The project manager on my project is now assisting with a village savings and loan project, and told me some interesting things about working in Bawku, a region in Ghana where violence has broken out between two tribes, the Mamprusis and the Kussassis.
According to my colleague (a Ghanaian), in the first century, the Kussassis, who were traditionally farmers but not fighters, asked the Mamprusis, who were known as warriors, to come to move to their land. In exchange for protecting the area, so the Kussassis could farm in peace, the Mamprusis were given the chieftaincy in the region. The agreement has held for centuries, and in Ghana’s system of parallel democratic and traditional governments, the Mamprusis still hold the chieftaincy, although they are far outnumbered by the Kussassis. The democratically elected official for the region is Kussassi. Several years ago, the Kussassis became unhappy with this arrangement, demanding the return of a Kussassi chief. Violence broke out between the tribes. Despite interventions by the central government, including curfews and prosecution of those perpetrating violence, the situation has remained tense. The Mamprusis control Bawku’s city center while the Kussassis control the surrounding land and villages, and members of the two tribes cannot safely visit the other’s territory, although visitors from other tribes or countries are safe. This situation has posed difficulties for the IPA survey team in the region, as they are trying to collect data in both tribes’ territories. It is crucial that surveyors be hired locally, so they have knowledge of the area, culture, and languages. Since young men on motorcycles have been responsible for much of the violence, the Ghanaian government has recently banned all men in the region from traveling on motorcycles --the chief form of transportation for IPA surveyors. Enter the ladies. IPA surveyors are overwhelmingly male, as it can be difficult to find women with top educational qualifications and a willingness to take on the physically demanding work. In Bawku, the project manager was successful in finding half a dozen qualified women with motorcycles to fill out the ranks of IPA surveyors in the region. Women are not subject to the ban, and can legally ride motorcycles to visit respondents. The team includes women of both ethnic groups, to enable IPA to work in both territories and with respondents of both tribes. The field manager, who will oversee the survey team in that region, is a women of mixed descent, half Mamprusi and half Kussassi, and can safely work in either tribe’s territory. I wish the team the best, and hope that they will demonstrate both the ability of women to be exceptional surveyors and the possibility that people of these two tribes can work together toward common goals.
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Operating in four regions, the logistics of this project have been challenging. The timing of our survey made it worse, as the wet season is a bad time for roads. It has been difficult for our management team to get to our field offices, and it has been difficult for our surveyors to get to some respondents.
Bole was the most difficult location to get to. Normally it’s a 5 hour ride on Metro Bus. Shortly after our survey began, they closed the road between Tamale and Bole, and routed transportation through Kantampo. This meant that to get to Bole, instead of a 5 hour ride, it was now an 8 hour ride, with two bus transfers. And the bus ALWAYS left late. Salaga had the most problems with inaccessible respondents. At one point, the survey team left to travel to a community, got nearly there before the road became impassable, and had to turn back. A wasted day. Salaga also had some respondents accessible only by boat, but high waters made the journey too dangerous. Since these respondents would likely be unable to get the treatment we are testing anyway, we replaced them in the sample. Salaga wasn’t always a breeze to get to, either. The road seemed to disintegrate a little more every trip I made there. The last trip there, Metro Bus wasn’t running because of road conditions, so I took a tro-tro. I estimate about 10% of the road was water on that trip. We were traveling at night, and there was a rain storm. Since the tro-tro had no glass in the windows, I spent the duration of the storm holding a plastic sheet up to shield myself and fellow passengers from the rain. After the rain stopped, the challenges continued, as all that rain flooded the road. At times it seemed like we were driving in a river. At one point, we had to get out of the tro-tro and trek through 100 meters of knee-deep water, so that the tro-tro could go through empty to avoid getting stuck in the mud. A few of the Ghanaians took great fun from telling me “Welcome to Africa!” Ironically, because I had traveled that road eight times in the past month, I was probably less surprised by the road conditions than they were. Donald Marron recently bloggedabout a new economics paper on gender arbitrage by multinationals in South Korea. The idea behind gender arbitrage is that discrimination in hiring against a particular group, like women or minorities, creates opportunities for non-discriminating employers to hire talented people for a lower wage. When non-discriminating employers take advantage of this, it should eventually erase the gap in wages between the disadvantaged group and the rest of the labor market. This paper found that multinational corporations have been able to benefit from discrimination against women in the labor market that drives down wages for educated women. In Korea, working women earn only 63% of what working men do. (Not all of this is due to discrimination.) The paper found that among multinationals, a 10 percentage point increase in the number of women in local management positions led to a 1 percentage point increase in return on assets. Marron points out that the fact that companies that hire more women have a hire profit margin means that there is still room for more arbitrage-- implying that discrimination is still resulting in lower wages for women compared with men who have the same skills and abilities.
