Enjoying the Calm While It Lasts

It's a beautiful Summer evening in Kigali. There is neither even a whiff of a breeze nor a cloud in the sky as the Sun heads swiftly for the Horizon, glowing bright red as it does the closer you are to the Equator. Being as close to the Equator as Kigali is (2 degrees south) the days don't vary enormously in length from Summer to Winter. At their longest, as they are now, the Sun sets at around 6.20pm. In Winter closer to 5.30pm. Which means no long, sunny evenings to sit on a terrace having a beer during the Summer (as I recently enjoyed back in New York, London and Toronto) nor does it mean mood-destroyingly short days during the Winter. At the other end of the day, the Sun is always up by 6am and the Rwandan people on the move not long after. This is still a country that walks to work even in Kigali. Only the elite and the taxi drivers have cars. Some can afford to take the little mutatus ("bus" in Swahili lingo, exactly the same little vans were in use in Lima and were called "micros"). Otherwise as you drive to work in the morning or home in the evening you see lines of people walking along the sides of the roads, which are frequently lacking in pavements / sidewalks. The reason that activity starts so early here is that everyone is in bed very early. After darkness descends only 28% of urban residences and a very low 2% of rural ones have electricity to make use of. What else is one to do but sleep? Or that other activity which the Rwandan government is actively discouraging in order to bring down the 5.5 fertility rate amongst Rwandan women.

In case anyone happens to be interested in further stats on Rwanda, mostly related to health, check out the newly released Interim Demographic and Health Survey (http://www.measuredhs.com/pubs/pub_details.cfm?id=936&srchTp=home). If you're a geek like me, it makes for fascinating reading. It has its drawbacks as a survey (much of the data is self-reported and impervious to verification and there is little comparison to previous years for trend analysis) however it's still for the most part pretty good as an indication.

As for work it never sits still. When I arrived three new people had been hired all starting the same day as me who would form the team I would manage. Two of those have now left, one to do a masters in Belgium and the other on loan to our sister organisation Partners in Health. What's more we're on the verge of hiring nine or ten additional people who will all have the misfortune to be managed by yours truly. It's exciting. I'm engaged in three broad areas: advising the Ministry of Health in Kigali on policy and planning; working in one of the 30 districts of Rwanda to help them manage their health system, consisting of a district hospital and thirteen health centres; perhaps most interestingly of all developing a large-scale data collection, storage and analysis tool/engine which will collect several hundred data points on every health facility in the country (450 and rising) every six months and allow every level of the health system (from rural, isolated health centres to the Ministry of Health in Kigali) to manage their investment and operational decision-making. This last piece of work is all the more fun because it's probably one of the first to be developed on the continent and is being built with one eye on other countries where we could deploy it. Right now we're going through a certain lull as most CHAI (Clinton HIV/AIDS Initiative, just one of several initiatives run by the Clinton Foundation) staff are out on vacation. However the storm clouds are clearly visible and due to arrive in the first couple weeks of August. From then until Christmas, and beyond, work is going to be wild. Our donors and the Ministry expect.

A New(ish) Beginning

Four and a half months into my life in Rwanda and I’ve managed to say virtually nothing about my life here so far! My intention was to round out my experience working on the Obama campaign with one further entry detailing the micro-managed, super-focused, hugely rewarding and in the end massively successful two months that I spent in Las Vegas but the task of writing that piece has seemed so overwhelming that all I have to show for it is two months of silence. So I’ve decided to skip that and move on to the present.

