Good article by Megan Mcardle on using technology to improve health care.  http://www.theatlantic.com/magazine/archive/2010/10/paging-dr-luddite/8292/

She writes:

Eventually, such systems [that unite data from multiple silos] might transform not just diagnosis, but the whole medical system. If we could develop more-comprehensive medical records, and collect that data in some central location, data mining might detect patterns in disease and treatment that we now discover only through painful trial and error. More than that, it could finally allow us to reach the holy grail of health-care wonks: paying for wellness rather than for doctors’ visits and procedures.

She concludes, as many conclude, that resistance from multiple sectors - skepticism regarding an unproven technology, reluctance to modify existing practices, and fear of new costs –  collude to prevent the new technology from being deployed.  While those issues surely contribute, I think that it underestimates the challenge of designing interfaces that allow doctors to interact with patients and simultaneously record data.  The inability to use these systems as easily and seamlessly as a clipboard is the biggest barrier to the adoption of an electronic medical record.

Doctors are as eager – and as reticent – to adopt new technologies as other professions.  Lasik surgery, medical imaging, fiber-optic procedures rely on advanced technologies.  Poor interface design and an uncertain return on investment contribute as much as the lack of regulatory and financial incentives.

Technology will Set You Free. http://www.ethanzuckerman.com/blog/2010/02/22/internet-freedom-beyond-circumvention/. Ethan Zuckerman jumps off Clinton’s Internet Freedoms speech to talk using internet circumvention to provide information to people living in closed societies. He concludes that while the State Department should fund circumvention efforts in the short-term, it isn’t the long-term answer (too expensive, only provides access to international content, and doesn’t protect publishers from cyber-attacks). He also highlights three theories of how access to information can drive change and argues that theory we adopt should influence our policy decisions. I liked: that he tied the policy and the technology together. I wished: that he didn’t imply that his three theories for change as mutually exclusive. State should be pursuing policies to support access to external information, tools for internal organization, and forums for debate that connect a countries citizens to those living in the diaspora.

Bureaucrats are Unhappy.
http://www.janbanning.nl/. The Buearocratics, a series of beautiful portraits by Jan Branning of bureaucrats around the world in their offices was worth struggling with Juba internet. I liked: the way that common themes connected government employees throughout the world. I also liked that my office in the Ministry of Public Services is nicer than any of the offices in the photographs (albeit with less character). I wished: that more of the bureaucrats smiled.

Senator Brownback is on the Case.
http://thecable.foreignpolicy.com/posts/2010/02/24/brownbacks_save_sudan_plan_a_traveling_basketball_team. Senator Brownback suggested to Secretary Clinton that having a South-Sudanese basketball team tour around the United States might help resolve the crisis in Sudan. I liked: that the Senator from Kansas knows that the Dinka are tall. I wished: that the Senator was as keen to remember that 4 million people are at risk of starvation as he is to recall that Manute Bol can dunk.

Cool Product of the Week: Bloom Energy Server is a fuel-cell that uses natural gas produces 100 kilowatts of power for about $800,000. With incentives, that’s about $.09 a kilowatt. (In DC we pay approximately $.20 a kilowatt and it’s powered by coal.) It’s cleaner and cheaper. The current version is geared to large companies, but they plan on building a consumer version for $3,000 that will recycle the carbon-dioxide to produce more power (and have zero emissions).

Consider this an open appeal for better options. I’m looking for COTS solutions that can store information and support common government functions such as Human Resources and Financial Management. There are zillions of COTS solutions that satisfy those generic needs, but I’m looking for tools with the following characteristics:

• Incorporate common desktop software. Installing remote clients on desktops and laptops that are scattered throughout rural environments dramatically increases the complexity of any deployment. Beyond the initial installation, it results in reoccurring maintenance requirements and additional license fees. While the proliferation of Microsoft Office promises one solution to this problem, modern browsers such as Google Chrome that store data locally and employ fast JavaScript engines offer another, intriguing, approach.
• Works offline and online. Low-Bandwidth does not mean zero-bandwidth. Solutions should connect to a centralized server or cloud-based data store whenever possible and gracefully devolve capabilities to a local store when necessary. In the US, developers think of offline capabilities as solving the airplane-scenario when the user doesn’t have any internet connection. In South Sudan, it’s more common to have a connection that fades in and out depending on the weather, the electricity, and the number of users. The solution should not break – and users should not lose their work – when the connection disappears. The Gmail flaky-connection mode and Outlook Send/Receive are models of how this could work.
• Consumes and conveys data in standard formats. EGovernment solutions must be interoperable. Just as the actions of one ministry impact the rest of the government, data that resides in one ministry’s solution supports the policy objectives of other agencies. Out of the box, the solution must be able to output data in standard formats that can be uploaded to adjacent systems. Likewise, it should be able to accept files that are shared via CDSs and flash-drives as a backup scenario when remote systems are not able to synchronize with the central database

