jablevine
I downloaded A Swim in a Pond in the Rain and read “Master and Man” and “And yet they drove on” because of this post. Thanks for recommending!
Compare to “The best and worst experiences you had last week probably happened when you were dreaming.”
tl;dr—Compared to waking life, dreams are pretty wild and emotionally intense. Example—in a dream last week all my teeth fell out which was pretty distressing, and nothing as interesting happened to me in waking life. How emotional/ extreme an experience is seems like a good proxy for how good or bad it is. So probably the best and worse experiences you’ve had last week were whilst you were dreaming.
And also gwern’s comment:My own observation is that while my dreams are not infrequently quite unpleasant and nightmarish in content, a corresponding emotional reaction is not there. Many dreams ought to have one waking up in a cold sweat, heart pounding, unable to focus for the rest of the day. (Why aren’t all bad dreams “night terrors”? Why does it decrease with age, and correlate with psychiatric problems?) But even if one were to write them down (and I did for a while in a dream journal) to block forgetting, I feel back to normal practically upon waking, and definitely within a short time.
Summary: Good news!! If you read this post last year, about 50,000 fewer people are dying each year than you thought.
I’m very sceptical of the WHO estimate of 81,000-138,000 annual fatalities. Following the citations:
That WHO stat (citation 6 in the report linked in footnote 2, note that link automatically downloads a pdf) cites Gutierrez et al. 2017.
Gutierrez et al. have a range of 81,410 to 137,880. This range is not a confidence interval, but “combined upper estimates of mortality” (page 2) — meaning these numbers are each upper bounds. Gutierrez et al. have two citations for the range, Kasturiratne et al. 2008 and Chippaux 1998.
Kasturiratne et al.’s “high estimate” is 93,945 deaths per year. They come to this number by averaging rural and urban incident/fatality rates in a way which I don’t agree with,[1] and applying regional fatality rates to areas without data.[2]
In Chippaux, the largest number I can find is 125,345. Despite the specificity, this paper relies heavily on round numbers.[3] Also, the paper is 26 years old, and the number of people employed in agriculture (top risk for snakebites) has fallen by more than a third.
I have no idea where the 137,880 number in Gutierrez et al. comes from, and therefore where the WHO got that figure, and therefore where the number in this post comes from. It’s widely cited to the WHO report, but I lose track of it before Gutierrez et al.
What numbers seem more reasonable? From the 16-year-old Kasturiratne et al. paper, I find their low estimate (19,886 annual deaths) too low, so I’d accept their range of 19,886 to 93,945 as a acceptable confidence interval (90% for the year 2007). The Chippaux numbers are much too high, and the higher Gutierrez et al. number is entirely unsourced. Further, as noted above, the decline in agricultural labor over the past two decades will have reduced exposure to snakes, and the rapid expansion of medical care in rural India will have further addressed the problem.
Thankfully, the 2019 GBD report[^5] did a much better job (imo) of estimating this. Their value estimate for all deaths from venomous animals is 79,700, and venomous snakes is 63,400.[4] This seems much more reasonable, though GBD figures do have a history of being too high, and I personally revise my median estimate down to 55,000.
[1] They assume that all rural areas have the highest incident and fatality rate, which seems obviously untrue. But to create an upper bound when dealing with lots of missing data, fine.
[2] “Our approach minimised this effect [of ignoring regions with missing data], although in some regions, such as the Caribbean, lack of data still meant that we were forced to use very high rates in our calculations of the high estimate.” (page 1601)
[3] 80% of this high estimate relies on this paragraph:
“In Asia (population, ca. 3500 million) as a whole there may be up to 4 million snake-bites each year, of which almost 50% are envenomed. Approximately half of the victims reach hospital and the annual number of deaths resulting can be estimated at 100000.”
The 100,000 number is not justified any further.
[5] I used the query tool here; you need to make a free account.
[4] This leads to the question, what other other venomous animals are killing 16,000 people per year? I couldn’t find an easy answer; my guesses in order are scorpions, jellyfish, and spiders. I highly recommend Venomous by Christie Wilcox for a cultural and scientific history of venom.
