If You Don’t Like to Think About AIDS, Don’t Read This.

June 10, 2007

Nicholas Kristof wrote a piece recently entitled “Save the Darfur Puppy.” I think he was going for getting a reaction with the title, and it worked, at least with me. You’ve probably notice that the media loves stories about endangered species–always cute, cuddly ones, never rodents–because people are moved by these stories. On the other hand, a crisis like the genocide in Darfur is unlikely to get airplay commensurate with its magnitude. And likewise with AIDS, which despite being of tragic scale–two or three flaming World Trade Centers full of people dying every day–rarely hits the news, in part because it’s the same old, depressing story, every day.

So, when I saw that Truthdig had an interview called “Stop Ignoring AIDS and Africa,” I gravitated light-wards. The piece is an interview of Stephanie Nolen, the author of a new book called “28: Stories of AIDS in Africa” which tells one narrative of a (real, actual, living and breathing) human being with HIV in Africa for every one million of the estimated 28 million living with the virus. I certainly plan on reading this book, but here’s what really caught my eye–this picture:

And its caption:

Bongos, an 8-year-old HIV-positive boy, waits in a hallway at the Sparrow Rainbow Village medical clinic in Johannesburg, South Africa, in November 2005.

This really hits home, because I volunteered at Sparrow back in 2005. They do incredible work, and my few weeks there were extremely moving. Sparrow is an orphanage and adult hospice–a “village”–where those with HIV are cared for. The corridor in the background is the central part of Sparrow’s administrative center, which connects some of the hospital rooms (for the sickest patients), a kitchen, administrative offices, and even a makeshift morgue. Because most of the patients there receive some level of antiretroviral treatment Sparrow is really, sadly, one of the best places to be in Johannesburg if you’re a kid with HIV.

Here are some compelling quotes from Nolen’s interview on Truthdig:

You show people a picture of one sad-looking puppy and everyone runs for their wallet, and you tell them that 30,000 children die a day of diseases that can be prevented for less than a buck and nobody gives a rat’s ass. I don’t know what it is, what that says about us as a species, but I certainly know from a long time reporting about HIV in Africa that it’s true.

On narrating an issue where the statistics are numbing:

Their lives could not look more different in some ways than the lives of an American or a Canadian. But when you sit down in the little counselor’s booth in Malawi or Lusaka and they say to you, “You have AIDS, you’re going to die,” that doesn’t feel different than it would if you were in America. And it’s getting people to realize that those people had all—sure, they’re Africans—but they had all those same expectations around their lives. They want to graduate from high school, they want to start a little business, they want to, you know, persuade that really cute girl they’ve been eyeing for a long time to go out with them. It isn’t any different. You’ve really got to go, go really micro to make people understand that story, to get them past the numbers.

On finding stories of progress:

You know, I think we get very often this perception of it being a grim story where not very much changes…We also don’t hear that huge progress has been made in responding. There were, for example, when I started reporting on this full-time, there were fewer than 100,000 people on treatments and today there are 1.5 million in Africa. And everybody said, “You can’t do it, there’s no way you can treat in Africa.” Well, that’s a 13-fold increase in four years, and those people have better survival rates on treatment than most Americans on treatment do. So lots of victories.

On money and broken promises and the real roadblock to widespread treatment programs (trained health care professionals):

And there’s a lot more money available than there was….They need about $6.8 billion to meet those proposals, and they have, you know, like, $1.85 in change. Constantly, countries promise money and don’t deliver or don’t promise anything like what’s needed to respond. So we need money. I think, even more than money, these days we’re realizing that there are some more intractable problems that are going to need more creative solutions. So you can use that money to fly in boxes and boxes of pills. You can’t fly in nurses, doctors, pharmacists. I mean, you can fly in a few, but not enough to meet the needs of a whole, continent-wide healthcare program, right?

On the underlying economic inequalities that drive the epidemic:

You know, I meet lots of young women who’ve been given information about HIV but who are selling sex down at truck stops because their parents have died, they’re raising their siblings and that’s the only option that they have. So, you know, they say, “Fine, we’ve been told about HIV in the safe-sex textbooks, but HIV might kill me in five years or 10 years and we’re all going to starve to death next week if I don’t do this.” So, you can address some of the obvious things around prevention, but unless you change the factors that drive people into risky behavior, then you haven’t achieved very much.

