Learning from Disappointment

A recent paper by Duke graduate student Peter McElroy surveys the literature on the Annenberg Challenge, a huge philanthropic school-reform initiative of the late 1990s, and reflects on whether, why, and how it failed.

A couple of weeks ago, when the new mayor of Newark was elected on a platform of opposition to a privately-sponsored school reform, I pointed out that public education has long been a minefield for philanthropy. Like many people who make that sort of observation, I cited the Annenberg Challenge (1995-2000), a half-billion-dollar bundle of grants to overhaul schools in 15 metropolitan areas, along with special initiatives for rural schools and arts education. Matching contributions brought the total cost of the program to $1.2 billion.

desks in classroom

Flickr user Geoff Llerena

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Sanford Voices Podcast: DISI has an Interdisciplinary Vision

DISI Set Pic_3

Sanford students Danny Heller and Jennifer Shen founded Duke Interdisciplinary Social Innovators this past year. The organization pairs Duke grad students with local non-profits to work on pro-bono consulting projects. They talk with the Sanford Journal about starting a student organization, working across disciplines, and how chicken and waffles led to inspiration.


Physicians’ Responsibility to Consider Cost

Physicians have a responsibility to patients – and to society, who shares the cost – to factor cost into treatment decisions. Medicine does not operate in a vacuum. Allocating dollars, in a family budget as in a state or federal budget, means making trade-offs. American medicine often ignores this reality. As a result, we spend more money per capita on healthcare than any other country but have little to show for it (see below). We’ve got to wise up. Physicians and other healthcare professionals – those who’ve chosen to care for society – should be leading this charge, not dragging their feet behind it. Some are, but too many are not. Continue reading

Tragedy in Afghanistan – The Personal Impact of Long Wars on our Military Leadership

I woke to the sound of my cell phone ringing early on a Saturday morning. I rubbed the sleep from my eyes and braced myself for what I knew would be bad news on the other end of that line. I didn’t know yet, but this time there was nothing I could do to be ready. A fellow SEAL officer and close friend of 25 years responded to my “hello?” and got right to business. “Jamie, I’m sorry to be the one telling you this, but Job died last night in Afghanistan.”  I felt the breath rush out of my chest and the tears well in my eyes – “how?” I asked. “There will be an investigation, but right now it appears that Job died from a self-inflicted gunshot wound to the head,” he responded, his voice faltering.  For several minutes, the silence on the phone line hid the currents of emotion running through our minds.  My friend broke the silence, “Will you notify his parents? They are in Pennsylvania. I need you there right away.” Continue reading

What’s the Big [Trade] Deal? The Significance of the Bali Ministerial for the WTO


By Caroline M. Kirby

The Ninth Ministerial Conference of the World Trade Organisation (WTO), held in Bali, Indonesia from December 3 – 6, 2013, brought out the best, and worst, in the World Trade Organisation and its 159 [bickering] Member States. While the achievement of an estimated $1 trillion agreement on trade facilitation (TF) is laudable—the first multilateral agreement in the Organisation’s twelve-year history—the slow rate of progress on the rest of the Doha round is lamentable.

Perhaps this lethargy can be explained, if not understood. Inherent in the multilateral trading system are stark differences from bilateral and regional frameworks, to which Member States are still adjusting. In lieu of protecting invested interests, countries must often accept vulnerabilities (i.e. restrictions on agricultural subsidies) for the sake of broad consensus. This lack of comfort and specificity makes multilateral agreements all too unappealing.

In addition, multilateral agreements can result in the exploitation of least developing countries (LDCs), who may defer to their region‘s consensus for political or other reasons. Some argue LDCs would derive more benefits from trade by engaging bilaterally and regionally instead of multilaterally.

Nevertheless, despite these and other recent criticisms of the relevence and effectiveness of the WTO, the institution remains essential to the stability of an increasingly globalized world.

Even considering the short-term economic benefits of bilaterial and regional trade agreements, the comparative advantage remains with the WTO. In the long-term, countries would be forced to expose national sensitivites for the sake of increasing trade partners.

While richer countries can indeed exploit the interests of developing countries, they can also work to protect them. The WTO is the only place where countries can address national sensitivities in a multilateral context.

The Office of the United States Trade Representative (USTR) can lead the effort in the WTO to expand gainful trade opportunities for emerging economies. As Ambassador Michael Froman has said on numerous occasions, for those countries willing to engage in earnest and who see the benefits of trade for themselves, the USTR will work to help them.

Already, USTR has demonstrated an unparalelled commitment to the WTO through its active role in securing consensus in Bali.

Let’s hope the TF deal in Bali is not a one hit wonder for the WTO. With renewed optimism for its mandate, the Organisation and its Member States, spurred on by Azevedo, can realize concrete deliverables throughout the continuation of the Doha round.

