Anya Schiffrin Wed, 12 Feb 2014 21:56:55 +0000 en-US hourly 1 The French way of cancer treatment Wed, 12 Feb 2014 21:56:55 +0000

When my father, the editor and writer Andre Schiffrin, was diagnosed with stage four pancreatic cancer last spring, my family assumed we would care for him in New York. But my parents always spent part of each year in Paris, where my father was born, and soon after he began palliative chemotherapy at Memorial Sloan Kettering my father announced he wanted to stick to his normal schedule — and spend the summer in France.

I humored him — though my sister and I didn’t want him to go. We felt he should stay in New York City, in the apartment where we grew up. I could visit him daily there, bringing takeout from his favorite Chinese restaurant and helping my mother.

I also didn’t know what the French healthcare system would be like. I’d read it was excellent, but assumed that meant there was better access for the poor and strong primary care. Not better cancer specialists. How could a public hospital in Paris possibly improve on Sloan Kettering’s cancer treatment?

After all, people come from the all over the world for treatment at Sloan Kettering. My mother and I don’t even speak French. How could we speak to nurses or doctors and help my father? How would we call a taxi or communicate with a pharmacy?

But my dad got what he wanted, as usual. After just one cycle of chemo in New York, my parents flew to Paris, to stay in their apartment there. The first heathcare steps were reassuring: my parents found an English-speaking pancreatic cancer specialist and my dad resumed his weekly gemcitabine infusions.

My parents were pleasantly surprised by his new routine. In New York, my father, my mother and I would go to Sloan Kettering every Tuesday around 9:30 a.m. and wind up spending the entire day. They’d take my dad’s blood and we’d wait for the results. The doctor always ran late. We never knew how long it would take before my dad’s name would be called, so we’d sit in the waiting room and, well, wait. Around 1 p.m. or 2 p.m. my dad would usually tell me and my mom to go get lunch. (He never seemed to be hungry.) But we were always afraid of having his name called while we were out. So we’d rush across the street, get takeout and come back to the waiting room.

We’d bring books to read. I’d use the Wi-Fi and eat the graham crackers that MSK thoughtfully left out near the coffee maker. We’d talk to each other and to the other patients and families waiting there. Eventually, we’d see the doctor for a few minutes and my dad would get his chemo. Then, after fighting New York crowds for a cab at rush hour, as my dad stood on the corner of Lexington Avenue feeling woozy, we’d get home by about 5:30 p.m.

So imagine my surprise when my parents reported from Paris that their chemo visits couldn’t be more different. A nurse would come to the house two days before my dad’s treatment day to take his blood. When my dad appeared at the hospital, they were ready for him. The room was a little worn and there was often someone else in the next bed but, most important, there was no waiting. Total time at the Paris hospital each week: 90 minutes.

There were other nice surprises. When my dad needed to see specialists, for example, instead of trekking around the city for appointments, he would stay in one room at Cochin Hospital, a public hospital in the 14th arrondissement where he received his weekly chemo. The specialists would all come to him. The team approach meant the nutritionist, oncologist, general practitioner and pharmacist spoke to each other and coordinated his care. As my dad said, “It turns out there are solutions for the all the things we put up with in New York and accept as normal.”

One day he had to spend a few hours at Cochin. They gave him, free of charge, breakfast and then a hot lunch that included salad and chicken. They also paid for his taxi to and from the hospital each week.

“Can’t you think of anything bad about the French healthcare system?” I asked during one of our daily phone calls. My mom told me about a recent uproar in the hospital: It seems a brusque nurse rushed into the room and forgot to say good morning. “Did you see that?” another nurse said to my mom. “She forgot to say bonjour!”

When the gemcitabine stopped working, the French oncologist said he would put my dad on another drug — one my dad’s U.S. insurance plan had refused to approve in New York.

By this time, I had become a French healthcare bore. Regaling my New York friends with stories of my dad’s superb care in Paris, I found people assumed he was getting VIP treatment or had a fancy private plan. Not at all. He had the plain vanilla French government healthcare.

I had read many articles about the French healthcare system during the long public debate over Obamacare. But I still I hadn’t understood fully, until I read this  interview in the New York Times, that the French system is basically like an expanded Medicaid. Pretty much everyone has insurance, it explained, and the French get better primary care and more choice of doctors than we do. It also turns out, as has been much commented on, that despite all this great treatment, the French spend far less on healthcare than Americans.

In 2011, France’s expenditure on health per capita was $4,086, compared to $8,608 in the United States, according to the World Health Organization. Spending as a percentage of gross domestic product was 11.6 percent in France while in the United States it was a far higher 17.9 percent.

Last fall, my mother asked me to come and see their general practitioner in Paris so we could plan ahead for my father. My mom got an appointment for the next morning and we walked to the office, five minutes from my parents’ apartment. We waited for a half-hour on a comfortable couch, chuckling over the very French selection of magazines on the coffee table (Elle and Vogue) and admiring the lush garden view. The waiting room was quiet. I realized what was missing: There was no billing department.

We spoke with the doctor for about 45 minutes. My mom wanted to know what would happen when my dad was no longer able to walk. “Oh,” said the doctor, speaking in English. “I prescribe a wheelchair and it’s delivered to your house. Shall I do it now?”

When I asked the price, she looked surprised. No charge. She asked if we wanted someone to come to the house every day and it was my turn to look surprised. What would they do? For example, someone could come and give my dad a massage to alleviate his neck pain. Again, no charge.

At the end of the appointment, my mom pulled out her French insurance card. Total cost of the visit? 18 euros.

When my dad began to get worse, the home visits started. Nurses came three times a day to give him insulin and check his blood. The doctor made house calls several times a week until my father died on December 1.

The final days were harrowing. The grief was overwhelming. Not speaking French did make everything more difficult. But one good thing was that French healthcare was not just first rate — it was humane. We didn’t have to worry about navigating a complicated maze of insurance and co-payments and doing battle with billing departments.

Every time I sit on hold now with the billing department of my New York doctors and insurance company, I think back to all the things French healthcare got right. The simplicity of that system meant that all our energy could be spent on one thing: caring for my father.

That time was priceless.


