19 March 2014

At the Airport

I was waiting at the gate at Johannesburg’s O.R. Tambo international airport, computer in my lap, pleased that I’d found a place to sit close to the check-in desk, where there was already a small group of people hovering anxiously next to the sign for priority boarding.

I’d been comfortably seated there 30 minutes earlier, when they called us up for a special security check—something they were doing for all the flights headed to the United States.

—For fuck’s sake, I’d muttered under my breath, agitated as usual just by being in an airport. I hate flying. Even the smallest bump or a noise I don’t recognize sends my imagination whirling, and the thought of sitting for 15 hours, hurtling over the ocean in a steel tube in the dark, had been on my mind for days.

I closed my laptop, gathered my notebook and pen, and rushed to join the line, which formed instantaneous, stretching down the terminal’s long white corridor.

I wound up in the middle of a group of 20-somethings who were returning to the States from vacation. In hip, studied outfits of trendy sunglasses and high tops, they talked loudly, conspicuously, surrounded by bags of alcohol from duty free. I listened to the girls tease one of the guys: we know you’re excited for the security pat down, haha. Evidently, it was the most action he’d had in a while.

Further up in line was a tall American who looked to be in his late twenties, and wore a khaki vest with an inordinate amount of pockets and zippers, all of which were stuffed full of God knows what. He had a scraggly goatee and eager blue eyes, and he gazed into the crowd, as friendly and good-natured as a pine tree.

There was an older American couple, also in hiking gear, who smiled vaguely at the group of cool cats talking behind me and looked mildly stoned. An attractive older couple, dressed in understated, expensive clothes, were at the head of the line. They kept their arms crossed and stayed close to each other, as if to avoid being contaminated by the masses. Next to them were three middle-aged ladies, one of whom wore an enormous pink blazer and kept laughing like a hyena and pointing at her phone.

There was a group of young women in scrubs; some quiet loners like me; businessmen; a of couple families with kids.

The security check was relatively painless and I made it back to my original seat. Fired up my computer. Exchanged polite smiles with the lady sitting next to me. Checked the time.

Then one of the SAA employees ran down the aisle behind me yelling for help.

I turned my head and noticed a man, about 20 feet from where I was sitting, slumped over in his chair.

He must not be feeling well, I thought. The commotion died down after a few seconds, and I looked again at my computer.

But then, a minute later, a strange sound wafted through the crowd, low and anguished, like a drone, and when I looked back down the aisle, I realized that the sound was coming from the man. Except now he wasn’t slumped over in his seat—now he was lying on the floor, and the girls in scrubs were on their knees, pounding on his chest, breathing into his mouth, while SAA employees ran frantically back and forth down the aisle, making telephone calls and talking in urgent, hushed voices.

And what started to dawn on everyone who was watching was that this man was either dying or already dead.


It’s hard to believe—that someone can be here one minute and gone the next, in the middle of a crowd, beneath the fluorescent lights, next to the Nandos.

What you expect, somehow, in a moment like that, is for everything to stop. You expect the crowd to be silent, for all conversations to cease, for all attention to be focused on that man, who ever he was, at least for a little while.

But what was so strange was that things did not stop. Some people gathered around him, of course. A couple of the 20-somethings who had annoyed me so much were crying silently in their chairs. Some, like me, watched from our seats, glancing at each other expectantly, waiting.

But all around us, things went on. People floated by on the moving walkway that snaked past our gate, bags on their shoulder, mostly unaware of what was happening. A voice came over the loudspeaker to make the final boarding announcement for a flight to London.

Even among our group at the gate, many seemed not to notice what was happening. The pine tree guy, who was sitting a few seats away, chatted jovially about organic farming and Al Gore with the two American campers he’d made friends with in the security line. They never once turned their heads or stopped talking.

The three women on vacation, who were in a better line of sight than I was to see what was happening, took selfies on their phones and laughed, only pausing after about 15 minutes had gone by.

The expensive couple stayed close to the check-in desk, jealously guarding their first place at priority boarding. They glanced over their shoulders once or twice to see what was happening, before turning their backs and checking their watches.  

I wanted to tell them to stop, for God’s sake, stop. Can’t you see this man is dying? He’s dying, right there in front of you.

Can’t you see?

