"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Saturday, January 24, 2015

The Law Of Unintended Consequences–Things Never Work Out Like You Planned

Insecticide-treated bed nets have been touted as the best way to fight malaria.  Not only do  the nets protect the sleeper from getting bitten, it kills mosquitos on contact; and if enough inhabitants of a community use them, the mosquito population will diminish.

So far so good, and if used properly these nets do the job.  There are problems, of course. The tight mesh weave keeps out the breeze as well as the mosquitos. The nets rip easily; and if a family is sleeping five-to-a-bed, the space is a bit cramped.  Perhaps most importantly, the nets are expensive relative to rural incomes in the Third World.

Economics rules, and rules absolutely in marginal communities. Families are always out to maximize income and productivity while reducing cost and minimizing risk; and rural Zambians have found out that bed nets make fine fishing nets. Jeffrey Gettleman writing in the New York Times (1.24.15) chronicles the life of a Zambian fisherman:
Nobody in Mr. Nfedi’s hut, including his seven children, sleeps under a net at night. Instead, he has taken his family’s supply of anti-malaria nets and sewn them together into a gigantic sieve that he uses to drag the bottom of the swamp ponds, sweeping up all sorts of life: baby catfish, banded tilapia, tiny mouth brooders, orange fish eggs, water bugs and the occasional green frog.
They arrive by the truckload in poor, waterside communities where people have been trying to scrape by with substandard fishing gear for as long as anyone can remember. All of a sudden, there are light, soft, surprisingly strong nets — free. Many people said it would be foolish not to use them for fishing.
“The nets go straight out of the bag into the sea,” said Isabel Marques da Silva, a marine biologist at Universidade Lúrio in Mozambique. “That’s why the incidence for malaria here is so high. The people don’t use the mosquito nets for mosquitoes. They use them to fish.”

Mr. Nfedi is making an intelligent decision. He understands the health benefit of treated bed nets; but when he calculates risk and reward he concludes that the value of additional food and financial revenue is worth more than the risk and debilitation of malaria.  He and most Africans simply deal with malaria and accept its consequences.  They know that the disease is endemic, but they have always dealt with it. Given sickle cell immunity, particular environmental conditions, and general economic development, the rate for diarrheal death in Zambia is nearly twice that for malaria. Death rates from influenza are much higher than those associated with malaria; and the mortality rate for HIV/AIDS is over four times as high.

At the same time, Africans like Mr. Nfedi live on the extreme margins of poverty. The choice between a guaranteed increase in family income and a speculative lowered risk from disease is obvious. Malaria is ‘the cost of doing business’ in rural Zambia.

Less economically-motivated uses for Insecticide-treated nets are common:

HIV/AIDS workers have heard this realistic assessment before. One of the main vectors for the spread of disease is long-haul truck drivers who frequent prostitutes at border crossings.  When advised of their high risk from HIV/AIDS, they said that it, like traffic accidents, assault, and robbery, were simply part of the cost of doing business.
The Zambian net controversy, however, goes beyond personal risk assessment. The use of malaria bed nets has had a detrimental effect on the environment.  By making catching small fish easy, the entire food chain is affected.
Out on the Bangweulu flood plains of Zambia, where the swamps stretch all the way to the horizon in every direction, a reed basket used to be the primary fishing technology.
But the other day, when one of Mr. Ndefi’s neighbors went to check some fish traps in a few feet of dank swamp water, it was obvious why mosquito mesh had replaced it. A trap made from traditional reeds was empty. The trap next to it, made from a mosquito net, was jumping with tiny silvery fish.
“It’s simple economics,” said Carl Huchzermeyer, a fisheries manager for African Parks, a conservation organization in Bangweulu. “You could spend two days making a basket out of reeds, or just use a mosquito net.”

The same was true for low-cost sanitation.  During the International Water and Sanitation Decade of the 80s, millions of dollars were invested in promoting fiberglass ‘pour-flush’ latrines.  These latrines were comprised of a high-tech pan and trap and a dual waste pit system which turned feces into valuable compost.  This modern sanitation facility would do away with ‘wet’ latrines and the collection, haulage, and disposal of human waste by head load.