Another case study I’d throw out is Somaliland.[1] Somaliland is the top bit of the horn of Africa, usually labeled as part of the better-known Somalia.
It’s one of those fascinating corners of the world which is in the grey area between country and not.[2] Its government exercises sovereign authority within its borders, it fields an army and enforces its borders, it issues and backs its own currency; compared to Somalia, Somaliland is far more stable and democratic. However, it is only recognized as a sovereign state by Taiwan (not a UN state itself), and has never been officially recognized by the UN or any international organization.
Due to this isolation,
Somaliland’s government has had negligible access to external capital, whether through official development assistance (ODA), loans from international lending bodies such as the IMF, foreign investment, or rents from either strategic or natural resources. [...] Private investors are also constrained, being unable to access commercial insurance or seek recourse through international commercial law because of Somaliland’s unrecognized status. (Phillips, 28)
So there’s a country which received practically no ODA (US$100,000 total between 1991 and 2016) and flourished, next to Somalia, which received more than US$13,000,000,000[3] and practically regressed. The border between Somalia and Somaliland[4] is the development practitioner’s version of the Korean peninsula nightlight picture.
These are, of course, just two countries, being assessed in a period featuring genocide, civil war, ethnic conflict, and extreme drought and famine. In other words, not very generalizable, especially compared to the panel data in the papers Ryan cites. But it is further along the spectrum towards random assignment.
We generally lack the ability to conduct counterfactual or what-if analyses to determine whether outcomes would have been better for certain communities without aid. (Phillips, 30)
In fact, I would call the Somali/land case quasi-random. The reason Somalia receives aid and Somaliland doesn’t is largely a matter of historical contingency.[5] Now, if only I had another thirty such cases, we’d be ready to run some numbers.
But — it’s just a case study. So just how successful has Somaliland been? Most of its success (relative to Somalia) is in civil order. Somaliland has not experienced large-scale violence since late 1996, unlike Somalia, where it’s easier to measure the months which don’t see civil war than the months that do. Somaliland looks better on economic indicators, but not wildly so. Because international organizations don’t operate (much) in Somaliland, we don’t have good health indicators, but what do do have, too, look marginally better than their southern neighbor.
I wouldn’t say Somaliland has been successful because of a lack of aid, and Phillips doesn’t go quite that far either.[6] One connection I see between aid and later prospering is agricultural. Somaliland is pastoral; Somalia is agrarian. Further, there had been less investment in Somaliland’s agricultural and domestic infrastructure, due to the dictator’s ethnic preferences.
In 1991, Siyad Barre, Somalia’s dictator for 22 years, was ousted, sparking the Somali Civil War which continues to today. Somalia was already the largest per capita aid recipient in Africa, and this had greatly weakened agricultural self-sufficiency, especially in the south. This key point isn’t really controversial: it’s consensus among academics and donors that the Somali famine was largely avoidable through better aid policy.
But other than that, what can we conclude from the lack of aid in Somaliland?
I see it as the opposite side of the Afghanistan coin which another commenter brought up. Much like Afghanistan, aid went wrong in Somalia. Really, egregiously, please-just-leave-them-alone wrong. This isn’t to say aid-done-well was impossible in either case. But maybe these were both situations where getting-it-right was so a priori difficult that it wasn’t worth the try. In Somaliland, we have the control group that we didn’t have in Afghanistan. Not through any purposeful decision, in fact through callous neglect, the international community did Somaliland a favor by just… staying away.[7]
There’s a ton of nuance which I’m missing here — what does it mean to “stay away”, how can we tell when a local or national situation is too complex, how to disaggregate “aid” to the useful and dangerous. If anything, Somaliland is a plea for modesty. As Ryan writes, aid “has very small effects” on average. But that average hides some disasters (and presumably, some miracles).