PHOTO (TOP): A pharmacist selects drugs for chemotherapy treatment in the pharmacy at Antoine-Lacassagne Cancer Center in Nice, October 18, 2012. REUTERS/Eric Gaillard

PHOTO (INSERT 2): An intravenous dose of Lambrolizumab during a promising cancer treatment clinical trial at UCLA Medical Center in Los Angeles, California, August 19, 2013 REUTERS/David McNew

]]> 9
Why we put up with the Davos whirlwind Tue, 22 Jan 2013 17:53:53 +0000 Thomson Reuters finance columnist Felix Salmon once noted that there is an inverse correlation between how important you are and how much time you actually spend at the World Economic Forum in Davos. Film stars, heads of state and the likes of Bill Clinton swoop in, speak on a prestigious panel, take a couple of important meetings and fly out within a day or two.

Things are very different in our house. After months of rending of hair and gnashing of teeth over the size of our invitation stack, we typically rock up on Monday or Tuesday, stay for the duration and tear ourselves away on Sunday afternoon after the black-tie gala; in 2011 there were all-you-can-eat Indian hors d’oeuvres and free shawls for everyone. While in Davos, we partake of everything we can: the pork-fat canapés at the Victor Pinchuk lunches, watching Imran Khan at the after-hour parties, attending university nightcaps (note to Columbia: please find a venue with at least one chair). We always drop by the Indian Adda in the Café Schneider for a cup of chai and, time permitting, we sign up for the free snow-shoeing lesson.

Our enthusiasm stems mostly from the fact that it’s so hard to get to the snowy alpine town, and economists believe in amortizing their expenditures (although you could look at the time on the Davos airport bus as a sunk cost). The other reason we stay so long and do so much is, frankly, we are comped, and so, as good guests, we want to make sure my husband is available to speak on whatever panels the WEF assigns him to. These can be pretty obscure. As I recall, we drew the line one year when they asked him to speak on a panel about parenting. You could say my husband is singing for his supper, but only if you count being gloomy about the world economy for the last eight years as singing. In any case, he can never resist an opportunity to talk about how dismal things are, and the joy of Davos is a sympathetic and captive audience that is actually interested in economics.

Six days in Davos means nearly a week of sliding on the icy Promenade, getting up at 1 a.m. New York time for breakfast sessions, not seeing any fresh vegetables, and spending up to 18 hours a day either taking off your winter coat, scarf, gloves, shoes and hat while standing on the security lines or sitting around stuffy, hot conference rooms. I know we are lucky to be invited, but as I ease into middle age, it becomes increasingly exhausting. For staffers and orange-badged members of the press, the Davos experience is even more tiring, as it involves trailing after the VIPs and constantly being told that you are not allowed in the panels and certainly not in the special lounge where seafood platters are served to the Davos 1% — wealthy businessmen who pay for the privilege.

So it is with longing that I and many Davos-goers trade stories of the people who don’t show up to most of the events. I’ve heard of college professors who spend the day writing and only go to a couple of sessions and of industrialists who hold court  in their hotel rooms and have people come to their suites for different meetings every half hour. I gasped with envy one year when I was told that a few years back, legendary foreign affairs pundit Fareed Zakaria stayed in neighboring Klosters and had people come to him (although this year he has been sighted on the premises in a cunning pale blue sweater). Zakaria was apparently ahead of the curve, as the word now is that many businesspeople have taken Davos off piste and spend the week in Klosters without ever making an appearance at the conference center.

Will we ever rise to this admirable level of sangfroid, waltzing in at 11 a.m. and taking a devil-may-care attitude to the prospect of bilateral meetings and luncheon invitations? I am afraid not. I suspect we will be toiling away in the conference center for years to come. See you at the metal detector.

PHOTO: A man cleans inside the Congress Hall of the World Economic Forum (WEF) at the Swiss Alpine resort of Davos January 22, 2013. REUTERS/Pascal Lauener

]]> 1
The tide goes out in Spain Thu, 27 Dec 2012 15:44:26 +0000 In his entertaining lectures at Columbia Business School, the economist Bruce Greenwald likes to employ cite the line often used by Warren Buffett: When the tide goes out, you can see who is not wearing a bathing suit. This is the feeling I have in Spain. In year five of the financial crisis, I can see which of my relatives and friends had no swimming trunks. The slow downward slide is horrendous for the people living it. Over and over we see the bewilderment of those who worked hard and paid taxes. They don’t understand why they are seeing their first-rate healthcare system being undermined, pensions and salaries cut, and their education system — still not up to par — being squeezed further, while being told they have to bail out the banks because that is what Germany insists on. The downturn is persistent enough that the country’s largest bookseller, Casa de Libro, had a shelf dedicated exclusively to books about the “crisi” (see picture).

Spain under Francisco Franco was often referred to “la vida en blanco y negro,” or life without color, because it was so grim and gray. Franco’s departure showed the pent-up energy and creativity of the Spanish people. It was but a short time before the economic disparity between Spain and the rest of Europe — large even before Franco but a yawning gap in the years of his dictatorship — dwindled. Barcelona, for instance, became a global center for design.

In this harsh new world, many people are now irrelevant to the daily functioning of the economy. Architects, graphic designers, book jacket designers–-these kinds of professions now seem like a quaint memory. No one needs them, and the fear is that, if and when the economy recovers, many won’t be needed then. The few friends who have jobs live with the threat of layoffs and repeated pay cuts.

In this new environment only the fittest survive. I’ve noticed that people writing about Spain tend to bring in their cousins as evidence for whatever point they want to make.  Well, two of my Madrid cousins didn’t go to college. They wound up in Amsterdam. One washed dishes in a hotel and the other sang on the street for change. Their mom was kicked out of a rent-controlled apartment in Madrid and now lives with a passel of other unemployed relatives in an old family house in a tiny town outside Seville. No heating or air conditioning, no car, and it’s a 20-minute bus ride to go get groceries. They would love to offload this white elephant, but no one is buying. Another friend inherited her mom’s apartment and before the crisis had the bright idea of buying a few fixer-upper apartments. She would spruce them up and resell them once the neighborhoods gentrified. We warned her not to buy more than one or two, but who listens to friends? Besides, in the days of the real estate booms in Spain and Ireland and the U.S., who could lose money investing in real estate? The naysayers were losing out on the opportunity of a lifetime!

She put down deposits on three or four apartments. Five years and multiple lawsuits later my friend (in her sixties) has lost everything. The good news is that after looking for a year she found a poorly paying office job.  “I don’t feel sorry for myself. I have food on the table every day, and that is more than many people in this country have now,” my friend said.