In short, I want a solution architecture that is more nuanced. I want something that finds the sweet spot between desktop-centric Office customizations and client-server structured solutions. Can someone point me in the right direction?

• http://www.ted.com/talks/peter_eigen_how_to_expose_the_corrupt.html It’s TED talk season.  In this November 2009 TED talk, Peter Eigen, the former head of the World Bank for East Africa and founder of Transparency International, talks about how the global economy contributes to corruption and poor governance in emerging markets.  I liked: that every company I have worked for requires all employees to take training on the Foreign Corrupt Practices Act which prohibits payments by US companies to foreign officials.  Eigen talks about the lack of laws preventing bribery of Foreign Officials in Germany, France and the UK and it’s nice to remember that the US has had a law on its books since 1977.  I wished: that his discussion of civil society also addressed tools to expose foreign companies that use bribes to achieve their business objectives.
• http://atwar.blogs.nytimes.com/2010/02/15/marja-from-usaid-to-u-s-marines/?hp The New York Times At War blog describes the surreal experience of visiting a USAID compound from the 1960s in the Helmand Valley that had since been occupied by the Taliban and is now a police station for the Afghan police.  I liked: the ballsy reporting.  I wished: that it didn’t make me think of the reserved parking space for the SPLA at our camp in Juba.
• http://aidwatchers.com/2010/02/four-ways-brain-drain/.  AidWatch summarizes a counter-intuitive paper by William Easterly and Yaw Nyarko about the benefits of educated Africans living outside of their home country.  I liked: that it added nuance to the debate over the challenges of building capacity in emerging markets by showing that there is benefit to training and education even if someone doesn’t stick around.  If this applies to migration out of a country, it certainly applies to someone switching jobs within a country. I wished: that it had also mentioned the costs of migration by the educated workforce (such as too few health workers).  While the economic benefits of someone living overseas may outweigh the costs of training, there are other ramifications that aren’t captured by looking solely at inflows and outflows.
• http://www.rovingbandit.com/2010/02/more-arguments-for-aid-as-direct-cash.html.  Friends at Roving Bandit (the best Economics blog in Southern Sudan) argue that more aid should be direct cash transfers and less spent on expensive US-based consultants (like me).  I liked: that it presents an interesting alternative to the traditional aid model (which doesn’t always work).  I wished: that it had mentioned that 51% of the GoSS budget is already spent on salaries and 59% of 2009 USAID funding for Sudan was spent on food.

This week’s cool product:  Google Goggles.  You take a picture of painting, a monument, a strange-looking meal, a bottle of wine, or anything else and Google looks it up and tells you more about the object (the name of the artist, the history of the monument, the ingredients, the Wine Spectator score, whatever).  It’s search by picture as opposed to by text.

This week’s bonus cool product: A machine that can print organs.

Yet, its siren call remains.  Excel seduces because there is limited connectivity.  Its omnipresence – and the sunk cost of the license fee – beckons.  Developers and users are comforted by its familiarity.  Implementors tell donors that it’s just a fling, a temporary solution.  The affair begins, but next thing they know, they are crashing against the rocks.

I advocate for prototypes to gather data, set up business processes, and define functional requirements, so I am not blind to Excel’s appeal.  (To kill the metaphor, imagine me blindfolded and thrashed to the mast of Ulysses’ ship as it drifts to an enchanted Microsoft island.)  But even for prototypes, I think that costs of implementing an Excel-based solution far outweigh the benefits.  In the final reckoning, there is one good argument for Excel, two arguments against Excel, and four bogus arguments that are just myths.

Before I go through each of these arguments, I want to establish a few assumptions.  First, we’re assuming that an experienced VBA developer creates the Excel solution.  The solution catches errors, is flexible, and runs quickly.  This is not always the case, but I want to give the benefit of the doubt.  Second, there is zero connectivity.  Once again, this is not always the case (most places have some limited, occasional bandwidth through V-Sats), but I didn’t want to split hairs.  Third, the implementing partner has access to developers who have skills beyond VBA.  I suspect that Excel is often adopted out of ignorance of other solutions, but I want to assume that everyone has the resources to do what is right and not just what is expedient.