Caroline M. Kirby (@carolinemkirby) has interned with both the U.S. Mission to the United Nations and Other International Organizations in Geneva and the United Nations Development Programme in Geneva, Switzerland.




New proposed nutrition labels are here!

In a follow-up to an earlier blog entry this week, yesterday the Food and Drug Administration announced new proposed food labels. On the labels, calories and servings per container are more prominently displayed in a larger size. The new labels will also clarify that the nutrition information listed is for one serving, specifying the serving size directly, instead of leading the consumer to possibly assume that the nutrition information is for the entire container. In addition, added sugars were proposed to be added to the label to complement total sugars. To comment on the proposed labels, go to www.regulations.gov within the next 90 days.

Proposed nutrition facts label from the FDA:

Nutrition Facts Label Proposed Format (350x660)

Image courtesy of the FDA.



A great week for child nutrition and health

I was about to go to bed last night when I decided to check the blog of Marion Nestle, a well known nutrition expert, to get the latest food policy news. I was caught off guard when I saw this title, “Let’s Move! announces universal school meals!”. I checked the links, as well as the USDA website, for confirmation of the news. Sure enough, the bottom of a USDA news release confirmed the news. A recently completed school meals pilot project was going to be implemented nationwide starting July 1st of this year.

To summarize what happened, schools with 40% or more of their students receiving free school meals will be able to serve free meals to all students enrolled at that school. The costs of paying for the extra students will be cancelled out by reduced paperwork and eligibility verification costs by using current data from the SNAP and TANF programs to enroll students in the free school meals program. This implementation is good, because it reduces negative stigma at school for the children who are eligible for the free meals, and also allows more children access to good nutrition.

What is that I heard? School meals are nutritious? There is an announcement on that too this week! Ninety percent of schools have reported compliance with the new rules for school meals under the 2011 Healthy, Hunger-Free Kids Act. Yes, the final parts of the Act were not perfect, as certain lawmakers wanted to count pizza sauce and potatoes as vegetables, but it also had a lot of great benefits, such as reducing the limit on sodium, increasing the amounts of whole grains served over refined grains, increasing the amounts of fruits and vegetables served, and setting standards on the types of vegetables to serve every week to get more nutritional variety, not to mention color and taste.

And that wasn’t all. I woke up this morning to the news that CDC researchers just produced a report showing a 43 percent decrease in obesity among two to five year old children. While the overall obesity rate stayed the same, it is positive news that things are changing for the better for our young children and future adults. Getting back to schools, new limits on advertising of unhealthy foods at schools and school sporting events was also announced, and should also help to reduce consumption of unhealthy foods and hopefully obesity rates as well.

The big news for us adults may come tomorrow, with an expected announcement regarding food labels. It’s about time that food labels are revamped to be easier to read. First of all, the type is small. For a person like me with 20/20 vision, the size is not a problem, but for many other people it may be difficult for them to read the nutrition label. Second, there is probably too much information on the label for all but us nutrition geeks.

Right now the hot thing in nutrition labeling is the front of the package label, and using a stop light system based on government nutrition guidelines so that consumers can easily identify foods high in things like calories, sugar, sodium or fat. The United Kingdom has already been working on a stop light system. Even Chile got into the act, implementing a system of colored warning labels that must be placed on foods high in calories, fat, sodium and sugar. While they are not perfect, it is progress. Let’s green light this process and give front-of-package food labeling regulations a go here in the United States!




Human Trafficking in Albania: Part One

Copyright: NYTimes

Copyright: NYTimes

By Greg McDonald

This article is the first in a series of three covering human trafficking in Albania in the context of centuries-old social customs. This article discusses Albania’s recent past, and the human trafficking crisis it has experienced since roughly the end of the Cold War. It also touches on the particular sections of the Kanun, Albania’s social doctrine thought by some to be relevant or even contributory to human trafficking in the country.  The two subsequent articles will lay out hypotheses I use to test the validity of the relationship between the Kanun and human trafficking, and make general policy recommendations pertinent to Albania.


Albania’s Recent Past

Albania experienced considerable economic hardship during the Cold War under the rule of Enver Hoxha, its dictator from 1944 to 1985. Under Hoxha, unemployment and poverty spiked, infrastructure crumbled, and corruption spread. Once the Cold War ended, the country became a hotbed for drug smuggling, arms trafficking and the trafficking of women, as there was no longer an authoritarian regime in place to prevent these activities.

Although human trafficking did exist in a number of countries, including Albania, during the Cold War, the fall of the Soviet Union brought about an increase in the prevalence of trafficking. Borders that were previously closed opened up, making it easier to transport goods, services and people from one country to another. And globalization deepened income disparities around the world, making it economically possible for people to be trafficked and later bought for “consumption” in comparatively richer countries.