What’s wrong with you? It’s impossible. This can’t be real.


It’s easy to moralize about a scene like this. But hang on, not too fast. We've all done things that don't make sense, behaved in ways we know we ought not to have behaved, for reasons we scarcely understand.  

So then maybe this is an example of our collective numbness, an example of how easily distracted and self-involved we can be. Those ladies taking selfiesthey represent all of us, don't they? Taking pictures of ourselves while tragedy unfolds around us? 

Or perhaps we can see it as a metaphor for impermanence, and the need to live life to the fullest, because you never know what day is your last.

Yes maybe. Both things are true, of course. We have a huge capacity for compassion, but sometimes we are as unmoved as stone by other peoples' pain.  

And most of us live as if we had all the time in the world when the truth is, we do not.

Life is precious, as Frederick Buechner writes, and “We must be careful with our lives, for Christ's sake, because it would seem that they are the only lives we are going to have in this puzzling and perilous world, and so they are very precious and what we do with them matters enormously.”

Everyone knows this. We don’t need to be reminded.

Except that we do need to be reminded, all the time, at least I do. Because no matter how much I know these things, intellectually, it is another matter entirely to live as if they were true.

Maybe that’s why we have religious rituals like Lent, which began just a few weeks ago. You don’t have to be a church-type to appreciate the idea—of taking time out of our frenetic, 100mph, too organized, too business-like lives, to stop and take stock, to step back and try, again, to get ahold of who we are and where we are going. 

Yes, these lessons are important. 

But still. 

There's a part of me that doesn't want to draw out lessons about Mankind from that night in Johannesburg, no matter how true they might be.  

Because it wasn't mankindbut one manwho died that night. One man who had a story of his own, who is more than the ideas we may draw. One man in the crowd who was someone. 

I tried to fight them, but tears welled up in my eyes, and so I sat at the gate and cried silently for a minute or two.

I cried because the man had been alive a minute ago but now he was dead, and it is sad when people die. I cried at the heroic effort that was being made to bring him back to life, how hard they were trying, and how right they were to drop everything and get down on their hands and knees and fight to save him.

I cried at the people around me who were carrying on, and I cried because I knew that I too would get up a few minutes later when they announced that our flight was boarding, and would become impatient and worried again, about the flight, about there being enough room in the overhead compartment, and I would feel sadness and exasperation at myself for how petty I can be.

They called us to board, and so we left him there on the floor, only to learn later that he had in fact died, despite the best efforts of his fellow passengers to resuscitate him. 

I wish that, before we boarded, we had stopped what we were doingall of us, together, strangers, but not strangersand been present with him, to honor his life and the fact that we were a part of it for a short time.


No man is an island entire of itself; every man  is a piece of the continent, a part of the main;  if a clod be washed away by the sea, Europe  is the less, as well as if a promontory were, as  well as any manner of thy friends or of thine  own were; any man's death diminishes me,  because I am involved in mankind.  And therefore never send to know for whom  the bell tolls; it tolls for thee.

--John Donne

28 June 2011

Evening Shadows (Dispatches from Kabul)

On Saturday afternoon, June 18, a group of young men approached the entrance to the Kabul central police station and proceeded to detonate a bomb attached to one of their vests while the others opened fire at whomever happened to be standing around. Nine people were killed.

When I heard about the attack, I did a mental calculation as to the last time I had passed by the police station, and when I might have passed by again.

It happened midday, about 1:30 p.m. The time when lunch is settling in your stomach. You run out for an errand, maybe, or make a phone call, squint your eyes at some emails you need to return—while somewhere else in the city people are dying.


I had come to Kabul two weeks earlier. Caught the mid-morning flight from Dubai. Ascend, up and up, over a skyline thick with high rises, sharp glass and steel that cut into the humid, polluted air like a forest of dead trees.

A few hours later we descend into Kabul. Flew in low, or at least it felt low, skimming the tips of the Hindukush mountains, which surround the city like a massive fortress.

Those mountains—staggering, raw. As imposing as thunder.

The plane bumped and jolted in the wind. Felt like we might be tossed down into those peaks, like we could be swallowed up and disappear.