As unfortunate as it is that women in Korea are being paid less than they are worth, from the perspective of both women and employers in northern Ghana, this is an enviable problem. In Ghana as a whole, about 20% of adult males have secondary education or higher; only about 10% of adult females have that level of educational attainment (source: GLSS 5), and the gender gap is most pronounced in the Northern Region. Traditional views of gender roles still prevent girls from having access to education at the same rate as boys. (Girls may also have a higher opportunity cost of education: girls are often more economically valuable than boys, because they can assist with child-rearing and food processing, or work as maids, at an age where boys are still too young to be much help with farm work.) The result of this is that it is difficult to find qualified female candidates for jobs requiring a high level of education. This is especially apparent to employers like me, who actually have a bias in favor of female employees. Since the majority of the respondents in my survey were female, I wanted to hire female surveyors because they are more likely to put female respondents at ease. Despite actively recruiting female candidates, posting notices encouraging women to apply, and asking the field managers to try to achieve a balance in the number of male and female surveyors we hired, we received few applications from female candidates, and less than a quarter of the surveyors we hired ended up being female. One thing my survey sought to measure was the respondent’s perceived risk of falling ill. We expected this to be tricky, because many of the respondents are not highly number literate, and most have no concept of probability. This was easily the most challenging part of our survey to design.
We tried to model our question after surveys that had been done in other developing economies, as detailed in Delevande, Gine and McKenzie. These surveys asked respondents to allocate piles of stones to different pots, depending on how likely they thought different amounts of rainfall were. The advantage of this is that the respondent does not even need to be able to count, he or she can just compare quantities, and see that one is larger. Also, the respondent can easily make marginal changes, moving a few stones to a different pot, if you change the conditions of the questions slightly. We adapted our questions to ask respondents the probability they would get sick over the next month. What sounded like a simple and elegant model turned out to be an incredible struggle. The responses we got failed basic logic tests as often as not; for example, respondents would predict a higher risk of getting sick once in the next month than once in the next year. After rounds and rounds of piloting, and consulting everyone we could think of, we identified the major problems, and attempted to address them: 1. People don’t like to say they will get sick, because they think it will then happen. We addressed this by changing our question to ask about the probability someone as healthy as them would get sick over the next month. This seemed to help. 2. “Chance” and “likelihood” don’t translate well in Dagbani. We did our best to write the questions in English so that they would be as simple as possible, and then carefully worked through the Dagbani to find the clearest translation. 3. People have little concept of marginal changes in probability. In northern Ghana, something is either certain to happen, certain not to happen, or may happen (50-50). Our weather reports, forecasting 40% chance of rain, would make no sense here. Conceptualizing one thing as more likely than another, or conceptualizing small changes in risk, is completely counter-intuitive. We never completely solved this problem. 4. People don’t like stones. Natural objects, like stones or beans, are associated with witches’ fortune-telling, which people don’t like. And here we were asking them to predict future sickness with stones. We switched to bottle caps, which as a man-made object, are less threatening. My friends in Tamale drank beer very diligently and enthusiastically in the weeks leading up to my survey in order to provide the 720 bottle tops I needed. As a result of continuing problems with #3, this section proved to be the most difficult in our survey. It was only a few questions long, but the time it took to explain the concept, go through examples with the respondent, and work through the questions added up to nearly 30 minutes, almost a third of the total survey. This week, my team will be completing our baseline survey. This is quite a landmark achievement for us. We pioneered a team structure my organization has not used in this region before, relying on talented temporary staff to serve as field managers overseeing survey operations in each of the four regions we worked in. The project manager and I rotated between the locations, monitoring progress and paying surveyor salaries. We administered a 1.5 hour survey to 1500 respondents, in at least 7 languages, using 60 surveyors. We did it in a month, not counting our piloting and census. During the survey, I have taken a hiatus from blogging, despite the fact that my survey has generated some material worth sharing. For the next couple weeks, expect to see stories about my surveying experience: the Survey Chronicles. I've spent 36 hours on Ghanaian bus trips in the past month, much of it watching Nigerian ("Nollywood") movies. The Cinderella story is a common theme in many of these movies: a poor village girl, or sweet middle-class modern city girl, meets a young African prince, who buys her lots of stuff, defends her from his disapproving parents, and takes her away to live in a palace.