So here are the arguments.  Let’s start with the good news.

The Argument for Excel

I want to be fair and look at both sides of the coin, but after a lot of thought I can only think of one argument that supports using Excel as an eGovernment platform and even that argument comes with caveats.

Excel is Easy. I am a fan of VBA, the programming language that enables custom Excel solutions.  I have developed solutions with it (and continue to develop with it) for over 10 years.   A good developer can develop a beta-application in hours, test it over days, and deploy it over weeks.  VBA in Excel is easy to modify and while it is optimized for calculations, you can create acceptable user forms and interfaces.    In a short amount of time, Excel workbook can become a prototype and test a solution to support business processes.

If, however, the (experienced) developer has struggled to fix an error prone solution for months, it probably means that Excel is not the right tool to solve the problem.   Excel isn’t the right software for many problems (writing reports, drawing pictures, sending emails).  Excel is useful for financial models, some types of data entry, and data manipulation.  It should not be used for everything.

The Argument against Excel

Sometimes I fear that these arguments are so obvious that people don’t even mention them.    Nevertheless, they are important reasons not to use Excel.  Let’s get through them quickly.

Excel is not Scalable. Deploying an Excel solution is like putting a male and female bunny in a cage.  Little Excel solutions will be hopping around very soon.   The best argument against Excel is that it creates an operating environment where information lives on desktops and is inaccessible to the entire organization.  It empowers a single user, but does not provide enhanced capabilities to the entire organization.

Excel is not Secure. While it is possible to protect worksheets and prevent a user from ruining a developer’s precious code, it is much more difficult to implement even the most basic security requirements.  There is no (easy, automated) way to enable segregation of duties, where one use enters information and other user approves the data.  There is no (easy, automated) way to track who has viewed or modified the worksheet.  There is no (easy, automated) way to check to see if the person making updates has the authority to make those changes.   Using Excel in a context where people have incentives to be dishonest (such as payroll or financial management) is asking for trouble.

The False Arguments

These are the most interesting – and infuriating – arguments for Excel.  People make claims that Excel solves intractable problems when often Excel makes these problems worse.

Excel is a Low-Bandwidth Solution. This used to be one of the most compelling arguments for Excel, but new web standards have allowed web-browsers to emerge as strong competitor.   Modern web-browsers, which can run JavaScript and have offline data storage, offer a compelling alternative to Excel.  These solutions can run when there isn’t a network connection and can output data in formats such as XML that can easily be transferred.    An added benefit is that when connectivity becomes available, the same interface can synchronize with central data-stores and be used in an online environment.  This solution is much more elegant (albeit harder to develop) than relying on a desktop-based application like Excel.

Excel is Available on Every Computer. According to Forrester Research, 80% of enterprise companies use Microsoft Office for worker collaboration and productivity.  We’ll ignore the 20% that don’t use Office and assume Excel truly is omnipresent.   In theory, since Excel is already installed on the user’s computer, the VBA solution should work without any modifications.  In practice, however, Excel’s security settings prevent VBA code from running by default.  While this prevents malicious code from hacking into a computer, it also make deploying a solution fairly complicated.  In addition, changes between Excel 2003, 2008 and (soon) 2010 complicate testing and deployment.  It’s available, but it isn’t consistent and it still requires manual installation.

Excel is Familiar. Even if people know how to use Excel, they will not know how to use the Excel solution that addresses the eGovernment problem.   Training will be required.  Worse, Excel’s worksheet, row, column, and cell structure constrains developers and offers limited options for creating intuitive interfaces.  For example, there is no easy way to validate an entire record (as opposed to a single cell) before the solution stores the record.  Likewise, creating interfaces that support workflow and approvals is very difficult in Excel.  Ultimately, this results in unintuitive solutions that need more training.

Excel is a Temporary Solution. It’s common to hear people claim that they are building an Excel based solution as an interim fix before they can deploy the solution that will last for all eternity.  Unfortunately, that claim is rarely supported by clear plans – and timelines – to actually design and deploy the sustainable enterprise tool that will replace Excel.  Temporary solutions sans a clear plan for depreciation are permanent solutions.

