Distress Call From an Ancient City

The recent uptick in violence in Syria had made it nearly impossible for aid organizations to deliver supplies to Syrian citizens caught in the crossfire of a civil war. Civilians trapped in the Syrian city of Homs because of bombings, sniper fire and roadblocks are low on food and medicine. Fortunately, aid organizations brought supplies to around 700 people and transferred them to a safer section of the city that was once a beacon of culture and civilization. Scenes like this are happening all across Syria, with pro-Assad forces and opposition fighters exchanging gunfire while women, children, and the elderly attempt to flee or seek shelter from the fighting.

A destroyed neighborhood in Homs, Syria.
A destroyed neighborhood in Homs, Syria.

Recently, negotiations between Syrian pro-government and opposition leaders have fallen apart. Mediated by the United Nations in Geneva, Switzerland, the first round of talks that began in late January failed to accomplish much aside from hurt feelings on both sides of the negotiating table.  Ten days later, in a second attempt at a dialogue, UN officials looked to ease the chaos breaking out in the Syrian city of Homs by coming to a transfer of power agreement with the Assad government. Lakhdar Brahimi, the UN mediator who took the lead in talks with the Assad government, apologized to the Syrian people after negotiations for a transitional government fell through.

On February 10 a cease-fire facilitated the evacuation of citizens and allowed supply trucks and aid workers to give care to the remaining civilians trapped within the crumbling city walls. The cease-fire was, unfortunately, the only positive progress made since talks began in January. Meanwhile, what little is left of Homs continues to be a battleground for opposition and government forces, an estimated 2,500 Syrians caught in their wake.  Photos of the devastation have triggered media outlets to post “before and after” pictures of some of the most treasured monuments in Homs and across Syria.

The UN Security Council came to an agreement on Feb 22 that gives the Assad government and the opposition forces 30 days to comply with a set of humanitarian goals. Russia and China, who are part of the five permanent Security Council members, came out in support of the resolution. All 15 members of the Security Council voted in support of the resolution.  Among other humanitarian goals, the resolution calls for:

  • The cessation of all forms of violence, some of which will be considered war crimes when the conflict is over.
  • The protection of civilians from indiscriminate aerial attacks, including the use of barrel bombs.
  • The expansion of humanitarian relief operations and the movement of medical supplies across the Syrian border.
  • The safe evacuation of all citizens who wish to leave the besieged cities.
  • The end of arbitrary capture and torture of civilians.

Still, the resolution saw opposition from Syria’s UN Representative Bashar al-Jaafari, who claimed that the humanitarian aid has a political agenda. United States Secretary of State John Kerry recently spoke out against the violence in Syria, putting greater pressure on Russia to tone down their support for the Assad regime. The United States continues to meet with world leaders, but a clear solution to the crisis in Syria has evaded them. Some feel that Assad is using these attempts at diplomacy as a buffer until his military can win the civil war against the government opposition fighters. Others remain hopeful that the dialogue at the UN brought forth the demands of both sides, even though no agreement could be reached.

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How We Define Inequality

"Saying Grace" by Norman Rockwell (1951)
“Saying Grace” by Norman Rockwell (1951)

During the 2008 Financial Crisis and into the Great Recession thereafter, journalists and policy makers alike turned their focus to the seemingly rising inequality in America. As protesters occupied Zoccotti Park in the financial district of Manhattan, their cheers and chants echoing down the side streets towards the New York Stock Exchange, we became a nation divided into 99 percenters and 1 percenters. Inequality has come to be the clarion call of the 2010s. Nearly every news program, town hall meeting, and op-ed these days brings up the topic in one way or another. Yet as Amartya Sen explains in his book Inequality Reexamined, a work that grapples with and expands upon John Rawls’ A Theory of Justice, “inequality” is a slippery term that carries with it many unconscious assumptions that greatly influence how we come to view society.

When speaking of equality, Sen argues, it would benefit us greatly to ask: “Why equality?” and “Equality of what?” Today, when a politician, journalist or blogger mentions inequality, more often than not they are referring to income inequality: the distribution of yearly income for a household or an individual. It is true that income inequality is easy to measure and easy for the majority of the population to understand, but to a large extent it ignores what Sen would call “the basic heterogeneity of human beings” and “the multiplicity of variables in terms of which equality can be judged.” After all, inequality is much more than one’s salary—it is also where you can afford to go to school, the type of groceries you can buy, the safety of your neighborhood, the hospital that you go to when you get sick, the opportunities for a job and much, much more. Understandably, these variables are difficult to measure. But they are just as (if not more) relevant in our nationwide discussion of inequality. Even if distribution were equal, Sen writes, “two persons holding the same bundle of primary goods can have very different freedoms to pursue their respective conceptions of the good.”

