Lake Victoria Triathlon

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.

Are you PeerSMART?

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.

The $100 Laptop

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.

I Volunteered for What?!

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.

The Sickness of AIDS Denialists

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.

Show Me the Passport.

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.

Are Double Lattes Sinful?

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.