I was born in an African village, literally in a mud hut. I spent the first 9 years of my life in a village. The town I grew up in wasn't far from the village so I spent holidays in the village too. I now work in IT and try keep up with the latest frameworks. That is I am not concerned with starving to death and I have health insurance.
If I compare my upbringing with my daughter's, there is nothing to compare. We walked around barefoot, unsupervised, climbed trees, ate wild fruit, made spears from wood and once you were four you had to take your two year old sibling with you and look after them. There were no nannies. Here is the interesting thing, none of us ever had to see an occupational therapist to help us with our hand eye co-ordination. Falling out of a tree was enough incentive to figure it out on your own. I digress, the point I am trying to make is that I remember my childhood as a happy time. Full of activity and adventure. I would have been classified as poor because I we slept on the floor, shared blankets as kids. Kids ate from the same plate, grouped roughly by age group. No toys except ones we made ourselves.
I am not advocating returning to the village. Running water and healthcare are good things. I often wonder about who is better off, me in town with access to water and health but with all manner of rates and taxes and social pressures?
> Here is the interesting thing, none of us ever had to see an occupational therapist to help us with our hand eye co-ordination. Falling out of a tree was enough incentive to figure it out on your own.
Survivorship bias. I have poor eyesight, no amount of practice would ever allow me to throw a spear and hit a wild animal. Heck with lots of occupational therapy as a kid, I can kinda-sorta catch a ball. On a good day.
I'll say that falling out of trees was a lot easier (even fun!) as a kid though. I do worry that the current generation doesn't have much unstructured play time.
> We walked around barefoot, unsupervised, climbed trees, ate wild fruit, made spears from wood and once you were four you had to take your two year old sibling with you and look after them.
Growing up working class in 80s and early 90s suburbia was awfully similar. Except we had to wear shoes when it got too hot, concrete is friendly to cars, not feet. :( But yeah, we ran around all summer day long without parents getting involved. The littler kids were looked after (dragged home for diaper changes though!), we road bikes all around, picked berries from the woods, got hatchets and chopped down small trees to make clearings in the woods.
Now days? I am not quite sure what childhood is like for the current generation. I know that I've see less and less groups of kids running around every year, and I haven't really seen any in the last few years, but maybe I'm just not looking in the right places.
> I have poor eyesight, no amount of practice would ever allow me to throw a spear and hit a wild animal.
What, specifically, is your eyesight problem? There's some growing suggestive evidence that our eyes need time outside in bright sunlight to develop properly. Depending on your particular sight problem, it may very well be the case that a failure to be outside attempting to throw a spear and hit a wild animal as a child is the cause of your problem.
Good vision is less necessary for hunting than you might think. One common hunting role is simply to walk though an area while making a lot of noise. Abstractly large numbers of people have poor vision in large part because our ancestors could get by with poor vision. Traps and fishing are other examples with minimal requirements in terms of vision.
Remember, hunter gathers don't need to read tiny text, or the pattern of bark on a tree. So, even what we think of as poor vision was actually often 'good enough'.
Funny (ironic?) thing is that each incremental advance in civilization may be a good thing in isolation and, given the choice between adding benefit X to their existing situation or not, most people would choose adding benefit X without hesitation.
And yet, somehow the sum of hundreds of such benefits (secure food, healthcare, fire departments, internet) doesn't lead to a significant increase in average happiness. In fact it may be that we in the west are less happy than people living in stone age societies.
I think about this a lot. One of my own theories is that we always want more. A columnist here, South Africa wrote about how when he was in high school he just wanted enough money to take his date to a movie and have enough money to buy popcorn. In college, he wanted enough money to buy a crate of beer, as a young employee he wanted enough to buy the cool car. Get the drift, somehow we always want more.
People in the village are not immune from wanting more but the pace is slower. They are more patient. They exercise, not by going to gym but walking 10km to say hello to a neighbor then walking back. Food is organic, all cows eat grass and roam free. Little of the food is highly processed. They also manually process their food. The thought of spending half a day pounding millet for supper has me getting so impatient and thinking surely there is a better way. They have accepted.
Sorry I went on a bit of a rant, but this is topic close to my heart.
I wonder if it's because of the kinds of stress people in western societies deal with. Humans have always had to deal with stress, but the modern world seems to have more "intangible" kinds of stress. It's one thing to be stressed about being in danger from a predator. The stress drives you to action, and you either survive or don't. But the kinds of stress people deal with now is somehow different. Most of the time, the things you're stressed about won't kill you, but the stress won't go away either. Worrying about money to pay rent, etc. The stress drives people to make enough money to make this month's rent, but that same stress will constantly be there, because of next month's rent.
I dunno if this makes any sense, just something that popped into my head.
I think you hit the nail right on the head. I believe there has been research with rats on this type of thing (sorry I don't remember the name of the study). The sort of 'ambiguous' stress of modern life is much harder on the body/mind than say, being chased by a tiger.
