Category Archives: Health

At Google, Tim Armstrong Was Sued for Demoting and Firing Employee Pregnant with Quadruplets

When CEO Tim Armstrong blamed “distressed babies” for proposed benefit cuts at AOL, here’s what he didn’t mention: While a sales executive at Google in 2005, he was the subject of a lawsuit by a former employee, Christina Elwell, who alleged he demoted and fired her because she could not travel during her high-risk pregnancy with quadruplets.

Elwell went to work for Google’s sales force in 2000, and in 2003 was promoted to national sales director, a position in which she managed the North American sales force. She worked from the company’s New York office. Her boss was Armstrong, then Google’s vice president for national sales. According to Elwell’s complaint, before her pregnancy, he praised her in a meeting as having made a “significant contribution” to Google’s preparations for its initial public offering.

In April 2004, four months before that IPO, Elwell told Armstrong she was pregnant with quadruplets and would not be able to travel by plane due to complications. He was concerned, but she reassured him she was eager to resume travel after giving birth. In May, Elwell miscarried two of her four fetuses. A few weeks later, Armstrong allegedly called her into his office and showed her an organizational chart in which her position would be eliminated and she would be demoted to the operations department, with no management responsibilities. He allegedly told colleagues he was moving Elwell because she could not travel.

Elwell proposed that she instead take a position as East Coast sales director, in which she would be able to travel by train and car. Armstrong rejected that idea and filled the job with a male employee whom Elwell had recently hired. Then, on June 4, 2004, Armstrong allegedly called Elwell into his office and told her she was a “HR nightmare” because she had talked with colleagues about her concerns regarding her pregnancy and employment status at Google. The following day, he called her at home and fired her, saying he had “a gut feeling” it was the right thing to do, in part because she had “spoken to others” about the situation. (Remember when Armstrong impulsively fired a guy in the midst of a conference call last year, with 1,000 employees listening in?)

Google determined Elwell had been improperly fired and rehired her in a low-level operations position, in which she claims she was given work comparable to that of a summer intern. She filed a complaint with the U.S. Equal Employment Opportunity Commission. She subsequently lost a third quadruplet and delivered one baby. After her maternity leave, Elwell went back to Google in January 2005, but when she learned she would not be able to return to her former position on the sales force, she left the company.

It all sort of puts into perspective Sheryl Sandberg’s cheery anecdote about lobbying Google for “pregnancy parking” at its California headquarters, doesn’t it?

In 2006 a federal judge moved Elwell’s suit into arbitration. Her attorney met with Google’s lawyers in 2007 to discuss a possible settlement, but the company’s lawyer allegedly responded, “These people are not settlers.”

Sources with knowledge of the case say the parties did eventually reach a settlement via arbitration, which was fairly financially advantageous to Elwell, and which the parties are barred from discussing publicly. AOL senior vice president for corporate communications Peter Land says, "We can’t comment on the lawsuit because it had nothing to do with us." The company points out that Working Mother Magazine has named it a top 100 company for working moms.

A woman who answered the phone at Elwell’s Manhattan home told me she was not in and took a message. Leah Schloss, director of marketing at Elwell’s law firm, Sullivan & Worcester LLP, says, “We are not able to discuss this case.” I have also reached out to Google. I will update this piece when and if I hear from additional sources.

Peter Buffett’s Solution-Free Critique of Big Philanthropy

I spent a year editing a philanthropy section at The Daily Beast. During that time, I often felt frustrated that corporate and celebrity donors seemed to lack understanding of the systemic causes of the problems they wanted to solve. A good example is what goes on in the Congo. Philanthropic and foreign aid dollars stream in to efforts to provide medical and psychological services to the victims of mass rape, but Western governments and corporations have expended very little will to end the regional, mineral-fueled war that is the root cause of the sexual violence there. As a result, many rape victims return to their villages and are raped again. Another good example is female genital cutting. The most hyped anti-FGC effort is conducted by the non-profit Tostan, in Senegal. A new UNICEF report finds no significant decrease in cutting rates in that country. Meanwhile, in the Central African Republic, an anarchic nation with fewer philanthropic interventions, cutting rates have decreased by almost half. Why? Nobody really knows!

