Who Will Educate the Educators?

After leaving Maker Faire Africa on Friday, inspired by much of what I saw there, I returned to Nakuru, where many of the town's residents stand or sit in the same places every day, staring at passers by, shouting the odd bit of abuse and joining in any commotion that happens to relieve the monotony.

I admit, I was a bit annoyed when I compared how some people do amazing things with their time and others do not. I always have to go through the same thought process; first I get exasperated and then I remember that there can be reasons why some people energetically pursue things that benefit them and others while some people seem condemned to get up every day and stare into the middle distance until it gets dark.

The vast majority of exhibitors that I talked to at Maker Faire were well educated and some were clearly from well off backgrounds. This means nothing on its own. Those with lots of education from well off backgrounds can also end up doing little with their lives. And some from poor families with only a basic education achieve great things.

But some of the exhibitors were also wondering why some of their fellow Africans didn't do what they were doing. And one reason I would suggest is lack of basic education and training in skills that allow people to prosper, or at least to get by better than they do now. When I attempted to demonstrate to people around Nakuru how they could make and use simple technologies, they went through a few phases: they were curious, even surprised; they raised objections; they became silent and sat on their hands.

I admit, they may not have had the best teacher. But I think there is something about education beyond what is imparted by a teacher and embraced by a learner. People didn't sit on their hands because they were unable to cut out shapes using patterns and stick things together with glue. They are well able to do such things and many others. I would guess that most of them could have done much of what the exhibitors at Maker Faire did.

What people gain from education, I hope, is the ability to make what they learn part of their day to day lives, whether this involves various bodies of knowledge or sets of skills. What people with a poor education receive is lists of things to learn off so that they can get the requisite number of ticks in order to graduate to the next class. These ticks are rarely, if ever, of any use to people thereafter. But once people have mastered the pretence of being educated, they have no way of taking their education further.

I'll say it again, people with education and training may not necessarily do much with it. And those with little education and training may spend their lives enhancing what they have got and benefiting themselves and those associated with them. But that seems like leaving things to chance for the majority, while allowing a minority quite an advantage, whether they use it well or not.

Development projects can be very narrowly focused. For example, many education projects focus on a few indicators, often the ones that show the project in a favorable light but give little benefit to the recipients. They might concentrate on enrolment but not attendance, exam results without any evidence of learning or the ability to continue learning after school has finished, gender parity without any change in genuine inequalities, etc. 'Success' in development projects can resemble the 'success' of students who have received a poor education.

HIV projects can involve huge amounts of money and produce amazing statistics about the number of HIV transmissions prevented, the number of deaths averted and the number of condoms distributed. Yet people are suffering from and dying from very ordinary diseases that are easy to prevent and cure. Health is not just a matter of disease or being free of disease and it's even less a matter of one virus (which is still endemic in many countries in the world, despite hundreds of millions having been spent on 'prevention' programs).

There seems to be an emphasis on size and magnitude and the measurement of these development projects, as if there is some great prize to be won on the basis of a few hackneyed quantities. Is the aim of development not to ensure that there are fewer millions of people receiving little or no education, suffering from and dying from preventable and treatable illnesses, unable to afford basic nutrition or water and sanitation? Of course you have to count people, but people are not indicators, nor are health or education.

Many of the projects at Maker Faire were about things that matter to people in their day to day lives, food, water and sanitation, agriculture, communication, income, energy, lighting, raw materials and the like. There was less emphasis on education that I would have expected, unless you count some electronic device that 'helps children learn to read'. But these are all concerns that are raised when you go to villages, slums and isolated areas.

Levels of education, especially among girls and women, can be shockingly bad. Many primary school teachers are said to have a low understanding of the subjects they teach and even those who know more don't manage to impart much. But education is not just a process of 'attaining' a set of facts or skills. It is the preparation that everyone needs in order to ensure the education and health of themselves and their families and to ensure that they grow up to be able to provide for themselves and their families, in turn.

A lot of development is dominated by quantities and measurement, a set of boxes to be ticked, regardless of the irrelevance of such processes to people's lives and livelihoods. The Millennium Development Goals, mentioned several times at Maker Faire, are the epitome of such a lifeless and administrative view of development. People need basic things, education, health, nutrition, income, water and sanitation and infrastructure, but they also need to be able to provide themselves with these and other rights. These are not things you can pack in sacks and send them off in an aid convoy.

Significant feats will not be achieved by hordes of administrators with clipboards (or technological variants of clipboards) recording a handful of indicators as people die prematurely and needlessly, though this is a great way of spending billions of dollars. I suppose development will only achieve anything when it has put people in developing countries in the position where they can do the development. So far, we have not been very good at this (and I include myself, of course).

