Archive for the 'Politics\' Category

Alice Stewart and Sudden Infant Death Syndrome

Tuesday, February 17th, 2004
“I have two of the ingredients for success in epidemiology—longevity and persistence. Sheer doggedness. I’ve hung on and here I am, still quietly going on.”
—Alice Stewart, quoted in The Woman Who Knew Too Much by Gayle Greene
Chase Cringely sounds like the name of a NASCAR driver. Chase Cringely was my son. He died this week after 74 days of life, a victim of Sudden Infant Death Syndrome (SIDS). He literally stopped breathing lying in my lap while I did e-mail. There was no sound, no struggle. I just looked down and he was no longer alive. I have no idea whether he had been dead for one minute or 10, but we were unable to revive him. He was never sick, he just died, and now there is a void in our lives that we can never fill.
—Robert X. Cringely, Finding Meaning in a Lost Life, April 2002

Alice Stewart was a doctor and a scientist who was one of the first practioners of a new post-war discipline, epidemiology. For what became the Oxford Study of Childhood Cancer, she drew up questionnaires, recruited volunteer interviewers, and assembled by hand enormous amounts of data about thousands of children. Her methods were unorthodox. She started the questions from conception, not birth. She tracked forward, from a healthy population, not backwards, from the sick. She did what none of the lofty, eminent men of her day had thought to do: “I asked the mums.”

She asked the mums. She gathered data, a beginner’s mind, and one brilliant statistician. With little funding, and sometimes active hostility in place of support, she and George Kneale coaxed stories from her facts and figures. Fifty years later, that data is still talking.

The most famous of her many discoveries was the link between x-rays and cancer, though it took decades for her findings to be accepted and for shoestores to stop x-raying for fit. Her later work on radiation and cancer was systematically squashed by the nuclear industry. Epidemiology, with its thirty-year studies, is a science for the long-lived. Alice was working right into her nineties, fighting suppression by powerful lobbies. As consolation for the Nobel Prize she may have deserved, she won the Right Livelihood Award, the “Alternative Nobel” awarded in Sweden. The British Embassy in Stockholm did not even take her out to lunch.

Her theories on leukemia epidemics were grounded in her background as a working doctor, not an academic. She realised, for example, that antibiotics had unmasked the true incidence of leukemia. It was the healthiest children who succumbed to leukemia, early doctors often noted. Leukemia dramatically compromises the immune system, so long before the disease visibly manifests, these children used to die of minor infections. When these infections were cured by antibiotics, they lived through long enough to develop cancers of the blood.

Her childhood cancer data also turned up a peculiar finding: twice as many children who died of leukemia under six months old were born between January and June than between July and December. Yet these periods are climatically the same in Britain—both half summer, half winter. The difference, she noted, was whether a month-old child was surviving into warmer or colder weather.

Alice, true to her name, looked the mirror image of this information and thought about SIDS deaths, which occur more often in winter.

Sudden Infant Death Syndrome (SIDS) kills between 6,000 and 7,000 babies a year in the United States alone, or between 2 and 3 cases per 1,000 live births. Nobody knows what SIDS is, or why it’s on the rise. What is known is that it happens more often in winter than summer and that it occurs mainly between four and six months of age.

“My theory is this: the reason we aren’t finding myeloid leukemia in children is that the child with myeloid leukemia is dying of a sudden, unexplained death, if he hasn’t already died of anoxia during the second stage of labour. Most SIDS deaths occur within one and six months of age, which is just when the child is losing its mother’s immunity and achieving its own. While the normal child is gradually acquiring his own immunity, the child with leukemia is gradually losing immune competence. Since you get from your mother defenses against infection in the form of passive immunity for one month or more, the weakness in the system doesn’t get put to the test until you go off your mother’s immune system.”

Myeloid leukemia is more acute than lymphatic leukemia. It has a shorter latency, manifesting between one and three years of age rather than two to four, and it involves the red blood cells as well as the white. Children who are incubating myeloid leukemia are—like all pre-leukemics—more infection sensitive than normal children. But they are also born with a defect in their hemoglobin, they have something wrong with their red cells as well as their white.

“While in the womb,” Alice explains, “the fetus produces fetal hemoglobin, which is geared to receiving oxygen through the placenta; but soon after birth this is replaced by adult hemoglobin, geared to receiving oxygen through breathing. At birth you have both kinds of hemoglobin present, enabling you to breathe through both the placenta and the new apparatus of the lungs; then you gradually get rid of the fetal hemoglobin. But children who are incubating this kind of leukemia don’t make the changeover from fetal to adult hemoglobin and are left with too much fetal hemoglobin. This hemoglobin fails to take up oxygen from the lungs, so that when they go into a deep sleep, or have the first effects of respiratory infection, the oxygen level falls to a fatal level and they’re liable to go into anoxia—shortage of oxygen.

