Category: public health

marburg, schmarburg

Tomorrow afternoon, the American delegates for the Global Youth Partnership for Africa’s conference on Youth, Development & Health arrive, meaning that blogging time will be limited as I guide American and Ugandan youth leaders around the country.

I probably shouldn’t be saying this, but my public health experience is limited to a basic familiarity with the ABC policy and the knowledge that, generally speaking, clean = good and dirty = things like cholera and tuberculosis. That’s okay, though — it looks like I’m about to get a crash course in health disaster management:

Uganda: Ebola-Like Virus Hits Kamwenge
Uganda: Marburg Feared in Kampala

Oh, goody.

My little brother’s greatest worry when I told him I was moving to Uganda was that I would contract Ebola, a disease he studied extensively in school and consequently fears like the plague (ba-dum ching). If I remember correctly, I laughed, patted his head and told him I’d be “just fine.” Look who’s obsessive-compulsively washing her hands now?

GYPA Immersion Program: Youth, Development and Peace-building

I gushed a little bit earlier about the Global Kimeeza II, a program of the Global Youth Partnership for Africa, an organization I’ve been involved with for a little over a year and a half. GYPA leads regular conferences for American and Ugandan youth leaders that focus on how young people can actively participate in finding solutions to the variety of challenges Africa faces.

I credit GYPA with cementing my interest in development issues as a whole and in Uganda in particular. For this reason, I am crazy excited to announce the first of our two summer immersion programs: Youth, Development & Peace-building.

These immersions are open to Ugandans ages 18-30 who are already involved in community development projects and/or youth leadership initiatives. The programs will take place in Kampala and Gulu, so applicants are encouraged to apply for the location that best suits them. Spots will fill up quickly, so apply soon — applications for the July trip are due no later than Saturday, June 16, 2007.

July Applications

Gulu
Kampala

Please feel free to spread the applications around to your friends, colleagues, and anyone else you think may be interested. More information is in the application, but please feel free to contact me with any questions you may have at rebekah@gypafrica.org.

July: Youth, Development & Peace-Building

Today Uganda lies at a crossroads. Last fall, peace talks brought about a cessation of hostilities in the 20-year civil war in northern Uganda; now is a critical time to examine the political situation and engage in the processes of reconstruction and reintegration. The end of the conflict brings with it dramatic challenges as well as opportunities. It is clear that youth will continue to be the driving forces behind development and peace-building in this fragile post-conflict environment. The goal of the Immersion is to provide a platform for Americans and Ugandans to explore the important role that youth play in post-conflict Uganda by sharing experiences, ideas, approaches, and strategies.

July’s program will provide opportunities for young global leaders to explore topics such as peace-building, poverty alleviation, post-conflict rehabilitation, HIV/AIDS, and gender issues, among others. Participants will meet with political, academic, and cultural experts and engage with local communities in dialogue, cultural exchange, and direct service.

August: Youth, Development & Health

I encourage those who are interested in Public Health issues to consider applying for the August Immersion. Applications will be available next month. Feel free to contact me with any questions in the meantime.

Uganda was one of the first countries in the world to come face-to-face with the devastating impact of the HIV/AIDS pandemic; it was also one of the first to respond successfully to control its spread. As a result, Uganda has been heralded as a model across Sub-Saharan Africa. The August Immersion will focus on the following questions: What role did the Government’s strategy play in combating HIV/AIDS? How has the international community assisted in Uganda’s fight against other dramatic health challenges such as malaria and tuberculosis? What effect does the 20-year civil war in North Uganda have on the various health problems facing the country? What tools do grassroots and civil-society organizations utilize to improve access to health care and treatment? How are women and children affected differently by health crises? What can you do to help?

Participants will also examine many other interrelated issues facing Uganda, such as post-conflict development, poverty alleviation, and democracy-building and will have a unique opportunity to interact with a wide variety of people. The program will include direct service with community-based organizations, international non-governmental organizations, and young leaders from the United States.

Global Youth Partnership for Africa

The Global Youth Partnership for Africa (GYPA), a non-profit organization based in Washington DC and Kampala, Uganda, seeks to fundamentally change the way Americans and Africans engage with and understand each other. GYPA fosters relationships between accomplished and emerging youth leaders in Africa and the United States. The partnerships forged this July and August will promote fresh, pragmatic perspectives on Africa’s challenges and encourage participants to work together for innovative, practical solutions.

my take on compulsory HIV testing

This week’s BBC Have Your Say focuses on the recent UN position that health clinics in countries with HIV epidemics should test all patients for HIV unless they specifically request not to be tested.

Supporters of the policy say that the vast majority of those infected with HIV/AIDS are unaware of their status and that testing could go far in preventing the spread of the disease.

Opponents say compulsory testing violates the human rights of patients, condemning them to a life of discrimination, and is especially problematic in areas where few can avoid life-extending anti-retroviral drugs (ARVs):

Why should it be compulsory when Africans can not afford the cost of the cure? Let me die in peace instead of being stigmatized to death.
Jonathan Enders, Monrovia

Ostracization of the HIV-positive is an enormous problem in sub-Saharan Africa, largely due to the misunderstanding about how the virus is spread. I would argue, however, that the best way to reduce this isn’t to avoid testing but to push for public health education that includes wide-spread sensitization efforts. The same goes for access to ARVs — this month Brazil issued a compulsory license to locally produce efavrienz, an ARV patented by Merck. The license, which overrides patent laws, will save Brazil an estimated $240 million in the next five years and will help the government provide better care for its HIV-positive citizens. Rather than encourage ignorance about HIV status, other countries should seek out similar ways to lower the cost of these drugs.

