On Obamacare and the Shutdown

When I'm home in the US - as I just was - one question constantly comes up:  Do you think you'll ever move back?

The truth is, I would love to at some point move back. I don't think I'm at a place career-wise where that makes sense right now, but there's also one, very practical reason that right now, I'm fighting like hell to find a way to stay in Europe: health care.

When I left for the UK, I had catastrophic health insurance. I was self-employed and with an extensive, scary family history of cancer, I was afraid that I would get sick and would go bankrupt if I had anything less than catastrophic health care. So I paid $150/month premiums in order to be capped at a flat $1,000 deductible. After that, everything would be covered up to $1 million / year.

One year, a single ER trip followed a series of routine medical procedures - pap smear, mammogram, yearly check-up with the doctor. That one trip meant I met the yearly deductible and my insurance kicked it. I knew then that as long as I was independent, I would need catastrophic health insurance.

Of course, my premiums were immediately raised to $300/month, doubling because of a single hospital visit. For those wondering, that was almost the same cost as my rent at that time (I shared a house and if memory serves, we each paid approximately $350/month). Now, I know my insurance was not expensive compared to my US friends who have multiple kids. But I was a single 30 year old, non-smoking female in good health without a history of anything serious.

At this point, I feel the need to translate the concept of premiums and deductibles into a UK term for my European-based friends, but I've never had to buy health insurance here so I have to use my phone insurance experience and hope it works. A premium is your monthly payment just to have health insurance, while the deductible is both the amount the claim must exceed before it kicks in and the excess you pay.

For my first year in the UK, I retained my US-based private health care. Even after learning I was covered by the UK National Health Service, I was afraid to give it up. Thinking I would return to the US in an uncertain job market, I didn't want to go through the pain of finding a new insurer - or try to anticipate what that cost would look like after time without insurance. So I paid over $5,000 to cover me for 18 months just so I didn't lose the right to be healthy.

For my UK and European friends, the concept of anyone paying $5,500 in addition to taxes just for a right to be taken care of is an insane proposition. Some of my friends know of my first trip to use English health care. I had one of those things women get that we need to go get an official diagnoses even though we know what the problem is. I called the Nurse's hotline to ask if I really needed a diagnoses or could pick something up over the counter. I needed a diagnoses. I explained I was American and asked how to use my health insurance here, knowing it covered me overseas.  She said she wasn't sure of the procedures in my area, but I would probably have to pay $25 and then submit the claim for reimbursement.

I went, got my diagnoses, and picked up the drugs from the counter as I'd been told to do. "How much do I owe you?" I asked, flipping my wallet open and putting my hands on two £10 notes. "£7.10" the sweet nurse replied.  "Oh, um, I think I owe you more than that.  I'm an American."

I said more about US health care than I intended.  As these graphs, compiled by Ezra Klein, indicate, as an American, I'm used to paying almost double the average cost to industrialised states. And according to an article in the Journal of the American Medical Association, that increased cost didn't get me better health care. It got me "mediocre" healthcare.

The nurse behind the counter looked at my slightly indulgently and said, "You live here, though, don't you?" "Yes, but I'm a student."  "Right, but you live here, so you only have to pay for the prescription."  "But, I'm a student. I think I owe you more money." "No, love, you live here so you only have to pay for the prescription." "But, I'm just a student. From the US."  "Right."  I could tell she was starting to lose her patience with my inability to accept free-ish healthcare. She reassured me the lady on the phone probably didn't realise I was a student, but it really, truly was free. Except for the £7.10 for the prescription.  If I was poor, that could be waived, too.

I left, set aside £25 in an envelope and didn't touch it for 3 more months, waiting for the bill to come. It didn't.

Then, there was the time I broke my leg. I got laughing gas and morphine, an ambulance ride to the hospital, x-rays (multiple), a cast, crutches, pain killers, and follow up appointments for the grand total of $ 0.  For those from the US, let me reiterate: that's not a typo.  I paid zero dollars.

Technically, I paid for those X-rays, etc., before and after through the taxes I pay.  But it was so nice in that moment to not have to quickly calculate how much money I had in my bank account, minus rent and phone and food costs to determine how much I could offer as a first payment towards my treatment.  I just sat there, begging people to give me water and getting a recurring 'no' until a doctor could confirm I didn't need surgery.

I also thought about how I would get home, when I should bother my friends with the information that I'd broken my leg, and whether I should call my parents before I learned about that potential surgery.  I never once thought, "Can I afford this?"