“There have been studies showing that children who die of SIDS have an exceptionally high ratio of fetal to adult hemoglobin—though this is difficult to measure after death, and it’s not something all hematologists accept.”

Alice’s theory is that SIDS children have difficulty replacing passive immunity with active, and fetal hemoglobin with adult, and the two effects combined might be sufficient to cause a sudden death. SIDS children die when they’re sleeping, and the mechanism of death seems to be respiratory obstruction—purple bruises are sometimes present, tiny bleeding points called “petechiae”, perhpas resulting from the infants attempts to take deep breaths against some obstruction in the airways. [...]

SIDS deaths are more common in winter than summer, which is when the immune-compromised child is more likely to succumb to infection. They often occur in a family situation where an older child brings an infection home, or where everyone in the family has a cold and the child goes to bed with sniffles and doesn’t wake up. You have no defense of your own, so you meet with an infection and go out like a light. [...]

“It’s also known that SIDS children have an easy delivery with a short second stage of labor. The second stage of labor is when the baby becomes dependent on its own hemoglobin for breathing and when any defect in its system could be fatal. These babies would have to have got into the world fairly easily because if they’d had a difficult labor, they’d have died.”

Alice’s theory of SIDS has been there in the literature since 1975 but no one has picked it up. This is the more remarkable, since it could so easily be tested. “There’s a blood test done on all children shortly after birth—the same test should be used to look at fetal hemoglobin. Then when the mother gets the follow-up exam at four weeks, do a second test for proportion of fetal to adult hemoglobin—then monitor the population for all causes of death in the next eleven months.

“According to me, you’d expect children who died of SIDS to have shown a high proportion of fetal hemoglobin at one month of age. You can’t test for this after death, since the blood count can only be diagnosed by flowing blood, but you could monitor children while alive—and you could easily establish whether SIDS children have a disproportionate amount of fetal hemoglobin.

“I tried to launch a study of SIDS in America through the Childhood Cancer Research Institute, but there wasn’t enough funding, and nobody in England has shown the slightest interest. I simply can’t understand why. No one knows anything about this mysterious syndrome—they’re stuck—so why not test my theory. As long as SIDS remains a mystery, my theory is as good as any other.”

Bob Cringely’s account of his son Chase’s death from SIDS two years ago is hard to forget. As a parent he desperately wants answers:

I can’t do it by myself. I need your help. I need hardware engineers, software engineers, I need people experienced with biomedical sensors and sifting mountains of data. I need folks who make tiny processors and RAM chips. I need people who know more about this stuff than I do. Yet they must also be people who are willing to believe that there is an answer, since the medical establishment seems to have given up.

Well, here is the theory of an extraordinary scientist who doggedly proved herself right so many times while she was alive. It seems to me, as laywoman as they come, to show all Alice Stewart’s practicality, intuition, and good science. Why is nobody testing this? For her memory, and for Chase’s, I’d like to think that someday someone will dig out those journals and try.

Reference: All Alice Stewart excerpts are taken from Chapter 15 of The Woman Who Knew Too Much: Alice Stewart and the Secrets of Radiation by Gayle Greene. (Many thanks to Alice’s granddaughter, Elly, for lending me her copy. )
See also “Our Brilliant Careers”, a 1996 documentary on Alice Stewart produced by Channel 4.

Creative Class War

Tuesday, February 17th, 2004

In effect, for the first time in our history, we’re saying to highly mobile and very finicky global talent, “You don’t belong here.”

My application for a US work permit has finally been approved. It’s identical to three others I’d submitted successfully over the years, but under the baleful Tom Ridge regime it was rejected at first attempt, causing minor heartflips for me, my boss, and my lawyer.

Next I have to sit an interview for a travel visa. They used to do this as a same day walk-in service at the Dublin embassy, but now the appointment needs to be booked (or cancelled) two weeks in advance on an information line that costs $2.50 per minute. I need a special prepaid envelope for the return of my passport. There’s a $100 charge for the application, plus professional passport photos (no booth photos allowed). The work permit has already cost my employers—a small startup—over three thousand dollars and seven lost weeks of work.

It is impossible to consider living there long-term. From Luke in Toronto, a link to an article that speculates on what this kind of codology is really costing America:

“Creative Class War”

Irish Studies

Monday, February 16th, 2004

Irish people like to see Ireland as an exceptional place. Our suffering throughout history is unparalleled. Our monks saved civilisation in the Dark Ages. Our religiosity is incomparable. Our struggle for freedom inspired the peoples of the world. Our sense of fun is unmatched. The complexity of our dilemmas is unsurpassed. The leap we have made from pre-modernity to post-modernity is faster and therefore stranger than that of any other society. And because Ireland occupies a place in the world grossly disproportionate to its population, this sense of uniqueness is often reflected back on us from the outside.

All this is, of course, an illusion…Indeed even the illusion of being exceptional is common enough and most small societies share it.

-Fintan O’Toole, After the Ball

Guilty as charged. With the magnificent megalomania of the miniscule, it doesn’t seem odd to me that any North American university whose navel is worth gazing at offers Irish Studies. But then Darren-in-Vancouver writes of his disbelief that American universities would offer courses in Canadian Studies. Why would anyone want to study Canada, he wonders? I can think of a few reasons. Canada is the most ethnically diverse country there is. It shares a border with the most powerful country in the world, yet chooses to maintain its own moral standards on education, healthcare, and foreign policy, standards which are—screw Chomsky—higher. Its literature is energetic. Its men are devastatingly attractive, except for Jim Carrey. Not to come over all Bowling for Columbine, but I’d be happier in an America that turned out more graduates in Canadian Studies.

It’s not just modest, self-effacing Canada. In Jeremy Paxman’s excellent book, The English: A Portrait of a People, he spends most of the introduction explaining—apologetically, by his standards—why anyone would want to write or read such a book. The English do not dissect their Englishness that often, beyond a moving fixation on sit-coms. Yet they are a fascinating people, having had the brass neck to take over the world, and then, like teenage shoplifters, grudgingly hand it back. They display a mixture of traits even quirkier than our own, with the Class System in place of the Catholic Church as the universal fuck-you-up factor.

I would ask why the difference, what makes us so sure we are unique and and worthy of endless study. But, you know, I have navel-gazing books to read.

How Can We Help?

Saturday, January 31st, 2004

From the Comments to “A Problem From Hell”, below. Justin is an Irish software engineer based in California; Caitríona is an Irish human rights worker based in Iran.

The question I keep asking myself is, is there a way to help human rights without full-scale immersion — that is, without going over there, cutting off links with your family and friends, and dedicating your life to it?

I try to do little bits to help these causes here and there — like developing open source software that’s useful for everyone; I’m ecstatic when I hear of an NGO getting good use from one of those apps. I keep contemplating doing more. But I haven’t — yet — and the idea of breaking away to such a degree is the big problem.
Posted by Justin at January 30, 2004 03:15 PM

Every little bit helps Justin. In fact, the most important person in our little office in Tuzla was Andre, our computer expert. He designed a special software to match postmortem data from the bodies we exhumed with ‘antemortem’ or ‘living’ information from the surviving families. His work alone reuinted countless families with their missing loved ones.
Posted by Caitriona at January 31, 2004 03:57 AM

So how do we do a better job of putting the Justins in touch with the Caitríonas? We need a matchmaking service to hook up tech professionals with the dedicated field workers who need help. (New York Cares is a good example of a matchmaker service for volunteers.)

The open source community is engaged and civic-minded, and clearly capable of building tools remotely. Product managers (like me) could ask NGO field workers what they need, helping them to build a collection of “user stories”, Extreme Programming style, for volunteer engineers to work on in their spare time.

Any examples out there of this working already? Perhaps the ambitious JHAI Remote Villages project, where Linux meets Laos.

A Continuum of Knowledge

Friday, January 30th, 2004

When I tell people what I have been reading, the word ‘genocide’ certainly stimulates a glazed, almost pained look, “Oh.” It seems to be a conversation stopper.
—Robert Birnbaum, interviewing Samantha Power

Well, sorry, but bear with me. From Andie in Capetown comes a link to great interview with Samantha Power. Her book, A Problem From Hell, deserves readers, but according to this isn’t getting them in spite of all its awards. Her description of her own political awakening goes towards explaining why:
“The easy thing—which I have done for most of my life—is to block the facts out. Once you are in a position where you have to process the facts, you are stuck.”

From Birnbaum’s introduction:

A Problem From Hell (the title is taken from Warren Christopher’s characterization of the Bosnian crisis in the mid 1990’s) is a scholarly analysis of America’s policy towards genocide in the 20th century. In a compelling and engaging narrative, Samantha Power traces the United States’ policy toward genocide: the Turk’s slaughter of the Armenians in 1915, the Holocaust, Cambodia, Saddam’s gassing of the Kurds, the ethnic cleansings of Yugoslavia and the Hutus genocide of the Tutsi in Rwanda…Suffice it to say, this is a very important book. That fact, however, shouldn’t discourage anyone from reading it.

