S3E6 Life After Loss for Orphans in Africa

The majority of the world’s population lives in low-income countries with extremely limited access to mental health care. This gap is largest in African nations, which have the world’s lowest ratio of mental health professionals: just 1.4 per 100,000 people.

For more than a decade, a multinational team of researchers has been exploring ways to close that gap for nearly 50 million orphans in Africa who are grieving the loss of one or both parents. HIV/AIDS and respiratory infections are the leading cause of death.

Being orphaned predicts other problems – problems like substance abuse, dropping out of school, or unemployment. Orphans are also more likely to engage in risky sexual behavior that may lead to new cases of HIV -- and perpetuate a vicious circle.

With a new, five-year $3.4 million grant from the National Institute of Mental Health, the team led by professors Kathryn Whetten at Duke and Shannon Dorsey at the University of Washington is testing how to help orphans in the Bungoma, Kenya, region.

Their strategy? Train local people with no mental health background to provide Trauma-Focused Cognitive Behavioral Therapy (TFCBT) in schools and community health centers, under the supervision of lay supervisors. The goal is to develop a blueprint for scaling up such a program on a large scale.

Music: Theme music by David Schulman. Additional music by by Blue Dot Sessions.

(Click the image above to see additional images.)

Note on translated interviews: In the interest of brevity, some portions of interviews conducted in Swahili were condensed or presented in a different order.

S3E5 Childbirth, Babies & Bonuses

More than 800 women die in childbirth every day in the developing world - often because doctors know what to do, they just don't do it. (There's even a name for this: the know-do gap.)

"We know for a fact doctors don't do as much as they know - the know-do gap in healthcare is a well-documented phenomenon," says Duke assistant professor Manoj Mohanan. "It exists because there are little incentives in the existing marketplace  for [doctors] to do everything that they know because effort is costly, doing the right thing, even though we know it needs to be done can be really costly. And so eventually, as human beings, people start cutting corners."

Manoj Mohanan, with collaborators from Harvard, Stanford and University College London decided to see if certain types of incentives could improve doctors' performance, especially when it comes to preventing women from hemorrhaging and dying in childbirth.

  • Read more about the study here and here
  • Read the episode transcript here
  • Listen to previous episodes in the series New Ideas for Policy in the Developing World here and here

Music: Theme music by David Schulman. "Circle Ariel," "Castor Wheel Pivot," "Dolly Pop," "Slate Tracker," "Thread Caramb" by Blue Dot Sessions/Creative Commons

This three-part series, New Ideas for Policy in the Developing World, is supported by the Josiah Charles Trent Memorial Foundation Endowment Fund.

The study was supported by the International Initiative for Impact Evaluation (3ie), DFID-India, the World Bank, and the Government of Karnataka

S3E4 How Sputnik Sent Women to College

Today, women outnumber men on college campuses, but that wasn't always the case. Before the 1960s, colleges routinely used gender quotas to suppress the number of women on campus. Some colleges excluded women entirely.

There's a curious backstory to how more women ended up in college, and it starts with the Soviet’s launch of the satellite Sputnik in 1957.

When Sputnik launched, it was a big deal in the U.S. Many saw the launch as a Russian win in the race to space.

"With the stunning defeat in the space race, the U.S. panicked, people were really freaking out," says Duke political historian Deondra Rose.  "This event really dashed Americans' perceptions of our relative strength when it came to academics, when it came to science and technology."

At the time, an Alabama lawmaker named Carl Elliott had been trying to get legislation passed that would provide federal support for students who wanted to attend college. The legislation was going nowhere.

Carl Elliott's legislative aide Mary Allen Jolley is now 90 years old. She says legislators recognized the launch of Sputnik presented a rare opportunity for the team.

"There was a sense of urgency," Jolley remembers. "A very clear feeling that, yes, that this was the opportunity and we had to take advantage of it and get a bill ready because we thought we could pass it."

In this episode of Ways & Means, we tell the story of how the authors of the National Defense Education Act were able to turn politics of crisis into a law that eventually opened the door to college to millions of American women.

S3E3 How Do Criminals Get Their Guns?

Duke professor Philip J. Cook has been tracking the underground gun market in America for the last 15 years. For one project, his team went to one of the largest jails in the country and asked the inmates one simple question: where do you get your guns?

