemed easy. We had “first world countries”, and “third-world countries”. We had the  stages of growth, and a belief that economic development and development itself were more or less synonomous.

Of course in the last half century times have changed. We now have a much more balanced view of development. The Human Development Index has brought to the fore the importance of non-economic indicators like literacy and life expectancy. The environmental movement has mainstreamed the significance of sustainability. And radical ideas like Bhutan’s Gross National Happiness have shown us that completely different ways of looking at development are possible.

As positive as these recent trends are, one fear I have is that the importance of economic development is quickly becoming underappreciated, especially in western “development studies” programs.

Nothing brought this home for me more vividly than, last month, when Malawi published projections for the income from this year’s tobacco harvest. Tobacco production is, by far, Malawi’s most important industry. It generates roughly 60% of export earnings – the foreign exchange from which, in turn, buoys the rest of the economy.

Tobacco is not just a big industry on paper, its very very noticeable here. In the central region, many smallholder farmers grow at least some tobacco, at times it feels it’s almost as common a sight in rural areas as maize. There are also huge tobacco estates scattered around the country, which employ hundreds of people each. And many better-off people, including a good number of my co-workers and friends, grow tobacco on a semi-commercial basis as a side business on family land. Come harvest season, tobacco is everywhere.

Tenje Field A small field of tobacco growing in Tenje Village, Ntchisi District, Malawi

That’s why I was so shocked by what I read last month: national export earnings for tobacco this year were expected to be somewhere around $380 million. $380 million?!!?! From the country’s largest export industry? From the crop I see everywhere, being grown, dried, graded, baled, and loaded on to trucks? From the industry everyone talks about when they talk about Malawi’s economy? $380 million…

Reading this in the local paper was one of the first times I think I really realized what economic development means.  Malawi’s leading industry, its source of 60% of export revenues, earned $380 million last year. That’s about on par with the United Kingdom’s 2009 earnings for the manufacturing of watches and clocks ($349 million). It’s lower than the UK’s 2009 export earnings from the manufacture of “corrugated paper and containers” ($435 million).

It’s less than the export earnings from the UK’s wine industry (I didn’t even know the UK had a wine industry), which came in at $504 million in 2009. It’s closest UK competitor seems to be the export earnings from the “quarrying of sand and clay” ($385 million), which is remarkable since sand and clay are low value, high weight products, which don’t generally lend themselves to export. And, of course, Malawi’s tobacco earnings pale in comparison to earnings from the UK’s ubiquitous and omnipresent “manufacture of tubes” industry, which brought $2,092 million in 2009.

All of this really puts into perspective for me the real challenge of economic development. Any economy which would generally be considered “developed”, like the UK’s, has dozens and dozens of obscure industries (seriously…UK wine?) which earn more annually than the flagship industry in Malawi. While Malawi’s economy rises and falls with annual tobacco earnings, people take little notice of the earnings from “manufacture of knitted and crocheted pullovers” ($654 million for the UK in 2009), “manufacture of toys and games” ($1,161 million) or any of the other diverse and unexpected industries that keep developed economies moving. And yet many of these industries absolutely dwarf Malawi’s tobacco crop in terms of export earnings.

 

Looking at this, I have to think that, while the pursuit of human development and quality of life should be the real goals of growth in Malawi, a lot of economic growth is also going to be needed to make these nobler goals possible. A lot. I knew that Malawi, like many developed countries, is dependent on one major export industry – I just didn’t realize how small that industry really was. I think that putting things into perspective can really help to appreciate the scale of the challenge, and maybe restore to the goal of economic development, e.g. the development of new industries and manufactures, a bit more well-deserved prominence in the greater development debate. Human development is important, but things like health and literacy won’t come freely – there needs to be a diverse and vibrant economy in place as well to support them. $380 million per year from your largest industry just isn’t going to cut it…

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Note: All UK economic stats were taken from the UK Office for National Statistics online site. Of course I initially wanted to use Canadian export statistics, but Stats Canada saw fit to try to charge me $81 for the privilege. Transparency at its finest…

How to Make Simple Maps of Water Coverage

A while ago I wrote a post on some waterpoint monitoring software we’ve been using to assist district governments in Malawi with water supply information management. The software lets us do a few things:

  • help district government staff quickly visualize data about water coverage in their district, without relying on expensive software or extensive training
  • build enthusiasm for data management and evidenced-based decision making so we can segway into more serious training on data analysis and planning
  • motivate district staff to fund/organize their own data collection surveys

The goal of all of this is to help improve planning of water infrastructure, making sure that new wells go to the communities with the greatest need for clean water, and that aid money is used as efficiently as possible. Right now there are serious inefficiencies in the way money spent on clean water supply is used, and better management of information is one way of addressing this. In effect this is all about aid effectiveness.