I was in Kabul to support the Health Economics and Financing Directorate (HEFD) of the Ministry of Public Health as they evaluate a conditional cash transfer program that was recently piloted. The scheme gave cash to mothers conditional on them giving birth in facilities and having their children fully immunized with DPT3. The program also provided incentives to the community health workers who are supposed to encourage and help them.

As part of my assignment at HEFD, I conduct key informant interviews with health policy and program experts. They tell me about their projects—We train midwives. We create guidelines. We build capacity.

They whisper about the latest controversies, like the survey that shows a maternal mortality ratio (MMR) much lower than the one calculated in 2006—which showed an MMR of 1,600/100,000, the highest in the world. Some don’t believe the numbers. Others are worried what they will do to funding.

Informants complain about other programs, about being left out of conversations and meetings. Once I gain their trust, they lean in, keen to tell me, the rooky, what their business is really like. Their comments about their Afghan colleagues are full of admiration and distrust:

—They are great at extraction, one says. They’ve seen a lot of people like us come through.

—They’ve learned how to survive, says another.

Everyone is very helpful and misleading.


It is Friday, the Holy Day. Early morning and the compound is empty, the sky gray.

The night before, I was awoken at 3 a.m. by a tremor. Kabul is near the meeting of the Indian and south Eurasian plates and there are frequent rumblings. Suddenly awake, alert, I strain my eyes to see the ceiling, the outline of the door. I imagine the walls caving in, crumbling to pieces.

Now on the road, I’m unsure where to go. Look out the window, men and women snaking between cars on their way somewhere. Everything about them is long and elegant: long beards, long drapes of white, taupe, gray, billowy blue chadaries. My own head scarf keeps falling clumsily to my shoulders.

My driver leans heavily against the steering wheel, while the shooter in the front seat, an AK47 draped lazily between his legs, picks at his teeth. We pass by a mosque, a market, crooked back roads that lead to the foothills beyond.

The police station is on our right, the same one I will pass twice a day for the next two weeks, the same one that will be attacked a few days after I leave. I hardly notice it, though. I’m looking in the opposite direction, at a wall peppered with graffiti. Something is scrolled in blue paint in Dari next to images of birds, one after the other—wings open, flying.

I ask the driver what it means, but he doesn’t speak English well and hesitates.

Then: It means we want a better life. It means everybody should have a happy life.

I think: Of course. It means Peace.


The pub on the U.S. Embassy compound is called the Duck and Cover.

Meet some friends there one night, two young American guys working on civilian-military relations for General Petraeus. Over beer, I tell them about the incentive program whose evaluation I’ve come to support. They tell me about another incentive program, this one to empower (read: arm) local police forces, also called militias.

Despite the fact that Karzai is a Pashtun, there are many who see him and all the other vestiges of security, as illegitimate, a mere reconfiguration of domestic power structures to serve external interests.

The Afghan National Auxiliary Police and the Afghan Public Protection Program are meant to protect the people who are on the right side of the war. My friends at the U.S. Embassy believe in the program. It’s not perfect, they say, but it’s a good thing to do.

—But I thought we are trying to disarm people?

—Well yeah, one of them says, we arm the locals so they can protect themselves from the enemy.

How can you tell which is which?


There is a restaurant called Cedars House near the central business district. My colleagues and I sit outside, in the garden.

There are so many gardens in Kabul. Sprawling, with trim lawns, lined with pink and red roses.

The evening is cool. There is a quiet murmur all around us: the chink of glass, conversation in the moonlight. Our meal is slow and meandering, the conversation drifting like smoke.

My Ministry colleagues tell stories. Their days at university in California, St. Louis, the Netherlands, Liverpool. They talk about cricket on the weekends, homes full of relatives, their crowded lives. They poke fun of each other, tell jokes, talk fluidly about philosophy, poetry, literature.

Shards of their pasts are occasionally exposed. One’s boyhood as a refugee in Pakistan. The dark days of the Taliban when they all grew long beards.

I study them. It’s like trying to keep my eye on a flame. I want to understand their lives, but I’m on the outside, straining to look in.


They say some expats can’t leave warzones. They get stuck in the netherworld of expat life—behind walls, lonely but never really alone. Submerged in motion, in alcohol, some of them, in constant work. Wake up one morning and realize the only place they feel comfortable is in places where they are uncomfortable.