Final note: in the last few years, Somaliland’s economy has opened up to foreign investment, mostly due to its very strong geographic position and lack of pirates. The UAE is building US$250 million highway from the Berbera port in Somaliland into Ethiopia, and an Emirati company was granted a half-billion USD concession to develop the port. These have not yet come with political recognition from any of the Gulf States, but they’re much-needed external dollars. Somaliland is a fascinating and beautiful country, and I hope to visit in the next few years. Even if its history of isolation had helped it remain stable, there’s no good reason to keep its population of five million separate from the world.
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This comment is based largely on Sarah Phillips’ book “When there was no aid: war and peace in Somaliland” and conversations with two friends, one Somalilander and the other a polisci professor. In fact, this comment isn’t really that related to this post at all, I just finished this book and talked to these friends and thought it’d be a fun thing to write.
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The two books on this grey area I can recommend are Josh Keating’s “Invisible Countries” (highly recommend) and “An Atlas of Countries that Don’t Exist” (meh). For a fun short Wikipedia read with colorful maps, see here.
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This of course includes support for military and peace-building processes during and following the civil war, tho not direct military assistance. ODA isn’t always exactly what we care about. Somaliland number is from Phillips; Somalia number is from the World Bank.
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Tho, it is a messy border. There’s another quasi-state in between the two, Puntland, and the borders are constantly shifting.
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This footnote was originally longer than the entire comment, so I’ll cut it short. Somaliland was independent and internationally recognized for five days in 1960, just after their independence from Britain. Then they voluntarily united with their neighbor, forming Somalia. Almost immediately, the national government was dominated by the southern clans, and the once and future Somaliland spent the next thirty years fighting to regain their independence. They succeeded in 1991. What I meant by “contingent” is that a) the initial union was a priori unlikely, b) the union was unusually structured to make the south the stronger partner, and c) the 1991 collapse of Somalia put Somaliland in an unusually weak position to negotiate with the international community.
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Phillips’ explanation is super interesting but not really in the scope here. She proposes that Somaliland has developed a unique “independence discourse” which discourages violence and encourages inter-ethnic cooperation. In this discourse, Somaliland is exceptional precisely because of its autonomy from international structures, and finding post-conflict and post-genocide peace without external support justifies their country’s existence. The subtle and counterintuitive bit of Phillips’ narrative is that Somaliland’s weak institutions actually strengthen this peace. Violating the peace is “a choice which, if taken, is unlikely to be contained by the country’s governance institutions and therefore must not be chosen.” I love this argument. It’s very “exactly because arf not arf!”.
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This is the most pessimistic paragraph I’ve ever written about aid, and part of me wants to walk it back and say, “ok, but maybe we could’ve limited aid to the un-misappropriable, like maternal mortality interventions”, but no. I think I stand by it.
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Yeah, the conflict in Laascaanood is a bit of a damper. But the rebels control less maybe 15% of the country’s land area, and ~5% of its population.[1] Further, Somaliland has never really asserted its sovereignty over the city,[2] and it’s not particularly important.[3] It wasn’t clear in Phillips why Somaliland attempted to include the Sool region in their secession from Somalia, as it voted against the constitution in a referendum. This current flare-up is a continuation of the (longer border conflict with Puntland)[https://en.wikipedia.org/wiki/Puntland–Somaliland_dispute].
I’m generally confused by this conflict. My main thought, different from what I wrote above, is that it’s an indicator that the Isaaq majority is more willing to assert stronger political authority, weakening the clan-based power sharing structure.
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These are really rough guesses. Would be happy to see good sources.
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And neither did Puntland: “In many respects, Laasaanood seems to be part of the Puntland state of Somalia. [...] In Garoowe it becomes clear that Laascaanood is perceived as the political periphery and people there are not fully trusted by officials in the capital of Puntland.” (Hoehne, 104)
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I think it would be the seventh or eighth largest city in Somaliland, in a largely un-urbanized country.
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“Elite Capture of Foreign Aid” is a relatively recent (and high-profile) attempt at quantifying the loss of foreign aid to “leakage”. Here’s the abstract:
Leakage is higher than we’d like but not as big as some fear. An especially important finding is on how aid interacts with institutional strength and political economy in the recipient country: