Christoph Niemann's creativity and wit are a joyful display of how art, in its many forms, can make people feel good and think reflectively. As he cleverly demonstrates, you don't need high tech or high expense to make your artistic point. which is in sharp contrast to some other artists. A London-based artist, Banksy, also does accessible, sly art though with a noticeably subversive twist.
Photo: Christoph Niemann's Lego take on NYC taxis.
The tragically and profoundly misgoverned country of Zimbabwe recently introduced a two hundred million dollar note to try and keep up with hyperinflation (now estimated in the hundreds of millions percent a year!). The breakdown of the economy and loss of political leadership has resulted in an implosion of the health system as well, marked by a deadly cholera outbreak and violent quashing of peaceful protests staged by health care providers. All this and much more calamity from the former bread basket of Africa.
Photo: A mere 10,000,000 Zimbabwean dollar. By the time you read this, it's worthless.
I recently visited a new home care HIV/AIDS care initiative in an urban slum in Kampala, Uganda. While parts of Kampala can be green and pleasant, this area looked, felt, and smelt like shacks on a toxic waste site which is what in fact they were. These are truly the frontlines of providing care in the rapidly urbanizing developing world. And who leads this care? It certainly doesn’t appear to be the government, but rather the NGOs with their bursting, financially-strapped hearts. While platitudes are appropriately rained down on the game-changing activities of PEPFAR and the Global Fund, a few steps on the mountains of trash, a quick hop over a filthy, putrid stream and one can see the harsh reality of a situation not captured in yearly reports.
Photo: The streets of Mbuya, one of the nicer urban slums of Kampala.
The tension between minority indigenous populations and the "ruling" majority is a constant and challenging reality of the modern world. For example, here in the USA we have a sad legacy in regards to our national treatment of the Native American. Across the way, in China, nationalistic fervor and authoritarianism result in the systematic oppression of the "aborigines". William Harlan and Ryan Wylie have made an excellent short documentary of the conflict between the Raramuri, an indigenous group in Mexico, and commercial loggers. It provides an instructive example of the elusiveness of providing justice to the indigenous and of obtaining an equipoise between societal morality, preservation, and modernity in the setting of many years of fault.
Photo: Opening screen shot of the documentary, "Running For Their Lives".
The Dominican Republic and Haiti are two fascinating countries of compare and contrast. They both occupy the same island in the Caribbean, yet their fates have been much different. The Dominican Republic is well governed, democratic, peaceful, and a tourist destination. Haiti is disastrous on all these fronts. A look at the environmental devastation of Haiti is instructive.
Photo: Satellite photo of the border between Haiti and the Dominican Republic demonstrating the clear cutting of Haitian forest.
"America might control the world, but we must control and keep our own language" -Queensland, Australia's premier
The iconic Sydney opera house is a distinctly Australian image and manages to capture the personality and spirit of both the city and country. Australian identity, like all national identities, are tightly linked to its language. What then to do (if anything) when the rise of American english and associated cultural detritus continues? English is the language of world business and of medicine and public health--though this might be argued by the francophile WHO/UN. There are clear efficiency benefits of a world language, i.e. english, but as accents fade will too the things that make a multicultural world so interesting?
The results of a US government sponsored study on abstinence-only education were recently revealed. The results may not surprise you--it doesn't appear to work. Abstinence-only policies have been a cornerstone of current domestic and foreign health-related programs, at significant financial cost. A funny and fascinating contrast to this failed health promotion strategy is the Healthy Penis campaign. This public health multimedia initiative has evidence to back up its successes and is quite a contrast to bland abstinence-only lectures.
It is difficult to pick a single picture to capture the ecohaven country of Costa Rica. I was fortunate enough to spend some there in February. It is a fascinating country in many respects, even outside of its stunning natural wonders. In fact, its politics (democratic and peaceful), lack of standing army, and relatively prosperity only add to the delight of it beaches, cloud forests, and people. However, no paradise is immune from the 3 R's: real estate, "retirement", and riches, and the battle for the heart, soul, and property of Costa Rica is well underway.
Photo: The still active Volcan Arenal in Costa Rica, taken February 2007.
What is the best show on television? The answer may surprise you, but some would say its The Wire on HBO. This Peabody winning show has been compared to Charles Dickens and praised as incandescent. And what would such a highly regarded show be about? Try the real Baltimore City, the complexity and simplicity of drug dealers, the flawed "honest" cop, and the repeated sorrows and humanity of poverty and inner city America that is played out in a riveting saga for your viewing pleasure and deeper reactions.
