Excerpts from Helen Epstein's The Invisible Cure

In The Invisible Cure, Helen Epstein writes about Uganda’s newfound born-again Christian fervor, and how it interacts dangerously with a pressing concern: AIDS prevention. In the 1980s the HIV infection rate was high in Uganda. But it dropped dramatically in the early 90s. The reasons are not completely clear, but Epstein argues convincingly that it was because of the Ugandan Health Ministry’s innovative Zero Grazing program, which encouraged Ugandans – through various grassroots community programs – to stick to one partner. The Zero Grazing program recognized and understood the nature of Ugandan polygamous relationships and addressed the problem of HIV directly and in realistic fashion. The community rallied together: AIDS patients were not stigmatized, but cared for. There was recognition that everyone was susceptible to AIDS. This homegrown, tailored-to-the-context effort was startlingly effective; something like it - frank and compassionate - was needed in other parts of Africa too.

But things have changed since. The evangelical Christianity now sweeping Uganda – supported in turn by the evangelical organizations in the US – is now involved in a push very different from Zero Grazing. The mantra now: Abstinence Only. Abstinence Only initiatives are funded by President Bush’s billion dollar program for AIDS prevention. Many missionary organizations have taken up the mantle. But it is unclear whether such a message on abstaining from sex until marriage is realistic.

Let me present two different excerpts from Helen Epstein’s book – both from a chapter that can be found here. The first is a humorous vignette from Makerere University in Kampala, which illustrates neatly some of the issues Uganda is up against:

“I arrived in Uganda in September 2004 ... As I usually do I stayed in Makerere University in Kampala. It was the beginning of the school year and students were arriving from all over the country. The freshmen dressed in the formal way of the 1940s American college men and women, in long skirts or slacks buttoned-up white shirts with collars. Each year, upperclassmen at Lumumba Hall, a men’s dormitory, welcome the freshmen by displaying their dorm mascot on the grass in front of the building. The mascot is a life-sized sculpture of a man, made from scrap metal, with a large drainpipe for a phallus. In order to educate their peers about HIV, the students dress the phallus in a new condom every day, and box of fresh condoms – free for the taking is placed at its feet. “He symbolizes the culture of our hall of residence,” one of the students explained to me. “He has girlfriends, but he always uses a condom.” One afternoon shortly after I arrived, a pastor from a nearby church marched up to the statue, removed its condom, set a match to the box of free condoms, and then prayed over the fire: “I burn these condoms in the name of Jesus!” he boomed, and then promised each student a free Bible.”

And the second is Epstein’s final philosophical paragraph from the chapter, which expresses very well humanity’s confusion about sexuality and its link to HIV:

Sexuality truly does belong to the world of magic and unreason. It is impossible to plan and control it totally. We were made that way. If sex were an entirely rational process, the species would probably have died out long ago. But the delirious, illogical nature of sex makes setting a realistic HIV prevention policy difficult. Cheerful, sexy condom ads that fail to address the real dangers of AIDS may promote a fatal carelessness; but an exclusive emphasis on abstinence until marriage may well lead to an even more dangerous hysterical recidivism. The genius of the Zero Grazing campaign was that it recognized both the universal power of sexuality and the specific sexual culture in this part of Africa, and gave people advice they could realistically follow.”

Frontline: The Choice and Heat

Once again, PBS Frontline excels with its superb documentaries. A couple of recent ones: The Choice, a deep analysis of the political backgrounds of John McCain and Barack Obama; and Heat, about the politics of global warming and the role of corporations. I've felt often that Frontline makes the best documentaries in the world. Check also: Frontline World, which brings us glimpses from around the world. And they are all available online - such high quality material, free!

Queues and illegal immigration

This idea for this note came from a recent short documentary by Frontline World.




















Queues can sometimes have interesting implications. In the graduate classes that I took, we learned something fundamental: if demand exceeds supply, queues will explode. And since exploding queues bring daily affairs to a standstill, those who want to bring such queues under control have to give in to other things - like the US border patrol, which has to yield to persevering illegal immigrants.

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The San Ysidro checkpoint near San Diego is the busiest border crossing in the world. On the Mexican side of the border is the city of Tijuana, famous as a hotbed of drug cartel activity, but also full of immigrants wanting to make it to the US. In fact, there is even a patron saint – Juan Soldado, a soldier who died in the 1930s – worshiped by those attempting to cross illegally.

More than 18 million people - legal and illegal - pass through San Ysidro every year. The queues are so long that the officers at the checkpoint can only selectively choose and check the cars; the line has to be kept moving. The officers have to rely on demeanor – if the driver is nervous, or something looks suspicious, the vehicle will be checked. And sometimes illegal immigrants will emerge from cleverly hidden compartments in dashboards.

But most vehicles go unchecked, so many immigrants are able to get through. Even if they get caught on the US side, the length of another type of queue, the queue of those waiting to be prosecuted, makes it impossible to detain them. Federal courts in the US just don’t have the capacity. So the illegal immigrants are simply sent back to Mexico. They smile and joke as they return. They know they can come back; there is no limit on how many tries you make. And that's because the human smuggling business has a remarkably customer friendly – or rather prospective illegal immigrant friendly – deal: you pay only after you are safely across.