I've read this is why soldiers like combat deployments. I always figured war was something you were drafted into and were terrified most of the time. There is a subset of the population who enjoy soldiering and this is part of why
When humans come into conflict, and they always do, it's not happiness that decides the winner, it's power. The societies that exist today are the ones that survived, not the ones that are best for their constituents.
Everything around us seems to be optimized for efficiency, speed and profits. Nothing is optimized for happiness anymore, unless that happiness is directly tied to someone's profits. And we are all judged on weird metrics - ("40 and still writing code, not in management?" "don't want to have kids?", "don't want to own a house?" etc all followed by "what is wrong with you?"). And everything seems complicated too - I just read somewhere that credit card agreements are like dozens of pages today, vs a couple of pages before.
Like you, I also wonder the same - fancy electronics, cars, running water etc are all great, but how much of it truly contribute to one's laughter, happiness, health etc?
Very interesting story and perspective, thanks for sharing. If you ever wrote a book about your life, or even a detailed blog post (didn't see anything on your blog about your personal life), I'm sure people would love to read it. :)
Your story is really interesting. Can you talk about how you transitioned from your original village to where you are now? Do you still have connections back to where you were born? How does it affect the way you raise your daughter?
My parents were both teachers. When I was born, they were stationed in my dad's home village. We just lived with the whole family. It was village of cousins.
We moved to town which is 60km (40miles) away when my dad got a job working in a mine. From then I went to school in town and only spent holidays in the village. To this day we still own our own cows and our home still stands.
To answer your questions, yes more than half my relatives are still in the same village. We talking a village of 60 odd people. I organise a gathering every other Christmas, we slaughter a cow (apologies to the sensitive) and talk about the good old days.
Times have changed even in the village. Everyone has a cellphone even in the village :-).
You make a very interesting point. I would say I am able to adapt to my surroundings pretty well. At work it is all about databases and SQL. When I am back in my home country, conversations are about the rain. Rain determines how crops fare and how much food is available for the livestock. Trying to describe what I do is a none starter.
The interesting thing is how easy it is to adapt and to also get caught up in the environment you are in. Suddenly the next great framework is the thing that occupies your mind the most. At that moment I am just like any other person in IT. I go home once a year because it keeps me grounded. Makes me realise I have come far but life is a bit slower there and people have genuine smiles but own less.
That's a great observation. I think it's hard to argue that someone happy in their life is not successful just because they haven't advanced economically.
Incredible. Can you talk about how you learned programming and the obstacles you hit along the way? (financially, health, or actual educational obstacles). How did you get a programming job?
Also, as others have noted, there is survivorship bias in your experience. If you or one of your siblings were born with a disability or became disabled in some way from a sickness, the experience would probably be quite bad.
I had replied to an earlier thread. In short, moved to town, went to school in town. Touched first PC in University at the age of 21.
Alot of the adaptation happened as a kid. I went to school not knowing a word of English. I don't even know how I learnt the language. Kids adapt. They are less self conscious. So I guess every new environment was new for as long as it took to adapt.
Benjamin Franklin on the appeal of the traditional Native American life: "When an Indian Child has been brought up among us, taught our language and habituated to our Customs, yet if he goes to see his relations and make one Indian Ramble with them, there is no perswading him ever to return, and that this is not natural [to them] merely as Indians, but as men, is plain from this, that when white persons of either sex have been taken prisoners young by the Indians, and lived a while among them, tho' ransomed by their Friends, and treated with all imaginable tenderness to prevail with them to stay among the English, yet in a Short time they become disgusted with our manner of life, and the care and pains that are necessary to support it, and take the first good Opportunity of escaping again into the Woods, from whence there is no reclaiming them"
Happiness is more closely linked to status (relative position and wealth) than absolute benefits[1][2]. In that respect, I imagine someone taken from the environment they understand and are accustomed to and put into a foreign one where they are likely a curiosity, and at best an outsider, would result in them longing for what they understood.
For the same reason, I imagine the poor in Benjamin Franklin's time might find a Native American lifestyle (if accepted by the group) to have some draw if exposed to it. I would by the same measure expect the middle and upper classes to find it less appealing.
I noticed when traveling through Central America, that while extreme poverty is everywhere, homelessness seems to be quite rare (with the caveat that I didn't spend much time in the capital cities, so the situation there may be different).
I think there are two reasons for it:
1) People don't seem to be as mobile, in general, and you'll find 3 generations of family living very close to each other quite often. I was hanging out with a local in Leon, Nicaragua and met like a dozen of her family members walking around a couple of blocks. People who are having hard times seem to just take up with family. We found one drunk lying on the side of the road, and she insisted we stop and find out what was wrong with him and take him back to his family. I had barely registered that he was there.
2) There don't seem to be as many zoning or construction safety laws, so building a shelter by yourself with almost no money seems to be quite easy. It might be a shack on the side of the road with no water or electricity, but it's better than sleeping on the street.