“A Problem From Hell”

Thursday, January 29th, 2004

The United States has never in its history intervened to stop genocide and has in fact rarely even made a point of condemning it as it occurred.”
—Samantha Power, “A Problem From Hell”
Caitriona at Lough Derg
At college, my best friend Caitríona studied History and Politics. I got Hob-Nob crumbs on the western canon, and wondered how she crawled through those dull books. She went to Bosnia after we graduated, and wore white Levi’s as her UN observer uniform. Afterwards, in Boston, she won a Fulbright scholarship to study Balkan conflict resolution, which I rarely asked her about for fear she would tell me. She went back to Bosnia. This time she lived in Tuzla, near where General Mladic had executed more than 7,000 men in a UN “safe area”. She worked for a group called Physicians for Human Rights. They gathered forensic evidence from the Srebrenica massacre so that each case could be prosecuted as a murder. She spoke daily with the widows and families, trying to reunite them with the bodies of their missing, murdered men. She drew media attention to the work they were doing, and needed to do. Later, she was called as an expert witness at the first war crimes tribunal held at the International Court in The Hague.

I spent those years caught up in the New York internet culture. I read The Economist, but often as not I skipped the depressing International news section. Why bother? I worked long hours, made more money than I needed, and puffed up on the importance of the startup company that grew out of my living room. The word “revolution” appeared in the business plan and nobody laughed. We used to call late-night code “hero check-ins”. CEOs studied The Art of War. When bad things happened to go projects, I would say “Babies won’t die, kids.”

Twice I went to visit Caitríona in The Hague, after she broke her back when knocked off her bike on the way to her first week at the tribunal. I met her friends: human rights lawyers, activists, and war reporters. Their intensity reminded me of the geeky evangelists in my world, only more so. They were animated as they tried to explain what had happened, who had stood aside, who was evil, why this mattered. All night I couldn’t get the Bowie song out of my head: “This ain’t rock and roll. This is…GENOCIDE.” I concentrated on getting the names of the generals right, and failed. These old Yugoslavia hands struck me as institutionalised, addicted to the intensity of a war zone, unable to let go. They drank too much. They acted like this was life and death.

I had never visited Cait in Bosnia, though she was there for three years. I was afraid. I wanted to spend my few holidays in comfort. I didn’t want to know about this unpleasant world, and I didn’t want to feel guilty for doing nothing to improve it. She came to me instead, in busy, glitzy, boomtown New York. I showed her my new toys and lectured her on the wireless revolution. I worried that she didn’t earn enough, that she lived in horrible conditions, that she dealt with decomposing bodies and desperate widows every day. She has always had an uncanny ability to interest influential people, and I thought she should use that to her own advantage, for once.

I was booted out of that New York life just as I turned thirty. I could only afford to travel in cheap countries, so I started to go to the kinds of places that Caitríona had studied and lived in. I wept in the War Crimes Museum in Saigon. Why, I wondered, had Cambodia turned out like this? What was wrong with Bolivia? With Burma? Politics, which I had seen as a dull, corrupt abstraction, began to seem real at last. In Laos, a sixteen-year-old monk said, “Why did America bomb my village?” I didn’t know how to explain the Domino Theory to a kid from the Plain of Jars.

I gave up most novels and scrounged books to puzzle it out. I read The Quiet American. William Shawcross’s Sideshow: Kissinger, Nixon, and the Destruction of Cambodia. Robert McNamara’s confession. Air America. The Girl in the Picture: The Story of Kim Phuc, the Photograph, and the Vietnam War. Norman Lewis’s Indochina books. Aung San Suu Kyi’s Letters from Burma. War Is a Force that Gives Us Meaning, by Chris Hedges.

They told me, over and over, that bloodbaths and famines are rarely unexpected or inevitable; that wars are usually caused by a very tiny number of influential people; that genocide can often be prevented by a very tiny number of influential people, but rarely is; that the law of unintended consequences leads to catastrophe in geopolitics. It was fresh news.

Duh.

As a Christmas present this year, Caitríona gave me “A Problem from Hell” : America and the Age of Genocide, by Samantha Power. Power is a friend of hers from their Bosnia days, and she is Irish too, though she moved to the US when she was nine. She is 33; fabulously young to win both the Pulitzer and the National Book award, but this book deserves all its praise. I couldn’t wish for a more patient teacher to sew together the scraps of an education I picked up in the last few years. In one chapter, for example, she sets out how the United States directly created the conditions for the Khmer Rouge to come to power, and then looked away as Pol Pot killed almost a third of his own countrymen in under three years. It was left to Vietnam, still reeling itself, to invade and overthrow Pol Pot—but since they were on the “wrong” side in the Cold War, the US and the UN continued to recognise the Khmer Rouge for many years after the Killing Fields had been dug up for the west. Her charges are clear and devastating.