Mathematically, it can be shown that virtually everyone attempting to cross – provided he or she can pay the required $2000 dollars upon crossing – will eventually make it through with enough tries. The pressure of queues in conjunction with a “money after service” deal creates an easy loophole immigrants can exploit.

Presidential debates: Then and now

If you watched the Presidential debate yesterday and are following all the points being debated, you’ll find the above video interesting. This is from 16 years ago, when Bush Sr. and Bill Clinton were debating. Notice how remarkably similar the topics of then are to the topics today. The same rhetoric about a burgeoning national debt, no jobs, and the need to improve the healthcare system: nothing seems to have changed.

The only difference, then, between the two debates is how they were conducted. Both were town-hall style affairs. But notice how insistent the questioner is in the Bush-Clinton video; she pointedly asks Bush Sr. to give a clear answer; and she was allowed to follow up. In yesterday’s debate the audience was dull, hardly part of the discussion; or perhaps they were asked to be that way, to be mere props while the candidates could go about repeating their already well-known views ad nauseum.

Somalia: Excerpts from Richard Dowden's Africa: Altered States, Ordinary Miracles

There is a large Somalian community in Rochester, Minnesota. Next to the town mosque – which bustles on Fridays after prayer – is a Somalian restaurant. The menu is limited – spaghetti, chicken, some salad and rice – but the place is always lively. Plenty of people talking, some arguing passionately; many wizened elders with stylish canes and a natural authority. I used to strike up conversations. Words flowed easily, and Bollywood was often a topic: the Somalis I knew were aware of and loved Indian movies.

I knew little about Somalia and its recent political history. That gap is still there, but as I now read Richard Dowden’s Africa: Altered States, Ordinary Miracles, the political outline is becoming clear: one man rule from 1969-1991; then civil war; a failed American rescue attempt; and then no government; and more recently, Ethiopia meddling in its affairs. Dowden also gives us an intimate feel of the landscape of this arid country and its people. We learn about clan allegiances and the Somali’s passion for poetry and camels.

The excerpts I’ll present here, though, are images of a modernizing Somalia, of how in the absence of a government, a free market thrived in the 90s and filled the void.

“In 1999 I went back to Somalia to see what had happened. Considering there was no state and civil war sputtered on, life was not as bad as I had expected. In some ways it was a lot better. Those few aid agencies that stayed on were no longer run by expatriate overlords but staffed by Somalis. Not many foreign aid workers wanted to be there. Somalis had also managed to get the economy going – without a single cent from the World Bank or IMF. The new economy was largely built around a worldwide telephone banking system – a truly free market system and , at the time, by far the world’s cheapest and most efficient. Several Somalis who had worked in telecoms in America bought dishes and telephone equipment and set up phone booths in small towns. From here, for a dollar a minute, people could call cousins and aunts and uncles all over the world.”

And how the cell phone is the perfect device for the wandering Somali herder wanting to learn market prices:

“Somali herders move around in a yearly pattern. In the dry season, towards the end of the year, they go down to the coast as they have done for centuries to sell some of their animals to traders who take them across the Red Sea to the markets of Saudi Arabia. I have watched them at the port of Berbera, herds of camels and sheep driven to holding areas where herders have to buy fodder for them and pay for water at the trough markets. These herdsmen are at a big disadvantage while they wait to sell their animals. But the mobile phone has rescued them. They can call up traders in Jeddah directly to find out the market price of animals there. They now know when to come down out of the mountains and sell. A week later I watch a herdsman on the outskirts of Berbera driving his herd towards the port with herding stick in one hand and in the other a mobile phone – perfect technology for the nomad.”

But however good the telecom industry may have been in Somalia, it has't provided a solution to its political problems. Clan differences, and meddling by neighboring countries has led to constant strife. The path to stability is still uncertain, as this Economist article points out.
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An aside: The parting image in the above excerpt - a wandering nomad with herding stick in one hand and mobile phone in the other - reminded me of recent Western media depictions of India, where a bearded, saffron-robed and levitating rishi is shown with a cell phone: epitomizing, I suppose, the seamless blending of modernity and tradition.

In India too, the cell phone has become an emblem of development, but this often ignores other realities, as Samanth Subramaniam argues here.

Shashi Tharoor, the Indian author and former candidate for the post of United Nations Secretary-General, has given his most recent collection of clichés a hybrid cliché of a title: The Elephant, the Tiger, and the Cell Phone. The elephant and the tiger are the most stereotyped symbols of India, flogged by writers for centuries before Tharoor ever took up the whip. But the cell phone is a freshly minted cliché, still winking brightly in the spotlight under which India has begun to find itself. Like its zoological predecessors, the cell phone is a lazy, shorthand way to talk about modern India for non-Indian audiences.

In a way, this seems to be the cell phone's own fault, for the athletic rapidity with which it has bounded across Indian class barriers, geographies, and urban-rural divides, becoming an easy stand-in for India's economic development. Really, though, it is a better symbol of the chronic bad journalism about India, by writers who reach for generalizations, who shrink from the complexity of the country, who refuse to venture beyond city limits, or who reinforce tired perceptions.

The socialization of risk and the privatization of reward

Heard the above phrase from Wall Street historian Steve Fraser on NPR yesterday. Quite a concise and accurate description of the current financial crisis, isn't it?