When the laughing gas wasn't working, I didn't hesitate to tell the paramedic it wasn't working. Well, that's not quite true. I tried the gas for about 7 minutes; it regulated my breathing but did nothing for my pain.  The US-trained part of my brain briefly thought, "Shit - can I afford --" before the UK side of my brain said, "Don't worry! You won't need to pay for a switch in treatments!"  I looked him in the eye and said, "This isn't working. I need something stronger."  He offered morphine; I said yes.  Within 5 minutes, I was feeling a lot better.

Then there was the cancer scare. I haven't told very many people about the cancer scare.  It happened over the summer, and I got the news 2 days before I left for Turkey. They set up the follow-up for the day after I returned.  Two weeks later, a letter informed me I was cancer free, but would need to be seen again in six months.

The other health issues were minor and I never worried that they would actually affect my ability to get health insurance in the US.  What I was concerned about was how my use of a national, universal, and foreign health insurance system would be counted by US insurance companies, who, prior to Obamacare and if they accepted you, had to cover pre-existing conditions if your insurance had not lapsed by more than 6 months. If they accepted you. At least that was the rule in Ohio.

It was the cancer scare that made me realise I actually only knew the rules in Ohio.  And even then, I didn't know whether the UK national insurance system would count as being "insured." Surely it would, right?

I only cancelled my almost-as-expensive-as-my-rent health insurance when I was back in the UK starting my PhD.  I realised I was staying for at least 3-4 years and that I would hopefully get a job teaching here after. I decided the expense of US-based health care was too much.  I was paying $3600 / year not to be insured in the present, but to protect the potential need for health insurance five years down the road.

That cancer scare, though, made me wonder: what if my UK coverage doesn't count?  What if returning to the US suddenly meant I couldn't get health insurance that included coverage for cancer treatments?

The answer is clear: I literally cannot return to the US but for Obamacare.  I would have to do anything I could to find a job or way to stay in the UK or Europe.  I would seriously need to update my online dating profiles.  I would need to be willing to accept jobs below my qualifications and to do things like teach property or wills and trusts, not exactly my go-to for excited teachings.  But I would do it if it would secure me the necessary right to remain.  The right to have a future cancer diagnosis covered.

That's ultimately what Obamacare - actually, the Affordable Care Act - is about.  People want to make it into something big and bad: a tax; socialism; government intrusion; new welfare; Hitler-esque notions of government.  But Obamacare is actually about allowing people to get coverage that couldn't get coverage under the old system. It's about giving people an opportunity to be healthy.

Some will get that through government assistance, but I am unlikely to be one of those people.  I am one of those people who are not only willing but able to pay into the system for insurance but who under previous rules would be unlikely to get coverage if I returned to the US - or at least unlikely to get insurance that would cover the thing I fear the most and the thing I would most need coverage for (cancer).

Of course, this is the second time that cancer has dictated life and career choices in my family.  The last time was after my mother's treatment for breast cancer in the 1980s.  It was before HIPPA - the health care privacy act that ensures if you're diagnosed with something your employers or future employers don't get to know about it unless you tell them.  It's the law that helps tamper down health-related discrimination.  Before HIPPA, my mother was told she was too costly to employ as a teacher; her cancer negated her excellence in the classroom and she took a job selling real estate. It's a nice job, and she's good at it, but I've always thought she should've been back in the classroom.  By the time HIPPA was introduced, though, her teaching credentials had lapsed and it would've been costly for her to go back and pass the classes necessary to get re-licensed.

We passed HIPPA because of the absurdity of situations like my mother's; we passed the ACA because of the absurdity of situations like mine:  that someone can be denied health care not for anything within their control, but for the very reason they would need health care, because they got sick.

Now the GOP wants to stop it and they are willing to sacrifice the good faith and credit of the US to do so. For reasons they haven't ever been able to really articulate, much less prove - unless "it's evil" and "it's socialism" are legitimate accusations.  But they aren't.

The ACA is one of the most capitalism-loving forms of universal health care. It actually mirrors the systems in the Netherlands and Germany. It allows for insurance companies to be competitive, while requiring they also do part of the job of the medical profession: ensure people who get sick can get better to the extent science and God allow, not to the extent their wallets can afford.

Yes, the ACA requires people to buy something, but it requires them to buy something that we as a society would have to pay for if they didn't buy it. In that sense, it encourages individual responsibility.

If I had never left the US, I still could have found myself in the same position I'm in now - cancer scare, no private insurance. It's the reality for millions of Americans, sometimes through their own fault, often times through no fault of their own.  If that had been the situation, I would have found out about the potential cancer after more symptoms developed, meaning after it had developed into cancer and had progressed to a stage where it is harder to fight. My necessary or emergency care would be covered by the government, meaning the other taxpayers.  And I would probably die because I wouldn't be able to afford the medicine or treatment. So the government would be paying not to get me better but to make sure my pain wasn't excruciating while I died.