Some prominent writers on the subject of inequality turn to the Gini coefficient to measure inequality across nations. This number has dominated much of the conversation on the subject of world inequality. It is, as we will explain later, a useful but perhaps imperfect calculation of inequality. The Gini coefficient, usually expressed as a number between 0 and 1, measures income dispersion by calculating the ratio of the area between the line of perfect income equality and the Lorenz curve. Most commonly it is used to measure income after taxes and transfers (this is a major factor when comparing the US with the EU). An unequal nation will have a Gini coefficient closer to 1 while an equal nation will have a coefficient closer to 0. In recent years the United States has hovered around the .45 mark. Brazil was calculated at .519 in 2012. South Korea and Russia are slightly more equal according to the Gini coefficient, ranking at .419 and .417 respectively in 2011.

Yet as Lane Kenworthy points out in his work Jobs with Equality, the Gini coefficient and its effect on inequality can be misleading. Consider the four hypothetical nations in the box below which have been borrowed from Kenworthy’s book.

Table 1

In Society D, inequality is at its highest (if we look at the Gini coefficient), yet poor households are pulling in more money than any other Society. Rather than rising inequality, Kenworthy argues, what should really concern us is that poverty has not improved in America. We should be looking to increase income at the bottom of the spectrum by providing well-paying jobs. The distinction between poverty and inequality is a crucial one. Additionally, the debate over poverty and inequality changes drastically when one frames the argument in relative rather than absolute terms.

In the end we must consider inequality in all of its forms, quantifiable or not. It would help to examine our end goals as well. What type of equality do we hope to achieve? What, if any, is an acceptable level of inequality? To what extent should we allow people to fail? Additionally, the tools that we use to measure inequality in America are somewhat inadequate in measuring inequality worldwide. It is difficult to translate inequality statistics between nations because each country has unique advantages and disadvantages stemming from geography, political institutions, trade agreements and an array of other factors.  Oftentimes the cost of living in “dollars-per-day” is a better measure of poverty because the price of goods and services varies greatly across the globe. Even if we are  limited in our tools for measuring inequality, that should not discourage us from finding new tools and furthering the conversation.

Slavery in the Modern World

Global Slavery Index 2013
Global Slavery Index 2013

Last month the Walk Free Foundation released their inaugural report attempting to quantify the number of people enslaved worldwide. The Global Slavery Index 2013 has concluded that almost 30 million people fall under their definition of slavery. Similar reports from the International Labor Organization and the State Department had estimated 22 and 27 million respectively. This new report clearly lays out the concentration of slavery in the world by country- implicating India, China, and Pakistan as the worst offenders in absolute terms. These three countries alone account for roughly 60% of the reported number of enslaved peoples. Mauritania, Haiti, and Pakistan are ranked as the top 3 countries with the highest prevalence of slavery relative to their population size.

Modern slavery, though it can take many forms, is generally defined as “one person depriving another people of their freedom: their freedom to leave one job for another, their freedom to leave one workplace for another, their freedom to control their own body.” Forced labor, what most people think of when they hear the term slavery, is specifically when a person is forced to work against their will through coercion or threats of coercion. While most forced labor (68%) involves activities in agriculture, construction, or manufacturing, an estimated 22% involves sexual exploitation. Bonded labor is the most common form of slavery, in which a person is forced into labor by an employer due to a debt owed. The employer stipulates that the indebted worker cannot find any other form of employment and will pay them little or nothing at all. Generally the debt can never actually be repaid despite their work exceeding the value of the original loan and in some cases is passed on through generations leaving some children born into servitude. Trafficking is also considered a form of slavery by which people are lured away from their homes through coercion or deception. Often trafficking leads to another form of slavery where people have their passport taken and are forced to work for little to no wage to repay a debt or simply to survive. Of course, other forms exist related to caste and ethnic structures or servile marriages.

The slavery Index estimates that there are 13,300,000 – 14,700,000 enslaved people in India, almost half of the global total. Slavery in India is largely internal with women and children of the lower castes or indigenous groups being the most vulnerable. In some instances people are lured away from rural areas to wealthier cities by false prospects of employment only be forced into a form of bonded labor or sold to wealthy families where they are often physically or sexually abused. Some sectors well known for their bonded laborers are stone quarries, brick kilns, construction and mining. India does have legislation banning most forms of slavery however officials do little to enforce these laws. One article states, “Officials don’t care, and sometimes even want maids for their own houses, [which is] partly why they’re silent on this.” India is also one of the few countries that has yet to ratify the Worst Forms of Child Labor Convention. Recently (April 2013), India has passed a more comprehensive ban on modern slavery though it has yet to be seen how this will be utilized by enforcement agencies.