After spending a great deal of time and some money buying knickknacks and traveler's kitsch, I decided to largely stop and instead just buy local art. You can probably think of some explicit reasons why this may be a good thing: 1. Supports local artist. 2. Supports the arts. 3.Unique "souvenir".
Some may not think there is much room for art in RLSs. Few would argue that life essentials (food, water, shelter, security) should not be prioritized, but life moves dynamically and asynchronously. Picasso's quote after seeing the ~17,000 year old cave paintings of Lascaux, "We have invented nothing", is instructive, i.e. art is universal and ancient, and it can allow us a moment of higher reflection in the midst of the mundane and even tragic.
Photo: Painting by Sudanese artist, Abusharia Ahmed, currently residing in Kampala, Uganda.
I have returned to
Attempts are being pursued to bring more bandwidth to
But if we believe that architecture serves a society as well as reflects its values, then we must provide for those with the most need and the fewest options. -Sam Davis, UC Berkeley architect.Why do poor people live in ugly houses? The answer to this question may seem rhetorical and sound condescending. But, Architecture, or should I say good architecture, may be defined as much by creativity, ingenuity, and empathy with the persons it is meant to live with, as with financial resources. Naivete aside (of course, many architectural masterpieces could not have been built without profuse funds), but the fundamental values of architecture would seem to be ones which could be adaptable to resource-limited environments.
It is the day before the official start of the XVI International AIDS Conference (IAC) in Toronto. The global health paradigm shifting Gates Foundation's eponymous leaders will help open the plenary. Celebrities will be circulating. And, political leaders cueing. One fact about the IAC that seems surreal but is quite true is that the IAC is no longer held in the United States (where it was founded) because of the US policy of denying visas to persons living with HIV/AIDS. This year's conference will be the largest ever, with an estimated 25,000 participants to attend.
My new home is also a city on the bay. Baltimore is not an easy place. It takes caution, curiosity, and, occasionally, modest bravery to begin to understand and become more of a local in this challenging town. Baltimore has been captured in press by The Corner and on TV by Homicide. The most enduring image of the City to me, however, is the row house. In the newly gentrifying areas they are status symbols (positive ones); a few blocks away they are frightening and omnipresent reminders of an equality chasm.
coffee house: a poem
the cups rest empty
but dreams will only wake to
her singular smile
The Best (& Bravest) Album of 2006 may be the recently released "Taking the Long Way" by the Dixie Chicks. In 2003 just prior to the Iraq War, lead singer Natalie Maines said the following at a London concert,"Just so you know, we're ashamed the president of the United States is from Texas."
The response back home was immediate. Country music stations boycotted their music, former fans burned their CDs, death threats arrived, and Natalie eventually had to move from her native Texas. Country music has thrived on themes of patriotism, lonely soldiers, and American pride since 9/11. Some would say this has been done honestly and earnestly; some would say ideologically. The story of the Dixie Chicks is illustrative then of how one of country's own disagreed, was labelled a traitor, and now, has emerged defiant and stunning as the War continues and our President struggles.
As may have been hinted at, I am back on US terra semi-firma. Peace Corps Volunteers (PCVs) have said that the hardest thing about their program is not the going or the staying, but the returning. Hard to compare my 3 months to their 2+ years, but I have an inkling of what they mean.
More specifically geographically, I am outside my hometown of Savannah, Georgia. Savannah has been called the most beautiful city in North America. It is also famed for being the star of the nonfiction book Midnight in the Garden of Good and Evil. It's history is long (for an American city) and its beauty, natural and designed, is unparalleled compared to any other city in the US (except perhaps for San Francisco). What does this have to do with Global Issues? Well, see the Bruce Feiler article from the NYT I blogged on from a while back for one type of answer.
Photo: The fountain in Forsyth Park, Savannah, Georgia. (Photo by Chris Jeffords).
Spending time in the poor countries of our world may make one a better person, but I am not sure it necessarily makes you a happier one. There are simply innumerable ways to lose varying levels of innocence here at a rapid rate (e.g. experiencing death, poverty, injustice, repression firsthand) which can lead to guilt, disillusionment, bewilderment, and, at the end of the pot-holed road, despair. Resilience then becomes such a vital characteristic to possess and grow in this land.