Since the early 1990s, Albania has experienced relatively high levels of human trafficking. Estimates place the number of women and girls trafficked from Albania between 1991-1999 at around 100,000. Albania currently serves primarily as a source (rather than a transit or destination) country from which people are trafficked to much of the rest of Europe. Male and female children are often exploited for commercial sex, as well as forced begging and other forms of criminality. The economic hardship faced by many Albanians makes Albanian women particularly susceptible to fraudulent job offers and marriage proposals, which often serve as a prelude to them being trafficked for sexual exploitation. Albanian men have been trafficked as well.  However, they are typically trafficked more locally and are usually subjected to forced labor rather than prostitution or other forms of sexual exploitation.

In recent years, the Albanian government has made efforts to proactively identify trafficking victims, used its witness protection program to protect them, and has given money to human trafficking-related NGOs. But this funding has been somewhat intermittent, which has resulted in the temporary closure of shelters for human trafficking victims. In addition, Albania still suffers from widespread corruption—specifically within its judiciary—which hampers anti-trafficking efforts in the country.


Albanian Social Customs and Their Effect on Trafficking

Illegal today, the Kanun of Lekë Dukagjini remains the most significant and comprehensive compilation of northern Albanian customary law. For centuries, the Kanun governed social behavior and everyday life in northern Albania, serving as a complete moral and legal framework and covering subjects including dispute settlement, division of property and blood feuds.

According to Siddharth Kara and others, there are two primary channels through which the Kanun has impacted human trafficking in Albania.  First, they argue the hardship placed on women in northern Albanian society—as evidenced by the social mobility and rights they lack, as well as the existence of “sworn virgins”—has made them particularly vulnerable to fraudulent job offers and marriage proposals.  Second, they argue that the Kanun’s sanctioning of blood feuds has caused the type of societal and economic unrest known to be a common precursor of human trafficking in other countries.


 The Role of Women under the Kanun

The Kanun’s arguably most well known quotation, “A Woman is a Sack, Made to Endure,” would suggest the Kanun generally holds that women are not equal to men. In terms of treatment, this gender difference manifests itself in a number of important ways in northern Albania.  In contrast to men, women are not allowed to choose whom they marry. A woman’s family decides whom she will marry, and, at the time of marriage, a bride price is paid. After marriage, women are effectively seen as property; they have few rights and little agency. Women are also not permitted to work outside the home to earn a living wage and cannot own property. Because women’s blood is considered to be unequal to that of men, they cannot incur a blood debt. Rather, when a woman wrongs her husband or even kills him, the blood transfers to her family at which point reprisals may be made. Even outside the context of marriage, women are exempted from blood feuds for the same reason.  More generally, a woman’s family is responsible for everything she does in the household of her husband.


Sworn Virgins

 In northern Albania, sworn virgins are women that have assumed a male identity and live as men; per the Kanun and the way Albanian society views them, they are equivalent to men. Rather than undergoing a medical procedure, sworn virgins make the transition to being a man via two processes.  First, they vow to remain celibate for the rest of their lives in the company of 12 witnesses; once this vow of celibacy is taken, it cannot be reversed. Second, they must dress and act as Albanian men do. Importantly, unlike women, sworn virgins are permitted to own property and work outside the home.

The fact that sworn virgins can work and generally serve in male roles in society is, in large measure, the reason for their existence. In a society where women were not allowed to vote, own property or even work outside the home, becoming more than a woman—a “sworn virgin”—enabled them to earn a living wage, maintain family property and generally provide for their families in the absence of male family members. Further, as Fatos Tarifa, an expert on Albanian culture and social issues, points out, in many cases women became sworn virgins in response to the hardships placed on men (via blood feuds) rather than those placed on women. In this way, blood feuds have facilitated and even driven transgenderism in northern Albania.


Blood Feuds

Blood feuds in Albania are a centuries-old, Kanun-sanctioned custom intended to provide redress for wrongdoing and violations of honor. In addition to murder, some offenses that can lead to blood feuds include insults, accidental killing, conflict over water rights, and, rather surprisingly, being disrespectful of a woman or “trafficking of persons.” According to the Kanun, if a “person’s honor is violated, it is incumbent on the person to take action to reclaim their honor.” Further, if a man is deeply affronted or killed, his family has the right to kill the person that insulted him. But in doing so, his family becomes a target of revenge, often leading to a cycle that results in the deaths of many more people than were involved in the original altercation.

Importantly, men are the only viable targets in blood feuds. Consequently, when blood feuds spiral out of control and take the lives of large numbers of people, families are often left with few—or no—male members, making it difficult for them to make ends meet given that women are not allowed to work outside the home.  There are also limitations to how and where men can be targeted in blood feuds.  Men can specifically take refuge in their homes, which, per the Kanun, are beyond the reach of blood feud-motivated violence. The fact that homes are off limits in blood feuds means that men being targeted often remain confined in their own homes, unable to leave or earn a living for their families. The (male) children of targeted men sometimes suffer the same confinement, as those seeking retribution may target them if their fathers or other male family members are incapable of being attacked.