Instead, the ACA gives me an opportunity for early diagnosis, takes the burden off other taxpayers to pay for my care, and gives me an opportunity to live. It gives me assistance in finding healthcare if I've had problems finding it, or if I'm still too poor to actually afford it.  And it does so while remaining true to capitalism.

The GOP wants to make the ACA some big bad socialist plot to kill America.  It's not.  It's a program for people like me.  And it's the only hope I have of returning to the US full-time in the future.

On Christianity and Homosexuality

I really wasn’t going to discuss religion on this page, but … a few friends posted on facebook A Teen’s Brave Response to "I’m a ChristianUnless You’re Gay" and as I quietly wiped away the tears this young man’s story inspired, I thought about Kayla and Kylie (not their real names) and felt inspired to write.

Kayla had transferred into my high school, which left her at a social disadvantage for a school where most of our 360 classmates had known each other since fifth grade. Kayla is quiet so while I knew who she was when we graduated, I’m not sure I ever had a real conversation with her in high school. I don’t know when she joined us, but I know she was in my twelfth grade psychology class. I know because over a year later, while attending the same undergraduate, she came out to me. Then she told me a story I hadn’t really remembered. Please keep in mind that this was the mid-1990s, before either Ellen or Rosie had publicly come out of the closet. Mr. M., our psychology teacher, had started our class on whether gay people should be allowed to adopt children by acknowledging that every year this was a difficult subject. Every year, he said, someone would come up to him after class and tell him he was gay, and Mr. M. wanted students to know at the outset that if they needed someone to talk to after this class, he was there. Even while he said this, though, I looked around the classroom and was firmly convinced no one there was gay. Surely, we would know right? I mean, we had been in school together for around seven years, how could we not know something so fundamental about a person? Plus, weren’t gay people supposed to be obviously gay?  Weren’t you supposed to be able to tell they were gay by the clothes they wore or their hairstyles?

Now virtually every person in my hometown would’ve claimed to be some type of a Christian.  We had something like 6 Catholic churches, 2 Methodist churches, a Lutheran, a Seventh Day Adventist, a Presbyterian, and some others thrown in. And those are just the ones I can name off the top of my head. I had been raised in the church and spent most of my high school time – sans a period towards the end when I was an atheist – professing Jesus Christ as Lord and Saviour. Yet, what came out of my friends’ mouths was shocking.  Sure, my parents didn’t like gay people, but they at least tolerated them.  They recognized they were human.  And if they were human, didn’t they have the same right to love and marriage and children and family as the rest of us did?  I mean, I’m not sure both of my parents believed all of this at the time, but they at least recognized the humanness of gay people and I made the rest of the connection on my own.  My classmates did not.  I was alone in my defense of gay parents.  After (or maybe during?), someone said that I must be gay and I remember replying that if I was, there was no way I would’ve been able to defend myself. I would’ve remained silent and alone.  That might not be true – I’m an emotional extrovert and I can’t imagine I wouldn’t have burst into tears during the debate if it had been that personal.  But it wasn’t personal – it was theoretical.  I was, however, concerned that others would also think I was gay and wanted to be clear that I was not.

When I got to university, I joined InterVarsity Christian Fellowship and a sorority.  I think these two things led Kayla to wait a little longer before telling me she is a lesbian. Or maybe she just needed a little more time before she felt she could tell people from her old life. I was only the second person from my high school to know – Mr. M. was the first.  I vaguely remembered the class; she remembered it in detail. I was the only person who didn’t make her feel like a freak.

I wondered then if my classmates would have said things differently if they knew someone in the class was gay. Would they really have been so harsh in their word choice? Would they really have suggested she was a freak?  That someone was inherently wrong with her? That she would be damaging her children? That she could turn her children gay?  I can’t speak for my high school classmates, but I generally think of them, on the whole, as caring and thoughtful individuals.  Sure, there was some bullying (though thankfully not as bad as what I’ve heard of in other schools, nor as bad as Hollywood portrays in their fake high schools), and high school students can be cruel (myself included; apologies to CL for my ill-spoken and unwarranted words), and there were clearly cliques. But, by the time we graduated high school – and definitely all these years later when we’ve reconnected as adults – my high school classmates seemed to really come to care for one another. As a class, we had faced the deaths of friends, the deaths of parents, illnesses, puberty, prom, and obviously all our first heartbreaks. In the end, we actually wanted to see the others succeed and be happy.  So would my caring classmates – the ones who spent two days celebrating our 10 year high school reunion with more honest conversations than we probably had in all our years of schooling; the ones who still send me encouraging emails or fb messages after a bad day on the PhD; the ones who celebrate each other’s births and weddings and engagements and professional successes – would they have reached out to Kayla if they knew they the pain they had caused her?