Though some may assume slavery no longer exists in the United States, there are an estimated 57,000-63,000 people enslaved within the U.S. today and, according to the index, almost all forms of modern slavery are present here. From bonded labor to sexual exploitation slavery in the U.S. affects populations of a wide range of socio-economic class, race, and age. Some of the most vulnerable groups include temporary visa holders, domestic servants to international diplomats, LGBTQI peoples, runaways, homeless youths, and sex workers. Much of these activities occur on interstate highway routes, truck stops, urban centers, and agricultural, fishing or forestry related industries. Though the State Department released an annual Trafficking in Persons Report, they had not analyzed the U.S. until 2010. U.S. citizens forced into sexual exploitation are often younger than those from abroad with an average recruitment age of 12-14. “The National Center for Missing & Exploited Children (NCMEC) estimates that at least 100,000 American children are the victims of commercial sexual trafficking and prostitution each year.” Foreign workers are sometimes lured into the agricultural sectors with the promise of well-paying jobs only to have their passports and visas taken and forced to work in remote areas. The government has taken great strides in addressing the issue and fostering cooperation between relevant agencies and streamlining prosecution practices. They have also been supporting the efforts in civil society to identify and assist victims of modern slavery such as Truckers Against Trafficking and the Polaris Project.

Should We Be Having More Babies?

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According to the CDC, the U.S. fertility rate fell to another record low in 2012 with 63 births per 1,000 women. In 2007, the rate was 69.3.

During a quick scan of the shelves of one of D.C.’s remaining bookstores, journalist Jonathan V. Last’s new book entitled “What To Expect When No One’s Expecting” caught my eye. The book forecasts an impending American demographic disaster by bluntly declaring that people are having too few babies. This prompted a hasty reaction from me: “But everyone says our population is growing out of control! Aren’t 3.95 million babies named Jacob and Sophia enough!?”  America’s total fertility rate, an estimation of the number of births a woman is expected to have during her lifetime based on current age-specific fertility rates, is 1.88 according to the latest figures from the CDC, a record low. This prophet of population doom argues that even this statistic is misleading because most of our fertility has been “outsourced” as we rely heavily on immigrants to prop up the fertility rate. Not including immigrants in the population profile reveals that America has a fertility rate of 1.5.

At first glance, any devout environmentalist would be thrilled with these shrinking population trends since human total environmental impact is exceeding the sustainable carrying capacity of Earth’s ecosystems. This is reflected by the I= PAT equation with I—the human impact placed upon any ecosystem—being the product of three variables: population (P),  per capita level of affluence (A), and technology (T) or more accurately described as the environmental destructiveness of production techniques. It does not take a environmental economist to realize that a lower global population, and hence a lower P value, will result in less of an impact on our ecosystems.

But an interesting deaggregation of what appears to be out-of-control growth reveals cross-country disparities and cultural differences in fertility rates: Japan has a total fertility rate of 1.3 compared to Mali’s total fertility rate of 6.25. Overall, 99% of the world’s current population growth is in developing countries while the fertility rate in each of the G-8 countries is below 2.1 children per women, the rate needed for a given generation to replace itself.  But environmentalists probably still significantly discount falling fertility rates. It is the absolute number that counts and even assuming that fertility levels will continue to decline, the world population is still expected to reach a staggering 9.6 billion in 2050 and 10.9 billion in 2100, according to the U.N’s medium-variant projection.

Last retorts that a shrinking population that is disproportionately old has dire economic, political, and cultural consequences. According to the U.N., “whereas the number of persons aged 60 or over is expected to more than triple by 2100, that of persons aged 80 or over is projected to increase almost seven-fold by 2100.” Last laments that a global population reduction results in a decrease of human ingenuity: “Low-fertility societies don’t innovate because their incentives for consumption tilt overwhelmingly toward health care.” Negative socio-economic externalities abound like a smaller taxpayer base and labor force and the limited availability of military-age manpower to serve in our armed forces. In 1950, there were 16 covered workers for each Social Security beneficiary. Today, there are a little less than three.