I fear I’m somewhat of a Utilitarian on this issue: everything for the greater good. I wouldn’t wish discrimination on anyone, but I don’t think it’s fair for a person to avoid testing just because she doesn’t want to know her status. The avoidance of stigma isn’t worth the lives of her partners and children.

oh, martin

I have to admit that I’m a little surprised you a) found and b) commented on my blog. I’m flattered, to be absolutely honest. I would say that I didn’t mean to hurt your feelings, but, with all due respect, I abhor the way you’ve gone about “educating” Makerere University students about HIV/AIDS, and I’d be remiss if I didn’t say why.

I agree with you on one thing: abstinence is the only guaranteed way to prevent the transmission of HIV.

Here’s the problem, Martin. People are having sex. Lots of people. Lots of people who have been taught that abstinence is the only way to protect themselves. But guess what? They’re still having sex, and I think it’s horrifically irresponsible of us to tell them that, since they denied themselves the first level of protection, we’re giving up on them.

Abstinence-only education has been proven (PDF) ineffective in reducing the incidence of sexually transmitted diseases among young people. It’s simple, really: they’ve never been taught about safe sex.

You’d probably say that the only “safe” sex is no sex, but I don’t want to argue semantics. The transmission rate of HIV is seven times less when using a condom. That sounds a lot safer to me. Also, you might want to check out Columbia University professor Maria Wawer’s study (PDF) of 10,000 people in Rakai, where she found that the decrease in HIV prevalence was due to an increase in condom use, not in abstinence.

So let’s talk about Engabu. In 2004 some consumers notice (DOC) that these condoms smell bad. The government sends some to Sweden for testing, where they fail the “freedom from holes” and “smell” tests (I couldn’t find anything substantiating your claim of breakage). All Engabu condoms are recalled, but further testing shows that the rest pass the hole test, and only one batch fails the odor test.

Instead of re-releasing the good condoms alongside an aggressive confidence-building and education campaign, the government decides to hold on to them all, as well as instituting a policy that requires all imported condoms to undergo an additional round of quality testing before distribution and passing heavy taxes on all non-donated condoms. NGOs can’t distribute free condoms anymore, and costs rise to anywhere between 300% and 1000% (PDF) of what they were in 2003, effectively pricing most Ugandans out of safe sex.

On top of all this, Janet Museveni decides now is a good time to bash the overall effectiveness of condoms, regardless of brand. This is where you come in, Martin — you somehow get your hands on a bunch of recalled condoms and decide to torch them on campus, which I’m sure does wonders for public morale. Think back — are you absolutely sure you talked smack only on Engabu, or could any of your actions have been construed by impressionable young bystanders as a condemnation of all condoms as a whole?

Meanwhile, Uganda’s holding on to 34 million good condoms and citing distrust of the Engabu brand and of condoms in general as their reason for not distributing them. Health and development experts have cited a “concerted effort to undermine public confidence in condoms…led, for example, by the First Lady of Uganda, Janet Museveni…and by organizations such as the Makerere Community Church, led by Martin Ssempa” as the major cause of the recent increase in Uganda’s HIV rate.

So you tell me, Martin. Was setting fire to those condoms, spoiled or not, really the best course of action if you truly care about the young people of Uganda (two-thirds of whom are sexually active)? I know the Bush administration’s current policies — such as spending a whopping 56% of their funds for prevention of sexual transmission of HIV in Uganda on abstinence-only education — make what you do pretty attractive financially, but since PEPFAR started throwing money around here, the HIV rate’s been going up.

Makes you think, doesn’t it?

arguing tragedy with a communist

Kelly, UBHH newbie Tim and I had a run-in with the ever-opinionated 27th Comrade over the Virginia Tech tragedy at this week’s UBHH. Our passionate young communist argued that Americans deserve what they get and shouldn’t make a big deal out of things like this because far more than 33 people die from violence, preventable illness or sheer neglect each day in Africa because of things America has done or failed to do. Kelly and Tim were ruffled, and I think the appropriate response to insensitivity and callousness isn’t more of the same. Still, I get his point…sort of.

The VA Tech shootings earned far more American media coverage than any event in Africa last week, despite the fact that Nigeria had hotly contested elections, Somalia is exploding, the Ugandan peace talks resumed and Zimbabwe is always in trouble. What makes the fates of these students any more media-worthy than the fates of thousands of Africans?

Well, location, for one — Americans want to read news about other Americans, and papers need to sell. Ugandan coverage of Somalia is from the Ugandan peacekeeper angle, and neither the Monitor nor the New Vision talked at all about the unrest in Kirkuk last week, so you can’t blame just the American media for being narrow-minded.

So let’s talk about foreign policy. By now pretty much everyone admits that American involvement in the Horn of Africa in the 1990’s was worse than worthless — approximately 85,624 books have been written about the terrible things we did there. I’d be one of the first to say that the HIV/AIDS programs we’re pursuing aren’t always the best course of action — supporting Martin Ssempa’s public condom bonfires is probably contributing to, rather than stemming, unprotected sex among infected teenagers. But Janet Museveni’s championing ineffective family planning methods just as hard, and the West isn’t exactly rallying around Mugabe’s latest antics or trying all that hard to keep Obasanjo in power.

Yes, America has been and continues to be stupid and occasionally harmful when it comes to Africa. But the majority of deaths on the continent aren’t solely attributable to the U.S. any more than to colonialism or corruption or lack of media coverage or an environment hospitable to rapidly spreading fatal diseases, and the students who were murdered last week don’t deserve to be used as part of a transatlantic morality scale that needs to be balanced.

Pointing fingers only goes so far, and that’s where I start to butt heads with the 27th Comrade. Tragedy is tragedy wherever it happens, and I think you could have picked your argument — and your audience — a little better.