A strange counter to this weariness of wordly souls may be the following phenomena: It could be that it is the relativeness of poverty, not the absolute level, that determines a person's health and social outlook. Will then a middle-class non-black Westerner (called mzungu in Luganda) suddenly thrust into a position of relative wealth and power in Africa reap the physical and psychic benefits of an increase in social position? Or (as has been reported at some of the seedier bars of Africa) will this unearned status elevation lead to a life of gluttony and corruption with the requisite associated unhealthy behaviors? Case studies requested.
The 3rd International Film Festival of Uganda is ongoing in Kampala right now. I was fortunate enough to see The Constant Gardener this past weekend (for free!). A good movie about a corrupt pharmaceutical company (Big Pharma) running a dangerous drug trial on coerced Africans. Fiction, right? Can we just praise and dismiss this as an emotive, skilled, but ultimately cynical act of story-telling by a liberal, bleeding heart filmaker?
I actually hate conspiracy theories, but I'll be damned if I didn't read the following in the Washington Post the very next day: Pfizer faulted over drug trials in Nigeria. Pfizer happens to be the world's largest drug company if you're keeping track of such things. And, I'll be damned if I didn't meet a bunch of representatives from a contract-research organization (CRO) yesterday searching out sites in Africa for clinical trials of new tuberculosis drugs. It is almost enough to turn a pragmatic idealist into a paranoid cynic.
Photo: Kibera, an urban slum in Nairobi, Kenya where many scenes from The Constant Gardener took place. It is home to ~1 million persons living in rather depressing conditions. Taken 2001.
Research in the developing world is quicksand, firewalls, and floods occasionally punctuated by light skies and cool winds. One thorny issue, suppressed to varying levels of depth in researchers' psyches, is the problem of ethics. Ethics not just in the sense of does Drug A's potential benefit outweigh its potential risk, but the foggier and subtler ethics involving cultural difference, the motivations, explicit and buried, of researchers and their collaborators, and the fundamental, overt power discrepancies between the North and the South.
Some folks talk of the 3 M's of global health: Missionaries, Mercenaries, and Misfits (a fourth M has also been proposed--Meddlers). Useful caricatures to a certain extent, but we certainly live in a more ambigious reality where many who work in RLS (resource-limited settings) have a mix of these characteristics--some of which may be in conflict. And the evolution/devolution from one M to another is a constant source of intrigue, talk, and concern.
Throughout Africa, many people will call from one mobile phone to another and deliberately hang up before the call is answered . . . but just long enough to have call missed and a number/name appear. This phenomena is called "beeping" or "flashing".
Beeping itself is free. It usually can be interpreted as a request for the beeped to call the beeper back, thus placing the financial burden of the call on the person beeped (due to most mobiles in Africa being based on prepaid rather than monthly charges). However, beeping can also have more subtle meanings. While seemingly nonspecific, contextually it can send a very specific message such as "I am outside waiting" or "'Thinking of you."
It can be remarkable what is able to be conveyed when you are forced to keep it simple--A ring tone can proxy for freedom of speech, a text message can rally a protest, and a beep can start an affair. It is said that necessity is the mother of invention, but human curiosity and finding new ways to flirt certainly help to move things along. . .
Just as you can not ignore culture and ethnicity when confronting AIDS in Africa, it would be a mistake to dismiss the role of religion. Religion permeates so much in this arena, from missionary hospitals to PEPFAR policies to patient and provider beliefs and behavior.
Religion does not necessarily need to be a divisive force. A friend of mine, Jennifer Gross, worked at a Christian faith-founded hospital while in the Peace Corps though she was not Christian. And I happen to work with a Catholic faith-based organization, Reach Out Mbuya, while not being Catholic.
Photo: The motto for Kiwoko Hospital where Ms. Gross worked. A hospital in the middle of nowhere originally founded by missionaries. Interesting fact: Hospital has baby incubators run off solar power. Taken February 2005.
Chance, African spirits, or some other force crossed my paths with an American psychologist, Jamie Fish, who is working with and studying traditional healers in Uganda. Ms. Fish invited me, quite literally, into the forest to teach and learn with these healers. Curious, I did so and spent an enlightening time participant-observing their classes and reciprocated by answering their questions about HIV/AIDS.One of our patients died yesterday. She did not die of AIDS or from a side effect of the HIV medicines she was taking. Instead, this is a young woman who had become pregnant with a child she did not want. She tried to self-abort her pregnancy (abortions are illegal in Uganda) and something went horribly wrong. She collapsed and died on her way to a local hospital.