I was also struck by how jovial even people with very little seemed to be. Like having cable tv, food, friends and family was enough for people to be satisfied with where they are with life. They also seemed relatively fatalistic about health and safety issues. When you don't really have any expectation that someone is looking out for you, the idea that you could die from an accident or sickness any day doesn't seem to be that unlikely. People there in general just seem to take it in stride. I guess you have to if you want to get out of bed in the morning.
I think it made me realize that loneliness might be worse than poverty, and that the lack of social support for poor people in the us is worse than the lack of money. We could do more for people by creating social connections than we could be just giving them a check. I don't really know what the answer is there. I don't think it's a problem at either the market or government can solve.
Just want to be clear that I don't want to paint to rosy a picture of what poverty looks like in Central America. It's not uncommon to see a single mom with a family of three or more kids living in a tin shack with a dirt floor. It's fucking heartbreaking to see. And you know that you could spend a few hundred bucks and help change their lives, but there are a billion more people just like them in the world. We in the west have no idea how good we have it. It's really hard to understand how the rest of the world lives unless you see it directly.
Even just watching a documentary doesn't really capture the scale of it like spending three months traveling from town to town and seeing nothing but abject poverty every where you go. You really do get an understanding of why people risk their lives to come to the US.
I know there's balance to this issue - I once spent an afternoon at a shantytown located in a garbage dump in Managua. Worldview-changing, especially when the interpreter noted that some people felt fortunate to at least have work to do in the dump.
But some things certainly are a matter of perspective. My grandmother was one of 13 kids, 12 of which survived early childhood. The way she describes it, they all lived in one three-bedroom house in a steel town: one bedroom for the parents, one for the girls, and one for the boys.
So, 14 people in a house that, assuming it was an average-sized house from that era that you see in these parts, was probably about 1,200-1,500 square feet. That'd be pretty unthinkable to your average American today (outside of NYC/SF, anyways).
"Keeping up with the Joneses", coupled with a lot of land, probably our economic policies, and other factors, has certainly moved the needle on what an acceptable home looks like.
I was born and raised in Managua. I think a visit to La Chureca (the dump you're taking about I think) would be a life-changing experience for most. I don't think you can truly understand poverty living in the US and not traveling to the third world.
Your observations are correct with respect to the part of Africa I come from. When you come of age you just pick an empty piece of land next to your family and build your home. We used to use wood from trees you cut down yourself but now the trend is to use bricks. The bricks are "home made", and don't go through any quality checks. All in all there are few homeless people.
It is also possible for a whole family to live in two rooms. I don't come from a family that does that but it happens. Everyone sleeping on the floor with a bed for the parents.
This phenomenon is what drove Henry George to write "Progress and Poverty," nearly 140 years ago. To quote from the introduction:
> But just as such a community realizes the conditions which all civilized communities are striving for, and advances in the scale of material progress—just as closer settlement and a more intimate connection with the rest of the world, and greater utilization of labor-saving machinery, make possible greater economies in production and exchange, and wealth in consequence increases, not merely in the aggregate, but in proportion to population—so does poverty take a darker aspect. Some get an infinitely better and easier living, but others find it hard to get a living at all. The "tramp" comes with the locomotive, and almshouses and prisons are as surely the marks of "material progress" as are costly dwellings, rich warehouses, and magnificent churches. Upon streets lighted with gas and patrolled by uniformed policemen, beggars wait for the passer-by, and in the shadow of college, and library, and museum, are gathering the more hideous Huns and fiercer Vandals of whom Macaulay prophesied.
He identified the reason for it as being the higher value of scarce lands in the midst of progress, and the tendency of private ownership in land to make this inevitable. To take your example from (2) ― if the land on the side of the road demanded great payments for its use, good luck building a shelter there. (This goes hand-in-hand with zoning laws, one of the tools wielded by the landowning class, but which didn't exist in George's day.)
The creation of housing is something that’s bothering me right now.
http://www.sfyimby.org
The people in the country consider us city-people to be wimps who can’t do anything to help ourselves. You need some shelter? Then build a shelter.
But in the city you can’t, because you need to get an architect’s sign-off and the unelected Planning Commission’s approval, and do endless studies about the environment and neighborhood character.
Some of the restrictions I feel are useful. Seismic regulations, because look at the difference between Christchurch, New Zealand and Port-au-Prince, Haiti. Electrical and fire, because just a couple months ago a block away a house caught on fire and I had no fear.
Some of the restrictions I feel are harmful. Zoning laws rooted in racism. Neighborhood preservation laws that do more long-term harm than they were trying to prevent. “Local control” that takes away power from the people and gives it to unelected bureaucrats.
I think a lot of the resentment felt by the rural American poor has to do with their perception that they are constantly ignored or overlooked, while similarly impoverished inner-city minorities are at least given some kind of institutional sympathy. It's hard to say how true this really is, or how much of it is simply further fuel for pre-existing racism, but apparently this perception is ubiquitous enough that it can be leveraged to win national elections.
I will say the events of the last year have definitely opened my eyes to the situation. The thing I've noticed is that it actually is harder to sympathize with the white, rural poor than it is with the inner-city minorities, at least for me - even though I want to sympathize and I acknowledge their suffering is probably more or less equal to the inner-city minority poor. I suppose the reason I find it more difficult to feel equivalent sympathy is that it's hard to get over the fact that the white rural poor seem to constantly cling to counter-productive political/world-views that perpetuate their poverty and act against their interests. I mean it's just really hard to allocate significant sympathy towards a large voting-bloc that seems to blame all their problems on terrorism and immigration. But then again, perhaps I am generalizing - I mean I'm just a clueless liberal living in my NYC bubble so what do I know anyway?
Much of the same can be said of impoverished inner city citizens. It's human nature to find external causes to your pains outside of your control.
There's a double annoyance with inner city residents, though, in that many just expect the government to solve the problems, leaving them without motivation. Almost robbing them of it in some cases. Anyone working hard towards their dreams, no matter how large or small, will naturally resent such mentalities.
It's hard to tell if you are making a counterargument to the parent or if you believe inner city residents[0] expect government to solve their problems, lack motivation, and don't work hard.
[0] Do the people you are referring to actually live in the inner city?
A little of both, but I'm mostly commenting on the "The thing I've noticed is that it actually is harder to sympathize with the white, rural poor" sentiment. Namely to say that the reasons listed for not sympathizing with the rural poor can and often are applied the same to the urban poor. Going further, urban poor have a stigma of being assisted by the government. It's an odd situation because at the same time that there is resentment for the urban poor receiving more government programs, there's more popular will to help the urban poor. I imagine it's largely a visibility problem.
Sweeping generalizations are sweeping. And general. I don't believe all poor people, regardless of residence, lack motivation or are just looking for handouts. If pressed, I'd probably guess no more than 10% of the poor population would fairly deserve those insults. But, you could probably say only 10% of the global population might deserve those insults.
Yes. I've also lived in rural America. While there are significant populations of lazy dolists in both, the population of do-nothings is much higher in rural America. Rural America really does believe that everyone has forgotten about them, and blame all their problems on other people while they happily do meth or get drunk all day in their trailers.
The thing is...they're right. Because they live so far from any place that matters, no one who matters thinks about their situation, so it's much more difficult to leave rural America than it is to leave the inner city.
Indeed. Looking at America from across the Atlantic, it seems that the American inner cities are making themselves heard by drug trade and a fairly large number of homicides, and rural America now made themselves heard through elections.
I kind of find the latter approach more constructive, in fact, even if it resulted in Trump.
It's a bit more complicated. Inner-city populations heavily vote Democrat, along with most densely populated areas. In fact, something like ~80% of Americans live in urban areas (which also includes dense suburbs), and therefore we should expect Democrats to win elections most of the time (even in spite of the fact that some dense sub-urban areas heavily lean Republican). However, this doesn't happen in practice because the electoral college system heavily reduces the weight of votes coming from inner-cities and urban areas, and also excludes votes coming from urban areas that lie within a larger, Republican-leaning state. For example, in the last election, probably most people in Philadelphia voted for Clinton, but their votes were nullified because the state over-all went to Trump.
So inner-city populations can't reliably make themselves heard on the national level via Presidential elections.
> However, this doesn't happen in practice because the electoral college system heavily reduces the weight of votes coming from inner-cities and urban areas, and also excludes votes coming from urban areas that lie within a larger, Republican-leaning state.
The Electoral College doesn't 'reduce the weight of votes coming from inner-cities and urban areas'; it allocates votes to states in roughly proportion to population.
Voting by states doesn't just 'exclude votes coming from urban areas that lie within a larger, Republican-leaning state,' but also excludes votes from conservatives living in Democratic states, e.g. California.
> probably most people in Philadelphia voted for Clinton, but their votes were nullified because the state over-all went to Trump.
Their votes weren't nullified any more than the votes of those against Brexit were nullified by those who voted for: it's in the nature of a vote that someone will lose (not be nullified).
I didn't vote for President Trump, but I am glad that we are a federal republic with an Electoral College, not a direct democracy or anything like it. I wish we had more federalism, not less, to include state legislatures appointing senators and electors, and the elimination of the popular vote for president altogether.
> The Electoral College doesn't 'reduce the weight of votes coming from inner-cities and urban areas'; it allocates votes to states in roughly proportion to population.
Um, that depends on what you mean by "roughly proportional":
+ Each state, no matter how low the population, gets a minimum of three votes in the Electoral College (one per House member and senator).
+ House representation increases by population, but Senate representation is capped at two, no matter how large the population.
+ As a result: "Each vote cast in Wyoming is worth 3.6 as much as the same vote cast in California. How can that be, you might ask? It’s easy to see, when you do the math. Although Wyoming had a population in the last census of only 563,767, it gets 3 votes in the Electoral College based on its two Senators and one Congressman. California has 55 electoral votes. That sounds like a lot more, but it isn’t when you consider the size of the state. The population of California in the last census was 37,254,503, and that means that the electoral votes per capita in California are a lot less. To put it another way, the three electors in Wyoming represent an average of 187,923 residents each. The 55 electors in California represent an average of 677,355 each, and that’s a disparity of 3.6 to 1." [0].