So I was gratified to read Peter Buffett's Sunday Times op-ed, which shines a powerful light on the problem of philanthropy disconnected from political and economic systems: "Because of who my father is, I’ve been able to occupy some seats I never expected to sit in. Inside any important philanthropy meeting, you witness heads of state meeting with investment managers and corporate leaders. All are searching for answers with their right hand to problems that others in the room have created with their left." 

Yes. Buffett doesn't explain how to solve this problem, but one place to start is with evidence. He complains that microfinance, for example, "feeds the beast" of the Western "system of debt and repayment with interest." This is a rather quixotic critique. The real problem with microfinance is that the most credible research finds that behind the heartwarming anecdotes of single moms who launch hatmaking businesses, these loans have no broad track record of success in lifting the poorest of the poor out of poverty, and in fact end up saddling many families with debt they cannot repay. A far better idea is for charities and governments to simply redistribute free money — no strings attached — to the poor. 

Another solution is to ask where the non-profit sector is truly the most effective actor, and where less corrupt government–supported by progressive taxation–must step in to solve deep-seated social and economic problems. The Buffetts are liberals who support higher taxes on people like themselves, though for some reason Peter Buffett doesn't mention the word "taxes" in this op-ed. Nor does he mention government regulation of international corporate labor and manufacturing practices, which could help solve some of the most pressing problems of poverty in the developing world.

On Doing Well to Do Good

Dylan Matthews has an interesting report about a group of young American and British professionals with progressive social values and high-paying jobs in finance and tech. The subjects of the piece are unusual because they are giving away between a quarter and a half of their incomes each year, typically to health and anti-poverty charities operating in sub-Saharan Africa. In fact, inspired by the philosopher Peter Singer, they say they have chosen handsomely paid jobs, like high-frequency trading, because they aspire to give away as much money as they can. 

I'm a fan of some of the organizations, like GiveDirectly and GiveWell, that are loosely part of this movement toward ethical, high-impact giving, with few or no requirements for the individual recipients of aid. Yet I worry about an ethical stance in which any career choice is socially responsible, as long as one pledges to give generously to charity. The fact is, the number of people who choose to make millions in order to give money away is infinitesimal; the ability to donate generously is usually cited as a guilty liberal's justification for richly rewarded work in fields, like finance, that can be defined by bad social values, such as lobbying for lower corporate tax ratestaking advantage of low-income consumers right here in the United States, and bad labor practices. That's not to say progressives should never work on Wall Street or for Big Food/Pharma/Tech; indeed, we need social justice-committed people within those fields to argue and work for ethical change. But the ethical behavior must go beyond individual philanthropy itself and toward efforts to make corporations better American and global citizens.

Att. Jason Richwine: You’re Not the First Guy to (Wrongly) Believe Immigrants are Dumb

It turns out that the deliciously-named Jason Richwine, author of an anti-immigration reform paper from the Heritage Foundation, is also the author of a 2009 Harvard public policy dissertation called "IQ and Immigration Policy," which claims that because Latinos are genetically intellectually inferior to whites and Asians, their immigration to the U.S. should be tightly restricted. Richwine has also contributed to a white nationalist website called AlternativeRight.com. 

The human brain remains, in many crucial aspects, a mystery to science. So what is IQ? It is a measure of the capacity to learn in the linear fashion prized by Western culture, and we know that it is partially determined by genetics. Yet in the life of the average, individual human, those "innate" genes are vastly, vastly overpowered by the effects of environment: decent nutrition; an emotionally stable, vocabulary-rich home life; physically and emotionally attentive parents; good schools and teachers. Those factors tend to be in shorter supply among high-poverty populations. Claiming that such populations are genetically inferior ignores about a century of research and writing on the malleability of IQ and the proper uses of intelligence assessments.