Where are the bright spots? Her daughter studied in Brussels and Germany and speaks multiple languages and now works for an international company. My friend Borja has set up a little business that writes memoirs for older people wanting their families to know about the past. If that isn’t a metaphor for Spain’s fate, then I don’t know what is. Happily, Borja reports that he has a regular stream of customers.

Of course, we can blame those who didn’t invest in their future, or who thought there was a free lunch in a real estate boom. Those who did the “right thing” and are managing can be smug — until they realize there are many others who did the seemingly right thing who are suffering. The hollowing out of Spanish society continues. Anyone who can leave is doing so, and so Spain is losing the educated people it needs the most and who would be the basis of its future prosperity — if and when it does recover. The existence of a few bright spots does not mean that Spain’s economy is functional.

In the past, life was full of vicissitudes. Farmers always had work to do, but droughts, collapsing prices, disease, floods could leave them destitute — no matter what they did or how hard they worked. Markets didn’t provide the insurance that would insulate them from these risks. As we moved from these primitive economies, the nature of risks changed. Now, it is individuals who face the prospect of no employment. Governments need to step in and provide the kind of social protection that people want and need. We can’t simply throw up our hands and say we accept a society in which the only people who get jobs are those with MBAs who speak five languages. When a few kids can’t get jobs, it’s not unreasonable to blame them:  They didn’t study hard enough, they chose the wrong subject, they haven’t searched hard enough for a job. When half of a country’s young people are unemployed, it’s no longer their fault.

Let’s be clear. Spain’s economy is in terrible shape and the reckless and irresponsible path of austerity the government is pursuing — a kind of austerity that is especially hard on those who are down and out — is already leading to social and political tensions and constant strikes and demonstrations. After all these years, it is astonishing that the Partido Popular has not learned a thing.

PHOTOS: Anya Schiffrin; Demonstrators march towards the Spanish parliament during a protest against the government’s austerity measures for the 2013 budget in Madrid December 20, 2012. REUTERS/Susana Vera

]]> 9
The end of the world in the heart of Mayan country Thu, 20 Dec 2012 22:01:35 +0000 Although the Russians and the Chinese are reportedly fretting about the end of the world tomorrow  — according to an interpretation of the ancient Mayan calendar — down here in the Yucatan, which was part of the Mayan empire, the locals couldn’t care less. Nor does anyone in Mexico City seem to notice. They are too busy thinking about what the new government is going to get up to. With its candidate, Enrique Peña Nieto, sworn into as president on Dec. 1, the Institutional Revolutionary Party (PRI) is back in power after 12 years out of office.

The new president is known in Mexico for a) being married to a famous soap opera star and b) not being able to answer when he was asked at the Guadalajara International Book Fair to name three books that had influenced his life. After mentioning the Bible, he blanked out and apparently could not remember the details of anything else he had read. He has, however, brought in young talent from the party’s lower ranks, and we met some of these officials in Mexico City last week. As in the Egyptian revolution, many in this group are elites who have been educated overseas. But instead of protesting in the streets, they paid their dues, waited patiently for their turn. Now they are raring to introduce reforms. The major parties have already come together to agree on a list of priorities, taken on the teachers’ union and pushed to give private capital access to the massive, state-owned oil company Pemex, which has been faulted for a decline in production over the past eight years. Included on their to-do list is tax reform; a complete overhaul of Pemex; improving education; introducing new technology to speed up the export of goods to the U.S.; and increased cooperation with like-minded Latin American countries.

In short, the new government is in full-blown honeymoon mode (although no one we saw mentioned fighting poverty or drug trafficking). We’ll see what gets accomplished.

PRI supporters argue that their party can get things done because it ruled for so many years and has an entrenched network across the country. It’s a strength that resonates in the Yucatan, a state that is still fairly old-school. But while more Mexicans are now focused on the next chapter of the country’s political life than on the end of the world, here in the Yucatan there are more practical reasons to be interested in a modern misinterpretation of a centuries-old calendar. Tourism is a major part of Yucatan’s economy, and the Dec. 21 festivals at the pyramids of Chichen Itza are expected to draw everyone from Burning Man enthusiasts to professional crystal readers and pierced teenagers whose primary source of knowledge on Mayan culture is Mel Gibson’s Apocalypto Locals have been regaling us all week with the tale of the Italians who, expecting a flood, built condos on the highest mountain peak they could find.

In addition to fretting foreigners, there are plenty of homegrown New Age types, including the autodidact Alberto Haggar, who sprinkles his lectures on Mayan cosmology with power points of sudoku puzzles, references to geometry, dismissals of global warming and a complaint about the number of drugstores that have opened in Merida in the past decade (4,000!). Haggar informed us that the world will soon start spinning in a different direction, as he said it has twice before, but noted if we all meditate together the next world will be a new reality with equality for woman. Not all bad, in other words.

Haggar and his ilk will be hanging around Chichen Itza on Friday, and traffic is expected to back up for miles. The local paper, La Verdad, which uses quotation marks when referring to “the end of the world,” reports that the government is planning extra security measures, including military patrols, in all five Mayan areas. Ticket prices for tourists are also being jacked up, which seems fair given the dozens of dance spectaculars, lectures, tree planting ceremonies, craft and food markets, conferences and book parties organized by the government. Subjects include Mayan astrophysics, death rituals, ancestry and food. Controversial Guatemalan activist, writer and Nobel laureate Rigoberta Menchu flew in over the weekend and called for the world to try to understand the potential for the Mayan culture to help bring about global harmony. I somehow managed to miss the parade of buggy carts in Izamal and a performance of a play in Merida called How to Find a Boyfriend. The events on offer are enticing, and I wish I could stay for weeks.

If I can get away from my stepchildren, I’ll see you tonight at the Mayan Ball Game — no decapitation allowed.