That development needs to be sustainable, that it needs to give rise to further development, seems clear. But it also seems to matter a great deal who is doing the development, who is able to do it, whether it is outsiders from developed countries or insiders from developing countries. Which is very similar to the conclusion I came up with yesterday! I could go on, but tomorrow is another day.

Measurement of Success is the Measure of Our Failure

Out of the top ten killer diseases listed by AlertNet, most relate to a lack of something very basic:

Number one, lower respiratory infections are closely related to poor environmental and living conditions; 2, HIV/AIDS is related to many things, including healthcare, education, infrastructure, labor practices, legal issues, equality and others; 3, malaria is to a large extent related to environment and living conditions; 4, diarrhea is mostly related to poor water and sanitation; 5, TB, environment and living conditions.

It's not until you get to numbers 6 to 9, measles, whooping cough, tetanus and meningitis that you find diseases that are generally controlled with a vaccine. And controlling these diseases still requires adequate health systems, education and infrastructure. Number 10, syphilis, can also be controlled by good sexual healthcare, sex education and drugs.

But the point is that medical treatment is not health. Medical treatment is for people who are sick. In order to avoid numbers one to five, the majority of people need things like good housing and domestic facilities, water and sanitation, access to nutritious food, education and the protection of the law against discrimination, exploitation and inequality. If these basic needs are not met, medical treatment alone is unlikely to be of any use. These top ten killers kill millions of people because of the absence of things other than medical treatment and supplying endless amounts of medicine will not prevent illness and death.

The AlertNet article is perverse in that it doesn't mention that the biggest killer, lower respiratory infections, are spread by poor living conditions and that, therefore, deaths could be significantly reduced by concentrating on improving these conditions. One of the Millennium Development Goals includes reduction in child mortality as an indicator of progress. But that doesn't necessarily translate into improving living conditions. Children are especially susceptible to respiratory infections and much of the mortality from these causes occurs in children and infants. But providing lots of treatment is not a substitute for better conditions.

Similar remarks apply to malaria. It can be better controlled if people live in decent housing. When they live in villages, towns and cities, especially, the environment also needs to be such that malaria carrying mosquitoes can be controlled. But a large percentage of people live in semi-permanent housing that doesn't protect them from mosquitoes and other threats. Mosquito nets are good if people have enough space and enough beds to make them effective, yet many live in cramped conditions where mosquito nets are less effective. Technical solutions need the right conditions and have sometimes proven to be a waste of money.

One often hears calls for vaccines against diarrheal diseases and big donors are especially fond of such vaccines.  But what these big funders don't seem to want to ask is why are people drinking water contaminated with their own feces? These vaccines may have some impact at first, but if people don't have access to clean water and good sanitation, they will continue to be infected with other water borne diseases. Is it even logical to give some medicine to people who then continue to drink contaminated water? Vaccines may be a good supplement to eradicating some of the big killer diseases but without ensuring safe water and sanitation, they will have little effect. The same applies to pneumonia vaccines.

Providing people with decent living conditions, water and sanitation and the like are expensive. But billions of dollars are spent on vaccines, much of the money going to rich and powerful multinationals. There isn't a lack of money, just a lack of equity. Most of the money is being spent on subsidizing the rich; pharmaceutical giants, agriculture and the like. It's true that most people in developing countries don't die for lack of food, and malnutrition doesn't usually kill people either. But these both leave people weaker, more susceptible to disease and more likely to die of preventable and treatable diseases.

Sometimes it appears that development misses the point: yes, people are poor, undereducated, unhealthy, isolated and otherwise deprived. But a handful of indicators is not a measurement of development. The aim of development is not to produce a few Olympic runners, jumpers and throwers and then claim some gold medals. The aim is that everyone can enjoy healthy and fulfilled lives. Achieving some goal such as immunizing all (or most, or 80%) of children against a couple of waterborne diseases is a failure if they still die from some other waterborne disease; it's a failure if they don't have access to clean water and good sanitation. Immunization, like much medication, can be a necessary condition to ensure health, but it is not sufficient.

Of course, development experts are not advocating that everyone be supplied with medication and ignoring other conditions. But the money is mainly going towards the technical solutions and not going towards supplying basic needs. In developing countries, many people spend more money on healthcare and health care products than they do on more basic things. And where they don't have the money to spend, a lot of development money is spent on these services and products. Basic needs are prior, in the sense that they must be supplied first. In highlighting how basic some of the top ten killer diseases are, AlertNet takes the first step towards refocusing attention. But it fails to say why so many people in developing countries are dying needlessly or what can be done about it.