> The Electoral College doesn't 'reduce the weight of votes coming from inner-cities and urban areas'; it allocates votes to states in roughly proportion to population.
It does reduce the weight of votes coming from inner cities, because it does not allocate votes proportionally all the time. The disparity occurs most obviously between the high populated states like New York, California, and Texas, compared with very low-population states like Montana or Wyoming. I live in New York, so my individual vote is worth less than someone living in Wyoming or Montana.
I'd like to see some data for that 80% urban population statement. Unless the definition of "dense suburbs" is outlandish, I can't see the percentage getting that high. Most studies I've seen put the US at a fair rural to urban split that up until very recently has always favored the rural population. It is only in the past 10 years that we've approached 50% urban to rural.
I know this to be true in North Carolina, and various readings about elsewhere make me believe it to be the case for the greater US.
You're right - the 80% is exaggerated. I got it from https://www.census.gov/geo/reference/ua/urban-rural-2010.htm.... Their definition of "urban" is actually outlandish, in that it includes "urban clusters", which means towns that have > 2,500 and < 50,000 inhabitants. I assumed the 80% just included all the sprawling, dense suburbs, but I see the definition the census is using here is much looser.
Of course I know it's complicated; I was making a simplification to express a point. The violence in cities wouldn't make me want to give the violent more voice in making decisions, rather to the contrary.
And the votes of those who are second-past-the-post are not "nullified"; they just didn't win. We have a different system (d'Hondt) and it has its drawbacks as well.
It doesn't help when voter suppression efforts make access to voting rights prohibitive to people in cities, especially the poor. 4 hour lines to vote (because there are fewer polling places) are painful even when your livelihood isn't on the line.
That's is something I don't understand: how come these cities cannot arrange enough polling stations? After all, if they're Democrat majority, it would be in interests of Democrat-elected local officials to arrange enough polling places.
(Another thing I have a hard time understanding is that Americans allow people to vote even if they have no ID. Over here, it's a basic requirement for democracy that only those vote who have the right to vote, and they each vote only once.)
Some of the resentment is because cities are no longer aspirational. In the old days, if you are unhappy with your life, then you move to the city and make a new life. These days, you can’t even imagine moving to the city, because one month of rent will wipe out years of savings.
I don't think there's anything broken just because you feel both sympathy and resentment for the same people. The real world is complicated, and it's good that you're able to admit that you have this internal conflict.
I will point out that there is one big blind spot I'm seeing in stuff like this. I suspect that you're conflating middle class white voters in conservative cities with poor rural white people and lumping them all together as "white rural voters". You shouldn't assume that they're a bloc, even in California lots of people are conservative and vice versa.
Every state has lots of open minded people who just want to find joy in their lives like everyone else. I grew up in Indiana, and if we want to go full anecdote, one example is my Boy Scout leader saying he'd stand by me against the national organization's anti-gay policies if push came to shove. Or NOBCChE letting me in because there was no other way to do the science fair at my high school. They didn't even tell me what NOBCChE stood for, and somehow I literally never noticed that I was the only person there who wasn't black. There are good people everywhere. Everywhere.
I have very little resentment for poor white people. I am very resentful of well off people voting for their own power, comfort, religious authority, and low taxes over the well being and safety of millions of people.
So yeah, I'm very sympathetic to anyone who is having a hard time. Especially those who see no way out. But that doesn't mean I'm okay with things that hurt me and my friends -- especially when that pain inflicted does nothing to actually alleviate anyone else's problems.
Kicking out immigrants or forcing gays into the closet or preventing transgender people from using the bathroom or preventing minorities from voting or making Jews fear for their lives won't help the opioid crisis or provide financial security. Treating these things like they are in any way intrinsically related is a huge problem in framing that results in poor tactics.
Do you need to feel involved at an emotional level with the problems of your fellow citizens - problems which limit their ability to participate positively in our society to the gain of all - in order to consider it worthwhile that our government take those problems seriously? If so, why so?
I ask because this seems a very strange fashion in which to approach such a matter. On the one hand, you seem by your comment here very concerned with the possibility that one effect of these issues going unchecked is the election of a president with whom I presume you gravely disagree on almost every issue. On the other hand, your analysis of the issues themselves, and the value of efforts directed at mitigating or resolving them, seems entirely colored by the degree of emotional involvement you feel with the people who are most directly affected.
I don't understand this perspective at all, and I'm hoping you will take the time to explain what about it you find as sensible as your comment here strongly suggests you do.
I would say it's counter-productive - but at least a direct causal line can be drawn between slavery and the current lower average socio-economic status of black people in the US. Whereas, there is absolutely no causal line between the current plight of poor white people and Mexican immigrants/Islamic terrorism.