PHOTO: A man in Aztec warrior costume dances in front of the Pyramid of Kukulkan at Chichen Itza in Yucatan state, December 20, 2012. The archaeological site of Chichen Itza is expected to receive approximately 30,000 people on 21 December, almost twice that in the spring equinox on March 21, according to the Institute of Archaeology and History. REUTERS/Victor Ruiz Garcia

]]> 1
Austerity and the new Spanish poverty Mon, 24 Sep 2012 16:19:25 +0000 During the parts of my childhood I spent in Spain in the sixties and seventies, life was what we call “de la vieja escuela,” strictly old school. My grandmother and her sisters, who were all widows or spinsters, had money left from their husbands and fathers but lived frugally. Ice cream (not artisanal but bought from the kiosk on the corner) was a treat for Sunday lunch. My great-aunt Clementina left an embarrassingly cheap 25-cent tip whenever she took me for an afternoon snack of hot chocolate and churros (fried dough). The same old leather address book sat by the phone in the living room for decades until it was all worn out, and even then no one saw the need to replace it.

I thought those days were over, but now every time we go to Spain we see the slow-motion unraveling of a world that was built after the end of the dictatorship that Spain lived under for nearly 40 years. With 50 percent youth unemployment and 24.6 percent general unemployment there is no hope and no end in sight. I no longer remember when the crisis began to hit the careful middle class that I grew up knowing, and the literary and artistic types I lived with in Barcelona in the exciting years after General Franco died.

First to go were vacations abroad, then it was buying clothes and eating out. Friends who had apartments left to them by their relatives tried to rent them out or sell them, but there were no takers. They moved in with each other to save money. They moved to the suburbs because it was cheaper. About 18 months ago, my friend Ana told me they had come up with a wonderful idea: Once a month her friends would come over and bring a dish, and they’d all watch a DVD together. It sounded like fun until my husband pointed out: “That means they don’t go to the movies anymore either.” Last June in Barcelona, Ana said: “We know none of us will work again. What we worry about is the young people. All those 20- and 30-year-olds living at home with their parents.”

It’s hard to imagine it getting worse, but it is. Here is a new trend: restaurants that don’t serve food but provide cutlery and a plate and reheat the lunch that cash-strapped office workers bring from home. Every day last week when we went out to eat in Barcelona or Madrid we found some previously ubiquitous food item was no longer available. Could we order a slice of the kind of ham that used to hang from the ceiling of every self-respecting bar in the country? All out. A glass of sherry? Nope. The bottle was finished and was not replaced. In a crisis like this, it’s not worth restocking.

The mood has changed dramatically in the last few months. The 2011 elections gave everyone a chance to vent their anger: They threw out Prime Minister Zapatero and the Socialists – blaming them for not doing more to fight the recession, and brought in Mariano Rajoy and his conservative Partido Popular. But as long as Spain remains in the euro, there is little to be done. The German politicians who demand austerity for Spain are accountable not to Spanish citizens but to the German electorate, and the Germans treat Spain as if it were Greece, as if it had been profligate – when in fact, before the crisis, Spain had a surplus and a low debt-to-GDP ratio.

It is easy to sit in Brussels or Berlin and pontificate about lazy southerners who don’t work long hours or pay enough taxes. But seeing what Spain has become is another matter. One of my favorite propaganda posters from the Spanish Civil War was a 1930s-style picture of a red mailbox with hands thrusting letters in to it. The caption read something like “tell the world about Spain.” Before pushing for harsh policies, it’s a good idea to listen to the stories told by the people who must live with economic austerity plans.

PHOTO: A man looks through the window of a store announcing a closing sale in central Madrid, September 24, 2012.  REUTERS/Andrea Comas

]]> 10
Electricity comes to an impoverished Mozambican island Thu, 26 Jul 2012 22:19:06 +0000

Antiquated electricity generator on island of Ibo, Mozambique

On a recent visit to the remote Ibo Island in the Quirimbas Archipelago in northern Mozambique, we were struck by the island’s stunning views and the soft white-sand beaches, the mangrove swamps and the wooden dhows that have plied in the Indian Ocean for decades. Beautiful though it is, the island is poor, and few people live there. The island has been abandoned many times throughout history, and cries out for more development and for businesses to come and turn the crumbling colonial-era buildings into boutique hotels, cafés and craft shops. Some are optimistic that recently discovered energy reserves will boost the island’s fortunes, but our timing was perfect to witness a smaller revolution: the arrival this spring of electricity.

We dropped by the spanking new Pasteleria Bela Horizonte on the main street to buy the fritters known locally as mandaze and find out how the arrival of electricity had affected the bakery’s business. Owner Assina Nmnuarkha surveyed the tidy seating area of plastic chairs and tables in her café with pride. She pointed to the refrigerator in the corner filled with soft drinks and then, pointing behind the counter, she broke into a wide smile: “Now we can watch television!”

“When the government came to make the announcement, we assumed it was the usual lies and promises,” said shopkeeper Abdel Ismail Musa, speaking in Portuguese through a translator. “But they put it in quickly, and we were so happy.” Leaning on the counter of his little shop, which stocks an array of speakers as well as skin creams, machine-washable diapers and hair ties, Musa said he had recently sold a large television set.

There is still the decrepit-looking generator that has sat in the main street of Ibo’s colonial, or “cement,” town for decades. According to the town elder and de facto local historian, João Baptista, the administrator governing the island had been given enough money from the government to buy a new one but instead kept half of it and bought a generator “from the colonial times” from another Cabo Delgado district. “It worked well only for three days, and then it malfunctioned,” he said.

Baptista, clad in sunglasses and a navy blue pajama top from British Airways’ first class (possibly donated by a passing visitor), sat on his porch one afternoon and told us a bit about the history of the island. He joked that in the Portuguese language, IBO stands for “Well Organized Island”. It was a port for the slave trade, and other trading, along the Indian Ocean coast and then run by the Nyassa Company during the days of colonialism.

Because the generator barely worked, the town’s administrator only turned it on for special occasions. Mozambican novelist João Paulo Borges Coelho, whose grandparents lived on Ibo, remembers that the generator was only turned on once a year for the Dia de São João, the patron saint of the island. Others remember the clunky old machine was turned on to light some houses and the town’s unpaved streets during Ibo Island Day on June 24 and Mozambique’s independence day on June 25.

Lack of electricity is a theme in New Yorker writer William Finnegan’s classic work about the Mozambique war between Frelimo and Renamo that was supported by South Africa and lasted from about 1975 to 1994. In one of the more memorable passages about his visit to the town of Beira (about halfway down the long coast of Mozambique) Finnegan wrote:

The Hotel Dom Carlos had its own generator, but that failed sometimes too. In the elevator, the thick glass panels on the doors had been smashed by desperate passengers trapped by power failures. When I mentioned this eerie sight to a Beiran, he said I was crazy to get in an elevator anywhere in the city. Even aging asthmatics who worked on the tenth floor in one of the downtown high rises that still had a working elevator used the stairs.