But simultaneously, what can the rationale be of the coerced low fertility rates of the Chinese? Surely the Chinese cannot be dooming themselves to a demographically poor future. And is America really subjecting itself to prolonged economic stagnation via a population implosion? A competing argument can be made that a low fertility rate can actually improve living standards. Until  recently, there were few examples of developing countries with both declining fertility and rising incomes. This has changed as some countries have undergone a Goldilocks generation” of fertility—a generation with a not too high but not too low fertility rate—with the result being fewer dependent youngsters, fewer dependent grandparents, and a bulge of working adults that increase economic output. Also, women comparatively do not have to spend more time raising children and can invest more in the education of the children that they do have and add to the productivity and quality of the labor force.

Because there are fewer dependent children and old people, households are able to save more, and there is more capital and resources that can be accumulated per capita.  Economist Klaus Prettner reproduces these findings in a dynamic consumer optimization model that incorporates endogenous fertility and health investments to show that a fertility decline induces higher education and health investments that are able to compensate for declining fertility under certain circumstances. Even as absolute population levels fall, the “effective labor supply” will actually increase, proving that it’s too simplistic to reduce a country’s economic growth and productivity to a simple population numbers game.

Even as absolute population levels fall, the “effective labor supply” will actually increase, proving that it’s too simplistic to reduce a country’s economic growth and productivity to a simple population numbers game.

Consequently, questions loom about such a key determinant of our environmental and economic future. It is clear that countries concern themselves with two questions: Do we have enough people to support an ageing society? Can we take advantage of the right population numbers to spur economic growth? Viewing these questions through an environmental lens, can we find reassurance in declining fertility amidst competing claims about its effects? Are claims about the global population explosion hyperbolized? Only one thing is for certain. Motivation to stabilize population can be undermined by excessive worry that smaller numbers of young people will be supporting larger numbers of the elderly. The prevailing patterns of behavior and resource allocation can be changed in ways that reduce pensioner/worker ratios and make population stabilization more politically viable. Even if falling fertility can raise living standards—especially the living standards of poor, resource-disadvantaged people—it cannot be an excuse for inaction in the realms of smarter governance and tempered lifestyle patterns in respect to environmental crises and economic stagnation.

UPDATE: The Chinese government announced late last week that they would begin to relax its “one-child policy”. The policy was introduced in the late 1970s to combat rapid population growth but has now resulted in an increasingly aging population and extreme gender imbalance. The change will allow couples the option of having two children if just one of the parents is an only child. Previously, both parents had to be only children.

Cholera in Haiti: 3 Years Later, Solutions Still Needed

October 2013 marked the 3rd anniversary of the widely-documented 2010 cholera outbreak in Haiti, a small developing Caribbean country which shares the island of Hispaniola with the Dominican Republic.   Haiti first reported cases of cholera in October 2010; within one month cholera had spread to all parts of Haiti and the Dominican Republic.  “Between October 2010 and August 2013, more than 670,000 people in Haiti were treated for cholera, with around 8,200 deaths attributed to the outbreak.”

UNICEF and NGOs Provide Cholera Assistance to Haiti Area Cut off by Flooding

Cholera is an intestinal infection, caused by ingestion – usually in contaminated food or water – of the bacterium Vibrio cholerae.  Cholera causes diarrhea and vomiting, symptoms that can lead to dehydration and death within hours.   Every year, 3-5 million people develop symptoms and 100,000-200,000 people die due to cholera worldwide.  Many developed countries, like the United States and Canada, have largely eliminated domestic cholera.  However, global cholera incidence has increased since 2005; in 2011, more than 60% of reported cases occurred in the Americas- mostly in Haiti.

As with many other diseases, cholera usually affects vulnerable populations.  Those with low immunity are most likely to develop symptoms if exposed, and cholera can spread easily in areas with poor infrastructure and sanitation facilities.  While cholera has been largely eradicated in most of the developed world, “cholera remains a global threat to public health and a key indicator of lack of social development. Recently, the re-emergence of cholera has been noted in parallel with the ever-increasing size of vulnerable populations living in unsanitary conditions.”

While many other countries in the Americas dealt with cholera epidemics in recent decades, Haiti had not encountered cholera for 100 years when the 2010 outbreak began.  This meant that there was no natural immunity or protection within the Haitian population against this bacterium, which spread quickly.  The cholera epidemic also began a mere 9 months after a magnitude 7.0 earthquake hit Haiti, which had destroyed infrastructure and displaced 1.5 million people.  80% of cases can usually be successfully treated with oral rehydration salts, but cholera in Haiti has had a high fatality rate- partially because of limited access to health services.