Not trying to derail the topic, but is Islamic terrorism a claimed cause for the plight of poor white people? If anything, Islamic terrorism is a boon to poor white people. US Military will provide a decent cash influx at sign-up, fund education, and provide a steady paycheck for a few years.
The distinction is that slavery is actually bad — a human rights atrocity with centuries of fallout — whereas globalization is (according to the liberal worldview) good.
That's an interesting distinction. On its face it suggests that some human rights atrocities are more morally acceptable than others, but I can't imagine how such a reading might be accurate to fact.
charles-salvia- the following is not directed against you because you seem to have some insight into your own prejudices.
Just about everyone is bigoted against some group or other.
The fascinating thing is that this now has a meta-component, that is, the perceived bigotry of an out group is one of the rationales for the moral acceptability of bigotry against them.
Of course to most people who have such bigotry they would never call it such.
I do hope down voting this comment helps others deal with the cognitive dissonance.
In one sense, this is a little true: It's easier and more efficient to provide access to the various safety net services in a city. Just like you can support a niche store in a big city that would never see enough customers to survive in a small town. Population density improves the "customer":"provider resource" ratio.
Access to lots of other services is better too... In the core of the large city I live in, there are so many emergency rooms/clinics that it would be difficult to be outside of walking distance of emergency care. That's much harder to do (and a poor allocation of resources) in rural Oklahoma, but it means my access to medical care is dramatically better.
I am a Bangladeshi who is now a grad student in US. Perhaps I can give a generalized peek view of the health system of Bangladesh. I feel much more safe being in Bangladesh if I were to have some urgent/serious health problems. There are public hospitals where doctors are always available. You go and buy a ticket which is very cheap(in the order of 1-2 dollars in BD currency) and you get to see a doctor. Sure, there are lots of people, you might have to wait for 2 hours, but it beats the insurance system here in US any day. In fact, the concept of having a health insurance is so alien in BD that I feel there will be riots if someone wanted to introduce that. Also, the quality of the doctors in the public hospital is almost on par with the private hospitals. Because for any up and coming doctor, if they want to gain recognition, they first have to get a job at a public hospital. Then they may also practice at a private hospital at their extra hours. If you do not want to wait and you have the money(which is in the order of 10 dollars in BD currecy) you can visit the same doctor at a private hospital. Medicines are really cheap mostly too. This is one of the reasons many Bangladeshi green card holders or US citizens would go to BD for health care if they have some serious issues. I feel there is a huge cultural difference regarding the solution of healthcare between US and BD. The public in BD expects the government to take care of its people through public hospitals. That is why when I came to US and got acquainted with the system of healthcare here it was a huge shock to me.
Very interesting perspective. Thanks for sharing. In South Africa you get both private and public. Some public hospitals are very good. Particularly those attached to medical schools. However you have to be referred and your case prioritized if you have something wrong.
Private medical aids are big business. It gets more expensive by the year and the benefits seem to be less and less. Its a grudge purchase. How much money is in medical aid in SA, take a look at this story. The CEO of the biggest medical aid made enough to [buy a top notch property](https://therealdeal.com/2014/01/06/south-african-insurance-m...) in New York. Bear in mind exchange rate is 1US$ = 13ZAR
The author of the question does not have a straightforward answer but puts this forward as a thought provoker.
For example while Appalachians have higher income on average (PPP) than a typical Bangladeshi, Appalachian life expectancy is lower. So maybe the marginal increase in income is more impactful in a place like Bangladesh -where people are less able to commit self-harm (even unintended like poor diets). Maybe people in Bangladesh, not having much in the way of comfort do more with marginal incomes. Maybe we can learn from these social forces to take advantage of our higher income and provide better living for people who while not at extreme poverty levels do worse then people living in extreme poverty.
> Does Bangladesh have a systemic prescription opiate problem?
If you want to talk about the impact of opiates on Bangladeshi poverty today, you should go back much further in history.
Bengal opium, being much higher quality than the product found in China and Afghanistan, was the major impetus behind the British annexing the territory back in 1757. They used this monopoly to extract exorbitant taxes from Bengal, causing widespread man-made famines which killed tens of millions of people. They then used this tax money and the opium to flood the Chinese market with cheap, high-quality opium, against the Chinese rulers' will, in an attempt to undermine the Chinese government as well by creating a widespread opiate epidemic. China did not come under explicit colonial rule the way Bengal did, but it came very close.
Over this time period, Bengal went from being the richest region in the second-richest empire/region in the world (next to China) to one of the poorest, which it still is today, despite its rapid growth in recent years.
This strategy isn't over, by the way. The opiate market was (and still is) a part of the US military strategy in Afghanistan - balancing the desire to "crack down" on heroin production and smuggling against the desire to provide Afghani civilians with an agricultural economy that doesn't rely on Taliban support.