This is not meant to be a pro-choice post. Or pro-women even. But to ask again the question as to how a person comes to such a place and end. And, of course, what can be done about it? The modest goods which might come from this sadness is to think more deeply about the context in which health care (HIV care in this case) must exist in to thrive, rather than to be so brutally and wastefully stunted.
I "competed" in a triathlon for the first time last week as part of a team (I ran and please ignore the fact that we came in next to last). Lake Victoria is under significant environmental pressure, as are many water sources throughout the world. Running through the back roads of Africa, dirt paths, lush valleys, fascinated children, et al., reminds me of my runner friend Will Harlan, editor-in-chief of Blue Ridge Outdoors, and his wife, Emily Diznoff, a family physician and my magnificent friend since medical school. Together, they have been consistent, thoughtful friends of the environment for many years.
Some friends have asked what the heck I actually do in Uganda. Every day I have a different answer. But, one thing I am helping do is jump start a peer educator program, called PeerSMART (Peer Supporter and Mentor for AntiRetroviral Therapy). The premise is that people living with HIV/AIDS (PLWHA) on ART will benefit from having some of their peers as frontline service providers to promote drug adherence and monitor for illness and medication side effects. These peers may then help ameliorate the large health care provider deficits found throughout the developing world.
Photo: Inaugural PeerSMART class of the Rakai Health Sciences Program. Taken March 2006.
Nicholas Negroponte, co-founder of the MIT Media Lab and member of Motorola's Board of Directors, wants to build a $100 laptop to distribute (not sell individually) to children in the developing world. The premise of this endeavor, which will require technologic innovation as well as significant financial committments from governments to purchase these computers, is that such a device would provide children a tech-based leveraged education and enable them to better learn and succeed in a globalized world.
Some folks, such as Bill Gates, seem to think the idea is not worth the effort. Google apparently disagrees. One common critique of such enterprises is "This money could be better spent elsewhere (on food, vaccines, bednets, etc.)" or what might be called the Transitive Argument (refer to your math textbooks prn). I do not fully prescribe to this argument, because I am not always convinced that money which does not go to one thing would have gone to another.
Time will tell if the $100 laptop turns out to be just a fanciful idea or one that does begin a small revolution in education. Regardless, this type of project has captured the imagination of a group of people who might not otherwise be as engaged in thinking about solutions to the world resource gap, and this fact alone is perhaps enough to earn the initiative some level of support.
Quasivolunteers (the chronically underpaid with do-gooder jobs), along with true volunteers, are everywhere in Uganda. Among this crowd, of which I will count myself included, the processing of 1.Coming here; 2.Being here; and 3.Going back; is an immediate and often prolonged (perhaps unending) internal/external discussion.
While at RSPH @ Emory, it seemed to me that there would always be a significant minority of good-hearted people who would go abroad and return disheartened and disillusioned. (A similar phenomena occurs with bright-eyed students entering medical school and transforming into cynical professionals). Is this avoidable? It appears we are reliant upon the good will of certain persons to "volunteer" for the altruistic jobs of an unequal world. This does not seem to be adequate as the needs still massively trump resources--human and financial. It is not, in the words of development folk, "sustainable."
It could be because most of us are NOT saints (shocking!). To paraphrase, this group of individuals has not perfected goodness, but they have seen what it means to be a good person and to want to strive for it. Recognizing that this cadre still finds the following occasionally attractive and sometimes irresistable: hot showers, tv, money, etc., . . . relative luxuries in an external environment of poverty, humanizes these humanists. And, brings us closer to a workable reality and, therefore, sustainability.
So, how to approach this issue. There do appear to be some good resources out there. And, I would refer back to the Global Health Corps previously noted on this blog as a good idea whose time has come, yet due to lack of political will has not.
Photo: A different type of California Salon. Taken in Ghana 1999.
Harper's, a historical and historically commendable magazine, has published in its March 2006 issue one of the more irresponsible and inaccurate articles in the modern recollection of mainstream media. For a magazine of its previous stature to publish the blatantly biased and poorly fact-checked article by AIDS Denialist Celia Farber entitled "Out of Control: AIDS and the corruption of medical science" is inexcusable and should have real consequences for its editors and publisher, not to mention the author. If you do read the piece, having this point-by-point guide to Farber's errors is quite helpful.
