Half Changed World

I’ve been reading the article on Bill Gates and his efforts to fight disease in Africa from the October 24 New Yorker.  (Not available online, although they do offer a slideshow on the effects of malaria in Tanzania.)  Michael Specter writes about how shocked Gates was to learn that there were public health investments that weren’t being made where the cost per life saved was in the hundreds of dollars.

Specter quotes Kent Campbell, a former chief of the malaria branch at the US Centers for Disease Control as saying:

"I would love to believe that in the United States this effort is being driven by a decent desire to help, but I don’t think most Americans give a rat’s ass about the death of millions of African kids each year.  I don’t think they ever have."

The argument in favor of this is based on what economists call "revealed preference," the idea that you can tell what option people prefer by the choices that they actually make.  If we let millions of African kids die each year, we must prefer the world in which millions of African kids die to the one in which we pay higher taxes and provide more public health aid, or else we’d do something different.  QED.

But, there’s some evidence that people behave in ways that aren’t explained by revealed preference.  The best example I know of comes from studies of how much people choose to save in 401k and similar retirement plans.  One of the things that researchers have found is that people are much more likely to participate if the default option is that a small percentage of their salary, 3 or 5 percent, is invested than if the default is non-participation.  This isn’t terribly surprising when you think about it; many people find the whole concept so hard to think about that they just go with the default.

As a country, we tend to go with the default too.  In fact, I’d be willing to argue that much of the structure of Congress (especially the budgeting process) is designed to make it hard to move away from the status quo.  And it’s designed to make it a lot harder to accomplish things that a lot of people want, but aren’t passionate about, than it is to do things that a smaller group desperately cares about.

Some useful links:

• Roll Back Malaria
• Bread for the World
• Campaign to End Fistula

I got up early this morning and went to the Capitol to pay my respects to Mrs. Parks.  "Pay my respects" is the right term; I didn’t know Rosa Parks personally, and she lived a long and full life, so I can’t really say I was mourning her death.  I was acknowledging her as both a person and as a symbol of what one individual can do.

I don’t have any photos — only the press were allowed to take pictures.  Bitch has a link up to a slideshow of images.  It was a beautiful Washington morning, with the sun just coming up and lighting the monuments.  All the official flags are at half-mast.  From the trampled grass and miles of barriers, it’s clear there were long lines last night (the Post says there were waits of up to 5 hours), but just before 7 am this morning there was hardly any wait.   The police officers guiding people through looked tired.

The people I saw at the viewing were racially mixed, teenagers on up.  (We thought about bringing the boys in this morning, but decided that they wouldn’t understand and it wasn’t worth the hassle in order to be able to tell them that they had done it.)  Everyone looked somber and mostly talked in hushed voices, if at all.  One woman called out "thank you, Rosa" as she walked by.  The coffin was on a box draped in black, and there were three huge wreaths, one each from the President, the House and the Senate.  A Capitol Police officer in dress uniform stood at attention at either end.

The list of those who have lain in state at the Capitol is a strange mix.  Being assassinated while President pretty much guarantees you the honor (Lincoln, Garfield, McKinley, Kennedy) but just dying in office doesn’t (Roosevelt).  Some pretty mediocre presidents have been honored (Taft?!) as well as a truly obscure Senator (John Alexander Logan).  Two Capitol Police officers who were killed in the line of duty were honored, as were unknown soldiers of World Wars I and II, Korea, and "the Vietnam era."  Congress considered so honoring Martin Luther King, Jr., but did not.  The list is enriched by the addition of Rosa Parks.

I’d guess that I may be one of the few members of the liberal blogosphere who spend the day hitting the refresh button on my computer trying to get the latest news on the Budget Reconciliation process rather than on Fitzmas.

I’ve spent a good chunk of the last three years of my life working on welfare reauthorization, and suddenly I have no idea what the heck is happening.  The Senate has not included it in its reconciliation package.  The House does seem to be including it, and has left the TANF block grant mostly alone, but is trying to take a great big chunk of money out of child support enforcement.  Whatever happens, it’s likely to be the result of some deal cut at 2 in the morning, and no one in Congress is going to have a chance to read the bill before they have to vote on it.  And then the Republicans are going to turn around and try to pass more tax cuts.

Yup, we’re making sausages now.

Did you know that October is "Disability Awareness Month"?

BitchPhD points to a post at Camera Obscura about how the Americans with Disabilities Act also protects people from discrimination based on their association with someone with disabilities.  She wonders (and suggests that I might be able to answer):

"So, for example, you can’t be not hired because your employer is afraid you’ll take too much time off to care for your disabled child. How this would play out if you already had a job and needed, say, flex time to care for the same child, I don’t know, but it’s an interesting question."