Since Ibo was not on the grid, some businesses bought generators, and some people had battery-powered radios and used solar power to charge their cellphones. The few that had televisions might charge neighbors a few pennies to watch sports, and the local disco was also known for letting local children and some others (mostly men) watch Kung Fu movies free of charge in the afternoon.

Apart from the opportunities afforded to a few local entrepreneurs with television, not having electricity was a sorry state of affairs. The administrator who was in charge of electricity reportedly had her own generator and a thriving sideline selling fresh fish, as she was the one person on the island who could keep it cool and transport it to the mainland. The local fishermen couldn’t afford to get to the mainland, so they had to sell her their fish to reach the larger markets outside of Ibo.

Given Ibo’s history it’s not surprising that it would be among the late entrants to the modern world. Ibo had been part of the Swahili-speaking coasts that included East Africa and, though much less developed than Zanzibar or the Kenyan island of Lamu, the port of Ibo was a center of slave trade. When the Portuguese expanded their hold in the late 19th century, the Portuguese government was too poor to fund its own colonial ventures, so it outsourced its exploitation to the Companhia de Moçambique and some small regional companies.

The public-private model of imperialism is not dissimilar to the British model that originally gave the East India company the right to dominate India. The Companhia de Moçambique essentially enslaved the locals, forcing them to sign spurious contracts and work in the local mines and plantations. The Portuguese were terrible farmers who failed to clear the land properly and did nothing to help Mozambique improve agricultural productivity or introduce modern farming techniques. Although neglected, Ibo was, luckily, too far out to be caught up in the war that ravaged Mozambique for decades.

With this colonial legacy and years of civil war followed by a socialist planned economy, it’s not surprising that today Mozambique is one of the poorest countries in the world. But the country is optimistic about the discovery of new natural gas and coal reserves.

As always, the question is whether the new riches will be shared with the people or stolen by the few. It’s not clear what jobs the new gas development will create for the locals of Ibo. The island has had development projects over the years, including support for schools, restoration of colonial-era buildings, help for traditional silver craftsmen and some scholarships. Some Portuguese have bought and restored a few houses on the island. But the most visible impact comes from the few hotels that create jobs for the locals – island men who work as waiters and also as guides for the many cultural and historical walking tours around the island, the dhow trips and an unforgettable hike we did at low tide through the mangrove swamps to eat fresh fish on a neighboring island. These efforts are not enough, but the arrival of electricity is a start.

The effects this spring were immediate. More bars and restaurants began to open. With the fish monopoly broken, traders could keep their catch cool and sell it for higher prices. Shops now stock ice lollies for the children, and the dilapidated schools have three shifts a day and stay open till 8 p.m. or 9 p.m. Routines are also slowly changing. Ibo islanders used to get up at 4 a.m. and go to bed early. Now they stay up later, socializing and watching television. Another benefit is more dancing, explained our tour guide Cosmo: “Disco means a lot to the people of Mozambique.”

We flew to Ibo from Pemba, which is already starting to feel a bit like a frontier boomtown as oil workers and engineers mingle with the usual NGO types and honeymooners at the hotels and restaurants (“It’s like a Graham Greene novel,” my London-based nephew said). At the airport, the Italian oil and gas company ENI has its own check-in counter, which was in full use the day we were there.

The extractive sector is notoriously bad at creating jobs, but at least the foreign oil workers are spending money and locally by staying in hotels in Pemba and eating at restaurants there. What the environmental impact of the increased gas production will be is not clear.

Getting solid information about the impact of the energy boom is not easy. Meeting with journalists in Maputo we talked about the role of the media in keeping government and business honest. Many of the journalists in Mozambique face the usual problems: lack of understanding of technical subjects such as tax regimes and production-sharing agreements; little funding, which means they cannot afford to visit the areas affected by the gas and coal extraction; and pressure from government, advertisers and owners not to report on sensitive subjects.

The press and the NGO community, including the Maputo-based Center for Public Integrity, will have to keep up the pressure to make sure the government gets a good deal from foreign companies and that the resulting wealth is used wisely and shared fairly. For its own sake, Mozambique needs to get it right and avoid the example of neighboring Angola. For a start, jobs, new roads and better schools and hospitals would help the people of Ibo Island.

PHOTO: Anya Schiffrin

]]> 0
Tunisia’s Arab Spring turns to anxious summer Fri, 06 Jul 2012 17:53:47 +0000 We visited  Tunisia last week, during a scorching heat wave. The women we met were wearing sleeveless summer dresses, but a couple of them said that when they go out, their neighbors now tell them off for wearing revealing clothes. With the religious Nahda party now in power, uncovered women worry that their daughters won’t be able to wear bikinis and wonder which countries their daughters can move to if things get worse.

Tunisia is where the Arab Spring began, but the stories we heard reflect the larger sense of uncertainty and debate about how to have a democracy in a place where the word means something different for everyone. Another sign of tension was the Tunisian court decision last week to uphold the seven-year sentence given to a Tunisian who posted a cartoon on Facebook depicting the Prophet Mohammad in the nude. This small country faces stresses and strains as it continues on its path away from the dictatorship of Ben Ali.

The uncertainty means that progress sometimes feels slow. Many of the country’s institutions – the Central Bank, the state-run TV station and the Ministry of Interior – are staffed with the same civil servants as before the revolution, and many of the judges remain from the old days, so not many people trust them. What do you do when people need jobs – and there is massive unemployment – but many of the major businessmen in the country were linked to the dictatorship? How do you reform the media, which acted as a mouthpiece for the government? How do you transform the state-run television station into a public service broadcaster? And what steps can everyone agree on?