She believes that much of the misery of the last century was predicted in advance and could have been averted. Failure to stop it was due not to ignorance but to considered decisions not to intervene. Referring to the many instances of genocide in the last hundred years, she says that “No US president has ever suffered politically for his indifference to its occurrence.”

Several heroic figures did work to oppose and expose ethnic cleansing as it took place, but the quiet majority of American politicians chose always to do nothing, as did the American public.

I am ashamed to be a silent voice in that majority.

Caitríona lives in Iran now, with her American husband Dan, who writes for the Guardian and The Economist. She and I just spent a few days together here in Limerick, catching up after too long apart, as usual. She had come back from a Christmas trip to the US and Dublin, and felt down. People couldn’t understand why she and Dan were still caught up in their little human rights kick. In New York, friends who “made a window” barely asked about Iran; they were busy telling her about the ups and downs of their own careers. In California, their family wanted to know when they were going to come back to America and start living like proper, middle-class adults.

Iran is not easy. She tells me about the men who scream obscenities and sexual come-ons in the street, no matter how modest her hejab, and about the rich Tehran women who talk of little but cosmetic surgery and clothes. Her phone is bugged. She caught typhoid. Still, she presses on, and will continue to, like Mary Robinson before her. As well as reporting for the Irish media, she volunteers helping victims of Saddam Hussein’s chemical weapons attacks; the Iranian women and children who were unlucky enough to be on the side not supported by the Americans. Sixteen years later, they have been long forgotten by all but the few like Caitríona.

Vote Early and Often

Wednesday, January 28th, 2004

I’ve never voted in a democratic election. For non-resident aliens, the US goes in for taxation without representation. Since the age of majority I’ve haven’t lived in my country of citizenship during an election, though I think I could have voted in the UK election that delivered a landslide to my Islington neigbour, Tony Blair. Ireland does not offer voting rights to its diaspora, which is okay. Now that most of us leave by choice, I’m not convinced that out-of-touch emigrants, paying taxes to other states, should be allowed to shape the country.

Colum McCann, the novelist, was interviewed on Irish radio last week about the Democratic primaries. (Ireland believes that fiction writers are sound choices as political pundits.) He was passionate, though not particularly articulate, on behalf of various downtrodden groups. Yeah, but they’re screwed, Colum, I found myself thinking. They don’t vote. Countries get the governments they deserve.

In America, the office goes to the candidate who can raise the money to beam most messages to television viewers. It is hugely expensive to speak through TV networks, and the scale of this money race scares me. How can corporate fundraising not taint everyone it touches? In part I am looking forward to working for Meetup because their service enables political engagement—and fundraising—on a human scale again. Several candidates have learned to use it to bring real people into their campaigns. Meetup is outside politics, but helping voters to come face-to-face can only be a good thing.

Every election, a new voter block is annointed with the power to swing the race. These are the people the TV ads dance for. Thatcher’s C2 Essex boys. Soccer moms. Blue-collar males. California Latinos. Seniors. The paltry modern turnout is easily dominated by interest groups who can get out the vote. But what if everyone voted? What if candidates had to address every franchised adult, not just those likely to turn out voluntarily? Jury duty and income tax are compulsory. So is filling out the national census. Why not voting in national elections? (You could check “Abstain” if so inclined.)

I have no idea what this silent majority would say, though I’d love to hear. Millions died for democracy in the 20th century, but many of those of us who grow up with it are too lazy to care. Is the very idea of compulsory voting anti-democratic? In the west, we think a lot about our rights, especially as Tom Ridge erodes them. It may be time to start on an overdue Bill of Responsibilities.

I Was A Non-Resident Alien

Wednesday, January 7th, 2004

One night last week I spent six hours tethered to my laptop, trying to complete a two-screen form. First name. Last name. Date of birth. Country of birth. Photograph. Address. Marital status. If I was lucky, the next page of the form would appear after a few minutes chugging, demanding the same information about my future ex-husband. I’d submit the finished form hopefully, but again and again the process timed out before it was accepted. Then there was nothing to do but wait—chug, chug—for a new, blank form to start again.

Eventually, at 2.15 a.m. on December 30th, two hours and forty-five minutes before the official deadline, I successfully submitted an application to the 2005 United States Diversity Program Visa Lottery.