Where to start? Let’s begin with the personal. That large house I referred to a few posts ago which was one of two options I was considering to move into is now my home. My bedroom, whence I’m writing this, is large enough for a huge bed and could comfortably accommodate a table tennis table and a pool table besides. I’ve no doubt this is the largest bedroom I will ever inhabit and would probably compare favourably in size to the entire flat I lived in before leaving London. It’s ridiculous. I share the house with three people, all girls and all Canadian. That they are all girls is entirely unsurprising; the NGO crowd here is overwhelmingly female (clearly not a problem, at least not for the minority gender). That they are all Canadian is much more so albeit that they’re an interesting mix: one Scottish-Canadian; one Eritrean-Canadian; and one US-Dutch-Canadian. In Kigali though one mostly comes across Americans, Belgians, Germans and Brits. And virtually no French. For those who don’t know the history, these last have not entirely covered themselves in glory in their dealings with this country and continue to shoot themselves in the foot diplomatically by pursuing government officials for war crimes and generally being on the wrong side of the argument. However I’m teetering into the political sphere about which I will unfortunately have to be less talkative than I was in Peru. (Incidentally the trial of Alberto Fujimori which I discussed a fair amount over a year ago is due to come to a close very shortly. A conviction is likely assuming the trial doesn’t collapse on the technicality that he’s in ill health and his absence from the courtroom for 12 days would entail starting all over again.)

Work at the Clinton Foundation is fantastically fun and extremely rewarding. And constantly in flux. Amusingly in some ways it’s very similar to what I was doing at Goldman Sachs, i.e. sitting in an office working with Excel all day. In important ways though it’s very different. Whereas my work at GS for six years was almost entirely inward facing, here I am daily in meetings with Ministry officials and every couple of weeks am out in the field meeting with regional health managers. At GS it was always difficult to explain to people what I did, particularly to those who didn’t work in finance, which led some to think I really worked for the intelligence services, but here it’s essentially very simple. We are here to help the Rwandans build up their capacity to successfully manage their own affairs and to do ourselves out of a job.

Unfortunately success isn’t going to come rapidly and someone will likely still be doing what I’m doing by the time I’m considering retirement but you would go mad in this line of work if you didn’t consider and accept the long view. And in Rwanda things happen. I’m constantly hearing from my NGO colleagues who work across African countries that there’s a level of thought, coordination and direction here that isn’t to be found anywhere else on the continent. From the Big Man on down there’s a will to pull this country up and to do so in a systematic, government-driven and clean way. It’s impressive to behold even for someone as inexperienced as me who has nothing with which to compare it. Of course the Rwandans have no resources. There’s very little to drive tax revenue so the country is massively dependent on foreign funding. And as previously said, this will not change anytime soon. But there is the will and there is the understanding of how to do it even if with other people’s money. It’s extremely exciting to be a part of. Over time I want to talk more about the challenges and the opportunities, the hopes of this tiny little over-populated country, the expectations of the international community and the tensions that result when the two rub each other the wrong way. There are endless anecdotes that constantly have us thinking about how to improve and make more effective our work to help Rwanda. The goal is nothing short of colossal.

A Short Backgrounder, Part One

How did I get here? And where have I been? Questions I’ve asked myself a few times of late. After seven months in Lima, the last one and a half of which I spent separately traveling with parents and friends from London, I decided the time had come to move on. But move on to what? I had looked into a few jobs which would make some use of my combined experience in the finance and non-profit arenas. I had even had a telephonic interview between Lima and my interlocutor in Nairobi (where she was visiting on business) for a job based in Washington DC. The line was bad and my interview sharpness not much better. The outcome was as expected.

Around the same time I pursued a connection I had made shortly before leaving London. During the whirlwind few weeks between leaving Goldman Sachs and leaving on a jet plane in June 2007 I had breakfast with the lovely Cassia who I’d been put in contact with by a colleague. Cassia worked at the Clinton Foundation, regularly commuting between London and various places in Africa, working in a division of the Foundation called CHAI. It sounded like tea, it sounded like fun. We spoke for about an hour at the conclusion of which she told me to give her a call when I was done in Peru because they were always looking for “people like you”. At the time my thoughts were more focused on microfinance than health system strengthening as I felt my finance background was more suited to the former. However a few months’ reflection led me to realise that my passion lay in international development generally not microfinance specifically. So come December 2007 I did what Cassia suggested. Unfortunately she didn’t answer my emails and I had no contact number for her. I did find out through our mutual friend the Goldman Sachs colleague that Cassia had gone on maternity leave but that she didn’t know much more than that as they hadn’t been in touch for a while. As practitioners of the espionage trade would say, the lead went cold.