Kayla deserved better from our class.  She deserved better even from me because while I may have recognized the humanity for theoretical humans, I hadn’t recognized the pain that someone was suffering in front of me. I had never questioned the stereotypes; I had never sought to know the reality.

Kayla was the first friend to come out to me as gay. A few others had declared bisexuality, and later more would do so.  Generally, each declaration was followed with a simple question: “So, do you think it’s a sin?”  I find being an open Christian leads a lot of people to question me about sin – or to confess their own perceived shortcomings. It also leads to a lot of questions about life, God, and religion.  In law school, girls would tell me, “I used to be a good girl like you, but then I met this one guy and fell in love…” or “I used to be a Christian but then…” or “When I was in eighth grade, I stole…”  or “How can you be a Christian and …”

When the Christian Legal Society adopted national requirements that leaders not be gay, it opened a can of worms within the chapter of which I was then President.  The head of Out & Allies asked me what I was going to do about it.  The chapter decided – after a contentious debate – that we wouldn’t adopt the national guidelines and we would turn in our credentials. When I stepped down as President, though, the new Presidents negotiated our membership with reworded bylaws. It would still exclude gay people from leadership but would also list other sins that were equally bad, like pride and heterosexual sex outside of marriage.  But having been in Christian leadership for over six years by then, I knew I would never be asked about my own sexual purity; I would never be asked to step down because I was too prideful or too arrogant or too … well, anything, really, because I wasn’t gay and I was a Christian. Our Vice President at the time was engaged and no one had once questioned her about her sex life. I dated a high number of men in my 3 years of law school and I was never asked about my sex life.  But if I had been gay, the mere “lusting in my heart” for another woman would have likely disqualified me; I most certainly would have been subjected to routine questioning to ensure I was “pure” enough to be a leader. So I left CLS.  I couldn’t talk about the love of Jesus for every human being while being a part of an organization that automatically created a second-class citizenry.  I retained my Allied status in Out & Allies and today remain proud of the way my life is reflected in my law school accomplishments: member of journals; former President of CLS; Ally; and, yes, my name even hangs on a plaque in a bar across the street from our law school.

I have not always handled my friend’s comings out well.  When a guy I had once dated told me many years later that he had a confession, I expected to hear he had never gotten over me. Instead, he told me was gay. I was initially less than gracious. I had mourned the end of this relationship for years, not understanding what had gone wrong, and his being gay made me feel that the chemistry I had felt was a lie. It also made me angry that he hadn’t told me sooner, thereby explaining what had always felt unexplainable. When I realized I had acted badly, I tried to rectify it, but even then it just ended in my lecturing him about how I didn’t find sexuality something he needed to ‘confess’ to people. After all, I don’t go around ‘confessing’ that I’m a girl or white or anything else that I consider just an intrinsic part of who I am.  Yeah, super gracious. 

I don’t remember exactly what I said to Kylie, a friend who came out to me more than a decade after Kayla did.  I assume I said the same thing I have most of the other times: Thanks for being willing to share that with me. With over a decade of experience, I have found that to be the most honest and most necessary thing to say. I do remember, however, a conversation that came later. A drunk Kylie told me she wished she wasn’t gay.  Perhaps, she said, she really was broken.  And if she wasn’t gay, then she could be honest about who she was with her conservative family. Such sentiments had been repeated to me often over the years.  And then she asked it:  Is it a sin? Do you think I’m sinning? Here’s my answer for Kylie, and for the others who have asked as much to me:

Honestly, I don’t know. But more pertinently: I don’t care.

It’s important for Christians to understand what Kylie was really asking:  Do you think God loves me as I am or do I need to try to be something I inherently don’t think I am or am capable of becoming just to gain His acceptance?  And on this point Christianity is unequivocal: we are all broken somehow, and regardless of where that brokenness comes from or how it manifests itself, God loves us, and in the words of “Bridget Jones,” He loves us just as we are. Unconditional love. Acceptance. Forgiveness for what’s wrong; pride for what’s right. He loves us.

I have heard Biblical scholars who suggest that homosexuality is a sin and Biblical scholars who state that it is not under the new Covenant of Christ. I have had gay friends who are Christians and believe they are sinners and those who think they are not. It is an area I don’t think about very much because I’m not gay. Christ didn’t tell me to worry about whether other people were sinning. He told me to worry about my own sin.  Only when I’ve taken care of my own sins am I to worry about encouraging others not to sin. 