It’s new, this electronic process. For seven years I’ve been sending paper entries more faithfully than Christmas cards. Every year approximately seven million others did too (though I hear the numbers have dropped now that the US is going through one of its loonier periods). The program grants 55,000 Green Cards a year to applicants from countries with low rates of immigration to the US. Canadians are excluded, as are British subjects, Chinese, and Mexicans. I qualify either on the basis of my Irish nationality or my Zambian birthplace. Each year I pick one randomly. Neither choice seems to make much difference to my 0.0075% chance of being selected. This year I’m Zambian.

Over those six hours I thought of my fellow hopefuls all over the world, choking the servers of the US Citizenship and Immigration Service, filling out three or four applications at once in the hope that one would get through before their internet café dollar ran out. There would be agents in Iran, in Cambodia, in Nepal, processing bulk applications in unfamiliar Roman script. In Ecuador last year there was a hunger for los Estados Unidos that made me feel starved myself. People told me stories about the Mexican coyotes who took eight or ten years of their savings and got them dumped in a border jail for a month before they were thrown back to Quito. The night of the lottery deadline, there would have been kids in internet cafés all over Quito, dictionaries propped up by the keyboards, dreaming of Queens.

But there weren’t too many Irish people huddled over the USCIS website at 2 am, I’d guess. You’d want to be crazy, or very fond of America, or knocking your elbows on a small island, to consider leaving a prosperous country for the land of Homeland Security and a once-mighty dollar that can no longer buy a bar of chocolate in Europe. I am not sure into which category I fall myself, but I’ve already invested my twenties in New York City, and my professional contacts, friendships, and furniture are there. That’s why I kept pressing Reload on my browser.

US immigration law has influenced every single major decision I made since the age of 24. I repeat that often here, because its reach into my private life has frustrated and baffled me so. None of my citizen friends has ever fully understood this web of sticky, near-invisible restrictions. The USCIS set the date for my wedding, steered me into the technology industry, ejected me to tramp around the world for a year. I chose my second New York job solely to get a certain kind of immigration status for my husband. Every year, or so it seemed, I stumbled off a red-eye flight to Dublin and went straight to the US Embassy to be interrogated for another visa in order to return.

There are two kinds of immigrants. There are the huddled masses, who seek asylum or simply a chance at a better life. They bring little but contact names and ambition. They may need help getting started, but in the US, at least, that help comes more often from private networks of people from home rather than from the government. In Europe and the US, poor immigrants, legal or not, do the jobs that the locals won’t. They are the reason why a punnet of blueberries costs three or four dollars, not twelve, and without them our economies would collapse. President Bush, looking to make Republicans of a generation of Latinos, seems to have understood this recently.

Then there are those immigrants who have already been lucky, the workers that a country brings in to fill skills gaps. Canada and Australia each have a Skilled Worker Program to attract people with education and work experience that can help the host country. I worked in the United States for five years under the H1-b program, designed as “a nonimmigrant classification used by an alien who will be employed temporarily in a specialty occupation or as a fashion model of distinguished merit and ability.” (Sadly, I am not a fashion model of distinguished merit and ability. If I were I could get a Green Card, or perhaps con a rich Yank into marriage—the Candace Bushnell version of the American Dream.) I’ve also spent time in the US as a J1 (student worker), J2 (spouse of a student worker), and H4 (spouse of an H1-b). There are various other immigrant and non-immigrant classifications for journalists, for hospitality industry workers, for medical workers, and so on.

The United States and Canada differ greatly in their treatment of skilled workers. Philosphically, Canada decides that these are good people to have around. They are a terrific deal for the country, after all: already vaccinated and highly-educated by foreign taxpayers, and ready to fill jobs where local skills fall short. They bring immigrant energy, and may even create jobs. Once an applicant qualifies on the stringent entry requirements, therefore, Canada grants freedom of labor movement and, after three years or so, full citizenship rights.

The United States, on the other hand, treats skilled workers like high-class indentured servants. Their status in the country is entirely in the gift of their sponsoring employer. As an H1-b worker, your employer’s name is in your passport. The work permit is granted for just three years, and may only be renewed for a further three. Then you have to get out. You may not change jobs without applying for a new work permit—a slow and expensive process for employers—and don’t even think about setting up your own company. If your employment ends, you have a few weeks in which to pack and get out. Forget about the social security contributions you made: you’ll never see them. The deal is that you are welcome to give America your ambitious and productive years, but you cannot plan a future or a family there.

In the recent boom, these restrictions imposed real inconvenience on American employers. The US education system wasn’t up to meeting the demands for skilled workers of the late 1990s, and employers were stuck with months of waiting and paperwork before they could hire. Eventually they lobbied to have the quota of these workers raised from 60,000 a year to 190,000 a year, and to ease some of the bureaucratic requirements in exchange for premium processing fees. In these rougher times that cap has just fallen back to a tiny 60,000.