As my pre-planned departure date of mid February slipped to late February, I did at last book my flight out believing that my future lay in the States, leaving behind some great friends and a wonderful Peruvian family who had taken me in as their sixth (and eldest) child. My grandmother in California was in failing health and I decided to move in with my uncle there to spend some time with her, a grandmother who had been a major influence in my life. This turned out to be fortuitous timing as just eighteen days later I watched as she breathed her final breath, thankful that I’d been able to spend a couple weeks with her. Her passing was to foretell further sadness in the family as both my French grandparents succumbed to old age just three months later and within a week of each other. My French grandfather had similarly loomed large in my formative years and I was fortunate to be able to spend some time with him just prior to his passing when I visited France in June.

From early March, when I arrived in California, until exam day in early June I had been studying for the second level of the CFA, the first level of which I had passed in 2003, since when I had concertedly avoided any further participation. By this time my decision to resume the qualification resulted from the combined desires of pursuing something useful to my career as well as giving me space to contemplate my next move. It succeeded on one of those fronts at least. By early June I was back into job-searching again in full force. Applications went out to various non-profits and a further attempt at contact with Cassia was made, this time successfully. I was extremely saddened to hear from her that she and her husband had experienced a tragedy in the intervening period and despite this Cassia was as helpful to me as could be and excited that I’d contacted her. She ran me through the various possibilities available at CHAI (Clinton HIV / AIDS Initiative) and asked me to forward my curriculum vitae.

A set of interviews ensued for a position which would have involved travelling around a third of Africa on a fairly constant basis assisting countries in their procurement and internal distribution of drugs. (That would be malaria prophylaxes and HIV anti-retrovirals rather than cocaine and ecstasy tablets.) Fortunately for me some combination of the three interviewers decided I wasn’t suited to the post and immediately it was suggested that I consider a “managerial” position. The job would have been very satisfying but too restless and clearly would have upped my carbon footprint by a not insignificant number of cubic metres. The Foundation’s suggestion was well taken. There followed two interviews, one with the CHAI Country Director for Rwanda and Burundi, Pascal, and t’other with the gentleman I would be replacing, the Program Manager for Rural Health, a Kenyan by the name of Kisimbi (which, I would later learn, is his family name; apparently all six sons in the family refer to themselves by their last name which causes no end of amusement when friends call their house in Nairobi). The interviews failed to entice me to say anything controversial or stupid and a visit to Kigali was hastily arranged for a tête-à-tête. After a mammoth Las Vegas – Washington DC – Rome – Addis Ababa – Kigali country-hop I arrived in Kigali for four days to seal the deal.

Thus am I now in the employ of the Clinton Foundation providing technical assistance to the Rwandan Ministry of Health. This has prompted several observers (as though I have those) to ask what exactly in my professional experience qualifies me to provide technical assistance on health matters to an African government. Or any government for that matter. Allow me to explain.

The Word of the Day: Opportunity

It's impressive how much introspection, if not outright criticism, is going on in microfinance. Not long before I left London, and well after I'd submitted my resignation to Goldman Sachs, I went along to a meeting of the Microfinance Club UK held at the Barclays building in Canary Wharf. The talk was entitled "What's Wrong With Microfinance?" If I was in need of a reality check for my off-to-save-the-world ambitions, here it was in flashing neon lights.

