(no subject)
Tiredness at the end of a week.
I am happy to report that our AIDS Awareness Week this year was the most successful one yet. It did help that we managed to have a large display in the library illustrating the past 25+ years of HIV/AIDS history. Our goal was to superimpose social history onto the history of the virus which was hopefully illustrative to those who see more subject-oriented traditional timelines as somewhat disconnected from the rest of the world. A chunk of my last weekend was noting how the same year Nelson Mandela was freed from prison, Ryan White and Keith Haring died from AIDS. The same year the US launched Operation Desert Storm, the red ribbon campaign was introduced, and Magic Johnson announced he was HIV+. The father from the Brady Bunch (Robert Reed) died the same year AIDS became the number one cause of deaths for US men aged 25-44 - the same year of the Rodney King riots. The same year Kaposi's sarcoma was finally proven to be due to the Herpes virus - the summer olympics was held in Atlanta, Georgia. All of these dates, and figures, and facts that we all now accept as a given part of history. All of these things (and so, so, so much more) that happened in our lifetime.
it's really outstanding to me.
now - it's onto the future, which appears bleak in regards to the disease. UNAIDS has published a report titled 'AIDS in Africa: Three scenarios to 2025.' All are recommended to peruse it. In a nutshell, it's suggested that maintaining our current pace with regards to combatting AIDS in Africa - by 2025, 83 million people will have died, and there will be 89 million new infections. Our best possible strategies require US funds of 195 billion dollars, and will still result in 67 million deaths, and 46 million new infections. it's unfathomable.
our first speaker last Tuesday spoke on AIDS in Rwanda. We were expecting about 15 people and ordered food for such. But the ~50 people who attended didn't seem to mind. Dr. Hoffman reminded us once again how HIV is believed to have emerged out of the Congo region in the early 1950s - the same time that hundreds of thousands of individuals were displaced from their homes into neighboring countries and refugee camps as the battles between the Hutus and Tutsis raged. It's not too far-fetched to see how a new virus from the same region could so quickly spread out of such a large area of turmoil. We've all heard of the millions who were murdered by machetes in Rwanda in the early-90s - and the sheer magnitude of the rapes occuring to essentially every girl and woman in the region. The desperation that occurs today is recognition that only those who are currently in jail, those who were the murderers and rapists, have access to the medicines for the disease which is a quick death sentence for all of those they harmed. One woman Dr. Hoffman interviewed noted how the Rwandan word for survivor is translated to 'one who survived the sword,' but since learning she is HIV+, she can't consider herself a survivor.
Our second speaker dealt with the pediatrician's perspective of treating HIV/AIDS in South Africa. As a note, despite the fact that a mother can pass HIV to her child through breast milk - studies are making it more apparent that even those babies who did not contract the virus either in utero or during birth, have a higher chance of survival past the age of 1 if they are fed by their mothers. It's better to risk the virus than risk the water required for dilluting formula paired with the lack of maternal antibodies contained within breast milk. Numerous studies are ongoing to determine the key window which can be used to counsel new HIV+ mothers in how to feed their vulnerable babies. Regardless, nothing will ever be without risk.
Our third speaker was an activist from the 'Crystal Meth Working Group' who publishes those ads around Chelsea (and elsewhere) essentially with the message 'Buy crystal meth, get HIV.' It was refreshing to have someone from outside the medical community to join us. It's so easy to lose passion and vitality as a physician. The career (and training) can simply wear on you. Many physicians are activists because after seeing the situation of their communities and patients from that health care perspective, it's impossible for them to not be so. It's validating to see that our passions are not only related to deaf ears. It's empowering to recognize that really, we are all part of a community, and we need to work together if we are going to accomplish anything. Besides being extremely interesting and informative, Dan was just fun.
Our fourth speaker discussed the implementation of HIV/AIDS treatments in various communities around the world. oi. read the UNAIDS document referenced above. I spent two hours just talking with her after her talk. She has been involved with HIV treatment for the last twenty years, has at least two children and manages to go to Ethiopia 2-4x/year for 3-5 weeks at a time (in addition to the time she spends consulting in the Ukraine, Nigeria and elsewhere). It's inspiring that I know a woman who does manage to juggle it all.