I have a lot of sin in my own life. I’m prideful and arrogant fairly often. I’m envious pretty much daily. I gossip when I should remain silent. I let fear control my responses to too many things. I am gluttonous. I lie, sometimes even to myself, and manipulate people, sometimes including myself. I withhold forgiveness over stupid things. At times, I’m lazy and procrastinate away God’s plans for me. I speak without thinking, and in doing so cause pain. And I reject God’s path regularly as I try to control things I have no control over, reject his call for me to do things I don’t want to do, and too often turn away when I feel He isn’t giving me what I think I deserve.

Quite simply, I am Jonah. 

Jonah, who was asked by God to tell the Ninevites to stop sinning. Jonah who told God he didn’t want to because he hated the Ninevites and he didn’t want them to repent. He wanted God to punish them. Jonah who ran away from God, boarded a boat and thought he could escape God’s calling by crossing the sea. And when Jonah ran from God, he really ran from God. He wasn’t just going from Israel to Turkey. Nineveh is now known as Mosul, Iraq, and Jonah boarded a ship to cross the Mediterranean, meaning the exact opposite direction. When God told Jonah to come back, and then started a storm that resulted in Jonah being tossed into the sea, Jonah was so freaking stubborn that he actually sat inside the belly of a big fish for three days because he didn’t want to do what God wanted him to do. He was hateful and selfish and arrogant and thought he could outlast God.  He was hoping God would blink first.  Talk about stubborn!  And that is me. 

I even talk to God like Jonah talks to God. When Jonah didn’t get his way – because he told the Ninevites to repent and they did, so God didn’t unleash his fury on them – Jonah threw a hissy fit. He actually told God he tried to forestall His grace for the Ninevites and he’d rather die than live after helping them. He sat in the dessert pouting like a child. When God tried to help Jonah understand his grace by using a tree, Jonah just became angrier, telling God he was “so angry I wish I was dead.”  I’m similar in my brutal honesty with God, telling him the other day – in worship! – that I hate the fact that English worship songs use music I’m not familiar with.  Then I realized I had said I hated something about worship and apologized. A few minutes later I was making a joke in prayer because God gave me a worship song where I knew the music but the lyrics were all changed, with the English church singing about how “My King rides a donkey.”  I couldn’t help but joke with the One who brought me all that.

Whether you take the Bible as literal or as part literal, part figurative, or as all fully man-made, you have to admit that it’s not a good sign of your religiousness when the character you relate to the most is Jonah.  Not Elizabeth or Ruth or Mary or the other Mary.  Jonah.  Because I’m pain-in-the-a$$ stubborn.

So I concentrate more on what the Bible says about pride, envy, and forgiveness than I do about homosexuality. I have too much on my own sinful plate to spend time worrying about whether something else I’m not engaged in constitutes sinfulness.  Too many planks in my own eye to be thinking about whether I see a splinter in someone else’s.

And Jesus loves me anyhow. This is something I believe with my whole heart.  And if I believe that with my whole heart – if I believe that in my most selfish, stubborn, unrepentant moments, Jesus loves me – how in the world can I consider myself well placed to hand out judgment to others? How can I possibly know what separates them from a relationship with God when nothing I do separates Him from me? And if I believe God loves each and every person He creates in his image – and I fervently do – than how in the world can I do or say anything less than loving to them?  If God wants a relationship with them – and I believe He does – how can I tell them He would reject who they are? How can I make them feel they are anything less than a reflection of God’s divinity and wondrous hand?

Professionalizing Human Rights (in which I point out the slightly obvious fact that Invisible Children’s Jason Russell isn't alone)

Human rights is my first true love. Long before I knew the term "human rights" - and definitely long before I realized I thought boys were cute rather than cootie-filled - I understood the concept. When I was about six, I gathered a few friends up to go collect money for poor children. I had seen a particularly sad story on the news – well, particularly sad to my six-year-old brain – about poor children. I don’t know if it was that they wouldn’t have food or they wouldn’t have toys for Christmas, or that they had lost their home in a fire, but it was the kind of story that my thirty-something brain is now used to seeing a couple of times a year on the local news. At six, my parents had already drilled into my head that I could do anything I wanted, and I wanted to help. So, we got a tin can and went around the neighborhood asking people to donate. Of course, I didn’t realize that I was living in a poor area of our city so a significant number of people who said they couldn't donate really meant it, some chuckling at us as they closed the door, likely thinking, "They don't realize they're poor! Silly kids." Then, there was a woman who told us we couldn’t collect money like this, that we needed to hand out receipts and have a register of all donors. That is true, by the way, but I was six so she could’ve just given me fifty cents and allowed me to learn about the intricacies of charitable donations and finance when I was seven or eight.