In the years before the Revolution, the media were highly controlled, and Tunisia consistently scored at the bottom of press freedom rankings. Now, there is a lively and raucous press with new publications, websites and TV stations. But journalists don’t know where the boundaries are. “We feel like we are walking on a cloud, and we don’t know what are the limits,” one journalist said to me. The National Authority for the Reform of Information and Communication (INRIC)  met over the last year and in April released a lengthy report filled with recommendations. It was chaired by human rights activist Kamel Labidi, who has studied cases of media transition in countries as diverse as the Czech Republic, Spain, South Africa and Poland. INRIC wants to see the new proposed media implemented and is planning to lobby the government and the Constituent National Assembly. “INRIC will publicly make it clear that it has no intention to remain ‘in business’ in the absence of a genuine will on the part of the government to help bring the country’s media into conformity with international standards for Freedom of Expression,” Labidi says.

Transforming the media after years of authoritarian control involves many different elements. New media laws should protect freedom of expression and allow journalists to report without the threat of jail. The defamation and libel laws need to be repealed or changed so that journalists aren’t imprisoned for reporting on public figures. The old rules requiring licensing of media outlets and government permission for the import of newsprint need to go. Journalism programs at universities are often out of date, highly theoretical and ideologically charged, so the curriculum has to be transformed. Typically in moments of democratic transition there is tremendous interest in news, and new media outlets arise (for example, France after World War Two, Ghana after Jerry Rawlings, Spain after Franco, Burma today) – but then can’t get enough revenue and eventually close down. Exiled journalists may want to come back, but the people who stayed sometimes resent them because the exiles missed out on the hard years at home. The new journalism is lively and passionate but often gossipy and short on facts, as there are not enough experienced professionals to staff the new outlets that have opened. The new chaos sounds normal enough to people accustomed to democracy, but it can feel excruciating for those accustomed to the order of the old ways.

Of course, the media are a microcosm of society. The reforms needed in the media sector resemble those necessary in other parts of the government. But during transition, media issues don’t always seem to be the most pressing: When unemployment is high and the economy is weak, media reform is not viewed as urgent. And as always, questions of gender are on the front lines in the larger debates. Banning pornography can be a backdoor way of controlling freedom of the press.

As the women we met kept telling us, sometimes the problems of women in a Muslim society and the problems of media freedom are combined. A communications professor who lectures on Jean Baudrillard and Jacques Derrida described to me his experiences at Manouba University, where Salafists spent the last year disrupting the campus as they called for the female students to have the right to wear the niqab. A woman came into his class fully covered, and he told her that in his class he has to see his students, that people who can’t be seen don’t exist. She lifted her veil to reveal her eyes, but he told her it was not enough – that she needed to be uncovered. “We faculty met every day” throughout those difficult four months, he said. “We took minutes, and we called lawyers.”

Dean Habib Kazdaghli of the Faculty of Letters, Arts and Humanities tried his best to resolve the ugly situation at  Manouba, but the underlying tensions are much larger than the turmoil on one campus. There is anxiety on all sides, but Tunisians’ willingness to debate and discuss is encouraging. Let’s hope that the new Tunisia – the place where the Arab Spring began – can remain an example of a relatively harmonious and peaceful transition, and a model for the rest of the world.

PHOTO: Hundreds of jobless graduates protest against unemployment outside the Parliament building in Tunis, July 2, 2012. REUTERS/Zoubeir Souissi

]]> 1
Can Bhutan become like other countries – and should it? Tue, 12 Jun 2012 18:51:26 +0000 On our way to Bhutan’s capital earlier this month we drove through a long valley surrounded by tree-covered mountains. This magnificent scene of natural beauty was dotted by the occasional Buddhist chorten. A  river rushed below – spanned here and there by a shaky pedestrian bridge made of planks and wire draped with prayer flags.

After this uplifting drive from the airport, it was a bit of a shock  to see downtown Thimpu surrounded by half-finished four- and five-story buildings. We passed 2 miles of frozen construction sites that resembled Bangkok after the 1997 economic crisis, when parts of that city became a ghost town. In Bhutan’s case the housing bubble has not yet burst, but the demand for raw materials from India has been so enormous that the country now has a temporary rupee shortage and has restricted imports of construction materials.

New York’s Mayor Bloomberg is probably not famous among Bhutan’s citizens, but he might be pleased to know they have some ideas in common:  Bhutan fines people for smoking in public and has banned the importation of cigarettes for resale. The Bhutanese recently added an extra tax on non-essential imports: cars and foreign junk food. As a result, construction seems to have slowed. But the shacks of the Indian laborers who do the building in Bhutan remain, sometimes screened from public view by a green fence. “We are building proper housing for them,” a government official promised.

Many economists, including my husband, are not worried about the rupee shortage, because Bhutan has about 740 million dollars in U.S. dollar reserves – an amount relative to its GDP that puts it in the same league as China, according to International Monetary Fund data from December 2010. Curiously, while Bhutan has been borrowing to buy rupees, paying an outrageous 10 percent interest, it has essentially been lending to the U.S., getting back close to zero return. It can easily sell off some of its dollars to pay back the rupee-denominated loans. Fixing the problem is largely a matter of better liquidity and portfolio management. Hard-currency shortages are common in import-dependent developing countries with overvalued exchange rates and dwindling reserves, but not in a country with large reserves.

Nonetheless, the rupee shortage has worried many Bhutanese, and the press has been warned by the government not to refer to it as a “crisis.” “I need to think of my grandmother in the village,” said one Bhutan Broadcasting Service reporter when describing his reassuring evening news coverage.

The construction boom and migration into the capital come from the success of the government’s development policies. The Royal Government of Bhutan, as it is officially called, provides free healthcare and education, and has dramatically raised life expectancy. So it is producing a healthy, educated generation that doesn’t want to stay down on the farm. Because the country is so mountainous and the villages so remote, life is hard. Growing vegetables and transporting them is difficult, so a lot of produce comes from India. Until a few decades ago there were no roads or cars, and people walked everywhere. Everyone above 40 has a story to tell. We met an official in the town of Punakha who told us that when he got into college in Thimpu, he and his uncle walked 17 days to get there. His uncle rested one night in Thimpu and then walked back home. Another told us of the time his father took him to boarding school in Darjeeling. There was nowhere to stay or eat on the way, so they packed the family horse with supplies and rode a week to get to school.

Even now, some children in remote areas walk up to two or three hours each way to school, and when they get where they’re going, they often find their feet are swollen and their legs covered in leeches. “It’s easiest to let them feed and then they drop off,” a government official told me. As we’ve traveled around the country we’ve seen the Bhutanese walk everywhere. One morning we saw a smiling group of families with small children on their backs walking up the side of a mountain. It was explained to us that a mobile health clinic was visiting and the village headmen had told the parents to bring their children in for medical checkups. When the program first started, families were offered cooking oil or other gifts to encourage them to go. But now they see the importance of medical treatment: Villagers bring a picnic, strap babies on their mothers’ backs, and make a day of it.