They talked to 99 inmates which is remarkable, Cook says, in part because "anything that they told us about how they got a gun was basically gong to be a confession of a crime that they'd  committed."

What his team found is this: while policymakers argue about things like background checks for legal gun purchases, criminals, for the most part, are not getting guns through legal means.

Samuel is a former gang member from Chicago. He says if you're connected to a social network like a gang, it's easy to get a gun. In his experience, getting a gun was as easy as getting a beer. Usually he didn't even have to pay for the gun.

"You know you didn't have to pay because whoever was in your gang that's really leading the gang, they would have that connection," Samuel says. 

Policy Implications

One thing that’s clear from Phil Cook’s research is that something needs to be done to stop the flow of guns into urban neighborhoods like the one Samuel grew up in. And lawmakers can do something about this.

For example, laws designed to regulate legal gun sales can significantly affect the underground market. After Maryland passed a Firearm and Safety act in 2013, 41 percent of surveyed parolees in the state reported that it was more difficult to get a handgun.

And a study of over three decades of data on handguns recovered in Boston shows that fewer guns are illegally obtained from states where people are restricted to legally buying just one gun a month.

Phil Cook argues for a change in the way law enforcement does its job.

"When a gang member or another dangerous person gets picked up that has a gun there needs to be a lot of questions asked about where that gun came from, what their source is," he says.

If detectives spent time tracking down the history of the gun, Phil Cook says, law enforcement could go beyond simply catching one perp with one gun. Rather, police might be able to arrest the person who sold that gun – and presumably other guns - into the underground market.

In this way, law enforcement could begin to chip away at the stream of guns coming into neighborhoods like the one where Samuel grew up.

S3E2: Robots, WikiLeaks & The Fight Against Human Trafficking

This episode is the second of a three-part series, New Ideas for Policy in the Developing World. In this episode, how diplomacy and public shaming are helping shine a light on a problem that depends on secrecy to survive.

Each year, the U.S. State Department releases the Trafficking in Persons (TIP) report. The report ranks how well or how poorly countries are tackling human trafficking.

Duke professor Judith Kelley was studying the report's effectiveness when she stumbled on an unlikely source of help: the WikiLeaks documents. She found first-hand evidence that countries get really upset when they are ranked poorly. In fact, such rankings can often cause countries to make change.

Also: For years, tiny children were trafficked in the Middle East and forced to become camel jockeys. But a surprising new solution has been created: robotic camel jockeys.

Music: Theme music by David Schulman. "Cases to Rest," "Denzel Sprak," "Base Camp," "Stale Case," "Are We Loose Yet," "Inamorata" by Blue Dot Sessions. "That Kid in Fourth Grade Who Really Liked the Denver Broncos," by Chris Zabriskie. "Disco Sheik" by Sound of Picture.

This three-part series, New Ideas for Policy in the Developing World, is supported by the Josiah Charles Trent Memorial Foundation Endowment Fund.

S3 Episode 1: Slum Detectives

Today, for our Season 3 premiere, we begin a three-part series, New Ideas for Policy in the Developing World. In this episode, high-tech meets high-need. How researchers are using Google Earth to find the undocumented slums of India.

Duke Professor Anirudh Krishna has been studying slums in India for the past several years. When he first began, he got an official map from the government, and he traveled from slum to slum. The ones he saw didn't seem very slum-like. They were concrete structures with electricity and water.

"And so we realized after having gone to about 15 of these settlements that we got off the official list, that these aren’t the real slums of Bangalore," Krishna said. His team now focuses on finding and documenting the undocumented pop-up slums that are proliferating in this one Indian city.

 This is one of the homes from the slum the team visited in Bangalore, India. [Credit: Anirudh Krishna]

This is one of the homes from the slum the team visited in Bangalore, India. [Credit: Anirudh Krishna]

 Professor Anirudh Krishna estimates there were 200 homes in the slum the team visited, and around 1,000 people. [Credit: Anirudh Krishna]

Professor Anirudh Krishna estimates there were 200 homes in the slum the team visited, and around 1,000 people. [Credit: Anirudh Krishna]

Music: Theme music by David Schulman. "Celestial Navigation," "Luchuza," "Algea Trio," "City Limits," "Algea Tender," "Outside the Terminal" by Blue Dot Sessions.