Summary

If you’re debating whether to use Excel to produce an eGovernment solution, ask yourself the following questions:

• Do I want the solution to support multiple users?
• Is the information sensitive?  Can modifying the information hide corruption?
• Do I want this solution to last for more than six months?

If the answer to any of those questions is yes, don’t use Excel as a development platform.  Excel is a great tool for many things, but it isn’t a great tool for everything.   When someone suggests using it for an eGovernment project, be wary of the false arguments.

• http://lindaraftree.wordpress.com/2010/02/12/7-or-more-questions-to-ask-before-adding-icts/ Lists 7 Questions that you should ask before engaging in an ICT project.  This post, which is written from the perspective of an NGO that wants to gather data to help decision-makers enact violence-reduction policy, focuses on how to collect and use information in a responsible manner.  I liked: that she focused on questions that have NOTHING to do with the technology; the technology is the easy part.  I also liked the list of resources for using mobile technology to gather data in developing contexts.  I wished: that she had also thought about how to make the tool sustainable over time and scalable to a larger geographic area.
• http://www.economist.com/world/middleeast-africa/displayStory.cfm?story_id=15491703 and http://www.economist.com/world/middleeast-africa/displayStory.cfm?story_id=15469303.  The first article describes dynamics of the upcoming Sudanese elections and the second article (from a week earlier) describes how corruption in the South has created obstacles for investors and ultimately a for building a secure and prosperous nation.  I liked: the typical lucid Economist writing.  This is the fastest way to understand what is going on in South Sudan.  I wished: that it wasn’t so depressing.
• http://www.foreignaffairs.com/features/readinglists/what-to-read-on-foreign-aid.  An annotated bibliography of the current literature of foreign aid and very appropriate to review as State/USAID continues the quadrennial review.  It focuses primarily on development economics.  I liked: having all of these resources in one place.  I wished: that they had included some of the blogs that cover the same topics.  In particular, I would have added Aid Watch (www.aidwatchers.com) and Rethinking US Foreign Assistance from the Center for Global Development (http://blogs.cgdev.org/mca-monitor/).

I was reminded of this recently when a colleague from a competitor firm bragged to USAID that his entire team was under 30.  His theory, which was greeted by sage nodding from the USAID delegation, is that most people who operate technology in South Sudan are under 30 and that their cultural deference to older people would make it difficult to create the peer relationships necessary to understand – and solve – IT challenges.  His approach was to take smart, young people who are interested in working in Africa and release them into the provinces of South Sudan with a laptop, a Sudanese colleague, and a boda-boda driver.  Good intentions, quick thinking, and the ability to quickly build rapport would win the day.

Deloitte’s approach (and the USAID approval process) prefers more experience.  For example, we are in the process of deploying a Financial Management Information System in South Sudan and our entire team has worked on similar problems for decades.  They have the grey hair to prove it.  There are manifest advantages to having a team that knows what it is doing: they remember what has worked (and failed) before, they understand the range of applicable solutions, and they don’t have to reinvent the wheel.  In this model, subject matter expertise, the ability to anticipate future challenges, and gravitas carry the day.

These options are not mutually exclusive.  Successfully deploying a new system requires teams that include both members with significant experience and younger members for whom it will be easier to connect with local IT staff.  (This is also a great way to get analysts and consultants out of the home office and into the field.)  While every project requires a different mix of capabilities, I think that the right team can be formed based on the following principles:

Understand the Audience. I am uncomfortable arguing that age alone determines the ability to forge successful relationships, but I think that it is a factor.  The guy in the server room, the computer operator, and the analysts (i.e. the people who use the technology) are young.  The managers and the political leadership (i.e. the people who make decisions about the technology) tend to be older.  Understanding this dynamic and structuring project teams to effectively work with this range of technical capability and leadership experience, is important.

Furthermore, as part of our efforts to build capacity, it would be incredibly valuable to match junior-level IT personnel with junior-level advisors, just as we match senior policy makers with experienced practitioners.  The IT environment – its security, reliability, and accessibility – has a huge impact on our ability to deliver effective solutions.  Mentoring the guys in the server rooms and working with them to provide a better infrastructure could be multiple the impact of the project.