A storm passes through one afternoon. I’m standing underneath an overhang at the security office with Beth, a British security specialist. She’s open and friendly—shakes my hand, offers me a cigarette as we watch the rain.

She was in Iraq for a while, passed through Sudan, then Kabul.

—I tried to be normal for a year, she laughs. She moved to South Carolina, started a business. “It didn’t work.”

Later, back at the Duck and Cover, I watch her compatriots at the bar: older men with tanned, deeply lined faces, and tattoos on their arms. One wears a gold crucifix, which hangs down over a t-shirt emblazoned with expletives.

It’s karaoke night, and one of them gathers himself solemnly at the mic. A hush falls over the room while he sings:

Would you know my name… If I saw you in Heaven?


There’s a lake just outside the city. Some colleagues and I have lunch—Karayee (lamb with tomatoes and garlic), cucumbers, flatbread and yogurt—while lounging on Afghan rugs. We’re in an open-air bungalow of sorts, on stilts that juts out over a cliff above the lake.

It's a rare midday break from the office, and for a while we are all quiet together, looking out over the water, which changes color in the pale afternoon sunlight, from turquoise to shades of grayish blue.

They are like ship captains, these men: smart, realistic, ambitious, trying to navigate the choppy waters of politics and money and ego that are the stuff of the aid business.

There are something like 62 donors to Afghanistan. Six provide more than 90 percent of external support. Aid flows amount to more than 50 percent of Afghanistan’s gross domestic product: official ODA from OECD members rose from US$87 million in 2000 to US$2.2 billion in 2005. [1]

The United States is by far the largest donor. Since 2001, the U.S. has appropriated US$127 billion for the war, and the U.S. military is currently spending nearly US$100 million per day in the country, a total of around US$36 billion per year.

The question on everyone’s mind is Sustainability. It’s the first thing informants ask when I mention the HEFD program to help save mothers’ lives. How will the Afghans, how will any of us, they ask, make this last?

One afternoon, I meet an American official who sneers at the money being “dumped” into Afghanistan. What about the taxpayers at home, she says? Too much money is never enough!

But the amount of aid that ends up in government coffers is hugely reduced by the fact that an estimated 40 percent of all aid goes back to donor countries in corporate profits and consultancy salaries (like mine, with my health insurance and pension, benefits some of my Afghan colleagues do not receive)—a total of some US$6 billion since 2001.

Later, I ask an Afghan colleague about the American official I met. He smiles thinly and looks out the window of our car.

—She has a lot of power, he says.

I think I see a flash of disgust in his eyes.


It’s early evening. A friend and I go up to the roof of the guesthouse where I stay, pull some concrete blocks together and sit down, look out over the city.

Sounds now familiar of the city at dusk: Early evening traffic jam. Some men gathered on the side of the road talking. A stray dog barking down a dirt alleyway. Beyond, the mountains stare back at us, harsh, haunting, somewhat obscured in the shadows of the setting sun.

Then the wind picks up, blowing dust and sand in our eyes. Feels like little needles against my skin.

A few days later, my friend will skype me to tell me about the attack.

I will ask him with a kind of panic if he is okay. How did it happen? Were you afraid?

And what will it take for these things to end?

—I wish I had an answer, he will say.

[1] See: Who Owns the Peace? Aid, Reconstruction and Development in Afghanistan, Jonathan Goodhand and Mark Sedra.

20 March 2011

The Ambiguity of Aid

Driving through Lusaka, the capital of Zambia, is like a first trip to Las Vegas. Everything is in your face, something to see. Dusty streets, potholes like craters, people hanging off the back of pickup trucks, women wearing babies like backpacks as they hack away at maize, the smell of smoke from burning trash on the side of the road, horns honking, traffic that moves like liquid.

Almost two-thirds of Zambians live below the international poverty line—around 7.5 million people. The average life expectancy is a stunning 46 years. Only 58 percent of the population has access to clean water.

Zambia is a poor country. It is also a cauldron of donor activity. In 2005, the country received $1.7 billion in official development assistance—that’s 17.3 percent of gross national income for a country of 12 million people.

“The question people ask,” says Justin Mubanga, the Director of the Economic Management Department at the Ministry of Finance and National Planning, “is, in the last fifteen years Zambia got so much aid but there was little progress. What caused this?”