This three-part series, New Ideas for Policy in the Developing World, is supported by the Josiah Charles Trent Memorial Foundation Endowment Fund.

S2 Episode 7: Secret Life of Muslims

Ahmed Ahmed is an American-Muslim comedian who was typecast as a terrorist. Khalid Latif is a Muslim chaplain for the New York Police Department who was saluted in uniform, but harassed as a civilian. Mona Haydar and Sebastian Robins fought Islamophobia with doughnuts and conversation.

There are as many different stories about being Muslim in the U.S. as there are Muslims. In this episode, we listen to stories from some American Muslims. We also explore how hyper-vigilance about the possible threat of Muslim-American violence might be making all Americans less safe.

Guests include Evelyn Alsultany of the Arab and Muslim American Studies program at the University of Michigan and Sanford School of Public Policy faculty member David Schanzer.

Music by David Schulman and Sound of Picture. Also, Driftwood, Rythn, Skepto and Light Touch from Sound of Picture; Heliotrope by Blue Dot Sessions; Wrap my Hijab by Mona Haydar.

Watch Ahmed Ahmed's story:

Watch Mona Hadar and Sebastian Robins' story:

Watch Khalid Latif's story:

S2 Episode 6: Flimflams, Scams and Ripoffs

John Rusnak was a currency trader in Baltimore when he was convicted of one of the largest bank frauds in American history. He made some poor bets, and rather than telling his boss or others at the bank, he tried to cover the losses up. When he was finally discovered, the bank had lost close to $700 million dollars.

On this episode we look at the case of John Rusnak through an historical lens. It turns out fraud has been a key feature of American business from the beginning. We’ll explore why, and why it’s more urgent now than ever that we pay attention to the rules and regulations our policymakers are creating and taking away.

Episode features Edward Balleisen, associate professor of history and public policy and vice provost for interdisciplinary studies at Duke University. His new book is Fraud: An American History from Barnum to Madoff.

Music: Theme music by David Schulman. Also, “The Zeppelin,” “The Caspian Sea,” “Lacquer Groove,” “Decompression” and “On Three Legs” by Blue Dot Sessions. “Fingernail Grit” by Sound of Picture, “La Duquesa del Bal Tabarín” by Rondalla Usandizaga (Library of Congress National Jukebox), “Commanderism” by Irving Aaronson and His Commanders, and “There is a Sucker Born Every Minute” by Jim Dale for the musical “Barnum.”


S2 Episode 5: Bootstraps and Silver Spoons

Most of us prize stories of people who start with nothing in life, and then become rich. Americans even have a saying for it: pulling yourself up by your bootstraps.  However, new economic research is revealing how wealth is actually built in the US and how difficult it is for some people to gain wealth, even when they do everything right.

This episode features William "Sandy" Darity, Professor of Public Policy, African American Studies and Economics at Duke University. Darity also directs the Samuel DuBois Cook Center on Social Equity at Duke.

Music by David Schulman and Sound of Picture. Also, Memories of the War 1861-1863 Conway’s Band from the Library of Congress National Jukebox; Begin the Beguine from the 1938 short Artie Shaw and his Orchestra; Pick Yourself Up performed by Fred Astaire and Ginger Rogers, 1936.


Professor William "Sandy" Darity is tackling important issues in society through his research. He tries to make "what many people might view as impossible, possible," he says.

S2 Episode 4: 7 Concerns About Teens and Phones, Unwrapped

Ninety percent of adolescents in the U.S. now either own or can access a mobile phone with the internet. Parents worry about how much time teens spend with their devices -- and it is a lot. Teens look at screens an unprecedented eight hours a day and cell phones are a major part of that; a quarter of teens say they are online almost constantly. 

On this episode we look at seven major concerns parents have about teens and their mobile devices and whether those concerns are justified:

  1. Is my teen at risk for stranger danger and/or cyberbullying?
  2. Does time online affects real-world relationships?
  3. Are phones causing a digital divide with parents?
  4. Are teens posting too much personal information online?
  5. Is multitasking bad for you?
  6. How pervasive is sexting?
  7. Are phones affecting teens' physical health?

Candice Odgers is the Associate Director of the Center for Child & Family Policy at Duke University.

Music by David Schulman and Sound of Picture.