What will be Bush’s greatest positive legacy? I think PEPFAR is a likely candidate, despite its flaws. I can’t think of any other program initiated by Bush that has helped so many people.
All of our investments in high-tech medicine and tons of tests, as well as the drive toward further specialization, aren’t really having an impact on public health indicators like life expectancy and child mortality. But for those who want to go into medicine (like me) the sexy, intellectually-stimulating, cutting-edge, fiscally-rewarding work is in those specialties.
We need to have a different focus.
“In an age of explosive development in the realm of medical technology, it is unnerving to find that the discoveries of Salk, Sabin, and even Pasteur remain irrelevant to much of humanity.” – Paul Farmer
“The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them.” – Rudolf Virchow
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Posted by brett
I’m currently reading Shane Claiborne’s Irresistible Revolution. I’m sure I’ll blog on it more fully once I’ve completed my leisurely perusal, but for now I’d like to highlight some quotes Shane brought to my attention. These are from Martin Luther King, Jr.’s “A Time to Break Silence,” a speech given on the Vietnam war in 1967 at a meeting of “Clergy and Laity Concerned” at Riverside Church in New York City. MLK’s concerns went beyond his (incredible) devotion to civil rights in our country, to an even broader view of social justice. And it’s always good to reflect on values that should bring rich and poor, Christian and humanist, theist and athiest together.
[It became clear that the war in Vietnam] was sending their sons and their brothers and their husbands to fight and to die in extraordinarily high proportions relative to the rest of the population. We were taking the black young men who had been crippled by our society and sending them eight thousand miles away to guarantee liberties in Southeast Asia which they had not found in southwest Georgia and East Harlem. And so we have been repeatedly faced with the cruel irony of watching Negro and white boys on TV screens as they kill and die together for a nation that has been unable to seat them together in the same schools.
Funny how these words still ring true today:
As I have walked among the desperate, rejected, and angry young men, I have told them that Molotov cocktails and rifles would not solve their problems. I have tried to offer them my deepest compassion while maintaining my conviction that social change comes most meaningfully through nonviolent action. But they ask — and rightly so — what about Vietnam? They ask if our own nation wasn’t using massive doses of violence to solve its problems, to bring about the changes it wanted. Their questions hit home, and I knew that I could never again raise my voice against the violence of the oppressed in the ghettos without having first spoken clearly to the greatest purveyor of violence in the world today — my own government.
And here a call for a brotherhood of man, rooted in King’s own Christianity, though it could as easily be read as a call for a global humanism (in fact, King might have been closer to that than most of the Christians we know):
This I believe to be the privilege and the burden of all of us who deem ourselves bound by allegiances and loyalties which are broader and deeper than nationalism and which go beyond our nation’s self-defined goals and positions. We are called to speak for the weak, for the voiceless, for the victims of our nation and for those it calls “enemy,” for no document from human hands can make these humans any less our brothers.
King also has this quote from a Buddhist leader on the war in Vietnam:
Each day the war goes on the hatred increases in the heart of the Vietnamese and in the hearts of those of humanitarian instinct. The Americans are forcing even their friends into becoming their enemies. It is curious that the Americans, who calculate so carefully on the possibilities of military victory, do not realize that in the process they are incurring deep psychological and political defeat. The image of America will never again be the image of revolution, freedom, and democracy, but the image of violence and militarism.
If you will, rephrase that quote for me with Iraq in mind instead of Vietnam (not the analogy is a perfect one, but analogies never are… this particular quote however makes a useful point):
Each day the war goes on the hatred increases in the heart of the Iraqis and in the hearts of those of humanitarian instinct. The Americans are forcing even their friends into becoming their enemies. It is curious that the Americans, who calculate so carefully on the possibilities of military victory, do not realize that in the process they are incurring deep psychological and political defeat. The image of America will never again be the image of revolution, freedom, and democracy, but the image of violence and militarism.
And here he waxes prophetic. One could make the same claim today about US militarism:
The war in Vietnam is but a symptom of a far deeper malady within the American spirit, and if we ignore this sobering reality…and if we ignore this sobering reality, we will find ourselves organizing “clergy and laymen concerned” committees for the next generation.
And another gem:
On the one hand, we are called to play the Good Samaritan on life’s roadside, but that will be only an initial act. One day we must come to see that the whole Jericho Road must be transformed so that men and women will not be constantly beaten and robbed as they make their journey on life’s highway. True compassion is more than flinging a coin to a beggar. It comes to see that an edifice which produces beggars needs restructuring.