There is a wealth of scientific evidence on HIV as the causes of AIDS, the consequences of HIV/AIDS, and the beneficial effects of medicines for HIV (called antiretrovirals or ARVs.). The distrust of Big Pharma (collective name used by many for large, multinational pharmaceutical corporations) and other large, "establishment" organizations such as the government and academia, is not new, and unfortunately, not entirely unwarranted. But, paranoia and conspiracy theories must be distinguished from healthy skepticism and objective critique.
We are faced with the most devastating disease in history, and Denialists are delivering harm through self-deception, individualistic narcissism, and cynicism. I will not pretend to fully comprehend the psychology of these Denialists (though I think it may be helpful to try and understand them from a personality disorder perspective), but I believe their words and actions are sources of confusion and needless suffering, and, for some, believing in their disbelief can lead to an untimely, unecessary death. The sniping voices of the Denialists should not be given a larger audience through a magazine such as Harper's, and it is unfortunate and shameful that they were.
I had a feisty conversation with some Canadians last night about whether Americans or Canadians are more internationally-focused (or really, which country was more insular). It is interesting to note that probably only 1/4 to 1/3 of Americans over 18 even have a passport. However, Mark Twain counseled caution, in a way, of travel snobbery. This having been said, I think I would err on being too well-traveled than too lightly. And, having done so, to try to keep learning humility in the process.
The Economist recently published an interesting article about Starbucks and its founder, Howard Schultz. While it may seem easy for some to villify any large, multinational corporation, Mr. Schultz seems to have done some very positive things with and within his company. For instance, that Starbucks gives comprehensive health insurance for all employees working >20 hours is commendable (though sad that his model is an exception to the rule). One striking fact from the article is that Starbucks spends more money on health premiums than on coffee! Personally, I would be thrilled if Starbucks starting opening stores in this part of the world.
We are in a remarkable new era of philanthropy, especially for the global health community. Unprecedented resources (think Bill Gates) are now combined with a more rigorous, businesslike methodology to giving. But could we actually have too much money going into Global Health? As one works in the HIV clinics in Uganda (average yearly income ~$300 per person) and have the resource-limitations omnipresent in clinical decision-making, the obvious answer is an emphatic, No. Money alone, of course, is only part of picture; the human resource shortage is real. Certain organizations (some previously noted on this blog) help fill this gap, and others exist such as GeekCorps.org and medically-oriented volunteer opportunities. Still, a more holistic, large-scale approach to paying for and promoting global health careers would be ideal.
Photo: A Ugandan HIV clinic on wheels that visits rural communities once every two weeks.
The elections in Uganda are over. The current president, Yoweri Museveni, won again. Overall, most seem to be relieved, as it would have been absolute chaos if Museveni had not won. The main challenger is protesting the results though, and it remains to be seen how his future (and his sometimes rowdy supporters) will play out. I was actually in a remote game park during the elections and found out the results via, you guessed it, a Uganda SMS mobile phone text messaging service
Photo: Voting in Kalisizo on Election Day. 
Well, things are heating up around here. The Ugandan elections are tomorrow and there has been some low level rioting in the capital. However, friends and family will be happy to know that I am in the semi-rural Rakai District currently, away from the capital and will be leaving tomorrow for a game park near the border of Rwanda. Our escape plan is to move into Rwanda if things go truly awry in Uganda (times have changed so quickly that Rwanda has become the escape route for potential political chaos in this part of Africa). Many ex-pats have acutally left already, hotels around the smaller city of Entebee, where the airport lies, are full, so that if there is an airlift people will be able to get to the airport quicker! I am at the Rakai Health Sciences Project (RHSP) now, in a very nice, new building (with wireless internet) and trying to get my project off the ground. Much more on RHSP to come.
Somewhat alarming were the recent deaths at an opposition gathering in Kampala. What does it mean to have good governance? The US government established some potential critieria for their Millenium Challenge Account, but it has subsequently been criticized for giving out very little money. And, some might argue American inconsistency with some of the principles we are espousing. While it may seem patent that good governments and economic development are directly related (Mugabe trashing Zimbabwe's economy is a good example), the reality is probably a bit murkier.