But, a few people were highly encouraging. They told us how wonderful we were for being such giving and caring children. I don’t remember how much we ended up collecting that day – probably just a few dollars, but my dad took it to some organization to ensure it got to the poor people I had seen on TV. I felt good about what we had done; I felt good about the kind of a person I had become (yes, at six I had “become” all that I needed to in my mind - I mean, I needed to get taller and learn to put on makeup at some point, but intellectually, I was obviously super smart and all I needed to become).

By eight years old, I had decided I wanted to be President of the United States so I could end poverty and ensure peace throughout the world. It is a self-indulgent and idealistic dream, but it was an appropriate idealism and self-indulgence because, well, I was eight years old. And fair enough, my idealism and self-indulgence lasted until my twenties when I realized that world peace is a lot harder than Miss America contestants make it out to be and that human rights isn't about me. Until that point, though, I really thought that I could be the one to change the world. I would bring about lasting changes in Rwanda. I would get the former Yugoslavia to love each other again. I would shape little hearts and minds, build schools, feed the world’s poor, etc. I. I. I. Because I could change the world and only I cared enough to do it well and do it right.

At some point in my twenties, I realized that I was actually unlikely to accomplish much of anything close to my goals. I could accomplish something only by pairing up with other people who were intelligent, thoughtful, knowledgeable, creative, and dedicated. (This was not, by the way, a realization made from a point of humility or out of self-doubt. As I told an ex-boyfriend more recently than I should be willing to admit to, I really do consider myself to be kind of f-ing brilliant. Not on everything - I increasingly need a calculator for simple mathematics, but on the whole.) More importantly, any contribution I make is only relevant to the extent that it is the contribution desired by those who need my great solution.

If I decided I was going to feed the entire Middle East by developing pork farms, I would be useless. My great plan to eradicate poverty in the Middle East would be a waste. Similarly, starting a beef emporium in India would be a laughable solution to hunger there. These “solutions” are an obvious mistake to anyone who knows even the smallest bit about Islam, Judaism, or Hinduism. But, the principles at the heart of this lesson are lost when we get to more complex problems in human rights, international assistance and development. We lose our recipient-focus and it suddenly becomes all about the donors: it is the donors who determine the projects; it is the donors whose interests need to be met; it is the donors who dictate what should be done and who should be targeted and how they will rebuild a country, start building a country, or provide security and human rights to a state or community or group in need. Sure, they all “involve” and “engage” the “local community” in decisions, but the longer you work in human rights, the more you realize that so often that that “involvement” and “engagement” is not widespread, it’s not democratic, it’s not representative, and often it's not honest. It’s a manipulation of the local population to get them to agree that what you are saying you are going to do is what they actually need. Even if they've already had someone do exactly that same thing last month or two years ago. As David Damberger, founder of Engineers Without Borders Calgary, pointed out in a Tedx Talk, this leads to the rebuilding of wells in cities that had a well built there five years ago but because no one trained the local population how to maintain the well, it no longer works.

In the last month, I’ve felt a little pelted with the egocentric nature of some in the field of human rights, development, and international aid. One only needs to spend a little time on Stuff Expat Aid Workers Like to get a sense of the me-ness of the field, but I love SEAWL for its self-critical snarkiness, so it never sends me on the downward spiral of questioning the professionalism of human rights or railing against the current status quo of our field. Instead, it started when I read a fantastic report from the International Legal Assistance Consortium about their Assessment Mission to South Sudan. In what at times is a quite scathing report, ILAC notes that most of the projects undertaken on rule of law in South Sudan are done so for the benefit and goals of the donor, not necessarily in view of the needs and desires of the indigenous population.

Then, I read this Q&A with Jason Russell, one of the founders of Invisible Children who narrates the viral Kony 2012 video. Russell and Invisible Children have been pilloried in the media and by human rights and humanitarian activists for the video. A collection of criticisms can be found here and here, and in a brilliant video by Ugandan Rosebell Kagumire that can be seen here. In this brief intro into Russell’s mind, we find two answers, which I think say more about him and Invisible Children than anything we’ve read in the media or on their website:

3: Where are you from and where are you going?

I am from San Diego California with an upbringing in musical theater. I am going to help end the longest running war in Africa, get Joseph Kony arrested & redefine international justice. Then I am going to direct a Hollywood musical. Then I am going to study theology & literature in Oxford, England, and then move to New York to start “The Academy” – which will be a school where the best creative young minds in the world attend.

4: Who is your biggest hero?

If Oprah, Steven Spielberg and Bono had a baby, I would be that baby.