And here’s another quote, though this time I’ve replaced “Communism” with “terrorism”:
This kind of positive revolution of values is our best defense against terrorism. War is not the answer. Terrorism will never be defeated by the use of atomic bombs or nuclear weapons. Let us not join those who shout war and, through their misguided passions, urge the United States to relinquish its participation in the United Nations. These are days which demand wise restraint and calm reasonableness. We must not engage in a negative antiterrorism, but rather in a positive thrust for democracy, realizing that our greatest defense against terrorism is to take offensive action in behalf of justice. We must with positive action seek to remove those conditions of poverty, insecurity, and injustice, which are the fertile soil in which the seed of terrorism grows and develops.
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Posted by brett
The NYT has an article on Freegans–people who reject consumerism and try to live off other’s trash.
Anthropologically speaking, it’s fascinating. Freeganism is certainly unsustainable (ironically) without the rampant consumerism of American society. The best metaphor is that of “scavengers of the developed world,” found on the front page of the NYT article.
While I may be too much of a cynic to find the lifestyle that appealing, all of it comes from a realization I can certainly sympathize with:
“Most people work 40-plus hours a week at jobs they don’t like to buy things they don’t need.”
May I always do work I love, and may I not buy crap I don’t need. Amen.
Eugene Robinson has a brief but excellent piece on TruthDig about Obama’s speech for Father’s Day. Fatherhood is, of course, a major theme for Obama, who’s own black father was absent. If you haven’t already read Dreams from My Father, I highly recommend it.
When anyone runs for office, the question of motivation immediately and inevitably (as it should) rises to the surface. Is Obama talking about black men and responsibility because he cares, or to appeal to the white voter base that’s wondering just how black he is? Robinson wonders too:
Is Obama speaking to African-Americans, or is he really trying to reach those whites who believe that most of black America’s problems are self-inflicted? I’m paid to be skeptical, but I think something much deeper than political calculation is involved here. One revelation that comes with spending time with politicians is that they actually have core beliefs. To cite one example, John Edwards may be a multimillionaire but I can’t doubt his sincerity when he talks about poverty. I’ve seen him volunteer in a soup kitchen without first summoning the television cameras. He grew up poor, and the experience has never left him.
One can care about an issue and also use it for political advantage. This is what we as voters actually want–for candidates to spend time talking about issues that happen to be both important to us and meaningful to them. I like this man more and more.
Obama grew up without his black father. It doesn’t take a psychologist to discern the impact this absence had. He has explained it himself in his books, at considerable length. He talked about it Friday in the fatherhood speech, saying that his mother—struggling to raise two children as a single parent—at times needed to rely on food stamps to make it through the month. He also spoke with admiration of his wife Michelle’s father, who was diagnosed with multiple sclerosis yet supported his family by going to work every day at a water filtration plant, “even when he had to rely on a walker to get him there.”
And Obama also pointed out some economic undercurrents I hadn’t really though about:
There’s nothing startling about Obama’s analysis of the macroeconomic forces that contribute to the problem of absent black fathers. Blue-collar jobs that once paid well and offered security, such as his father-in-law’s job at the plant, have largely disappeared. “In the last six years, over 300,000 black males have lost jobs in the manufacturing sector,” Obama said. The forces of globalization are inexorable. Inner-city schools don’t prepare students to compete in today’s economy.
In general I like globalization because I see it bringing jobs to the poor in the developing world. I understand that there’s an effect on blue-collar workers in the United States, but I tend to see protectionism as a short-sighted and inefficient solution. We have to get those workers better jobs, not set up artificial barriers to their jobs going to more cost-effective, equally-needy overseas workers. But I’m certainly torn by the affect the current situation has. Notably, Obama recently had a minor political gaff that served to bring the outsourcing issue back onto the table for the Democratic candidates. And what does Obama–former overseas resident (Indonesia) that he is–say?
“While it’s not possible to stop globalization in its tracks, what we can do is make sure we have a government that’s looking out for our workers,” Obama said. “We can do more to create a government that’s creating quality jobs here in America, and we can do more to create a government that’s helping workers who lose their jobs.” In Newton, Obama spoke before about 300 people and promised to increase federal grants and job training programs to communities dealing with job losses.
I’m down with that.
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Posted by brett
I am not a patriot. I dislike nationalism in all its forms, and I hold no extraordinary allegiance to my country of birth. I see no more reason to fight for the economic gain of those who share my nationality at the expense of others as I do to fight for my Caucasian ethnicity.