Unfortunately, the residents of Northern India where they were heavily promoted did not think they were a good idea. They were expensive, even though highly-subsidized.  The pits had to be placed under the verandah thus ritually polluting everyone in the house; and the shiny, durable, and lightweight pans were far more valuable as containers than for toilets.  On an extended field trip through Uttar Pradesh, a World Bank sanitation advisor wrote, “Shitters used as flower pots.”

Program planners never seem to get thing right. Rajiv Sengupta shared this blog post:
The term cobra effect stems from an anecdote set at the time of British rule of colonial India. The British government was concerned about the number of venomous cobra snakes in Delhi. The government therefore offered a bounty for every dead cobra. Initially this was a successful strategy as large numbers of snakes were killed for the reward. Eventually, however, enterprising persons began to breed cobras for the income. When the government became aware of this, the reward program was scrapped, causing the cobra breeders to set the now-worthless snakes free. As a result, the wild cobra population further increased. The apparent solution for the problem made the situation even worse.

Developing countries are not immune:
In 2008, Airbus made the new A380 quieter than any previously-manufactured plane in an effort to improve passenger experience. Unfortunately, Airbus didn't realize until after they shipped the aircraft that the quieter cabin resulted in more unpleasant sound for passengers, in the form of bathroom noise, talking and other audible sounds (e.g. coughing, sneezing, crying). The result was a worse experience for both passengers and pilots, and caused Airbus to recall some of the fleet and reengineer the A380 once more to add more sound back to the cabin (Anonymous Flyer)
Examples are in the tens of thousands. One can never predict the result of any deliberate action.
Fletcher Robeson seemed to have the worst luck ever in terms of planning his fate. He successfully negotiated an office with a window despite his relatively low seniority, but quickly found that the room to which he was assigned fronted on the alley.  Instead of girly chatter in the cubes, he now had to put up with dumpster-hauling and septic service.

He became a vegetarian to lower his cholesterol and increase his transit time, but found out that that phytate buildup resulting from so many carbohydrates blocked his utilization of available iron.  Without his knowing it he became severely anemic, had to be hospitalized, and never returned to full health.

He planted environmentally-friendly Portuguese yews in his back yard, but soon found out that their Spring blooms were particularly seductive to an unusual breed of nectar-dipping wasps (Phylochtera apiensis) which so proliferated in his garden, that his property had to be fumigated by the Montgomery County Environmental Protection Agency, forcing him and his family into the Bethesda Holiday Inn for two weeks.

His solid Christian upbringing led him to a remarkably generous consideration for those members of his small community troubled or marginalized because of social or personal ineptness. Although Fletcher was sure that God was taking notice of his charity and concern for others, he suffered. He befriended the woman in black who made precise military turns on the city block in front of Krauss Haberdashery and sponsored her for treatment at a voluntary B’Nai Brith (Krauss was Jewish) association for the disinherited. As a result the woman found out where he lived and began doing her military about-faces in his driveway.

He arranged for a blind date between his cousin, Annabelle, and an acquaintance from work.  The relationship worked well, and they got married.  It turned out, however, that the business colleague had a ‘hidden derangement’ and abused his cousin so often that she had to go to the police. She was able to obtain a quick and decisive divorce, but little did Fletcher know that she, too, was deranged, but in a different way.  She was congenitally impossible for her to forgive and forget, and she embarked on a personal vendetta against him which was to cost him thousands in legal fees, opprobrium and isolation by his neighbors, and untold job application rejections.

The moral of the story is that you do the best you can, always assuming and expecting whatever you did to come back and bite you in the ass.  So many rewarding personal relationships, family rehabilitations, and sexual adventures have turned out the wrong way, that we all should know better than to expect what we planned.  A Romanian doctor with relatives in France, blogged this:
Most of us are aware of a system that is in place in many parts of the world, where an old person with no family or relatives will employ someone for help / nursing until they die and then leave them their house as compensation.
In 1965, Jeanne Calment, a 90 year old French lady who had no heirs signed a contract of such kind with a 46 year old lawyer. He would get her house after her death, and in the meanwhile he would give her an amount of 2,500 francs monthly. Even if she lived to be 100, getting that house was still a very nice deal.
Except she lived a little longer. She lived to be 122 years, and had the longest (confirmed) lifespan of a human. The contract lasted for 32 years, she actually outlived the lawyer who died of cancer at 77, and his wife continued paying the 2,500 francs until the end, amounting to over $180,000, a lot more than what the house was worth.
 No such thing as a sure investment.

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