Alfred Binet, the French psychologist who invented IQ testing, made quite clear that his exams could not draw conclusions about the difference in innate ability between two individuals from different cultural and socioeconomic backgrounds. Little has changed. In 1995, after the tempest around Charles Murray's The Bell Curve, Nobel Prize-winning economist James Heckman summarized what is known about intelligence, race, class, and heritability. The consensus is that IQ can help distinguish between the capacities of "within-group" individuals–for example, two upper-middle class American Jewish girls who attended good public schools and then Brown University. However:

1. IQ supremacists claim IQ is a measure of innate ability. Yet IQ tests are actually achievement exams, which, in Heckman's words, can be "manipulated by educational interventions." If a child is asked during an IQ assessment to memorize and repeat a long string of numbers, she will do a better job if she has an excellent math teacher or if her dad helps her with her math homework at night — if, in other words, she has had the opportunity to gain confidence around numbers.

2. If two race-similar individuals are compared, the person with the higher IQ will often have superior social outcomes. He is more likely to graduate high school or get a high-paying job. Yet the evidence suggests that IQ itself–as opposed to all the other social factors correlated with IQ, like parental income–is responsible for only a small fraction of this difference in achievement. Not to beat a dead horse or anything, but correlation does not imply causation. 

3. IQ is one predictor of success on the labor market, but it is not the only or even the most important factor. Social skills and work ethic are not measured by IQ, yet can be substantially improved through education and training, especially if that training is received in childhood. 

4. We know socioeconomic factors influence intelligence, but our measures of those factors are crude. For example, a nutritious diet increases cognitive function, but we don't know by exactly how much. If we get better at isolating and measuring such effects, it might turn out that genetic intelligence is even less important than we assume. 

One of the books I recommend most often is The Big Test by Nick Lemann. He shows how wave after wave of new immigrants, including white immigrants, were assumed to be innately stupid, in part because of their initial bad scores on IQ exams. This is true even of those groups, like Jews, whom we think of as "smart" today. Here Lemann writes about IQ tests given to World War I recruits, and the way the scores were intepreted by Carl Campbell Brigham, a Princeton psychologist who became an author of the SAT:

On the Army IQ tests, Nordics scored higher than Alpines, who scored higher than Mediterraneans. The test results as a whole were like a photograph of American culture, so faithfully did they reproduce the social order. Officers scored higher than enlisted men, the native-born scored higher than the foreign-born, less recent immigrants scored higher than more recent immigrants, and whites scored higher than Negroes. There were ironclad natural laws at work here, Brigham felt, and he warned that wishful thinkers who pretended otherwise were deluding themselves–writing, for example, "Our figures, then, would rather tend to disprove the popular belief that the Jew is highly intelligent." Brigham's stern conclusion was this: "American intelligence is declining, and will proceed with an accelerating rate as the racial admixture becomes more and more extensive…These are the plain, if somewhat ugly, facts that our study shows." 

The social and cognitive science has improved since then. But somehow, Richwine didn't get the memo, so we keep rehashing these noxious old arguments.

Update: Via Twitter, Daveed Gartenstein-Ross points out that in his dissertation, Richwine does discuss the Brigham research. He concludes that Brigham unfairly discriminated against certain white immigrant groups, since those groups, like Italians, now perform equally to Northern European Americans on today's more sophisticated IQ tests. This is from page 20:

Screen Shot 2013-05-10 at 1.32.50 PM

Richwine recognizes Brigham's bias toward certain white people. Yet he assumes that innate genetic traits are responsible for Latino's lower IQ scores over the past several decades, as opposed to the many socioeconomic realities described above and acknowledged as far-greater predictors of IQ. Richwine writes that since Asians are both poor and do well on IQ tests, this destroys the argument that poverty accounts for Latino's lower scores. Yet poverty is not a monolithic phenomenon. It differs culturally, across the globe, in terms of how much emphasis is put on academic learning. Ex; Until Reconstruction, it was illegal in the American south to teach black people to read. Chinese culture has emphasized success on written civil service examinations for over a millenium. Some Latino teenagers arrive in American public schools nearly illiterate in Spanish; they come from agricultural communities in countries where anything beyond an elementary education is off-limits to the very poor. Comparing Asians to Latinos is thus exactly the sort of "out-group" analysis that Heckman and Binet warned about.

Is Working From Home a Feminist Issue?