Finally, Joia Mukherjee from Partners in Health (and, originally, Minnesota!) spoke last night to speak on 'A World United Against AIDS.' First off, she does speaking arrangements all.of.the.time so if you can track her down, make certain to go and see her speak. Besides everything else outstanding, I felt she finally illustrated a way to break others beliefs of why Africa is ravaged by AIDS the way that it is. Promiscuity, drugs - these are terms some use to dissociate themselves from the causes of AIDS. Establishing an 'other' makes us immortal. 'But then,' Dr. Mukherjee stated, 'everything I learned about AIDS in Africa, I learned from this man,' and a picture of Keith Richards pops up on her powerpoint. 'Not to criticize Keith Richards, but he has had more sexual partners than everyone in this auditorium combined. His history of intravenous drug use is well documented. But, he is not HIV+.' Next to Mr. Richard's picture, she then put up a photo of an eight year old orphan in South Africa, carrying one younger sibling, while two others hang on to her dress. 'Now, which of these two are more likely to contract HIV?' Of course, this is not to imply that Keith Richards should have HIV, or anything like that. It just eloquently illustrated that promiscuity and sex and drugs and ETC have nothing to do with the epidemic. But, poverty does. Imagine you are in a refugee camp, and you had three young babies, and they were starving to death, which if you don't know, billions of people are.. and at some point, an individual with just a little bit of power, and a little more food than you, is willing to give you food for your starving children if you have sex with him. In that desperate of a situation, can you imagine a single mother saying 'no' to that? When I lived in Kenya, I remember walking through Nairobi, and seeing young babies strapped to young mothers' shoulders with bottles of glue literally stuck beneath their little noses .. bottles of glue because the fumes calmed their hunger, while killing their brains at the same time. One of the first projects Dr. Mukherjee worked on when she travelled to Africa (Uganda) consisted of her going with a team to numerous schools, teaching about HIV/AIDS, and then collecting perceptions of the disease from these same students. After all the trainings, at the end of the day, when the same question was asked over and over to what are the main risk factors for HIV infection - one answer kept coming back in the top 3: poverty.
(I have to wonder if that answer is more or less optimistic than the one i kept hearing in Kenya, 'being African.')
a take home point is that whether or not the disease is still seen regularly in our American streets - HIV is still here, is still viscious - and isn't going anywhere. Monetary, but even moreso, personal committment to eradicating poverty is what i believe will make the difference in the future to taming this disease. There are lots of way to do this, but the point is to be doing something - and little things ALWAYS count. Finally, it's recognizing that we are the other. We are the anomalies. When we talk about global health committment - it's in fact human health committment, and it's hopefully recognizing our sheer luck and accepting its responsibility that will send us into the future.
2025 - here we come. Well, after i finish up this dang Ph.D. :)
I am happy to report that our AIDS Awareness Week this year was the most successful one yet. It did help that we managed to have a large display in the library illustrating the past 25+ years of HIV/AIDS history. Our goal was to superimpose social history onto the history of the virus which was hopefully illustrative to those who see more subject-oriented traditional timelines as somewhat disconnected from the rest of the world. A chunk of my last weekend was noting how the same year Nelson Mandela was freed from prison, Ryan White and Keith Haring died from AIDS. The same year the US launched Operation Desert Storm, the red ribbon campaign was introduced, and Magic Johnson announced he was HIV+. The father from the Brady Bunch (Robert Reed) died the same year AIDS became the number one cause of deaths for US men aged 25-44 - the same year of the Rodney King riots. The same year Kaposi's sarcoma was finally proven to be due to the Herpes virus - the summer olympics was held in Atlanta, Georgia. All of these dates, and figures, and facts that we all now accept as a given part of history. All of these things (and so, so, so much more) that happened in our lifetime.
it's really outstanding to me.
now - it's onto the future, which appears bleak in regards to the disease. UNAIDS has published a report titled 'AIDS in Africa: Three scenarios to 2025.' All are recommended to peruse it. In a nutshell, it's suggested that maintaining our current pace with regards to combatting AIDS in Africa - by 2025, 83 million people will have died, and there will be 89 million new infections. Our best possible strategies require US funds of 195 billion dollars, and will still result in 67 million deaths, and 46 million new infections. it's unfathomable.
our first speaker last Tuesday spoke on AIDS in Rwanda. We were expecting about 15 people and ordered food for such. But the ~50 people who attended didn't seem to mind. Dr. Hoffman reminded us once again how HIV is believed to have emerged out of the Congo region in the early 1950s - the same time that hundreds of thousands of individuals were displaced from their homes into neighboring countries and refugee camps as the battles between the Hutus and Tutsis raged. It's not too far-fetched to see how a new virus from the same region could so quickly spread out of such a large area of turmoil. We've all heard of the millions who were murdered by machetes in Rwanda in the early-90s - and the sheer magnitude of the rapes occuring to essentially every girl and woman in the region. The desperation that occurs today is recognition that only those who are currently in jail, those who were the murderers and rapists, have access to the medicines for the disease which is a quick death sentence for all of those they harmed. One woman Dr. Hoffman interviewed noted how the Rwandan word for survivor is translated to 'one who survived the sword,' but since learning she is HIV+, she can't consider herself a survivor.