Understandably, the younger generation rejects the hardships of the countryside – beautiful though the scenery and simple way of life are. The trouble is that there aren’t enough white-collar and civil-service jobs to go around, so the Bhutanese government is trying to think of ways to make, for example, employment in the construction sector more appealing to unemployed Bhutanese youth. Their plans have not yet succeeded, and there are an estimated 60,000 laborers (mostly Indian) in Bhutan doing backbreaking tasks like moving rocks from the river and chipping away at roads, eventually sending home remittances. As for jobs in other sectors, there aren’t many choices. Tourism, agriculture and construction are the main areas for employment, and the new hydroelectric power plants being built to sell power to India will bring in rupees, but not create many jobs.

There is much discussion about the unemployed young, urban Bhutanese. There are reports of gangs, knife fights and violence in the capital. A country of unity, hierarchy, deference and outdoor traditions such as archery, Bhutan is figuring out what the new world of handheld games, the extremely popular local version of American Idol, Facebook, and celebrity culture means for their society. The older generation decries consumerism, litter, and the lack of discipline among the young and speaks of the values enshrined in the Gross National Happiness framework introduced by His Majesty the 4th king in 1972. The government supports television and filmmaking in the local Dzongkha language. It’s also trying to work out whether it’s ready for detailed right-to-information laws and whether it’s time to start cutting back on advertising in local newspapers. There are now about a dozen papers, and since their circulation is low, they rely on government advertising for survival.

The young people show a respect for authority and a deep interest in the future of their society, but when it comes to GNH, they express their skepticism online as well as in conversation: “There are people who are so poor that they must walk one day to get water. For those people it is a bucket of water that is GNH. For the politicians GNH is air-conditioning and a new house,” a young teacher told me.

The Bhutanese love to tell stories about themselves, and a common theme is their encounters with modernity. Here are a few of my favorites (none are independently verified):

  • To join the United Nations, Bhutan needed to have a population of 1 million; so they put it down on all the forms, and a few officials flew to New York and stayed with friends until they were accepted. Today the current population listed as a more realistic 600,000, but no one is certain, and it’s likely that many of the original U.N. reports that mention Bhutan are incorrect due to their creative accounting.
  • A former newspaper editor says Kuensel newspaper (the country’s oldest) used to print an astrological calendar that listed which days were auspicious and which were not. The religious Bhutanese began canceling their travel plans on inauspicious days, and so Druk Air, the national carrier, called the paper to complain. The same former editor says that the first classified ad Kuensel ever ran was from a yak herder who wanted to swap a yak for an enhanced crossbow.
  • A small-business owner we know describes the electrification of his village. Each month the bill collector came to be paid, and his visit turned into a social event for the village. The businessman’s aunt was so careful about turning on her light that her bill only came to 3 cents a month, causing great merriment among her assembled neighbors.
  • A newspaper editor I met described how the country got its first radio station: After the first gulf war, the central bank of Kuwait was burnt down, and the Kuwaitis had no idea who owed them money. The Bhutanese were the first to stick up their hand and repaid everything they had borrowed. The Emir of Kuwait was so grateful that he sent a BMW to the king of Bhutan. His Majesty thought the gift was too extravagant, so he sold the BMW and used the money to start Bhutan’s first radio station.

These tales, cute as they are, show the Bhutanese are trying to fit together old ways and new customs as they find their place in the world. Influences from India, Tibet, Nepal and even Singapore help shape Bhutan, but the country is trying to see how it can forge a new identity based on some of its old values. It’s a fascinating exercise in consensus building. As an outsider I am rooting for conservation of nature and the traditional style of architecture with its bright, painted buildings. The traditional clothes, soft-spoken courtesy and generosity of the Bhutanese are also treasures to be guarded. But as the Bhutanese tread carefully, how they find their way in our brave new globalized world is ultimately a decision they will have to make on their own.

PHOTOS: A statue of Lord Buddha is pictured at Kuensel Phodrang in Thimphu, May 20, 2012. REUTERS/Singye  Wangchuk Buddha statues are pictured from the Druk Amitabh Mountain monastery, locally known as White Monastery, on the outskirts of Kathmandu, February 11, 2011. REUTERS/Navesh Chitrakar

]]> 1
A Chinese view of Savannah Thu, 19 Apr 2012 15:51:44 +0000 A recent New York Times story about high-end U.S. retailers like Saks Fifth Avenue, Bergdorf Goodman and Tiffany marketing directly to wealthy Chinese visitors reminded me of some of the extreme Chinese shopping I’ve witnessed in Europe. Stopping in the Zurich airport branch of Sprungli on my way home from Davos, I saw a Chinese man (who spoke no English at all) spend $900 on Swiss chocolates. Offered a free taste by a saleslady as a courtesy for buying so much stuff, he waved it off. Apparently he was not actually a chocolate lover but just buying gifts for some lucky friends. On the tube in London I saw Chinese women en route to Heathrow with the most enormous Louis Vuitton shopping bags and clocked the resentful glances of their fellow passengers. It reminded me of how Americans abroad used to be rich and universally loathed.

While Chinese tourists in the 1 percent may be living large, for those in the 99 percent travel is often less luxurious. Evan Osnos’s clever piece in the New Yorker last year described his trip on a tour bus with a group of Chinese rushing through Europe and eating Chinese food. A Chinese friend once admitted to me that she regretted missing out on Italian food during an organized tour through Italy; in Peru a tour guide told me that the Chinese were famous for bringing their own food. Clearly there is an opportunity here for a canny tour operator, and based on my last weekend in Savannah I’d like to suggest that Charleston, Savannah and New Orleans be added to the list of must-sees for the nouveau Chinese tourism market.

After my trip to India with my parents last November went off mostly without a hitch, I was ready to travel with other people’s parents. So when my young friend Dandan announced that her mom – who teaches at the Shanghai Maritime Engineering College – would be making a maiden voyage to the U.S. in time for Dandan’s graduation from Columbia, I invited them both on a girly weekend I had planned with Nguyen To Hong Kong (another Columbia student I spend a lot of time with) as a last treat before the two young women graduate and leave the U.S.