And, a bit further afield, but still in Africa, on Darfur and the war in Uganda:

And, you know, it’s also interesting to talk about Darfur because, yeah, there are probably 300, 350,000 dead there and a lot of people displaced, but it is in fact a far smaller conflict than the war in northern Uganda which has been going on for 21 years. You have four times as many people displaced in northern Uganda. You have four times as many people dead. Well, when did we last hear about that one, right? I mean, Darfur is suddenly sexy because George Clooney goes there and, meanwhile, the war in northern Uganda that relies almost entirely on child soldiers … you don’t hear about that one.

On Bush’s PEPFAR program (providing treatment for AIDS in Africa):

Well, you know, I’ve done a lot of call-in radio lately where people call up and are yelling about the Bush administration letting people die, and here they are, spending all these billions of dollars in Iraq. Why don’t they do something in Africa? So I say to people, “Well, guess what? Actually the $15-billion, five-year program to intervene for AIDS in Africa, that the Bush administration dreamed up, has been the single greatest response to the pandemic ever.” And then there’s kind of silence on the end of the phone, you know?

And its problems:

…They’re saying a group that’s going to get U.S. funds to distribute condoms or put AIDS programs in schools or care for sick people, has to sign a piece of paper condemning sex work. And that’s like crazy moral language that just has no place in a place where people are selling sex to eat.

I like Stephanie Nolen. And I like Truthdig.

(If you’d like to learn more about or donate to Sparrow, please do so!)


Nigeria…

June 10, 2007

ThruthDig has an excellent piece on the recent “elections” in Nigeria and what they may or may not mean. More thoughts coming soon.


McCain’s Agnosticism Kills

March 20, 2007

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I now officially loathe John McCain. When asked simple questions about whether condoms protect users from sexually transmitted diseases, including HIV, McCain simply “didn’t know.” In other words, he’s so afraid of offending his “moral conservative” base that he professes to be agnostic about the most basic of scientific facts, and ends up supporting policies that kill.

A transcript borrowed from The Caucus blog:

Reporter: “Should U.S. taxpayer money go to places like Africa to fund contraception to prevent AIDS?”

McCain: “…Let me think about it a little bit because I never got a question about it before. I don’t know if I would use taxpayers’ money for it.”

Reporter: “What about grants for sex education in the United States? Should they include instructions about using contraceptives? Or should it be Bush’s policy, which is just abstinence?”

McCain: (Long pause) “Ahhh. I think I support the president’s policy.”

Reporter: “So no contraception, no counseling on contraception. Just abstinence. Do you think contraceptives help stop the spread of HIV?

McCain: (Long pause) “You’ve stumped me.”

Reporter: “I mean, I think you’d probably agree it probably does help stop it?”

McCain: (Laughs) “Are we on the Straight Talk express? I’m not informed enough on it. Let me find out. You know, I’m sure I’ve taken a position on it on the past. I have to find out what my position was. Brian, would you find out what my position is on contraception – I’m sure I’m opposed to government spending on it, I’m sure I support the president’s policies on it.”

Reporter: “But you would agree that condoms do stop the spread of sexually transmitted diseases. Would you say: ‘No, we’re not going to distribute them,’ knowing that?”

McCain: (Twelve-second pause) “Get me Coburn’s thing, ask Weaver to get me Coburn’s paper that he just gave me in the last couple of days. I’ve never gotten into these issues before.”

Mr. Senator, this is absurd. I’m nauseous. Actually, this reminds me of the President of Gambia. He had a vision from his ancestors telling him about a magical cure for HIV. And because of his ignorance, people are going to die.

And it reminds me of Thabo Mbeki, the President of South Africa. In 2000, while under pressure from activists to begin providing life-sustaining antiretroviral treatment for HIV using public funds, Mbeki found the easy way out. He publicly questioned whether HIV causes AIDS, and suggested people should opt for good nutrition alone, with no other treatment. Mbeki’s dithering was eventually overcome, but the delay in providing public treatment for HIV in South Africa cost lots of lives, and those lives aren’t just statistics. In 2004 I watched several kids die of HIV in Johannesburg–kids who might have been on treatment by then if Mbeki hadn’t publicly encouraged ignorance and backpedaling.