I had an interesting conversation about women, love and money with several male Ghanaian colleagues the other day. All three of them agreed that women, in general, loved men for their money. One of them said that he was glad he married his wife My male American colleague gallantly came to the defense of my gender, and contended that while this might be true for some, it was untrue for most, and it was impossible to "love" anyone for their money anyway. One coworker suggested that American women were less likely to love a man for his money than Ghanaian women. With Nigerian Cinderella fresh in my mind, wasn't so quick to dismiss the attraction of money, but instead asked what was wrong with that? What we find attractive is influenced by our needs, and what society admires. Marriage has long been an economic union, and ability to provide economically has been necessary to that union, and socially admirable. And it is no more shallow than many of our other criteria for love-- which is a more accurate reflection of character, the looks a person was born with, or the money they earned? (We will put aside the money a person was born with for the moment.) The major difference between West African women and American women is that for West African women, economic survival is much less assured-- and hence a greater need. If the Cinderella fantasy still limps through American culture, it should be unsurprising to find it prevalent in West Africa, where many women do not have the luxury of discounting their mate's ability to provide economically. If men want women to marry them for attributes other than money, they should do all they can to empower women to provide for themselves, so they will have that freedom. Also, they should consider their decisions to have multiple wives and mistresses. When being able to provide for multiple women becomes a mark of status, it only reinforces the link between money and relationships. Treat women like people, not objects, and they will treat you as people, not meal tickets. India has a new, attractively-designed symbol for the rupee. It’s a combination of the Latin letter “R” and the Devanagari “ra”. (It looks like this: र) I’m not sure yet what strokes I would use to write it: R-bar-bar, or bar-R-bar, but I approve. Now I think either China or Japan should come up with an alternative to ¥… For those interested, Slate’s The Explainer has a quick article about the origin of common currency symbols here. The Ghana cedi is noted with the symbol GH¢, or the ISO code GHS. (The ISO code for the rupee is INR; the U.S. dollar is USD, etc.) The name “cedi” comes from a word for cowry shell, which were once used in Ghana as currency. Last week, I managed to get an infected scratched cornea in my right eye. I am now doing much better, and my doctors are predicting a full recovery, but the process I went through to obtain treatment offers a great deal of insight into medical care in Ghana. Here is the story:
On Sunday evening, what I had thought was typical contact lens irritation became very red and painful, to the point where I slept with an ice pack on my eye. By Monday morning, I realized that I likely had either a scratched cornea or an eye infection. I took a taxi to KABSAD Scientific Hospital, which is not actually a hospital, but rather a small clinic favored by ex-pats in Tamale because it is fairly clean, admits cash-and-carry patients with relatively little paperwork, has an actual MD on staff, and will let you do your own malaria tests. I arrived at KABSAD at 8am, and was informed that the doctor would be there any minute, and then he would decide whether they could help me, or whether to refer me to Tamale Teaching Hospital. An hour later, the doctor had still not arrived at KABSAD, so I took a cab to Tamale Teaching Hospital. I wandered around the hospital with one eye open until I found the eye clinic. They informed me that I needed to get a folder from the OPD before they could help me. I wandered around the hospital with one eye open until I found the OPD (which, by the way, I still do not know what stands for.) The OPD appears to be the single biggest bottleneck in the Teaching Hospital’s services. Everyone who is there for anything must first go to the OPD. There, they must supply personal information, including name, age, phone number, address, and religion (which sounds completely irrelevant, but as you will find out, is not.) You must also tell them what services you will use—before you ever get a diagnosis—so you can pay for them. Luckily for me, I knew I needed a consultation at the eye clinic. Also luckily for me, I happened to befriend an off-duty male nurse named Awal. Awal helped me procure my folder and pay for my eye consultation. Awal then took me back to the eye clinic. Before seeing the ophthalmologist, I had to first see the eye sight nurse, who made me read off letters on an eye chart, and tsk-tsked at my poor vision, apparently oblivious to the fact that my right eye was red as a tomato, barely open, and dripping tears all over her precious eye paddle. Next I got to visit the “eye open”, which quickly became my favorite stop, because an elderly nurse, exuding competence