Two gentlemen, who had coincidentally just published a book with the same title, stood forth and pontificated on their views that microfinance is really microcredit, with loans being dispensed but with few other financial services being offered. It promotes debt and often excludes the poorest whom microfinance nominally seeks to help the most. Microfinance isn't the basis for a sound economy. Women (to whom the majority of microloans go) don't create businesses, they work for themselves. [This one drew bemused laughter from the assembled.] Self-employment is just a euphemism for survival. There's too much cash pouring into the arena chasing too few real opportunities for investment. A large section of the population being unbanked doesn't mean there's unmet demand. And so it went. A GS colleague who had similarly just left our esteemed employer to join Five Talents, she on a full time basis, was sitting next to me at the meeting. Was it too late to change our minds, we joked?

So is there any foundation to the accusations? Well three months of exposure to a small corner of microfinance in just one country does not an expert make. However having spoken to quite a few of ECLOF's clients and having perused much of the learned writing of microfinance insiders, both pro and anti, the answer, as ever, lies somewhere in the middle.

Richard Posner exclaims (on the excellent Becker-Posner Blog) that "the idea of borrowing one's way out of poverty is passing strange". Furthermore, he states, "I am unaware of any historical examples of nations that climbed out of poverty on the backs of small entrepreneurs financed by credit". He has a point, but it's unfortunate that he chose to express it so starkly without considering the whole picture. Microfinance is, and should be, the provision of financial services to the poor. That is to say that as well as loans, savings and insurance products should be offered. Many institutions in the field focus on the debt and this is what is drawing much of the criticism. And it is valid. Consumer debt cannot solve the problem on its own.

The crucial goal is to provide opportunities. The poor are not just poor of cash, but generally poor of opportunity, mainly because of the view that providing opportunities to the poor is a money-losing (or at best profit-neutral) proposition. Which for some players it is bound to be mainly because they're not set up for this kind of high-cost, low-margin customer interaction (e.g. my former employer). However this is a profitable (but please, not too profitable) business if done right. Though the providers need to be constantly mindful that the goal is not simply to load up the poor with debt. Microfinance needs to be a means of assisting the poor with all of their financial needs. At times and for certain people the need will be to give them a place to keep their money other than under their mattresses. At different times and for other people the need will be for leverage to enable them to exploit a niche they see in the market. And for all of them the need should be to hold inexpensive insurance such that they aren't starting from scratch if an earthquake fells their home.

The suffering doesn't let up

Last week I was working with a third NGO called Comunion Peru (in case you missed the first two, please see blog entry of 10th August), started by the Anglican Bishop of Peru, William Godfrey. Comunion Peru has set up eight kitchens (so far) in the regions of Chincha, Pisco and Ica where the earthquake had its most devastating effect. My main goal has been to raise funds to keep these kitchens, and the additional ones we plan to open, supplied with food to keep them running and to keep the citizens of the surrounding communities fed.

The situation the people of San Juan Bautista, where I was on Friday night delivering storage sheds to three of our kitchens, and Pueblo Nuevo, where I was last weekend, find themselves in is desperate. When your house collapses, you don't just lose a place to live, a safe place to sleep, a place to congregate, a place to cook, a place to wash, a place to be. You lose most of your possessions. They get buried, crushed, smashed or just lost. The money you make which in normal times goes primarily to feed and clothe the family, to pay the lighting and water bills and in miniscule amounts, if there's any left over, to a little home improvement, suddenly is required to pay for new everythings. Plates, glasses, forks, knives, spoons, cups, beds, blankets, clothes, lights. There's no insurance policy. Even if you could afford it, who's going to provide contents insurance against an earthquake for houses built of mud brick lying near a major fault line, or if you could find that person, how could you afford the necessarily stratospheric premiums?

The kitchens which Comunion Peru (and others) have set up and are setting up provide a small amount of relief to people from the overwhelming challenges they now face, one less thing they need to worry about. All are looking to their government for help. And millions of dollars have already been earmarked for reconstruction by President Alan Garcia. When this will begin however is anyone's guess and in the interim, life must go on. The only visible contribution the government is making to this end thus far is to demolish the structurally unsafe houses and cart away the remains. In San Juan Bautista that duty falls to one man with a loader for what must be heading for 200 houses to be cleared (related article from El Comercio).