I've worked in offices for small magazines, large media companies, and think tanks. So I know there's a lot about office culture that sucks: useless meetings, crackberries that ruin your precious out-of-the-office hours, and sometimes an assumption that whoever stays latest or arrives earliest is working hardest. In New York, there's competitive dressing. In DC, there are old-school dress codes, as if everyone were about to meet with a senator, any minute now! A lot of this is absurd. I'm a huge believer in flex time for office workers. There's nothing about the hours 9-7 that make them especially productive; a lot of us get more done in the evenings, or while fighting insomnia, or at sunrise. And the occasional guilt-free day of working from home is priceless: the quiet, the pajamas, the home-cooked lunch. For new parents, people with chronic health conditions, or people who serve as caretakers for sick or elderly relatives, having the ability to work from home at least some of the time can mean the difference between being able to hold down a job and being forced to quit. 

So I sympathize with those who are outraged over Marissa Mayer's decision to put the kibosh on work-from-home arrangements at Yahoo. It's insulting to employees to suggest that the only legitimate reason to stay home is "for the cable guy," and Mayer does sound like kind of a nightmare boss, counting the cars in the corporate parking lot at 5 pm. Because women tend to disproportionately handle child care and other domestic responsibilities, it is very likely that female employees will be especially affected by Yahoo's policy change. 

All that said, I'm not sure working from home is feminist nirvana.

I'm a freelance writer — a really lucky one, with a book project, an interesting editorial consulting gig, and frequent magazine assignments. I love what I do. But working from home is by far the hardest and least enjoyable part of my professional life. For one thing, it's lonely, isolating, and, at least in my case, challenging for my physical and emotional health. I often get so caught up in my indoor responsibilities that I forget to get fresh air, put on real clothing, take a walk, or talk to other human beings. At The Awl, Ken Layne pretty much nails what this can feel like. 

And here's the thing. For a woman, being stuck inside "the home" all day–a space traditionally coded as female, one that many women hold themselves to high standards to care for–can be especially stultifying. Here are some of the things I can do, in my home, when I'm supposed to be writing my book: Laundry. Emptying the dishwasher. Booking a hotel reservation for a friend's wedding. Cleaning the toilet. Shopping for and preparing a healthy, low-carb, high-protein dinner for my boyfriend and me. (This morning, I've already done several of these chores, and it's only 11 am.)

No one is forcing me to take sole responsibility for these tasks. If I don't do them when I'm "working from home," they will still get done. My boyfriend and I will split them up, or do them together. But here's the thing: It's really hard for me to be at home and ignore my domestic to-do list. I have a voice in my head telling me that until my apartment is neat, clean, and stocked with fresh food, it's perfectly okay to procrastinate on my real jobs, the ones for which I get paid: reporting, writing, and editing. After nearly three years of freelancing, I've learned that I shouldn't work from home more than one or two days per week. I now commute from Brooklyn into "the city" almost every morning, to work at the New York Public Library on 5th Avenue and 42nd Street. Yes: I voluntarily spend my days in midtown Manhattan, eat lunch at the ubiquitous Hale & Hearty Soups, and dodge tourists in the subway.

Granted, I don't have children yet. And if I'm still freelancing when I do, I know my flexible schedule will make parenthood much easier. Yet I have many freelancer female colleagues, a few years older than me, who admit that a big professional challenge is learning to turn off their mom selves and simply get to work (luckily, work they love). They are some of the people who helped me realize that even if you "work from home," you have to work outside your home often, and if that means scrimping for a babysitter, a coworking space, or a $104 monthy Metrocard, it's totally worth it, if you're privileged enough to be able to afford it. 

So here's my tentative conclusion. Flex-time is a feminist issue. Working from home full time? Maybe not so much. And here are some very definite feminist issues: Access to high-quality, affordable childcare. Paid sick leave, maternity leave, and paternity leave. Male partners who pull their weight at home. 