I do however hold allegiance to certain principles–freedom and justice being primary among them–that I believe are worthwhile. To the extent that America is in line with those principles, or at least better than some other countries, I love America. To the extent that America falls short, I am an irrepressible critic. Principle stands higher than country, and it seems that most of the wars in the world have followed when country stands higher than principle.
Truthdig has a piece on Bush’s (positive) reception in Albania, at the same time as a report was released by the Council of Europe on America’s secret prisons. From the report:
What was previously just a set of allegations is now proven: large numbers of people have been abducted from various locations across the world and transferred to countries where they have been persecuted and where it is known that torture is common practice. Others have been held in arbitrary detention, without any precise charges leveled against them and without any judicial oversight. … Still others have simply disappeared for indefinite periods and have been held in secret prisons, including in member states of the Council of Europe.
So, how should we judge President Bush? They say history will judge him… Who knows, maybe later Americans will retain their penchant for preemptive war and laud Bush as a hero for setting a precedent. That’s not an America that I look forward to. One thing I can certainly say now is that the abuses of freedom and human rights that were often justified in our foreign policy by utilitarian calculations (civil war in Guatemala or elsewhere is better than a Communist takeover) have been thrown front and center by George Bush. From TruthDig:
We will remember that long after it was clear that Guantanamo was doing serious harm to our nation’s reputation in the world—on Sunday, Bush’s former secretary of state, Colin Powell, called for the place to be shut down “this afternoon”—Bush stubbornly kept it open.
Let the scandals of today pass. Certain things will stick in our minds much longer:
We will remember Alberto Gonzales not for his hapless stewardship of the Justice Department or the firings of those U.S. attorneys—well, actually, we will remember him for those things—but we’ll also remember that when he was White House counsel he dutifully provided legalistic justification for subjecting prisoners to treatment that international agreements clearly define as torture.
And, one last note on the Council of Europe report:
Marty [the author of the report] makes this point in his report. “We are fully aware of the seriousness of the terrorist threat and the danger it poses to our societies,” he writes. “However, we believe that the end does not justify the means in this area.” Resorting to “abuse and illegal acts,” he says, “actually amounts to a resounding failure of our system and plays right into the hands of the criminals who seek to destroy our societies through terror.”
If America is a beacon for freedom, justice, and human rights, then she is worthy of praise. If she is a den of selfish, aggressive foreign policy and a hunger for economic gain with no question of its consequences, then she is not. Most Americans don’t really care about numbers killed that much. In truth, American forces have killed (whether purposefully or accidentally) many more civilians in Afghanistan, Iraq, and elsewhere then died on 9/11 in New York. The conflagration begun by our military belligerency has arguably resulted in the deaths of more civilians than the continuation of Saddam’s murderous regime would have.
We, as Americans, normally accept these numbers not because we like death, but because we believe the American government is fighting for something that is true, noble, and just: American forces are fighting to preserve the American way of life. If America is not just in its treatment of enemies, are we fighting for justice, or for blind self-preservation?
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Posted by brett
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!)
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Posted by brett
ThruthDig has an excellent piece on the recent “elections” in Nigeria and what they may or may not mean. More thoughts coming soon.
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Posted by brett
My parents gave me a copy of Khaled Hosseini’s The Kite Runner for Christmas, and it’s a tribute to the crazily-high-busy-ness quotient of the past semester that I just now got to it.
Hosseini immigrated to the U.S. from Afghanistan and became a physician, a profession he only gave up after the success of his novels. The Kite Runner is his first novel, and runs in a sort of parallel to his own life. Amir, the main character, grows up in Afghanistan and ends up fleeing to the U.S. during that country’s decades of violence.
The Kite Runner is one of those excellent books where fiction may give one a better introduction to a reality that nonfiction ever could. The characters are imaginary, but in a sense they are very real, telling stories about their country’s history, its culture, its religion, its prejudices, and its wars. Amir is an upper-class Pashtun who has a conflicted friendship with Hassan, the son of his father’s Hazara servant. Much of the book centers on Amir’s guilt over an incident from his childhood and his struggle to redeem himself.
It’s not perfect though. At times I thought the coincidences–such as in meeting the same characters repeatedly, unexpectedly–veered away from realism. The book could have used a few more characters not vital to the plot to flesh it out, but this doesn’t interfere too much. If you want to know more about Afghanistan, The Kite Runner is probably an excellent first book to draw you into a world that is otherwise utterly foreign. And maybe reading it will help humanize the people of Afghanistan, in a way that Americans desperately need.
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Posted by brett