and humming church hymns, put soothing drops in my eye that made me feel considerably more comfortable. Finally I got to see the ophthalmologist, who looked in my eye, then sent me back to the “eye open”. Again I got soothing drops, but this time the humming nurse betrayed me by following them up by putting a stick in my eye. The stick must have had some type of dye on it, because after that, three nurses, Awal, and the ophthalmologist gathered around to look at my eye and make interested-sounding noises. They then bustled me out of the “eye open” and back to the ophthalmologist’s room. The ophthalmologist explained that my eye was cut; that I had an ulcer in it. I interpreted this to mean that I had a scratched cornea, which I took to be good news, because although they are painful, they usually heal quickly and without complication. “Good,” I said, “so it is not infected?” “No,” said the ophthalmologist, “it is also infected. We will give you medicine.” Of course, I then had to first pay for the medicine, and then go get the medicine, and then bring it back to the “eye open.” At the “eye open”, the humming nurse applied antibiotic drops and a soothing ointment, and then put an enormous bandage over my eye. The bandage didn’t quite succeed at keeping my eye completely shut; I do not think the nurse was used to working with people whose noses are quite as pointy as mine. I left feeling a bit better, but with limited vision, at 12:30pm. I should note that, as long as these steps took, two things enabled me to care more quickly than the average Ghanaian would have. First, I was paying cash for the services, not using health insurance, which would have entailed more paperwork and longer lines. Second, Awal somehow managed to get me to the head of every line, from the eye sight clinic, to the “eye open”, to the ophthalmologist’s office, to the pharmacy. I felt a little bit guilty about this, but at the time my eye hurt badly enough that I didn’t really care. In retrospect, none of the other patients appeared to have conditions in need of immediate attention—the only person who objected to my speedy admission was a man concerned about missing the bus. I do wonder how someone with a true eye emergency would fare: would a guy with a stick stuck in his eye have to wait in line to read an eye chart before seeing a physician? The first day after my eye was treated was generally miserable. I had been given pain medication, which turned out to be ibuprofen. I had been holding out hope for codeine. I seriously considered treating myself in the “traditional” way, and if I’d had some vodka on hand, I probably would have put away a few shots. Fortunately, my body was being cooperative after a stressful day, and I was able to sleep through the worst of it. The next morning, the pain had improved, the humming nurse changed my dressings at the hospital, and I shuffled back home to go back to sleep. My friend Kris brought me some groceries, and despite my reduced depth perception, I was able to cook a fine dinner of poached guinea fowl eggs, toast, cheese, and boiled carrots with no mishaps. . The next morning found me sitting back in the “eye open”, as the humming nurse removed the bandages from my eye. Again, two nurses, Awal, and the ophthalmologist peered at my eye, and made pleased-sounding noises. However, although my eye looked better, it wasn’t doing so well at seeing. When I closed my good eye, I found that looking through my right eye was like looking through a fogged glass—I could see light and some shapes, but little else. I asked the ophthalmologist why my vision was blurred. He peered at my eye, and declared I had some scarring. I asked if it would improve, and he said that it might, as it healed. I asked if anything could be done. The humming nurse flipped through my chart, and noted that I was Christian. “You can go to any church in Tamale,” she said, “and they will pray for your eye.” I took that as my cue to go not to church, but to Accra. (Accra has taken on mythic proportions to me living in Tamale. In Accra, you can buy sushi, blue cheese, a new eye, and possibly baby unicorns. Since the next-day flight to Accra was full, my boss arranged for me to drive to Accra with several of the PhD researchers who were visiting Tamale and were planning to drive back to Accra starting that afternoon. We stayed the night in Kumasi, at a very nice hotel. One night cost me the equivalent of one month’s rent in Tamale. I was actually fine with that, since it was still considerably less than the cost of an airplane ticket. However, I was a bit annoyed when the AC in my room didn’t work. I slept fine anyway, but in retaliation, I stole the soap. I arrived the next day in Accra. By the time I was able to hire a taxi to take me to the well-reputed Emmanuel Eye Clinic, it was 2:30. To my surprise, the clinic was closed, except for a receptionist who booked me an appointment for the next day: the doctors only work in the morning. Since my eye sight had improved over the past day, I was not too concerned about the wait, but I made a note to tell my father that if he ever gets tired of being on call on holidays and weekends, he can come to