Inside My Interview with Bill Gates

Yesterday I got to meet and interview Bill Gates, along with five other writers and reporters. We sat around a conference table at a midtown Manhattan hotel. Gates, wearing a totally unassuming gray suit and sipping Diet Coke out of a glass bottle, was business like and to the point. His passion flared up a few times during the hour-long conversation. He vehemently pushed back against economist and blogger Tyler Cowen's suggestion that macroeconomic and population growth, as well as better roads and other infrastructure, could bring faster humanitarian relief to Africa than more direct health interventions like vaccinations or contraceptives, which the Gates Foundation funds. Discussing the bleak living conditions in the Central African Republic and Yemen, Gates said, "If you don't invest in health there, you're a cold-hearted bastard." In a rare personal comment, he discussed how one of his daugthers was moved by video footage of a child survivor of polio limping down a dirt road. "What did you do to help her?" she asked her dad — an insightful comment, since Gates said he feels growing concern about the survivors of once-deadly childhood diseases like malaria and polio, who often arrive at school with cognitive delays that make it difficult to learn. 

On education, I think a few of Gates' comments broke news. He hinted that his foundation may soon invest resources in alternate rankings of American colleges, saying the true metric for success in higher education should be whether a school accepts a student "with a combined SAT score of 600, and they got $100,000 jobs, and they're super happy." In response to several questions from yours truly, he also discussed standardized testing and teacher evaluation at length, particulary in non-traditional subjects such as art and music. Gates said he isn't sure if good tests can be created in the arts, and he called Florida's plan to move forward quickly with such non-traditional testing "crazy," as well as something that could create a popular backlash against education reform. 

In response to Jason Kottke, Gates briefly addressed his reputation as one of the world's most celebrated college drop-outs, and I thought his comments were interesting considering the backlash against college coming from Peter Thiel and some other Silicon Valley luminaries, who tend to imagine upper middle class kids and the Ivy League when they hear the words "higher education." First, Gates correctly pointed out that community colleges and four-year public universities make up "the heart and soul of education in America," and that those schools are currently operating under severe budget constraints, which hinder their ability to move the working poor into the middle class. Second, he said the number of successful tech entrepreneurs or programmers without a college degree is "a rounding error, that's why it's so mythic," and added that he had enjoyed college and "I'm just about as fake a drop out as you can get," since he loves lectures and left Harvard only to pursue the once-in-a-lifetime opportunity to launch Microsoft.

Lastly, in response to Jacob Weisberg, Gates addressed the potential of MOOCs–massive online open courses–to transform higher education, saying such classes would not live up to their full potential unless they enroll more low-income students and provide some sort of counseling or support to guide students through completing the MOOC and ultimately attaining some sort of credential. Currently, most MOOCs are seeing drop-out rates of up to 80 percent, and are reaching a fairly privileged audience. 

Head on over to The Atlantic to read my full report.

Further Thoughts on the Politics of Unconditional Cash Transfers and the Notion of the “Deserving” Poor

This morning I told you about my new Atlantic article about GiveDirectly, a charity that distributes cash to poor families in Kenya, and allows them to spend the money on whatever they want. The recipients are chosen not because they have demonstrated any kind of favored behavior, like enrolling their children in school, but simply because they are among the poorest people in their rural villages, living in homes made of mud or thatch and frequently going without enough food. They are generally spending their new income on worthwhile causes, like food and weatherproof roofs.

Yet conditional cash transfer programs are more politcally palatable across the world than unconditional ones like GiveDirectly, whether they are pursued by philanthropies or governments. Why? Because, as this beautiful Reuters piece demonstrates, much public policy rests on the assumption that there are two kinds of poor people: the deserving poor and the undeserving. Deserving poor people work, even if the wages they earn are less than the costs of child or health care. They endure cumbersome bureaucratic processes to seek child support from the absent fathers of their children, even if those fathers are in jail, drug addicted, or otherwise unable to provide for their kids. They open college savings accounts, even if they need 100 percent of their monthly income just to cover the costs of housing and food. They attend classes on why it's important to get married.

In the United States, government tells a small group of poor people — typically mothers of young children — that if they fulfill such requirements, they can receive, for a discrete period of time, a small amount of supplemental monthly income. Childless adults and the longterm non-working, non-disabled poor are almost completely excluded from social welfare efforts in many states. 