The United States, naturally enough, wants to protect jobs for its own workers. This is only fair and right. However, it is not making full use of the talents at its disposal. These skilled workers are exactly the kind of people who create jobs when times are tough, but they are expressly forbidden to. Though it’s close to impossible, still some of them figure out how to work the system, not in order to claim the piddling US social welfare handouts—please—but to start companies. They front them with American business partners and keep legal status with the help of working spouses. When my husband wanted to start a company he spent hours with a sympathetic lawyer interpreting whether language like “actively managing investments” could be stretched to mean “unpaid Founder and CEO”. A third of the companies in Silicon Valley were set up by new immigrants like him, no thanks to USCIS. For his trouble, and thanks to great bureaucratic effort, he will eventually get permanent residence as an Alien of Extraordinary Ability. No joke.

Ireland is now facing these issues for the first time. It has to decide soon whether to extend to immigrants the conditional, crippling welcome of the United States, or the freedom that Canada and Australia give. Small countries demand personal contacts to get most jobs, and for new arrivals often the best way to survive is to start a business, however small. But right now many of our immigrants are not allowed to work at all, though they get extensive social welfare benefits. This means we have potential workers stuck in state-funded bed-and-breakfast accommodation, unable to contribute. I hope we make an imaginative decision.

I’m lucky. When I don’t win that US visa lottery, I have other choices. I have access to a job market of 300 million Europeans. Thanks to an education funded almost entirely by Irish and European taxpayers, I have some saleable skills. My English is fluent. My own country is still thriving, so I could work at home, near my family, and earn the euros that each buy more than a dollar and a quarter now. I could get into Canada if I tried hard enough, or Australia, or New Zealand. I am free of oppression and poverty, and I have access to generous European social benefits.

My heart goes out to those whose choices aren’t as broad, to the Ecuadorians and Iranians hoping on a lottery for what might be a chance at life.

Iran Undercover

Monday, December 1st, 2003

Irish and UK readers, check out “Iran Undercover: Inside the Hidden Revolution” on Channel 4 tomorrow night (Tuesday) at 10.40 pm. Interesting stuff, not least because it includes an interview with Shirin Ebadi, this year’s Nobel Peace Prize winner, conducted by my best pal, who lives in Tehran.

Seventy per cent of the population of Iran is under 30. They’re well-educated, men and women alike. Those are the demographics of revolution.

The Cu Chi Tunnels

Tuesday, October 28th, 2003

During the American War, the Viet Cong spent years in warrens like the Cu Chi caves. These tunnel networks were dug in the rich soil of the Mekong Delta when Agent Orange and other defoliants dropped by the Americans made jungle cover impossible.

Last year I crawled through these tunnels, cradling a broken hand for authenticity. The mud walls pressed tight, and the smell of the stale air and damp, packed earth was heavy. We had the luxury of occasional lightbulbs; the original tenants crawled in blackness.

Long bamboo pipes funnelled smoke from the underground kitchens away to outlets under distant bushes. The underground hospital was stocked with sticks to bite away screams. There was a small factory for turning out hideous booby-traps. Silent villagers sharpened stakes, brushed on poison, made pipe bombs. Their designs were modelled now by large Caucasian dummies, and our stomachs flipped at the sight. There were bouncing betties; forget-me-nots—foot traps you could take home with you; concealed drums that spun above a stake-lined pit; staked boards that would swing down from the trees and impale a soldier at chest level.

Americans threw grenades down the tunnels when they found them, so the Viet Cong developed a system of blind alleys and sharp turns where explosives were marooned. Cave-ins were a constant danger. Sometimes Americans invaded the tunnels, but so many were killed on these missions that they began to refuse to go down. They sent dogs instead. The Vietnamese began to wash with American soap and eat C-rations to confuse the dogs’ senses. Sometimes the tunnels were so extraordinarily well-concealed that they were simply never found. The day I visited, the bigger westerners had trouble wedging their protein-fed bodies through the hidden trapdoors, but the Viet Cong had managed to stay so inconspicuous here that the Americans had once built a camp right on top of a network of caves. They couldn’t figure out why they kept getting shelled.

Mr. Hai, my tunnel guide, was a handsome, charismatic man in his mid-fifties.
   “The question I want you to answer me when we leave,” he announced just before we crawled into the tunnels, “is where did they shit? Think carefully! Where did the people who lived in these tunnels take the shit?”