In the mean time, people are sleeping in tents or temporary straw shelters, visible in at least one of the photographs I took. On Friday night I passed the night in a tent in San Juan Bautista's main square, fully clothed all the way to my jacket in a sleeping bag and I barely slept from the intense cold. I'll admit that I couldn't wait to get home to a warm shower and my bed. One of the ladies we spoke to last week, when we were conducting the census in Pueblo Nuevo, told us that the worst part about the nights was not the dark from lack of electricity, nor the cold, nor the uncomfortable sleeping conditions, but the screaming of children. Screaming out of fear of further tremors. Screaming out of suffering from the cold.

A minor miracle

Miraculous.

This weekend I was down in the province of Chincha, three hours by road south of Lima. I was asked by a group unaffiliated with my organisation to help out with a census the government has been conducting in the last week in the three provinces of Chincha, Pisco and Ica. Several of my new Peruvian friends are members of the Movimiento de Vida Cristiana which at the government's behest mobilised 650 volunteers in the space of a few days to spend the whole weekend, from very early on Saturday to late on Sunday, in Chincha and go house to house, filling out one questionnaire per household on the status of the occupants and their dwellings.

The number of people who died in the whole province of Chincha, as reported by the government as of late Sunday (26th Aug), was 99 out of a total population in that province of 182,000. The miracle I refer to should be evident from the photos I took (please see Picasa link top right to view whole album). I wasn't able to be fully adventurous in taking shots for fear of being relieved of my camera so the angles are limited. However from the shot at right, you get some idea. It's difficult to describe how this view should look without having been there, but take my word for it that you're looking straight through three houses, at least. The lower of the two walls at middle left of the shot is almost all of what's left of the house on the corner of the street, which if it were still standing would take up most of the picture. Just above that wall an old lady in dark blue is visible, reduced to washing her family's clothes in the street, outside of the temporary straw and bamboo hut which for the forseeable future counts as home.

Not one of the households which my partner and I censused, approaching 50 in number with perhaps an average of 6 inhabitants each, had suffered much more than a few scrapes. Despite the fact that in my estimation fully a third of the houses were razed to the ground and heading towards four fifths would have experienced flying debris of the very heavy variety during the quake or subsequent tremors. An aerial shot of the surrounds, though impossible due to lack of a helicopter, would have shown that despite the mercifully low number of deaths, the scale of the tragedy is yet mammoth and urgent. How more people were not seriously injured or worse I don't know.

Meeting good people

The organisation I'm working for here in Lima is called ECLOF (Ecumenical Church Loan Fund) Peru. I've been seconded to them by the organisation that hired me in London, Five Talents. ECLOF's set up here includes a central office, where I'll be spending most of my time and three regional offices, one in the northern suburb of Lima, one in the southern and one outside of Lima down near Lake Titicaca (the highest commercially navigable lake in the world, so they tell me). In each of the regional offices, between one and five credit analysts meet clients, provide business training and moral support and of course cash.

I've been spending this week in the two suburbs of Lima, following the credit analysts around as they visit clients. It's been a humbling experience to witness both the work the credit analysts perform day in, day out in uncomfortable conditions, as well as witnessing the habitats of our clients. These run the gamut from those who have the basic necessities of a decent amount of space, four walls with a solid roof, running water and waste disposal services to those who live in shacks to which a stiff wind would pose a problem, to which water has to be brought by tanker (not by the government but by enterprising private individuals) and whose toilets are communal outhouses.

At the end of each day this week, I've been able to come home to my brand new apartment in a quiet area of the swankiest part of town. Those clients are still in their little abodes in the hills around Lima probably somewhat cold as the evenings close in. And the credit analysts also live out in the burbs in (obviously) much better conditions than most of our clients, but probably still in areas that many of us would find difficult to cope with. I've met a few people over the years I've thought were doing virtuous work. These credit analysts rank with the best of them. A lesson in humility.