Now, in fairness to Russell, I want to point out that this was released a year ago, well before Kony 2012, and perhaps he would change some of his answers. I’m not sure how old Russell is – I can’t find it anywhere in media reports or on Wikipedia, and so I’m done attempting, even though if I put my lawyerly sleuthing hat on I’m sure I could find it out eventually – but he was an undergraduate student in 2003 when he and his two mates went to make a video about Darfur and discovered that the LRA existed and had been abducting child soldiers for their campaign in Uganda. Jason, Laren Poole and Bobby Bailey decided they were going to free all the child soldiers in Uganda and they were going to do this by raising awareness of the situation in the US. Based on the time they were there in relation to my own life, I'm guessing they're about 30 years old and were 21 or 22 when they started this ride.

Unfortunately for them, Joseph Kony left Uganda three years after they decided they would track him down in Uganda, arrest him, and free the entire country. But why let a little fact spoil a good story and an ever gooder goal (yes, that gooder was intention)? So, the Kony 2012 film focuses pretty much on Uganda, leaving the impression that Kony is still a massive threat (he’s not), still operating in Uganda (he’s not), and that the only way we will save Uganda – or in Russell’s words “end the longest running war in Africa, get Joseph Kony arrested & redefine international justice” - is if Americans and other westerners buy a $30 kit so they can wear a bracelet and plaster Kony’s picture around… Cleveland? Washington DC? Colchester, England? All of the above, I guess. (It isn't.) Uganda? They don't really need posters of Kony, so … no need to be sending money there, I guess.

Now, it would be easy for me to just pick on Russell. After all, he compared himself to the hypothetical offspring of Oprah, Bono, and Steven Spielberg. And he declared he would help end the war in Africa and redefine international justice. I'm not sure how he thinks international justice works, but if he wanted to redefine it by ensuring a war criminal is arrested, he really needed to be involved sometime prior to 1994, or at least in the early years of the ICTY and ICTR. By now, arresting a war criminal doesn’t redefine international justice, unless that war criminal is Omar al Bashir and you’re getting to arrest the first sitting head of state for trial before the ICC. But, whatevs. Details, details.

The point is that Russell’s answers are all about what he is going to accomplish. Not partnerships, not service, but, rather, Russell is going to singularly (or in connection with the others at IC, I guess) end a war and redefine justice. Now, here’s the thing: unless you’re actually Ugandan, you’re probably not going to end a war in Uganda. You might be particularly important to process if you’re of the stature of Kofi Annan and are asked to mediate the negotiations. But, the heads of NGOs – particularly those involved in denouncing one side as war criminals – don’t get to mediate peace negotiations. That’s left for diplomats, because, well, they’re diplomatic and are less likely to make arrests and prosecutions a requirement of the peace process.

I was supposed to be in Uganda a few months ago to help in a training program on the oil industry. Because of funding cuts, I didn’t get to go, but I did help prepare the training program and advised on embedding human rights into two draft Petroleum bills. I also learned a lot about Uganda and what Ugandans are concerned with. Not as much as I would like, but I got a good sense of it because even though others had to find out exactly what the Ugandans wanted through extensive discussion with Ugandans, I wouldn’t have been able to do my job without some insight (and extensive meetings). Joseph Kony isn’t on the list.* Not really, anyhow – he might be there, but he’s pretty far down, as evidenced by the “growing outrage” in Uganda over the film. Because he doesn’t pose a threat anymore.

*I do realize that he is probably on the list for some people in Uganda, and this is not intended to be a statement on behalf of all Ugandans. I am not Ugandan, so it would be unwise of me to speak on behalf of them - they're able to speak for themselves - but that's the general, situational assessment I've made. And it seems to be backed up, at least from some news reports.

Is Kony a bad guy? Yes. Is he a war criminal? Probably (but I do believe in the presumption of innocence until conviction). Does that mean that Ugandans would be better off if he were arrested and brought to justice? Maybe in the justice-as-deterrence sense, but not in the immediate needs-oriented sense. Yet, Russell is resolute, rebuffing criticism and telling NBC’s Today show that “[w]e can all agree we can stop him this year. … We’re not going to wait.” So what’s keeping Russell’s commitment to arresting Kony alive? My guess – with particular insight from that interview? Russell’s needs. Not Uganda’s, but Russell’s.