And now...I'm in Uganda! London was a fun time. Cailin Henderson, another fellow UCSF resident and future rheumatology fellow, joined Jimee and I during my last weekend. We ended up one night at an Argentinian boat party into the wee hours (but that's another story). Now, I am in Kampala, the capital of Uganda. The big news around here are the upcoming elections which feature an incumbent president looking for his 3rd term (thanks to some constitutional changes allowing him to run again) and his main opponent who happens to be his former personal physician! I will end with a plug for Sona Aggarwal's Blog which chronicles her ongoing travels through South America.
Vodafone, a global telecom company which has been commended for its corporate responsiblity, has recently published a policy series paper entitiled Africa: the impact of mobile phones. This influential document makes a few key points including the positive influence of mobiles on development, social capital, and quality of life as well as the differing roles of mobile phones in developed vs. developing countries. My current project will look at how mobile phones may be used to improve the health of persons living with HIV/AIDS in rural Africa.
I made it to London. I am staying with my wonderfully talented friend, Jimee Hwang, who is soon to add a DTM&H to her MD as she is taking the short course Diploma in Tropical Medicine & Hygiene at the London School of TM&H. It sounds like a great program, and the people I have met from it are an interesting, eclectic, well-travelled group from around the world. For many reasons, it is fascinating to hear non-Americans chat about global issues, with one reason being how it emphasizes how isolated America can seem (to both outsiders AND insiders).
As some of you know, an unexpected medical event to one of my family members has been a recent and difficult ordeal. I don't particularly believe that bad things may happen for future good reasons that we cannot, in the emotional confusion of a crisis, see and understand until later, but it did make me think about how I see myself as a doctor...past, present, and future. It is almost trite to talk about the experience of doctor as patient, less so perhaps of doctor as family member of patient, and many good (and not so good) books and essays have been written on this topic. However, it does remind me of something I read a long time ago, Empathy and the Practice of Medicine : Beyond Pills and the Scalpel, and how challenging it is as a physician to constantly put yourself in the patient's situation, particularly if you have insufficient personal experiences to draw upon. Perhaps this is one of the better reasons to argue for admitting well-rounded applicants to medical school and supporting their "nonflatness"--They will have a potentially larger body of experience to draw upon to empathize with their patients which is, I think, the core of the humanity of this particular profession.
My former roomate, Margot Welk, was in the Peace Corps in Thailand and eventually started her own fair trade business in Southeast Asia, Beyond the Banyan Tree. She is now working with the for-profit company, World of Good, which directs 10% of its profits to its sister non-profit, World of Good Development Organization. (Side note: Google, a somewhat larger organization, also has a similar model where they direct profits and equity to their charitable arm, Google.org, more on Google to come in future blogs). World of Good provides a nice example for how business techniques, globalization, and capitalism can be a potentially synergistic and positive effector for the poor, but I suspect some would still disagree on principle.
The Society of Adolescent Medicine recently published an excellent editorial on abstinence-only programs. I was impressed with their use not only of science to make their case (see accompanying review article), but also calling in ethical and human rights arguments. It reminded me of the Presidental Emergency Plan for AIDS Relief's (PEPFAR) stipulation requiring "66 percent of resources dedicated to prevention of HIV from sexual transmission must be used for activities that promote abstinence before marriage and fidelity."
The CDC is certainly an interesting organization. I first worked with them several years ago in Nairobi on a study of antiretrovirals in the private sector. It has always been to me a largely admirable and perhaps even semi-legendary organization (particularly when reading such books as Virus Hunter by C.J. Peters or And the Band Played On by Randy Shilts). But, it has experienced it's share of controversy lately as well.
This is a very exciting idea that was proposed last year (though it may be dead in the political waters given Katrina and Iraq costs). The report by the IOM, Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS, outlines a plan to bring US health professionals to resource-limited settings to contribute to major health needs, most specifically, though not exclusively, to the fight against HIV/AIDS. It is somewhat visionary, compensates providers appropriately, is holisitic (plan is not just for recruiting physicians, but inclusive of nurses, pharmacists, IT specialists, etc), and creates an entire new career path for global health enthusiasts. And yes, this was created under W's watch.