Bangladesh doesn't have a synthetic opiate problem, simply because people there are generally too poor to purchase synthetic opiates in the first place. Raw opium is still used in these areas due to its widespread availability, but it's much less addictive than the synthetic opiates, because pharmaceutical synthetics are obviously designed to be highly concentrated and potent.
As for the raw numbers, 0.3% of Bangladeshis consume opiates at least once per year, compared to 0.57% in the US, 0.8% in Italy, 2.65% in Afghanistan (the highest) and 0.004% in Singapore (the lowest).
>Bangladesh doesn't have a synthetic opiate problem
I feel that's the key here. That oxycontin was over prescribed for about a decade. We are talking people getting in a car wreck and waking up in a hospital addicted to opiates.
I'm assuming we are in agreement that the pharmaceutical opiates are way more addictive than their illegal analogs.
Snorting a pill is way less work than shooting up or "chasing the dragon" but once you're addicted and your brain tells you need dope to live, you'll do whatever you need to do to live.
>As for the raw numbers, 0.3% of Bangladeshis consume opiates at least once per year, compared to 0.57% in the US.
I wonder what the opiate use rate is amongst the Appalachian population. A few days ago there was a map posted of heroin overdoses in the US and West Virginia was the hottest hot spot. Anecdotes of OD's and pill heads in WVA abound. When I showed the map to one of my friends, he told me has had 12(!) people that he went to high school with die of pills and/or heroin.
I can't help but feel that the pharmaceutical companies and their executives are complicit in the current US opiate epedemic.
> I'm assuming we are in agreement that the pharmaceutical opiates are way more addictive than their illegal analogs.
Actually, that's... a complicated question.
Pharmaceutical opiates are definitely more addictive than raw opium (that's like asking if eating white sugar is sweeter than cane sugar). But once you're comparing heroin available on the street to prescribed opiates, there are enough variables (variable quality of product, means of ingestion, the different situations under which a person chooses one over the other, etc.) that there isn't a straightforward answer.
We have to acknowledge the biological component of addiction, that some people are predisposed to certain addictions. There is a physical, chemical component that comes into play.
I, for example, smoked my first cigarette at 12 y/o. I continued to smoke cigarettes socially for the better part of the next decade, often buying my own packs of smokes. I never understood the "need" to smoke that many of my fellows expressed. I enjoyed the nicotine high, but never once felt it necessary to smoke tobacco to live a "normal" life. I stopped smoking one day after college and never felt the urge to smoke again. Even after long-term repeated exposure to nicotine I never developed a physical dependancy.
The "William Shatner seat" article posted yesterday sent me down a rabbit hole of Shatner talk shows (in "Aftermath" he interviews Bernie Goetz and it is amazing) ending on his "Raw Nerve" interview with Rush Limbaugh where Rush goes into great detail regarding his own painkiller habit. Contrasting how he speaks about opiates about how his body told him he needed pills like he needs food or water to my own personal experiences with opiates and nicotine only reinforces this belief that some people just have the right brain chemistry to get addicted.
My next thought is that the chemistry of the brain changes over time, under stress or when exposed to other chemicals.
Ergo, at some point, people may be more prone to particular addictions than at other times.
opiate addiction may not be that prevalent in Bangladesh; but from what I understand Methamphetamine (popularly known as 'Yaba') is a significant problem.
the history of 'Bengal Opium', especially its production & distribution is indeed a fascinating one.
The historical fiction by Amitav Ghosh in his "Ibis Trilogy" is very illuminating:
Thanks for the reading suggestions, I'm pretty intrigued by this topic.
The opioid epidemic is seriously bad here in the US and its negative effects are definitely magnified by the Appalachian malaise that existed before oxycontin.
I mean, they have recently run out of morgue space in South Eastern Ohio (also Appalachean).
I think Appalachian malaise predates the opiate problem. I think it would be worthwhile investigating the cultural aspects which allow an extremely poor population in a poor country fare better than a merely poor population in a developed country where some aspects of lives are subsidized by commonwealth.
Bangladesh borders one of the bigger opiate exporting nations of the world Myanmar (Burma) and the borders are largely porous. I wouldn't be in the slightest bit surprised if getting heroin would be very easy in Bangladesh.
I'm not convinced that ease of access to illicit opiates is a major driver for addiction. I'm sure there's a bunch of good dope that's cheap and easily found.
I'm curious on the differing levels of use/abuse. My gut tells me that Bangladesh opiate consumption OD rates are lower than Appalachian.
Government runs hospitals in every town but only poor people use them(though they put up with bribes here). Rich and middle class typically use private health care as its generally better. Private health care in cities is excellent even by western standards. In towns, its decent. Poor also turn to private hospitals when time is important or when government doctors fail. One thing government does well is giving vaccines to new born and infants.
Also, many times, you just walk up to a pharmacy and ask the pharmacist for a medicine instead of talking to the doctor. Saves money and time
It would be risky to rely on this single story. I have heard directly from 2 friends both have parents based in India hospitalized there. Once doctors got hint that people from US are coming to take care, medical bills skyrocketed. One colleague end up spending 15 lakh (USD 25K) as hospital would refuse to release body of his father and issue death certificate. They keep claiming patient is critical and need ICU.