Mr. Hai had been an officer in the South Vietnamese Army. He worked as a translator for the Americans. Tank Division. Years later he still got a kick out of the memory of those American boys. “Hai,” they would say, “Is hot. Is damn hot!” He laughed, delighted at his command of idiom. The short words sounded good from Mr. Hai.

The boys Mr. Hai fought with went home suddenly in 1975. Mr. Hai was sent to a reeducation camp for three years. His uncle, who was far more senior, was cruelly “reeducated” outside Hanoi for seven years. When he got out, he refused to go back to his job as a surgeon. He would not work for the communists; he would sweep the streets instead. Eventually he got out on a boat and became a heart specialist in Ohio.

Mr. Hai did not hide his own dislike of the communists. “We give them name Viet Cong. They never call themselves Viet Cong. You know why? Because it mean “Dumb Vietnamese”, or “Stupid”. They do not like this. And when they won they took revenge on the South Vietnamese. Especially anyone who had helped the Americans. I did not speak English for twenty-five years. Pretend I never learn English. Only in last five years I can speak English again and work with tourists.”

He had never heard from any of the Americans he served with, though in the last few years he has met a few other servicemen. He could find them on the Internet, I told him. He smiled vaguely.

Tim O’Brien wrote an extraordinary short story about serving in Vietnam. It’s called “The Things They Carried“, the title story in his first collection. In it he lists with great care every item he and his fellow U.S. soldiers carried as they slogged through the jungles outside Saigon.

They carried USO stationery and pencils and pens. They carried Sterno, safety pins, trip flares, signal flares, spools of wire, razor blades, chewing tobacco, liberated joss sticks and statuettes of the smiling Buddha, candles, grease pencils, The Stars and Stripes, fingernail clippers, Psy Ops leaflets, bush hats, bolos, and much more. Twice a week, when the resupply choppers came in, they carried hot chow in green mermite cans and large canvas bags filled with iced beer and soda pop. They carried plastic water containers, each with a two-gallon capacity. Mitchell Saunders carried a set of starched tiger fatigues for special occasions. Henry Dobbins carried Black Flag insecticide. Dave Jensen carried empty sandbags that could be filled at night for added protection. Lee Strunk carried tanning lotions. Some things they carried in common. Taking turns, they carried the big PRC-77 scrambler radio, which weighed 30 pounds with its battery. They shared the weight of memory. They took up what others could no longer bear. Often, they carried each other, the wounded or weak. They carried infections. They carried chess sets, basketballs, Vietnamese-English dictionaries, insignia of rank, Bronze Stars and Purple Hearts, plastic cards imprinted with the Code of Conduct.

Pages and pages of stuff, he lists. The personal choices reveal the human beings in O’Brien’s soldiers, and the pounds of standard issue show them as grunts. The people they fought wore black pyjamas and carried a pouch of rice, perhaps a rifle and a few magazines.

We sat in the tiny kitchen, deep underground, and ate boiled taro root dipped in salt.
   “And now,” said Mr. Hai, “you will tell me, where did the Viet Cong living in these tunnels take the shit? Because remember, if the dogs smell, they are dead.”

They buried it in dead-end chambers, we guess. The women who sneaked in rice smuggled it out again in bags. They…burned it in the kitchen fires. They piped it out, like the smoke. Mr. Hai kept shaking his head.

Tim O’Brien had the answer.

They would often discard things along the route of the march. Purely for comfort, they would throw away rations, blow their Claymores and grenades, no matter, because by nightfall the resupply choppers would arrive with more of the same, then a day or two later still more, fresh watermelons and crates of ammunition and sunglasses and woolen sweaters—the resources were stunning—sparklers for the Fourth of July, colored eggs for Easter—it was the great American war chest—the fruits of science, the smokestacks, the canneries, the arsenals of Hartford, the Minnesota forests, the machine shops, the vast fields of corn and wheat—they carried like freight trains; they carried it on their backs and their shoulders—and for all the ambiguities of Vietnam, all the mysteries and the unknowns, there was at least the single abiding certainty that they would never be at a loss for things to carry.

They were defeated, these American boys, by the things they carried and by the things they dropped. They were bogged down in the swamps and the jungle on size twelve boots. They dropped C-rations and soap, and all kinds of materials that shored up tunnels. They dropped ammunition and knives that were turned into booby traps against them.

Meanwhile, under night cover, boys in black pyjamas combed the rice fields for metal ammo containers dropped from the choppers. Shockproof. Waterproof. Stinkproof.
   “You don’t know,” says Mr. Hai, laughing again. He waves an ammo case at us. “They take the shit in the ammo box, and carry it out at night. That is how they stay down here for all the years.”