I wish the problem was limited to Russell, and then I could just join in the fun with those making snarky comments about the white guy from southern California with a saviour complex who is, probably unwittingly, a great patsy for the military industrial complex in the US. Instead, the ILAC report on South Sudan indicates that there are a lot of Russells out there in the international aid and humanitarian business. Here are a few highlights from the report:

To address the lack of judicial manpower, the Chief Justice has proposed hiring an additional 100 judges. Given the lack of lawyers in the country, it is unclear where qualified personnel can be found to fill these positions without decimating other institutions. UNDPKO apparently has funding to hire more than 40 new judges and prosecutors, including a majority of non-South Sudanese. … However, under the current restrictions on the UNDPKO program, these professionals will have limited functionality, and it is unclear if they will provide any significant assistance to the beleaguered judiciary.” (pg. 12)

So, UNDPKO has the funding to provide individuals who will ultimately provide no real relief to the South Sudanese judiciary?

“First, a tremendous number of international organizations, NGOs and contractors ostensibly have worked on constitutional and rule of law issues in South Sudan before and after independence. If their reports and websites are to be believed, each has accomplished remarkable feats, made all the more remarkable by the fact that many seem to have accomplished the same feat.” (pg. 20)

“Why has this occurred? Based on our observations, three reasons emerge:

Some projects are driven more by the donor/implementer’s needs than the recipient’s needs. In this era of matrices, management theories, and deliverables, donors insist on tangible results for a project. Goals must be set and met, regardless of the situation on the ground. Accordingly, international consultants “assist” their indigenous counterparts … Boxes get checked for goals and milestones – set by donors – that are met.” (p.20)

In South Sudan, the bureaucratization of the technical assistance effort, coupled with the scarcity of committed indigenous partners, often has meant that projects proceed primarily to meet the bureaucratic goals of the donor/implementer, with little meaningful long-term impact on the South Sudanese system. (p.21)

I eliminated some of the other quotes that targeted specific organizations (in part, admittedly, because I may need to interview / work with them for my PhD research), but I found the entire tone of the report quite telling. There doesn’t appear to be that much difference between Russell’s treatment of Kony and that of some in the IGO and NGO community toward the rule of law in South Sudan. It’s not about servicing the client – unless you really believe the “client” in South Sudan is the UK, US, or Norwegian governments, or a mega grant writing organization. It’s about meeting the “me” needs of the donors. What do I want to see? What do I think would be important? What do I believe South Sudanese would benefit from? And what will prove that I am the one “saving” South Sudan?

Coming from a law background, I can’t help but believe that these attitudes harm not just the individual missions they are supposedly designed for, but also the perception of the benefit, reality and professionalism of what we do in the fields of human rights, international assistance and development. We are supposed to be field orientated around a professional service. In other professional service-oriented fields, though, the needs of the client are sacrosanct, not the needs of the service provider. As a lawyer, I can give advice based on what my clients want and need, but I can’t tell my client I’m going to franchise his business because I think franchising is important, or it's what I've been working on for another client, or because if he just trusted me a little bit, he would see it's real benefit and potential. The client gets to dictate what she needs and my job is to answer that with a quality product that provides her with protection and both short- and long-term benefits. Similarly, when you go into the ER (or A&E to my British friends) for a broken leg, the doctors don’t get to take out your appendix because they really want to bank more surgery hours. If I tell a doctor I've broken my legs, he'll give me the best treatment for my broken leg, not for some condition I haven't mentioned because I don't have it and am not exhibiting any symptoms.

Professionalism demands a set of ethics that puts the client at the heart of the work. You might have great ideas and grand plans for what you as an individual or you as an organization can accomplish in a community. Unless you know that your grand plan is meeting the needs and desires of your client, though, your greatness is useless. It is filling up a me-me-me need that you have, but it’s not addressing the client and therefore it’s not actual service.

My six- and eight- and eighteen- year-old selves were all about me. My feelings, my goals, my need to change the world. At some point in my twenties, though, I realized that human rights isn’t about the good internal feeling you get when you hand someone a bowl of food at the soup kitchen. It’s about serving the people not because it feels good, and not because at the end of the day I get some great pictures and some weak praise, but because it is what elevates their human dignity. It’s about figuring out how to get the guy in the soup kitchen that bowl of soup (or something more fulfilling and healthier) in a way that is more regular, more sustainable, and more addressed to their needs and their human dignity than the daily trip through a soup kitchen.

The great Woody Hayes (Go Bucks!) once said, “Any time you give a man something he doesn't earn, you cheapen him. Our kids earn what they get, and that includes respect.” I don’t actually agree with that statement because human dignity demands that we sometimes ensure people have basic necessities so they have the opportunity to find their inner strength, but I do think that we can alter the quote a bit and provide at least one guiding principle for human rights ethics and professionalism:

“Any time you give a man, woman, or community something they don’t need and desire, you cheapen them.”

If we put that at the heart of our work, perhaps we'll stop thinking about our own needs and desires - to ensure the rule or law or to transform international justice - and start focusing on the needs of those we profess to serve.