Understand the Technology. The public sector in emerging markets tends to have limited infrastructure and technical capacity.  While deploying a client-server (or even a cloud-based) architecture may be the preferable long-term solution, this approach requires whole-scale modifications to the operating environment.  These modifications are costly, complicated, and chancy.  For example, a 2006 survey on eGovernment in developing countries found that only 15% of implementations were fully successful.  Today in South Sudan, the government relies on a primarily paper-based process for recruitment, appointments, and payroll.  Admittedly, this process is inefficient, inaccurate, and inflexible, but it still exists 60 years after it was implemented by the colonial government.  

While I disagree with solutions that reduce everything to an Excel spreadsheet (much less paper), simple prototypes that can be designed, developed and deployed quickly can be more effective.  Designing these prototypes requires a deep understanding of the problem, but doesn’t require extensive technical skills.  Deploying staff that gravitates to the simpler, less disruptive and (potentially) longer-lasting solutions can help implement technology that is more sustainable over time.

Understand your Goal. eGovernment systems achieve multiple goals: they streamline (and sometimes create) processes, they improve data quality, and they allow governments to perform new services.   They require inter-disciplinary teams that are able to understand the regulatory environment, improve the existing business processes, develop systems, and provide training on the solution.  If you think about these projects as purely technology – or, worse, structure your team with only technologists – you will be less likely to succeed.

I have no clue whether this broad scope means that teams should be younger or older, but I think it is a powerful argument for diversity.  Technology projects demand teams with varied competencies and (some) of these skills can be best provided by younger staff.

Let me give you one example. Let’s say I want to create a mobile phone application that would allow people to rate government ministries, including ours, on their responsiveness and efficiency and also to ferret out and report corruption. The hardware required to make this idea work is already in the hands of billions of potential users. And the software involved would be relatively inexpensive to develop and deploy.

If people took advantage of this tool, it would help us target our foreign assistance spending, improve lives, and encourage foreign investment in countries with responsible governments. However, right now, mobile application developers have no financial assistance to pursue that project on their own, and the State Department currently lacks a mechanism to make it happen.   But this initiative should help resolve that problem and provide long-term dividends from modest investments in innovation.

The speech did not contain details about the shape of this initiative, but I hope that the Department of State goes beyond the typical response of providing funding and training.   Unlocking the potential of mobile developers in emerging markets and spurring economic growth requires two additional steps beyond more money and more capacity:

Create and Promote Tools for Developers. The open source community has been leading the way in mobile application development for emerging markets with tools like FrontlineSMS , which enables mass communication through text messages, and Ushahidi , which creates maps based on information submitted by SMS.   Both these tools require developers to install and maintain servers, which isn’t always feasible, and are only available to NGOs, which excludes local entrepreneurs.  The United States could help accelerate the creation of new mobile tools by provided hosted versions of these tools similar to Google App Engine or the WordPress.com instance of the wordpress.orgblogging software.   In addition, it should support innovative, open-source tools, by requiring implementing partners to use them.

Advocate for Governments to Improve Regulation of SMS. In the 2008 report ICT Access and Usage in Africaby ResearchICTAfrica.net , researchers found that Kenyans in the bottom 75% in terms of disposable income spent 63% of their disposable income on monthly mobile fees.     The cost of sending text messages, which cost nothing to transmit on GSM networks, eats up a significant amount of that expenditure.   Certain premium services, such as Google’s Trader, which allows people in Uganda to buy and sell goods via SMS, cost even more.  The State Department should encourage countries that receive development assistance to pressure mobile networks to drop the price of sending text messages.   This would be help poor people throughout Africa by reducing their mobile costs and would help spur innovation in the mobile application development market.

It was exciting to see the Secretary of State speaking enthusiastically about the role of technology in achieving the US Government’s foreign policy objectives.  I hope that they think about more than just pouring in money.

Platforms provide a common infrastructure, accepted standards, a consistent governance structure, and established service expectations.  Platforms can refer to computers or networks (the Internet is a platform) but also to a legal framework that regulates a sector of the economy or a microfinance program that provides credit to entrepreneurs.  It is a structure – occasionally physical, but also conceptual – that permits growth.  By articulating the rules of the road and building infrastructure that can be used by multiple stakeholders, development projects can meet the objectives of the donor while still creating space for local partners to pursue their own goals.

What would this look like in practice?

