Tuesday, May 20, 2008

Democracy Doesn't Scale

Oligarchy is a form of government where political power effectively rests with a small elite segment of society (whether distinguished by wealth, family or military powers).


The "iron law of oligarchy" states that all forms of organization, regardless of how democratic or autocratic they may be at the start, will eventually and inevitably develop oligarchic tendencies, thus making true democracy practically and theoretically impossible, especially in large groups and complex organizations. The relative structural fluidity in a small-scale democracy succumbs to "social viscosity" in a large-scale organization. According to the "iron law," democracy and large-scale organization are incompatible.


Democracy just doesn't scale.

Thursday, May 15, 2008

The Fistula Hospital

In the villages in Ethiopia, the girls carry pottery jars of water so heavy that their bone growth is slowed so much that their pelvic bones are often too small for a baby to pass through. A hole in the bladder or rectum can appear, the girls leak, the community shuns them, husbands send them back to their father, a separate hut is built, and they live alone unable to even stay clean. Some walk a day or two to the fistula hospital, receive free repair surgery and recuperation, some are fixed and walk back to their villages.

The girls are advised to deliver at a hospital, to start walking towards care when the baby starts to walk. At first I was drawn to the noble service of the local physicians, the countrywide need, the shame erased, ...

Until I began to think that this repairing isn’t preventing.

Perhaps the next generation will not work girls so hard, perhaps the next generation will not wed girls so young, perhaps the next generation will use birth control.

Someday there might be water at a village tap, and girls would not carry pottery jars of water so heavy that their bone growth is slowed.


One of the characters in Cutting for Stone, a fine book by Abraham Verghese (set mostly in Ethiopia), becomes a fistula expert.