Global Health Corps Proposed to Fight AIDS
Jeffrey Sachs is a superstar economist (note his daliances with Angelina Jolie 
and his role as teacher/mentor to my favorite rock star, Bono, aka one of Time's Persons of the Year). Dr. Sachs recent book, The End of Poverty, is a must read in my opinion. It does an excellent job outlining the extent of extreme poverty, its consequences, and then provides measurable solutions. I think his proposals are relatively evidence-based and holistic with appropriate doses of rigor, transparency, and optimism. Note that fighting HIV/AIDS is one of the major interventions he proposes to promote economic development.
Living in SF offered many benefits, one of which was being surrounded by creative, entreprenual types. One such person is Jason Krikorian, husband to my wonderful former resident colleague Jennifer Burkham. Jason is Head of Business Development at Sling Media which makes the Slingbox™ (pictured), an innovative device that allows one to "placeshift" and watch/control one's TV/cable/Tivo from any computer (and soon, apparently via any cell phone as well) with broadband. While this appears to have a viable developed world market, I would interested if anyone has any thoughts on how this type of technology could be used in the mid-term to deliver health care (and other services) to the developing world.
This is such a tragic and rage-inducing story. But, in some ways, it is just a more overt example of the rationing of care we experience daily in less grotesque forms. Doctors make many difficult decisions, and I wonder if the health care providers are being unfairly portrayed here. While I think class (and race) are always part of the background in which many sensitive medical decisions are made, I'd like to believe that we often rise to making such intimate decisions based on the humanity of the situation and not the lucre of it.
Do the Poor Deserve Life Support? - A woman who couldn't pay her bills is unplugged from her ventilator and dies. Is this wrong? By Steven E. Landsburg
An interesting organization I have been learning more about recently is Grameen Foundation USA which grew from the legendary tradition of the Grameen Bank in Bangladesh, a pioneering organization in microfinance. The US-based organization has a strong tech component and has helped bring mobile phones to rural Africa through a public-private partnership with MTN Uganda (phone kit pictured) that promotes and supports village based, entreprenual phone businesses. I am impressed with this nonprofits' strong business sensibilities, efficiency, and organizational prowess. And it has been rewarded and commended for such.
A few friends of mine from Emory Med School and I have had dreams of opening a coffee/jazz cafe, a sort of modern bohemian gathering place. Perhaps this article should serve as a warning. . .
Bitter Brew - I opened a charming neighborhood coffee shop. Then it destroyed my life. By Michael Idov
Indulge me for a moment, but the article below is about a man, Bruce Feiler, who attended my small high school in Savannah. He brings an interesting perspective to some ecletic issues and reinforces that perhaps one of the best ways to get started on a global career is to be born in the Deep South.
But How Do You Get It Home? - New York Times
A nice example of Coke's reach. Photo taken February 2005. 
As many of you already know, I will be in Uganda for several months in early 2006 (the major impetus for starting this blog in the first place). I will be working with two insitutions, UCSF and Johns Hopkins, on a couple different projects which I will go into at more length later. Uganda is an interesting country for many reasons, one of these being the dynamic, usually relatively harmonious, occasionally problematic relationships it has with multilateral organizations and NGOs.
Hi Everyone! After finishing my 3000 mile x-country trip all the way back to Savannah and spending the holidays with the folks, I have returned to Atlanta, home of CNN, the CDC, and Coca-Cola and my alma mater, Emory.
I've been enjoying catching up with Justin Ortiz, current EIS officer at the CDC in the influenza branch and a former resident with me at UCSF. But, to backtrack a little, several interesting things happened to me before I left San Francisco that I was hoping to chat about. First, . . .
Via Craigslist, I had a chance encounter with an interesting person who happened to buy some of my furniture. Her name is Jennifer Anastasoff and she is the CEO of Building Blocks International.
Below is the introduction from their web page. Check it out. I personally really like the merging of traditionally different work cultures and the bringing of some of the business/management skills of the for profit sector into the NGO/non-profit world.
-------------------------------------------------------------------------------
Building Blocks International: Building Global Leaders through Public Service
BBI is an international nonprofit that is working with corporations to develop what Business Week calls a corporate "Peace Corps" and what we call corporate service fellowships. During a corporate service fellowship, employees spend four weeks to a year (full-time) applying their management skills within community-based organizations around the world.
Opt out policy: Everyone mentioned and links posted will be done so with good intentions. However, if you would like your link, name, contacts, etc. removed, for whatever reason, just let me know, and I will do my best to respect your wishes.
To keep in touch with friends and family across the distance.
To inform and network with persons with similar interests.