Ghana, work half a day, five days a week, and drive a very swanky car. (Note: no one has ever had fewer ambitions to drive a swanky car than my father. Maybe a swanky bicycle.) I returned to the clinic the next day at 10am. Emmanuel Eye Clinic is very efficient for those who make appointments, but appointments seem to make up only a small share of the clientele. Getting in to see the ophthalmologist, getting my eye dilated, and picking up my new medications took only a couple hours. The news was good: the ophthalmologist said that the scarring on my eye would not obscure my vision, and that in time all of my sight should return, although I might have some permanent light sensitivity. This news was a considerable relief. I did have one further complication: my eye remained dilated for about 50 hours (3 to 4 is the norm). Apparently this happens to some people, and it is more common among those with light colored eyes like mine. Still, I wonder if the eye clinic uses a particularly strong dilator, since most of their clients have very dark eyes. I returned home to Tamale after taking a day to relax in Accra. My vision in my right eye is still a bit blurry, but I am continuing with my medications, and it seems to be slowly improving. I seem to have been lucky in a number of things: the location of the scarring on my eye, the fact that I know a good deal about health care providers in Tamale as a result of my research, and not least of all, my coworkers, friends and family who provided support for me: Jessica for getting me to Accra, Lana for checking in with me each day, Kris for bringing me food, Ryan for hosting me in Accra, and my parents for taking my calls at ungodly hours of the night. Thanks for everything! The U.S. trade deficit has been trending up over the past year, and the goods deficit is now at the highest level since November 2008. While a large and persistent trade deficit is not a good thing for the American economy, the recent trend should not itself be particularly alarming: at this point, we are merely retracing declines in the deficit that came as a result of the economic downturn. The recent increases in the deficit can be seen as symptoms of an improving U.S. economy that is consuming more goods and services, and importing more to meet that demand. That said, we should consider how we are funding this increase in imports. The last two expansions in the trade deficit corresponded with asset bubbles: the tech bubble and the housing bubble. U.S. investment outpaced U.S. saving, and foreign investment made up the gap-- and the influx of money enabled the United States to buy more from abroad. Where are we getting the funds to increase our imports now? Part of the answer may be that households are consuming more and saving less (savings rose during the recession), but another source may be government debt. U.S. Treasuries fared well during the crisis, as investors turned to them in a flight to safety. If investment in U.S. government debt really is a driving force of the increase in the trade balance, this could be concerning, because, while we certainly don't want investment bubbles in any asset type, we should generally prefer to go into debt in order to increase future growth. Taking investment from abroad is great if it increases future growth in the tech sector; if it is fueling consumption that won't translate into future growth, it is concerning.
One could argue that the government stimulus policies are indeed an investment in future growth, because they have prevented a potentially devastating depression. However, as the economy starts to turn around, I think the United States will need to tackle the discrepancy between domestic saving and domestic investment and consumption. To note, Ghana is doing its part to help the U.S. trade balance: the U.S. is currently running a surplus with Ghana. Main exports include petroleum products, mining equipment, and cars. If you all will send some more Parmesan cheese this way, we can do even better! I was visiting microfinance groups again. Today's group was just about to receive their first loan.
While discussing the community, the group had an interesting complaint: a man in the neighborhood, noting soil erosion and worrying that his home would be affected, bought--as in paid for-- a truckload of trash and had it dumped on the eroding slope. I should note that buying garbage here is just absurd, because there is no garbage collection, so garbage sits around in piles until somebody burns it. The community was understandably upset at having a load of garbage dumped in the middle of the neighborhood, but when they confronted the man, he tried to start a fight. The microfinance organization plans to help the community complain to a local official, and hopefully they will convince the man there are more hygienic ways to prevent erosion. |
About Liz
I have worked in economic policy and research in Washington, D.C. and Ghana. My husband and I recently moved to Guyana, where I am working for the Ministry of Finance. I like riding motorcycle, outdoor sports, foreign currencies, capybaras, and having opinions. Archives
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