The answer, according to the EEOC, is that you need to be treated the same as other employees.  If they’re allowed to take unpaid leave, or juggle their hours, your boss needs to let you do the same.  But if everyone else has to work 9-5.30, the ADA doesn’t require them to cut you a break.  If you work for a big enough company and have been there for at least a year, and the person with a disability is an immediate family member, the Family and Medical Leave Act (FMLA) might help you take unpaid leave, but otherwise you’re out of luck.

While I’m on the topic, a friend forwarded me this list of Myths and Facts about People with Disabilities, from the Easter Seals.  I was particularly struck by #8:

Myth 8: Curious children should never ask people about their disabilities.
Fact: Many children have a natural, uninhibited curiosity and may ask questions that some adults consider embarrassing. But scolding curious children may make them think having a disability is "wrong" or "bad." Most people with disabilities won’t mind answering a child’s question.

This morning, before showering, I decided to peak at a couple of my favorite blogs, and immediately learned that Rosa Parks had died.  I love this quote from her biography (quoted in the Washington Post):

"People always say that I didn’t give up my seat because I was tired, but that isn’t true. I was not tired physically, or no more tired than I usually was at the end of a working day. I was not old, although some people have an image of me as being old then. I was forty-two. No, the only tired I was, was tired of giving in."

Until I heard about Parks, I had been planning on blogging about the book I just finished, Neil Gaiman’s Anansi Boys.  I thought about skipping my weekly book review, but then saw a connection between the two.  Because Gaiman claims that Anansi stories — stories about the trickster Spider (or about Coyote, or Br’er Rabbit, or whatever name you choose)  — were what taught humans that there are ways to get what you wanted without resorting to violence and that brains can be as effective as sharp knives.  Those are certainly lessons of the Civil Rights Movement.  Anansi stories also teach that making your enemy look foolish is sometimes better than scaring him.  And the Civil Rights Movement suceeded in part because it made segregationists look foolish and backwards.

I don’t want to give away the plot of Anansi Boys, but I will say that I enjoyed the book and stayed up later than I should have to finish it.  Most of the reviews seem to describe it as a sequel to American Gods, but I thought it had more in common with Gaiman’s Neverwhere.  It’s a fable, set in the present day, about someone who thinks he’s quite ordinary (even super-ordinary) and turns out not to be.

One detail that I really liked is the way that Gaiman handles race in this book. Almost all of the main characters are of African or Afro-Carribean descent, but that’s never explicitly stated; a few characters are identified as "white."  It made me realize how many books I’ve read where characters are assumed to be white unless stated otherwise.

On a related note, I took out from the library Anansi and the Moss Covered Rock by Eric Kimmel, which is on the list of 100 Picture Books Everyone Should Know that Jody at Raising WEG found.  I think I liked Anansi Goes Fishing, by the same author, a bit better, but they’re both good.

Last Friday, the Washington Post website carried a pair of stories about senior citizens afflicted by the hurricanes.  One discussed the sequence of events at a nursing home in New Orleans that failed to evacuate in the face of the hurricane warnings.  Twenty-two people died.  The other reported on the bus that exploded, carrying senior citizens from  a Houston nursing home, evacuating in the threat of Rita.  Twenty-four people died.  Damned if you do, damned if you don’t.

I’m not arguing that the governmental preparations for Katrina, or the immediate response, were appropriate.  There were major screw-ups at many levels, no doubt.  But I have some sympathy for the planners, because figuring out how to prepare for this sort of high consequence, low probability event has got to be one of the hardest tasks there is in public policy.  If you mobilize fully every time there’s a risk, you’re going to sound a lot like Chicken Little.

In grad school, we did an extended policy exercise around the 1976 swine flu scare.  It’s a useful cautionary tale.  As with today’s worries about a bird flu pandemic, this was a case where experts were convinced that there was a high likelihood of an outbreak of a flu variety that no one living had been exposed to, with fears that it could resemble the deadly 1918 epidemic.  HEW undertook a massive vaccination campaign in the fall of 1976, with over 40 million people vaccinated.  However, the vaccination campaign was called off in mid-December, as reports started coming in of cases of Guillain-Barre Syndrome among people receiving the vaccine.  The anticipated epidemic never occurred, and the federal government was widely criticized for exposing people to a dangerous vaccine. 