Some people say that aid caused this. They say that it has hampered, stifled and retarded Africa’s development. But there are others who say, on the contrary, that aid improves the lives of the poor and makes the sick well.


Gordon Brown is standing at his desk in a crisp navy blue blazer and khaki slacks, a phone in one hand, the other tapping his keyboard. Even standing still, he’s humming with energy.

Gordon is the 35-year-old Zambia country representative for Africare, a U.S-based non-governmental organization (NGO). His job is to develop new programs, oversee those that already exist, and form alliances and partnerships.

It’s a long way from Augusta, Georgia, where he grew up. “The first time I walked into a store [in Africa] and nobody knew who I was or cared, I felt like I fit in by not being noticed, you know what I’m saying?”

Africare’s work in Zambia centers on health, food security and agriculture, and emergency response. Their projects, Gordon says, are about meeting peoples’ essential needs. So for example, they are helping to install something called PlayPumps, a merry-go-round of sorts that, when children spin it, pumps clean water into a storage tank that can be accessed by a simple tap on the ground below.

“Market forces alone aren’t enough to solve the problem of poverty in Africa. If we take the Darwinian approach—if you have resources, then you’ll succeed—if we believe that and act on that belief, people will die.”

There are many who think that putting things in such stark terms is just a clever way to drown out the voices of critics.

“[But] it’s okay to be motivated by wanting to do good,” Godron says. “We don’t live in a purely dog eat dog world. We want to believe there’s something greater. We want to be able to respond to need. Not everything we do is about self interest.”


Looking at Boyd is like staring into the bottom of a well. His eyes are small and dark, impenetrable. I ask him: What is it like to care for orphans? What is it like to live in a village in the Zambian bush? What is it like to be poor? My words are like arrows shot into the ocean, pointed and tiny against the vast waves.
We pick him up at a small church made of exposed cement blocks where he and other volunteers are being trained in Gender Equity. The words seem sterile and queer in the dust beneath the jacaranda tree, where a little girl stands, hiding in the folds of her mother’s skirt, while some wazungu (white people) try to coax her to speak

Boyd Hamuchemba lives in Shimukuni, a village two hours up the Great North Road from Lusaka. He is a volunteer caregiver with a PEPFAR-funded program called RAPIDS (Reaching HIV/AIDS Affected People with Integrated Development Support). RAPIDS gives him training, a bicycle and a modest medical kit, and Boyd and his wife look after eight orphans, three of whom are his dead brother’s children, and five from the surrounding village. He visits them each week and records each visit in a ledger that is signed by the orphan’s guardian. If they are hungry, he tries to bring them food. If they are sick, he gives them a ride on his bike to the clinic. It was a volunteer caregiver like him who took Boyd to a clinic in February 2008, where he was diagnosed as HIV+.


The adult (aged 15-49) HIV prevalence rate in Zambia is 14.3 percent, according to the country’s 2007 Demographic and Health Survey—the seventh highest prevalence rate in the world. Anti-retroviral therapy was introduced in 2004, and 120,000 people now receive treatment in no small part because of the vast sums of money PEPFAR has poured into the country—more than $269.2 million in FY2008 alone. (The entire budget of Zambian Ministry of Health in 2008 was $317.5 million.)

PEPFAR has been criticized for devoting too much money to a single disease and for channeling aid mostly through international NGOs, circumventing the government. One afternoon I asked Dr. Ben Chirwa, Director General of the National HIV/AIDS/STI/TB Council, if Zambia’s battle against the epidemic is too reliant on donor funds.

“AIDS is a global problem,” he said. “It is beyond what any one government can do.”

What about the Washington economist who termed ballooning U.S. funds for AIDS treatment an entitlement that is unsustainable?
Dr. Chirwa just grinned like a pumpkin. “Life is priceless,” he said.


Boyd showed me around his compound—the hut where he stores food, his two goats, a checker board carving in the dirt where his children play games. I ask what he would do without RAPIDS.

“I was already a guardian and parent. But the work has become easier. When given a bike, it lightened my work. I felt very good.”

Aid is keeping Boyd alive. It is also helping him help kids in his village who lost their parents to HIV/AIDS. He would do it anyway, but the help makes his burden light.


I meet Joy Hutcheon at her office on the second floor of the British High Commission, on Independence Avenue. Joy is country director for the Department for International Development (DFID), the national aid agency of the United Kingdom.