My initial post on the software generated a lot of interest. This afternoon I have been working on some user manuals for potential international sharing of the software, and so given the interest people have already expressed, I figured I’d share one of them on this blog. The following set of instructions show how the software can be easily customized for setting up maps in new districts (or even countries).

(As always, acknowledgement to Edward Ng, from the University of Waterloo, as the software’s original author.)

Getting a Base Map

In order to set up a new map in [the software] you will need to get a base map from somewhere, as a .jpg or other image file. For instance, you can obtain a base map by taking a screen capture from GIS software, by finding an existing image file of a map, or even by taking a photo of a hard-copy map using a digital camera.

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A screencapture of Karonga District, Malawi, taken using ArcView GIS

Setting Up the Map in Excel

Step 1: Right-Click on the “Map” tab and choose “Unprotect Sheet…”

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Step 2: Insert your .jpg base map and resize it to fit nicely into the white rectangle.

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Step 3: Click on the “Water Coverage” button and re-locate the legend as necessary by dragging and dropping it. Click on the “Waterpoint Functionality” button and do the same.

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Step 4: Click on the “Water Coverage” button and change the words “[District Name]” on the title to the appropriate name. Click on the “Waterpoint Functionality” button and do the same thing.

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Step 5: Click on the “Insert” tab, choose “Shapes” and then select the “Freeform” shape.

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Step 6: Use the “Freeform” shape to trace a neat outline of each subdivision of the district.

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When completed you should have a map of the district with all subdivisions outlined.

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Step 7: Select all of the district shapes you’ve just drawn, right-click on them, and select “Send Backwards”. Continue to do this until all shapes are behind your original base map.

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Step 8: Trace all of the roads on the map with red lines. Group the lines together and name the shape “Roads”. (This allows the “Roads” checkbox to work.)

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Step 9: Trace all of the rivers on the map, group them together, and name the shape “Rivers”.

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Step 10: Use the “Freeform” tool to draw outlines of all protected areas, national parks, and lakes. Colour them in accordingly.

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Step 11: Delete your original .jpg base map. You should be left with a full outline map of the district.

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Step 12: Select each district subdivision shape, and change its default name to its real name. (This will allow the software to assign the shape its proper colour based on that subdivision’s water coverage and waterpoint functionality rates.) Note: It can help to turn off the “Roads” and “Rivers” checkboxes first.

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Step 13: Once each of the subdivisions has been renamed, select all of the “freeform” shapes on the map and group them together. Name the group “AllMap”. (This allows the “Copy Map” button to work.)

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Step 14: From the “Insert” tab choose “Shapes” and then “Textbox”. Use “Textboxes” to label each subdivision in the district, and any other relevant features.

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Step 15: Group all of the Textboxes together and name the shape “Labels”

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Step 16: Right-click on the “Map” tab and choose “Protect Sheet”.

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Step 17: Click on the “Legend” tab. Choose a colour scheme for the map. Click “Update”. The legend on the Map should now have changed. (Note: you can also change the values associated with your colour scheme.)

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Step 18: Click on the “Database” tab. Enter some sample data into the Database in order to test the map.

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Step 19: Click on the “Pivot Table” tab. Click the “Update” button. A summary of the data should appear on the Pivot Table.

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Step 20: Click on the “Map” tab. The Map should now be coloured in based on the data you entered and the colour scheme you selected.

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And that’s all there is too it. Generally we start by setting up a map for district government staff, and focus training more on basic data management skills and evidence-based decision making. Once staff become more proficient at managing/analyzing data, we can also train them to set up/modify the map as well. So far this software has been really well received by district government staff, as it works completely offline (e.g. requires no internet connection and all the data is stored on their computers) while also allowing staff to create maps with a fraction of the training required for conventional software.

Technological Inflection Points in Waterpoint Monitoring

One of the cornerstones of our work supporting waterpoint monitoring in Malawi has been the creation of custom software for local government use. The software allows government staff, with limited computer skills, to produce powerful and user-friendly summary tables and maps based on very simple data. So far it’s  been very popular with staff at district water offices across the country.

image An example of mapping output from our software. (Note: in this case using fabricated data).

As our approach with districts has been getting increasing attention, we’ve been getting requests from different stakeholders to add more and more functionality to the software. Requests have ranged from maps showing political constituencies, to more data on specific waterpoints, to information on community mobilization.

A couple weeks ago, while attending a major conference on water/sanitation mapping (my first such opportunity), a new realization finally crystallized for me. There are a lot of software packages already out there for database management and mapping. Creating your own can be very useful in a specific context. However, at some point of desired software functionality, it’s probably better to stop trying to reinvent the wheel, and just use what’s already on the shelf. Being a visual person by nature, this realization led me to the following graph:

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Technological Inflection Points in Waterpoint Monitoring – Shown Graphically

What this is trying to show is that custom software can be great, up to a point, but if you want to do something really complex, then eventually you just have to bite the bullet and use the real stuff.