No matter how much economic research we cite showing that unconditional cash income and savings improve the lives of poor people and their children, it will remain politically difficult to tell taxpayers that we aren't going to require anything from the recipients of social welfare. That's because most of us assume poor people need to learn how to best help themselves. The radical premise of GiveDirectly is that poor people already know, much better than their governments or a charity director, what they need. 

Which assumption is true? Should governments and non-profits use the promise of cash to attempt to train or educate the poor out of poverty? Or should a basic income be understood as a matter of human dignity?

Can Four Young Economists Build the Most Efficient Charity Ever?

It's holiday giving season. Would you donate cash to a poor family, and let them spend it on whatever they wish? That's the radically simple premise of the new philanthropy GiveDirectly, which I report on today at The Atlantic:

GiveDirectly remains an outlier in the development arena, perhaps the only organization that distributes private donations, made online, directly to the poor with no strings attached–no requirement to launch a business or to immunize one's child; no distribution of bed netssolar lanterns, orgoats.

The economics might be sound. But the politics within the non-profit world are more complicated. Niehaus, now a professor at the University of San Diego, says other development experts who have tested unconditional cash transfers are enthusiastic about the approach. The trouble is convincing NGOs to invest in such programs beyond the pilot stages.

"We had conversations with people [in the non-profit sector] who said there was a lot of internal resistance to unconditional transfers," Niehaus told me. "If this works, what are we all here for? Why do we have jobs? There's an industry that exists that tries to make decisions for poor people and determine what's best for them. In some ways, that's the industry I came from. But the value of that hasn't been proven."

Read the whole piece!

Young Parents, Old Parents, and Children

My grandmother gave birth to my father when she was 19-years old, and I've been especially lucky, well into adulthood, to have a close relationship with healthy, young-at-heart, active grandparents. Yesterday they sent my boyfriend and me John F. Kennedy chocolate gelt for Channukah, which was pretty cool. But my grandparents, who are wonderfully creative and intellectually curious people, never went to college; between them, they worked in retail, at banks, in medical offices, and doing childcare, though they could have thrived as artists, as teachers, or in many other professions. My grandfather is an expert photographer and is passionate about history, and my grandmother paints and cooks beautifully, in addition to being one of the warmest people most of her family and friends have ever met. When our clan gathered at my aunt's house for Thanksgiving this year, I thought a lot about the shape of my grandparents' lives. Their three kids all went to college and graduate school, and waited until their mid or late-thrities to reproduce. Today the joy of three children and four grandchildren is overwhelming, and my grandparents may someday meet their great-grandchildren, as well. Yet they have never been rich, or been their own boss, or achieved the financial stability they would have liked. I'll have far fewer years with my descendents than they have had with theirs, but I'll also have an intellectually challenging career, more money, and fancier vacations, too. Life is full of trade-offs. 

So I was really moved by Judith Shulevitz's New Republic cover story on the health and social effects of delaying parenthood. Now that it looks like advanced paternal age is correlated with autism spectrum disorders and certain mental illnesses in children, men might finally join women in the anxiety Olympics over how to fit education, career, the search for true love, and reproduction into the ever-shrinking window of opportunity before one's 35th birthday. As Shulevitz states, we'll "have to stop thinking of work-life balance as a women’s problem, and reframe it as a basic human right." Correct. Similarly, it's refreshing to read about the potentially problematic breeding practices not of young, unwed single moms, but of some of the affluent, hyper-educated married couples who delay childrearing into their forties or even beyond, and who will be well into senior citizenship by the time their children are fully "launched" into the adult world.

But. The risk is that by focusing on the genetic and epigenetic ways in which disabled, differently-abled, or simply complex children come into the world, we blame parents for their kids' disabilities, or begin to see conditions like autism and schitzophrenia as the "fault" of parents who could have made a different set of choices. In part, this is already happening with Down syndrome. The risk for Down syndrome goes up significantly when an expectant mother reaches 35, but 80 percent of children born with Down syndrome are delivered by women younger than 35. Because these mothers are not in the highest-risk group, they are often counseled to forgo more invasive and riskier Down syndrome tests. When I reported on Down syndrome screening in 2010, I talked to several mothers who had been pained by strangers' assumptions that because they had a child with Down syndrome, they had somehow failed to undergo basic prenatal medical care. The truth is that although 90 percent of parents who receive a prenatal Down syndrome diagnosis choose to abort, there are no failsafe tests, and most parents are surprised when a child is diagnosed with Down syndrome or any other disability. Other parents actively choose to carry atypical pregnancies to term, for religious or other personal reasons. 