Our second speaker dealt with the pediatrician's perspective of treating HIV/AIDS in South Africa. As a note, despite the fact that a mother can pass HIV to her child through breast milk - studies are making it more apparent that even those babies who did not contract the virus either in utero or during birth, have a higher chance of survival past the age of 1 if they are fed by their mothers. It's better to risk the virus than risk the water required for dilluting formula paired with the lack of maternal antibodies contained within breast milk. Numerous studies are ongoing to determine the key window which can be used to counsel new HIV+ mothers in how to feed their vulnerable babies. Regardless, nothing will ever be without risk.
Our third speaker was an activist from the 'Crystal Meth Working Group' who publishes those ads around Chelsea (and elsewhere) essentially with the message 'Buy crystal meth, get HIV.' It was refreshing to have someone from outside the medical community to join us. It's so easy to lose passion and vitality as a physician. The career (and training) can simply wear on you. Many physicians are activists because after seeing the situation of their communities and patients from that health care perspective, it's impossible for them to not be so. It's validating to see that our passions are not only related to deaf ears. It's empowering to recognize that really, we are all part of a community, and we need to work together if we are going to accomplish anything. Besides being extremely interesting and informative, Dan was just fun.
Our fourth speaker discussed the implementation of HIV/AIDS treatments in various communities around the world. oi. read the UNAIDS document referenced above. I spent two hours just talking with her after her talk. She has been involved with HIV treatment for the last twenty years, has at least two children and manages to go to Ethiopia 2-4x/year for 3-5 weeks at a time (in addition to the time she spends consulting in the Ukraine, Nigeria and elsewhere). It's inspiring that I know a woman who does manage to juggle it all.
Finally, Joia Mukherjee from Partners in Health (and, originally, Minnesota!) spoke last night to speak on 'A World United Against AIDS.' First off, she does speaking arrangements all.of.the.time so if you can track her down, make certain to go and see her speak. Besides everything else outstanding, I felt she finally illustrated a way to break others beliefs of why Africa is ravaged by AIDS the way that it is. Promiscuity, drugs - these are terms some use to dissociate themselves from the causes of AIDS. Establishing an 'other' makes us immortal. 'But then,' Dr. Mukherjee stated, 'everything I learned about AIDS in Africa, I learned from this man,' and a picture of Keith Richards pops up on her powerpoint. 'Not to criticize Keith Richards, but he has had more sexual partners than everyone in this auditorium combined. His history of intravenous drug use is well documented. But, he is not HIV+.' Next to Mr. Richard's picture, she then put up a photo of an eight year old orphan in South Africa, carrying one younger sibling, while two others hang on to her dress. 'Now, which of these two are more likely to contract HIV?' Of course, this is not to imply that Keith Richards should have HIV, or anything like that. It just eloquently illustrated that promiscuity and sex and drugs and ETC have nothing to do with the epidemic. But, poverty does. Imagine you are in a refugee camp, and you had three young babies, and they were starving to death, which if you don't know, billions of people are.. and at some point, an individual with just a little bit of power, and a little more food than you, is willing to give you food for your starving children if you have sex with him. In that desperate of a situation, can you imagine a single mother saying 'no' to that? When I lived in Kenya, I remember walking through Nairobi, and seeing young babies strapped to young mothers' shoulders with bottles of glue literally stuck beneath their little noses .. bottles of glue because the fumes calmed their hunger, while killing their brains at the same time. One of the first projects Dr. Mukherjee worked on when she travelled to Africa (Uganda) consisted of her going with a team to numerous schools, teaching about HIV/AIDS, and then collecting perceptions of the disease from these same students. After all the trainings, at the end of the day, when the same question was asked over and over to what are the main risk factors for HIV infection - one answer kept coming back in the top 3: poverty.
(I have to wonder if that answer is more or less optimistic than the one i kept hearing in Kenya, 'being African.')
a take home point is that whether or not the disease is still seen regularly in our American streets - HIV is still here, is still viscious - and isn't going anywhere. Monetary, but even moreso, personal committment to eradicating poverty is what i believe will make the difference in the future to taming this disease. There are lots of way to do this, but the point is to be doing something - and little things ALWAYS count. Finally, it's recognizing that we are the other. We are the anomalies. When we talk about global health committment - it's in fact human health committment, and it's hopefully recognizing our sheer luck and accepting its responsibility that will send us into the future.
2025 - here we come. Well, after i finish up this dang Ph.D. :)