For instance, our software application works by allowing district staff to manage their own database of rural water access (in Microsoft Excel, with which they’re usually familiar), produce summary tables breaking down raw data into useful statistics (happens automatically using a Pivot Table linked to their database), and produce maps at the click of a button using a custom VBA macro. We keep it obsessively simple, and generally it works well.

image An example of statistical summary information produced automatically using our system.

The advantage of this approach is that we can train someone in the basics of database management, information analysis, and map production in only a few hours, often less. This lets the user quickly move on from struggling to manage the database to using it to make improved decisions. Training someone from scratch in the equivalent skills using a more traditional ArcView/MS Access approach would take days, if not weeks.

However, if we wanted to help someone manage a database with ten times as many indicators, calculate 15 different custom statistics, generate 10 different types of map, update in real-time while automatically analyzing trends, etc., then it would probably better to bite the bullet and do it using conventional software approaches. It wouldn’t be easy, and it may not be possible, but it’s easier than trying to create a bloated custom application which tries to make extremely complex tasks simple and user friendly, and ends up collapsing under it’s own weight.

The point I’m making is similar to my last post. Custom waterpoint monitoring software applications can fill a niche. I think our application is doing a very good job of that at the district level in Malawi. But it’s unrealistic to expect them to do everything. Understanding where the inflection points are is key to understanding which approach makes sense.

Waterpoint Monitoring – Working at the Intersection of “What’s Important” and “What’s Possible”

A lot of things are important when it comes to creating a monitoring system. Not everything, however, is possible. Through my work, I’ve found that people are generally great at appreciating the former, often less great at appreciating the latter.

“What’s Important”

There are a lot of things people want to know about water access. As a result, most monitoring systems end up pretty bloated. Sit in a room full of water-sector people, and ask what data should be collected. Expect to be overwhelmed. The following diagram shows some common requests.

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Figure 1 – A (small) selection of commonly requested waterpoint monitoring indicators.

“What’s Possible”

This is where it gets harder. You could make a great water access monitoring system by attaching radio-signal emitting flow-rate censors to every tap and boreholes in the country. Would it work though? Could you afford it? Of course not. And what’s true for radio-signal emitting flow-rate censors (a technology I may have just invented for the sake of this post) is also true of much more commonly requested indicators.

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Figure 2 – Some of the reasons why not everything that’s important is possible.

Next Step – Know What You Want to Do

“What’s Possible” changes immensely depending on what you’re trying to do. If you’re trying to do a one-time survey for policy/research purposes, a lot is possible. In a one-time survey, with enough money, you can collect almost any data.

If you’re an NGO trying to monitor your own programs, a lot is usually possible as well. NGOs typically have relatively few waterpoints that they’re trying to monitor, and have a lot more money to play with than government.

However, if you’re working with government, trying to help them set up their own monitoring systems, you probably want to be careful. Local level governments (which is who are usually responsible for monitoring ) are generally subject to a lot of constraints. Money, incentives, staffing levels, technical capacity – all of these things can dramatically limit what you can do with a monitoring system.

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Gratuitous Photo 1: The Temple of Apollo which housed the Delphic Oracle – “Know Thyself” (source: Wikipedia)

A lot of unrealistic monitoring system implementation is attempted because people confuse what they’re trying to do. So know yourself, know what you’re trying to do. If you want a lot of data, do a survey – but don’t try to take a survey-amount of data and cram it into a government monitoring system. It usually doesn’t work.

Monitoring at the Intersection

Generally, I think the concept that “the proof is in the pudding” works well here. A very good way to guarantee from the beginning that a government waterpoint monitoring system is at least possible is to have government staff at the helm from the beginning. This means relying on them to do the work, and to fund it. If they can’t implement the system initially, with your technical support, then it’s unlikely to be sustainable anyways.

Think about it – if the system is failing even while still enjoying your technical support, than the challenges probably aren’t technical; more likely the issue is that people aren’t incentivized to do the work, they can’t afford to fund the system, or they just don’t care about it. Either way, something is fundamentally off. But if you fund it and do the work, hoping government will take over after, you may only learn the truth once it’s too late. So have government fund the system, and do the work from the beginning.

Many of the challenges with sustaining waterpoint monitoring systems in Africa come from the  lack of appreciation for “what’s possible”. Developing a monitoring system based solely on what you think is important is like developing a product without thinking about whether your customers want it or can afford it – it’s an incomplete strategy. But it happens all to often. Here’s to hoping that this approach will eventually change.