And with McCain, it’s worse. Really, who do you expect to be more scientifically informed, and more likely to use financial resources to promote condoms, a former revolutionary and current president of a country in Africa? Or a United States Senator, who is a leading politician in a country with massive resources?

And how did McCain respond? He laughed. He hedged. He refused to acknowledge that condoms in any way prevent the spread of HIV or STDs. He probably would deny they prevent pregnancy as well!

This is no laughing matter. McCain will get some negative publicity, but his conservative base will say “look, he’s really anti-condom, so we like him,” imagining that not sending condoms to Africa is actually going to make people celibate and turn them to God.

May McCain be cursed with a stingy bout of gonorrhea and ongoing neural degradation (if he can afford it, since he’s obviously already lacking) from syphilis.


Obama on Globalization

January 7, 2007

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Before reading Dreams From My Father, I knew that Barack Obama had a Kenyan father and an American mother, and had assumed from that that he would have thought out issues of international relations in greater depth than many American politicians. Reading his book, I was pleasantly surprised. Prior to his multiple trips to Kenya, Obama actually spent about three years living in Indonesia as a child. His time in Jakarta has, at least from some of the thoughts he included, given him a level of healthy skepticism regarding globalization and economic development. Also, for what it’s worth, his degree from Columbia was in international relations.

Based on his experience and study, I think Obama is at least more likely to understand the complexity of international economic developments. The greater question is whether a nuanced view of the effects of particular U.S. foreign policy decisions would really lead to substantively better decisions when he’s placed in a position where the accepted thing to do is to promote U.S. interests (i.e., the presidency, or the U.S. Senate).

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Dreams From My Father

January 6, 2007

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My friend Bethany gave me Barack Obama’s Dreams From My Father: A Story of Race and Inheritance for Christmas. I was deeply grateful, and proceeded to demonstrate my gratitude by reading it over a 3-4 day period. The book was surprisingly long (over 400 pages) yet held my attention strongly throughout. Obama, writing ten years ago after being named the first black editor of the Harvard Law Review, describes the development of his own unique racial identity as the son of an African man and American woman. He uses flowing, descriptive prose that is unsentimental yet thought-provoking, while avoiding many clichés.

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Animals, AIDS and Evolutionary Epistemology

December 29, 2006

Peter Singer writes in the India Times about how certain aspects of American democracy hinder the movement for animal rights. In this case, it’s nothing “extreme,” just laws that would allow pigs and calves raised for meat to have enough room on their tethers or in their cages to turn around and lie down. Arizona and Florida recently passed measures like these, but Singer points out that America’s lack of federal animal welfare legislation for farm animals is largely a result of political lobbying. Our political parties are relatively weak, forcing candidates to raise their own money for campaigns and therefore making them subject to pressure from special interests. In other countries, where parties fund reelection campaigns, this pressure is less direct.

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A Change of Fortune?

December 29, 2006

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Somali troops representing the UN-recognized government have retaken Mogadishu from the Islamist rebel government, the capital of Somalia. This is a striking reversal in the often-dark recent history of Somalia, a country in the horn of Africa, bordering Ethiopia, Kenya, and Djibouti (see a map of the region).

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Cruising the Nile

December 22, 2006

These pictures were taken on a cruise and a felucca ride on the mighty Nile, from Aswan down the nile (north) to Luxor, Egypt. The mausoleum in some of the pictures is that of Aga Khan III, the 48th imam of Shia Ismaili Muslims.

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Sins of the Father

December 13, 2006

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And you think the Catholic priests have problems in America…

CNN just ran a story about a Catholic priest who was a leader in Rwanda’s 1994 genocide. Athanase Seromba was just convicted by the International Criminal Tribunal for Rwanda (which meets in Tanzania) and sentenced to 15 years.

According to the charge sheet, Seromba directed a militia that “attacked with traditional arms and poured fuel through the roof of the church, while gendarmes and communal police launched grenades and killed the refugees.”

After failing to kill all the people inside, Seromba ordered the demolition of the church, the document said.

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