Prenatal testing for Down syndrome and other disabilities will become more sophisiticated and safer. Someday there may be a prenatal screening for autism. But there will always be differently-abled children, like Shulevitz's son, and I know she would agree that once they are with us in the world, we ought to focus more on how to best meet their needs than on the supposed reproductive failures of their parents. (The same goes for poor children, by the way, born to single moms.) Better genetic science may mean more social pressure on both men and women to reproduce in their twenties and early thirties, but I hope it never means we lose our compassion for the disabled children of older parents, or for the adults who wait for romantic or financial stability before having children. 

Susan Rice, Obama, the Clintons, and the Tragedy in the Congo

The decade-long conflict in the Democratic Republic of Congo, mostly over control of mineral deposits, is the deadliest the planet has seen since World War II, with an estimated 3 million people killed and 500,000 women and girls brutally raped. Every expert agrees that the governments of neighboring Rwanda and Uganda, which receive hundreds of millions of dollars in American military aid each year, have enabled the militias that perpetrate much of the violence in the Congo. We also know that multinational mining and tech corporations, many of which have deep political influence in the United States, are dependent upon the minerals dug up in rebel-controlled Congolese mines. These materials are used to build cell phones and other small electronic devices.

UN Ambassador Susan Rice’s history of consulting for the autocratic Paul Kagame regime in Rwanda should certainly be on the table as the president, Congress, and public weigh her candidacy for secretary of state. But it is crucial to note that in her repeated attempts to downplay the role of the Rwandan government in the systematic mass killing, rape, and torture of Congolese civilians, as well as in the recruitment of child soldiers, Rice is serving not as a lone actor, but in absolute concert with the Obama administration’s overall Africa policy. Under Hillary Clinton, the State Department committed $17 million to alleviating sexual violence in the region. Most of the money was spent on treating rape survivors, which, while absolutely crucial, did not address the political and economic root causes of the conflict. That’s a problem because no matter how hard health and development organizations work to rehabilitate rape victims and former child soldiers, as long as the conflict continues, these survivors risk being re-victimized once they return to violence-torn communities. That is why so many Congolese women and girls are raped multiple times.

As I reported in 2010:

Obama has long been interested in Africa, both personally and politically. As a freshman senator in 2005, he sponsored legislation, later signed into law by President Bush, empowering the secretary of state to withhold aid from neighboring countries that play a role in destabilizing Congo.

But that prerogative was never exercised, under either Bush or Obama, even as both Sweden and the Netherlands de-funded Rwanda because of its support for armed rebel groups active inside Congo.

In its dealings with Rwanda, the U.S. is “paralyzed,” argued Mvemba Dizolele, a native of Congo and Africa policy expert associated with the Hoover Institution and Johns Hopkins University. “We lost our moral authority in 1994 when the genocide happened, and we allowed [Rwandan President] Paul Kagame”—the leader who ended the genocide—“to become the authority in the region and go into Congo.”

As a veteran of the Clinton administration, Rice is part of the group of policy-makers who deeply regretted America’s inaction in the face of the Rwandan genocide, and who greeted Kagame’s rise to power with relief. In 2009, Bill Clinton presented Kagame with a Global Citizenship Award at his annual Clinton Global Initiative conference in New York. In 2010 I asked President Clinton about UN reports holding Kagame’s administration partially responsible for violence in the Congo. Clinton replied:

“The U.N. said what it did about what happened after the [Rwandan] genocide, in Congo. … Kagame strongly disputes it. Right now I’m not going to pre-judge him because there’s this huge debate about what happened in the Congo and why, and I don’t know.”

In reality, Kagame’s culpability has been broadly documented for years, by the United Nations, by Human Rights Watch, and by Africa scholars and advocates. It’s fine to hold Susan Rice accountable on this, but we have to reach higher, too, into the State Department, the Department of Defense, and the Oval Office.