Common Infrastructure. In South Sudan, deploying an enterprise system faces three hurdles: limited local technical capacity, unreliable electricity, and inadequate connectivity.  Currently we address these problems in the context of our individual projects.  We deploy generators and V-Sat connections at each project office and Ministry.  When the Bank of Southern Sudan decides that it wants to allow local banks to make electronic transfers, it constructs a microwave mast.  When the Financial Management Information System project needs a local database administrator, it offers specialized training.   When the Human Resources Information System team wants to overcome the absence of connectivity in the regional States, it updates the system design to accommodate asynchronous information exchange by placing files on solid-state media such as CDs.  In each case, the project team adopts the most efficient solutions to its specific problem, but holistically this eliminates the incentives within the broader community to coordinate efforts and enjoy economies of scale.

By designing a single, comprehensive network and identifying technical competencies that can be used on multiple projects, we would be able to develop products that don’t rely on ad-hoc solutions and specific personnel.  In addition, by opening this infrastructure to the broader community, we could provide the scaffolding that other projects and local firms can use to build their own solutions.

Accepted Standards. The proliferation of technologies and standards, an unfortunate byproduct of ad-hoc infrastructure development, saps resources and prevents the deployment of scalable solutions.  In Juba, for example, there is limited interoperability between cell phone networks.  Beyond the inconvenience and expense of requiring people to use multiple cells phones, the competing options undermine the provision of new services such as m-banking.  By clearly articulating technical standards and ensuring interoperability between solutions, we will lower the barriers to entry and make it easier for local firms to take the initiative to provide services.

In addition, the adoption of standards serves as an auto-catalyst, accelerating the effects of incremental improvements as their benefits compound overtime.  For example, by employing data-exchange standards for financial transactions, we can connect the payroll system to the financial management system and ensure that they work seamlessly even if they were not originally designed to be interoperable.   Standards allow independent teams to build small pieces while making sure that the larger puzzle fits together.  They make sure that our solutions are flexible enough to adapt to future problems that we cannot imagine today.

A Consistent Governance Structure. Successful platforms attract a range of users and these users must be confident that the platform will not suddenly disappear under their feet.   Common infrastructure and standards require management that is accountable and transparent.  They require operational teams to conduct maintenance, compliance committees to provide oversight of the standards, and administrative ownership to ensure a reliable funding stream.

In the developing country context, a governance structure must be strong enough to maintain the existing investment and flexible enough to adapt to unforeseen developments. It is not enough to deploy hardware and hope.  Deploying a structure that engages local government, private sector, and the development community will increase the likelihood that the platform attracts users and provides benefits into the future.  It also increases the likelihood that the platform can adapt and become a sustainable asset for the country.

Established Service Expectations. Organizations build their own infrastructure due to a limited market for ICT solutions, a lack of confidence in the quality of services, and then absence of information to price offerings.  This leads to a situation in which each ministry and project creates its own infrastructure that is expensive and frequently inadequate.   In addition to the cost, this dynamic creates variance between the capabilities of different organizations and creates new obstacles to designing solutions that can work in multiple environments.

Service expectations specify the reliability, speed, and cost of a platform.  They allow multiple providers to emerge while ensuring that each provider adheres to a minimal level of accepted performance.  Over time, this will lead to a competitive marketplace that can provide basic ICT services to the government, the donor community and the private sector.

By promoting a common infrastructure, accepted standards, a consistent governance structure and established service expectations we can create an environment that leads to accelerated growth in ICT.   This moves beyond our current efforts at deploying specific systems and would help create a sustainable foundation on which our partners can build.

“[Intrusive paternalism] programs…are led by people who figure they don’t understand all the factors that have contributed to poverty, but they don’t care. They are going to replace parts of the local culture with a highly demanding, highly intensive culture of achievement — involving everything from new child-rearing practices to stricter schools to better job performance.”

My experience in South Sudan makes me skeptical that this approach will work in the developing country context.  Beyond my discomfort with the idea that people in the developing countries share a culture, chronic instability creates barriers that people in the US who are trying to escape poverty don’t face.  In US cities, neighborhoods with endemic poverty are a subway ride away from wealthier zip codes.  Americans living in poverty must overcome social and educational constraints, but they benefit from the opportunities of the society in which they live.  That is not the case everywhere in the world.  Somalia, which is reported to have a thriving entrepreneurial culture despite the constant state of chaos, shows that wanting to achieve is not always enough.

In South Sudan, the prospect of renewed violence casts a pall over any decision about the future.  The conventional wisdom is that now is a time to eat, not a time to build.  Convincing the South Sudanese that they can succeed is important, but that requires ensuring that the fragile peace will endure and not just imposing notions that they could be successful if only they worked harder.