Last week, Mieke emailed me to draw my attention to her post about lead found in soft vinyl lunch boxes.  Her post is based on a report from the Center for Environmental Health which is suing the makers and retailers of kids’ lunchboxes in which they found excessive levels of lead in an assortment of kids’ lunchboxes that they tested.

As it happens, I read her email about half an hour after I had ordered D a Buzz Lightyear lunchbox.  (His teachers have asked that we provide him with a full-sized backpack, and while I was ordering the backpack, I decided for an extra $5, we could spring for the matching lunchbox.)  So, what am I going to do?  Am I going to throw it out?  Or spend as much as the lunchbox itself cost on a lead test kit?  Or give my precious child a potentially toxic bag?

Probably the last.   I read the CEH press release carefully, and it never says how many lunchboxes they tested, or what fraction tested high.  My guess is it’s a fairly low percentage, or they would have said.  And, as they said:

"The levels CEH found in the lunch boxes are not high enough to cause acute lead poisoning during normal use. However, if your child is exposed to lead from other sources, a leaded lunch box would add to their health risk."

As a basis for comparison, the amount of lead any child is likely to be exposed to through a lunch box is small compared to what every one of my generation and earlier breathed as a result of leaded gasoline.  I’m not criticizing Mieke or anyone else who wants to test their child’s lunchbox.  I’m glad that CEH is keeping the manufacturers’ honest.  But I’m not going to worry about it myself.

Except at 2 am.

Earlier this week, I turned on the radio and heard this NPR story about the bridge at Gretna.  My husband, who generally avoids the news as much as possible, hadn’t heard about this event before.  When the story was over, he looked at the handful of goldfish crackers that he had picked up, and discovered that he had turned them into goldfish dust from clenching his fists.

Rob at Big Monkey, Helpy Chalk faxed a letter to Mayor Ronnie Harris of Gretna, and Harris called him back.  Rob posted his transcript of their conversation.  It’s quite fascinating.

Rivka at Respectful of Otters suggests that cognitive dissonance leads some people to portray the victims of Katrina as bad people, who got what they deserved.  She writes:

Cognitive dissonance gets particularly ugly when reality collides with the just world hypothesis, the belief that "the world is an orderly, predictable, and just place, where people get what they deserve." Faced with tragedy, victimization, or injustice, just world believers have four options to reduce the cognitive dissonance: they can act quickly to help relieve the victim’s suffering (restoring the justice of the situation), minimize the harm done (making the tragedy a less severe blow to their beliefs), justify the suffering as somehow deserved (redefining the situation as just), or focus on a larger, more encompassing just outcome of the "poor people will receive their rewards in heaven" variety.

When the NPR story on Gretna ended, I said "And when they die, they shall go to the Pearly Gates.  And there will be a bridge to get there…."

Unfortunately, I don’t really believe in a heaven/hell where everyone gets their just deserts.  So I’m left believing that the only justice in the universe is that which we create.  And that’s often a pretty weak justice.

The usually funny WaiterRant got all philosophical in the aftermath of Katrina.  He quoted a pastor named Dietrich Bonhoeffer, executed for his part in an attempt to assassinate Hitler, who said: “God is weak and powerless in the world, and that is exactly the way, the only way, in which he can be with us and help us.”

The Waiter’s take on this was:

"But within Bonhoeffer’s words lies a challenge. Since God doesn’t come down in a blizzard of special effects to bail us out – we have to help each other. We recognize the suffering of others and are moved to relieve it. We can’t coop ourselves up in our apartments, churches, and mosques wishing all the bad things will go away. There’s no room for childish magical thinking. We have to act. The rescuers of 9/11 and the Gulf Coast understood this without all the fancy theological reflection. Bonhoeffer would say when we help each other that is God helping us."

That sounds about right to me.

I’m trying to make Shabbat more a part of my life, and (at least for right now) that involves staying away from the computer.  See you Sunday.

Arrgh!  Typepad just ate my post so I have to start over. 

Arrrr!  Did you know that today is International Talk Like a Pirate Day?  It’s a wonderful example of how silliness can take off.  Two guys had an idea, they emailed Dave Barry, and the rest is history.

Oh come on, some of you are saying, it’s not a real holiday.  Well, my local Barnes and Noble thinks it is.  We went in last week, and they have a big display labelled "September 19: Talk Like A Pirate Day."  Ok, it’s hidden in the children’s section, but still… if it’s being merchandised, it must be a real holiday.  Shiver me timbers!  And flea is even offering a special discount of 40% off all purchases from her sex toy shop. 