Three years after the epidemic began, the emergency response is slowly winding down.  However, the underlying problems that allowed cholera to spread so quickly – most notably lack of access to clean water, sanitation facilities, and health services – remain unsolved.  Haiti has the lowest coverage of improved water and sanitation services in the Western Hemisphere.  According to the World Health Organization, in 2010 only 64% of Haitians had access to clean drinking water and only 26% had access to adequate sanitation facilities– and the number of people in Haiti with access to adequate sanitation has since decreased to 17%.  But the problems extend beyond merely providing access; one recent survey showed that 50% of improved water sources in rural Haitian households tested positive for e. coli.  To meet the Millenium Development Goal of halving the proportion of the world’s population without access to improved water and sanitation facilities by 2015, Haiti would need to achieve 74% and 63% coverage for improved water and sanitation facilities, respectively.  Unless the situation quickly improves, these goals likely will not be met.

Children in Haiti

These unsolved problems in Haiti could represent an international health threat as well.  In the years since the beginning of the epidemic in Haiti, cholera has spread to Cuba, most likely through international travel.  Health officials in Mexico detected cases of cholera in early September 2013; since then, there have been 171 reported cases in Mexico. 75% of individuals infected with the bacteria do not show symptoms- but can still infect others around them.  If cholera remains present in Haiti at current levels, many other countries are then at risk of ‘imported’ cases.

In February 2013, the Haitian government began a National Plan to eliminate endemic cholera in 10 years through improvements in water and sanitation, health care services, epidemiology and surveillance, and health and hygiene promotion.  It is estimated that the National Plan will need $2.2 billion to be successful; however, funds and resources are scarce.  A recent publication by the Center for Strategic and International Studies, Water and Sanitation in the Time of Cholera: Sustaining Progress on Water, Sanitation, and Health in Haiti, argues that the international community – specifically the United States – must step in and contribute to support these anti-cholera efforts.   Improvements in water and sanitation coverage and health care in Haiti could have far reaching effects, such as decreasing the disease burden from other diarrheal and water-born illnesses.  The report argues: “failing to adequately support Haiti’s water and sanitation activities threatens the sustainability of other U.S. development investments in the country, including improved population health, economic development, the empowerment of women, and progress toward democratic governance and political participation.”

Cholera is preventable with adequate water, sanitation, and healthcare services and treatable with oral rehydration salts; the most effective anti-cholera campaign in Haiti will combine all these strategies.  Three years after the epidemic began, international coverage, attention, and action are beginning to wind down.  However, these challenges persist and need permanent solutions to prevent future cases, future unnecessary deaths, and possible future epidemics in other countries.  Eliminating cholera in Haiti will require a sustainable and coordinated long-term strategy – and will require participation from a variety of actors, including domestic governments and communities, non-profits, and the international community.

Professional Volunteers: The Living Earth Institute and the Modernization of Aid

Nestled at the foot of the Himalayas and balanced somewhat precariously between India and China, Nepal is a country which could be excused for its seeming isolation from the rest of the world. Fortunately, improvements in transportation infrastructure and its own unique culture of hospitality has brought the world to Nepal. The country certainly needs it. Despite tremendous progress in recent years, including the dissolution of a 240 year old monarchy and accelerating economic growth, Nepal is nonetheless a state wracked by poverty, with over half of all Nepalese subsisting on less than $2 per day. Despite the area’s destitution, Nepal has remained something of a foreign aid backwater, slated to receive just slightly over $80 million in aid from the American government in FY 2014. While this might not at first glance seem a paltry sum, it pales in comparison to the estimated $3.5 billion in remittances sent by Nepal’s emigrant community abroad in 2010 alone. For better or worse, it is not the American government that the people of Nepal have looked to for development assistance, but rather those individuals and groups determined to help.

The Living Earth Institute (LEI) is one such group. An American nonprofit based nearly half a world away in Seattle, the LEI has initiated, led, and collaborated on a variety of development projects not only in Nepal, but also in Nicaragua, El Salvador, and Nigeria. Focused on developing and improving access to water resources, the LEI specializes in the management and facilitation of water and sanitation projects in areas that are historically under-served by both the government as well fellow aid organizations. At the LEI’s Drinking Water and Sanitation project in Nepal, the Institute collaborated with the Women Development Service Center (WDSC) as they sought to improve conditions in two chronically distressed communities located on the outskirts of the city of Janakpur. By nearly any standard, they did just that. In just three short years and on a shoestring budget of just $60,000, the LEI and the WDSC installed 230 latrines and constructed 36 tube wells, bringing water and sanitation to around 2,000 individuals who had hitherto gone without regular access to these necessities.

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