The ladies took an energetic approach to Savannah sightseeing, and we went through the guidebook at a rapid pace. No stone was left unturned, including the carriage tour of the stately, tree-lined squares, the tours of the old houses and the torpid alligators in tanks at the Crab Shack (too lazy to even open their mouths to eat the “treats” offered by tourists).

Adding to the amusement was the homespun commentary provided by Dandan’s mother and translated by Dandan as her mother does not speak English. (Dandan’s mom is named Hong, but is no relation to Hong Kong.) Hong’s name means red, and her sister was named “blue.” “My parents have no imagination,” Hong said, explaining that her enterprising sister changed her name to “intelligence.”

Here are some of Hong’s views on the Savannah highlights she enjoyed:

Breakfast grits at Goose Feathers Express Café & Bakery: “My congee is better.”

A long wait for lemonade at the landmark Gryphone Tea Room, which is housed in a gorgeous old pharmacy lined with wood shelving and now owned by the Savannah College of Arts and Design and staffed by its laid-back students: “Just like the Cultural Revolution. The service was so slow then.”

Fort Pulaski, which was filled with locals dressed in Confederate uniforms and ladies in hoop skirts and where you can see the cannons being fired on Saturdays at 3 p.m.: “Like the Great Wall of China. but flatter.”

The pan-fried whiting at Sisters of the New South: “Pass the hot sauce, please.”

The tour of the 18th century Green-Meldrim mansion designed by New York Architect John S. Norris for Mr. Charles Green, who arrived in Savannah in 1833: “He started with only $2, and he became rich. I like this independent American spirit.”

When we arrived at Wormsloe Plantation, which is famous for its driveway lined with oak trees dripping with hanging Spanish moss, and took a three-mile walk in the woods, Hong’s reaction was: “How much did the tickets cost? In China only senior officials would be able to walk in such a big, empty place with fresh air.” She was surprised that admission was free and intrigued by our system of using taxes to help fund our national parks.

Arriving at the beach on Tybee Island, Hong gasped: “So clean and quiet. Chinese beaches have so much litter.”

Coming from a big and bustling city, Hong loved the parks and the fresh air. She was impressed by the unhurried pace and the friendliness of the Savannahians, who kept asking us where the women were from and whether they were enjoying their hushpuppies. Coming back to crowded and dirty LaGuardia Airport on Sunday was a bit of a letdown, and we all agreed that, apart from the abundance of fried food, Savannah was a wonderful place for a weekend getaway.

“Such good manners. In Shanghai everyone is always rushing,” was Hong’s final verdict about her trip to the American South.

PHOTO: Entrance to Wormsloe Plantation, Savannah, Georgia/Nguyen To Hong Kong

]]> 4
The limits of happiness Tue, 03 Apr 2012 18:19:39 +0000 Despite being a cynical New Yorker, I was charmed by Bhutan on a visit there a couple of years ago. The beauty of the unspoiled scenery, the rhododendrons in bloom, the mountains and the monasteries — all were uplifting. The quiet intelligence and the thoughtfulness of the people we met were inspiring. Bhutan is  a country of  traditions and pride in local culture. Visiting the villages we saw astounding feats of archery, which is the national sport, and we took long walks with a local guide who also happens to be a serious cyclist and has helped spread mountain biking throughout the country. One scene stayed with me: Walking to a monastery one day we passed a man sitting on a mountainside doing embroidery as he looked out over a dramatic view of cliffs and mountains covered with trees. With him was a friend who peered over the embroiderer’s shoulder as he stitched. We went for a long walk, and when we came back a few hours later, the two were still there embroidering and watching.

Peace and quiet and the time for leisure must surely be part of what makes people happy, and the Bhutanese have become famous for popularizing the concept of gross national happiness (GNH), which is a favorite cause of the current prime minister. The Sarkozy commission (which my husband co-chaired) also worked on the subject and in 2009 issued a report that provided a framework for how to think about going beyond gross domestic product and how to measure success in a broader way.

The Bhutanese are out in full force this week for a conference on happiness. There was an all-day meeting organized by Jeffrey Sachs at Columbia University on Sunday, and on Monday diplomats from all over the world met at the United Nations to discuss what constitutes happiness and how it can best be measured and promoted. The star of the morning was Costa Rica’s president, who spoke about the country’s conservation laws and the need to protect the environment. It was also agreed that altruism, compassion, social life, feelings of belonging, political stability and good health are essential to happiness. The Bhutanese spoke of the importance of community and their program of introducing meditation into schools to promote contemplation, concentration and quiet reflection.

There are, however, people like me for whom complaining is essential to happiness. The right to kvetch doesn’t seem to be part of the happiness indices, and that could explain why the French, who live in a civilized society filled with good food, a strong social safety net and rights for workers – but who also find great joy in complaining – report only average levels of happiness.

The right to be unhappy and to tell people about it is, of course, related to political freedom. Also important is the feeling of equality and fairness. According to the Sarkozy commission’s findings: “If inequality increases enough relative to the increase in average per capita GDP, most people can be worse off even though average income is increasing.” Studies have shown, too, that there is a connection between inequality and health, so people on the bottom of the income pyramid are often less healthy and probably less happy, as good health is one of the top causes of happiness. Even in wealthy societies, the rich are happier and in better health than the poor.

But the proponents of happiness also stress that income accumulation is not conducive to happiness, and striving to become rich can cause unhappiness. This is where I began to get confused: How can poor countries be happy if they know there are richer ones? And is it fair for the rich countries to tell poor ones that happiness does not lie in becoming rich? Couldn’t that be interpreted as kicking away the ladder, in the same way that countries like the U.S., which consume far more than their share of resources, now lecture fast-growing countries like China about their carbon emissions? For the world to buy into the happiness agenda there must be some understanding that happiness should not come at the expense of basic needs. Happiness is a good thing, but essential to it are fairness, healthcare, social mobility, education and jobs.

PHOTO: A girl holds a parrot in Gundonovia at the Isiboro Sécure National Park and Indigenous Territory (TIPNIS) some 132 miles east of La Paz, Bolivia, March 17, 2012. The indigenous peoples who live in Isiboro Sécure have been protesting plans to build a highway that would bisect the park. REUTERS/Carlos Vargas

]]> 6