Joy’s interest in development began early. “I can’t remember a time when I haven’t been interested in the different ways people do things in different parts of the globe.” After a visit to India, she applied for a position with the U.K. civil service, marking the Overseas Development Administration (DFID’s predecessor) as her first choice.

“For any country,” she says, ‘the way it is governed is so fundamental. I had the feeling that [in government] I could change something.”


The U.K gives about two-thirds of its aid to Zambia directly to the government, more than any other bilateral donor. The idea is to help build the accountability and capability of the state so it can provide for its citizens. Aid to an NGO that buys HIV/AIDS medicine will save lives today, but working with the government to improve its drug distribution system (one of the things DFID is doing) will help all Zambians access essential medicines over the long term.

Chris Pain, who works for the GTZ, the German development agency, as an advisor to the Ministry of Finance, attributes much of Zambia’s strong economic performance over the past four years to budget support, and the way it is helping to slowly strengthen the civil service. “Budget support opens up the whole budget for discussion, so it’s good for enhanced transparency.”

Justin Mubanga at the Ministry of Finance (MOF), who oversees the economic technical cooperation department (the four people in the MOF who manage donors), says that budget support has brought some predictability to the flow of funds, and the division of labor helps “but they still want an audience. They come indirectly to tinker.”

One of the ways donors “tinker” is through the performance assessment framework. Twice a year, they meet with the government to assess its performance on a number of predetermined indicators. If the indicators are not met, funding can be pulled.

Monitoring the government’s performance is necessary because donors must sell aid to policymakers and their constituencies back home, and assure them that funds are not being wasted.

“You can’t have budget support without being worried about corruption,” says Joy.

DFID is trying to help the government create an environment in which finances are well-managed and where corruption is not tolerated. So for example, DFID is helping the MOF install a single Treasury bank account (as opposed to the 300 or so accounts it currently has), to make is easier to track spending. The result is that corruption is more noticeable, Joy says, but there are also voices prepared to speak out and challenge it.


When Joy first arrived in Zambia, before anyone knew who she was, she visited a remote village called Kazuni in Southern Province. She shared a mud hut, walked to the river to get water, burned her fingers cooking nshima, laughed around a crackling fire with the women who were hosting her.

One day, a plane passed overhead. The women asked: what is it like to be way up there, in the sky? She felt clumsy as she tried to describe it: imagine you’re in a bus, sitting next to someone, little windows on the side. Are there are toilets, they asked? Yes, there are toilets. There are trays that fold down, and sometimes televisions. The women stared at Joy in wonder. They would probably never set foot on a plane.

“Everyone in Zambia has a village,” Joy said, “and will talk about going to the village. I have heard people I know say things like: this isn’t so bad; it’s like camping. But it’s your life. It’s everything you’ve got and there is no prospect of it changing.”

After three days she returned to Lusaka, over dirt roads, then paved roads, past buildings until she was back in her office, sitting in front of her computer, listening to the hum of the air conditioning.

As she told the story her voice cracked, like a rock breaking the surface of the water. “I really, really have to be sure that what I’m doing matters."


Night comes early in Lusaka. In the dark sounds are amplified. The rustle of leaves, dogs barking down an alley, a car engine trying to turn over.

An aid worker from Ireland once told me about a man she met at a health center who was holding his dead daughter in his arms. He needed a ride home; my friend said she could take him. The coffin he had was too small, but he hurried to squeeze the little girl’s body in, worried if he didn’t move fast enough, his ride might leave. The aid worker panicked: she won’t fit in there, let’s find something else. But there wasn’t anything else, so they took a hammer, knocked the end out of the coffin, and drove home with the wooden casket in the back of the pickup truck, the little girl’s legs dangling out the end.

Sometimes it feels like you’re being swallowed up, pulled under by a rip tide. The enormity of need. The limits of what we can do.

Boyd said it was hard to show up at someone’s home, ask them if he could help, and realize that sometimes he couldn’t. I remember him walking across a dirt path to the garden where he grows vegetables for the orphans; Gordon striding across a school yard to see a new water pump; Joy walking down the hall to meet some government officials.

They put one foot in front of the other.

*This is adapted from a piece I wrote in 2009 for the Center for Global Development.