With other friends' mother doctors would keep ordering injections, each worth 20,000 Rs ($300) confident in the fact US based son can surely afford it. In the end he ended up spending about $35-40K for about 2 weeks of treatment which ended with mother's death.
Medical council is in cahoots with doctors and hospitals. If anyone has grievance they can spend years in courts before they see any justice about medical malpractice.
For most cases the price transparency in Indian medical system really really beats the American experience. If you have a Cadillac plan in America and you have really cutting edge advance needs that is when American system is both tolerable and better.
It's growing. It is seen as a business, so lots of new investment going in there. Quality of service where available privately is quite comparable or even better than their foreign counterparts.
Because in the article Deaton uses India also ("...But if you had to choose between living in a poor village in India and living in the Mississippi Delta...").
People downvoting this, did you also approve of UC Berkeley deleting videos because they were not captioned for deaf people? Setting minimum standards on housing quality without guaranteeing affordable housing availability seems very similar to me.
I agree with your post, perhaps the word slums didn't sit well with some people. If I were to rephrase it I would say, 'The poor in Bangladesh are at least allowed to build shelters without approval from city/building councils."
Sometime ago on HN, there was the story of the Canadian gentleman who built his house. His crime was that he didn't use wood stamped by inspectors. It was found that he used wood far superior to what was required.
Back home, people make their own bricks. South Africa is more advanced than other African countries. The poor here do not make their own bricks. There too many laws and the laws are enforced.
Rent is just theft based on the monopolization of land. Forcing the poor to pay to live in government approved ghettos is more extortion of their limited resources by those who monopolize the commons.
Private property "rights" can only exist if the state violently enforces it.
Not just that, but all property claims are backed by threats of force, state or not. The universe doesn't anoint anyone Legitimate Property Owner, and if you can't convince others to leave you with your object of claim, then your claim has to be backed by force. Otherwise, it's just hot air.
So, where did you steal that computer that you're composing your messages on? Where did you steal your phone? Your car?
You sound like you want a world where cars and computers are free. In practice, that would be a world without cars and computers.
Or are you only talking about "property" in the sense of real estate? But if the land doesn't (enforceably) belong to me, I'm not going to build anything substantial on it - not a skyscraper, not even a decent suburban home. I'm not going to build anything but what I absolutely need, because I can lose it.
And I can't get a loan on it, either. This matters. In parts of the world without secure property rights, a family can't take a loan on their property so that the wife can buy a sewing machine and develop an income. It makes it harder for people to climb out of subsistence.
So your position makes a nice soundbite, but it doesn't actually work very well in the real world.
(Your post parallel to this one is correct - property rights can exist only if the state enforces them. The thing is, it is good that the state does so.)
>In practice, that would be a world without cars and computers.
I'd gladly trade my computer and phone for a world without private property.
> not even a decent suburban home. I'm not going to build anything but what I absolutely need, because I can lose it.
Maybe if what you built actually contibuted to your community, the community would protect your contributions.
>And I can't get a loan on it, either. This matters.
There is no money to loan to anyone without private property. I don't think this matters in a state of nature.
>So your position makes a nice soundbite, but it doesn't actually work very well in the real world.
This "real world" you speak of isn't working either. Climate change, arguably the worst unintended consequence of private property, is going to end our civilization in the next century. I only say it's the worst, since slavery only really effects humans, climate change impacts all species, not just one race.
Too bad it's our children and grandchildren that are the ones that will realize how selfish we are being.
Witnessing the loss of squatter's rights across much of the industrialized world is one of the most shocking things I've experienced during my lifetime.
It is true, poor people in those places really don't need much. You can live, eat grow for almost nothing. People can have happy lives without much money.
The thing about homeless encampments is that (frequency depends on the city) every few months/years, the police raid them, evict the residents, and steal/burn everything that the residents can't carry out.
The mayor claps his hands, makes a press release about how great it is that we've finally cleaned up this den of filth/violence/drug abuse, while the homeless get to sleep under bridges for a few months.
If I compare my upbringing with my daughter's, there is nothing to compare. We walked around barefoot, unsupervised, climbed trees, ate wild fruit, made spears from wood and once you were four you had to take your two year old sibling with you and look after them. There were no nannies. Here is the interesting thing, none of us ever had to see an occupational therapist to help us with our hand eye co-ordination. Falling out of a tree was enough incentive to figure it out on your own. I digress, the point I am trying to make is that I remember my childhood as a happy time. Full of activity and adventure. I would have been classified as poor because I we slept on the floor, shared blankets as kids. Kids ate from the same plate, grouped roughly by age group. No toys except ones we made ourselves.
I am not advocating returning to the village. Running water and healthcare are good things. I often wonder about who is better off, me in town with access to water and health but with all manner of rates and taxes and social pressures?
Edit: typos