So, go to it.   Arrr.

Update: Pass the grog, mateys!  Many of my favorite bloggers are joining in the party:

• Yo Ho Ho, from Mr. B
• Pirates ONLY, from Pharyngula (although he appears to have walked the plank midday).
• Happy International Talk Like a Pirate Day, by Lauren at Feministe
• Aye! Avast Me, Chiklits, from Kameron at Brutal Women.

Today I got an email with the header "Reminder ** Commemoration of Patriot Day SUNDAY, September 11th."   Not to be confused with Patriots Day, which commemorates the Battles of Lexington and Concord, "Patriot Day" is apparently the officially designated name for September 11th.

The email went on to say:

"Our citizens have been looking for a meaningful way to commemorate September
11, 2001, its victims, and our heroes in uniform who continue to serve.

This September 11th, we are answering our citizens’ call-to-action by
hosting the inaugural America Supports You Freedom Walk, organized by the
Department of Defense and supported by Stars and Stripes newspaper."

I believe that commemorating the September 11th attacks and honoring those who serve America in the military are both highly worthy goals.  But I’m intensely uncomfortable about combining both causes into a single event.  I see this as part of the Administration’s attempt to blur the lines between the war in Iraq and the ongoing struggle against terrorism and to imply that Saddam Hussein was somehow responsible for the 9/11 attacks.

So, I wasn’t planning on participating in the "Freedom Walk" in any case, but my jaw dropped when I read in the Washington Post about the security measures being imposed:

"The march, sponsored by the Department of Defense, will wend its way from the Pentagon to the Mall along a route that has not been specified but will be lined with four-foot-high snow fencing to keep it closed and "sterile," said Allison Barber, deputy assistant secretary of defense.

The U.S. Park Police will have its entire Washington force of several hundred on duty and along the route, on foot, horseback and motorcycles and monitoring from above by helicopter. Officers are prepared to arrest anyone who joins the march or concert without a credential and refuses to leave, said Park Police Chief Dwight E. Pettiford."

The Post reports that the park police offered to screen people entering the Mall, as they do for the big Fourth of July concert and fireworks, but DoD said "We didn’t want a bottleneck at the concert."  Somehow it works ok on the 4th, when hundreds of thousands of people come.  What the heck are they so afraid of?  Terrorists or anti-war protestors?

Instead, I’ll be participating in the DC Unity Walk, an interfaith walk from Washington Hebrew Congregation, to the Islamic Center, and the Gandhi memorial.  The mission statement is:

"We walk together as neighbors from many faiths and cultures. We gather in
peace to demonstrate our unity, recalling the spirit of togetherness that
grew out of 9/11 and rejecting the paths of despair and revenge. We
commemorate this day because concern for each other’s welfare is the shared
hope of us all."

If anyone reading this is planning on going and wants to meet up, drop me an email.  I’ll probably have N with me in the stroller.  (D has a birthday party to attend.)

Via Making Light, I ran across this vaguely attributed quote:

Any sufficiently advanced incompetence is indistinguishable from malice.

As Roz Kaveny explains:

"I love it simply because it nails both the folly and the irrelevance of conspiracy theory. It is not necessary to claim that the President of e.g. the USA is setting out to kill a maximum number of African Americans out of deliberate spite. It is sufficient to point out that if you take a job involving life and death, and go on doing it when you are clearly incompetent, then you are morally responsible anyway. There is a duty not to be crap at what you do."

This fits in very nicely with Barack Obama’s take on the federal response (via MsMusings):

"I think there were a set of assumptions made by federal officials that people would hop in their SUVs, and top off with a $100 tank of gas and Poland Spring water."

"We as a society and this administration in particular have not been willing to make sacrifices or shape an agenda to help low-income people."

In the last couple of days, my office has been very peripherally involved with responding to Katrina, and all I have to say is that it doesn’t give me a whole lot of reason for hope.

On a related note, I’ve been thinking a lot lately about Susan Wood, and her resignation from the FDA over the emergency contraception decision, saying that it "is contrary to my core commitment to improving and advancing women’s health." 

Shortly after I started working at HHS (over 9 years ago!), my new boss, Wendell Primus, resigned his position in protest of Clinton’s decision to sign the welfare reform bill.  Several months later, he was followed by his boss, Peter Edelman, and the ACF Assistant Secretary, Mary Jo Bane.  But all three of them were political appointees, obligated to represent the President’s position. 

At what point, if any, is a career civil servant morally responsible for being part of an organization that is crap at what it is supposed to be doing?