Exceptional tragedy and exceptional compassion

Sometimes the reality of the rather drying academic topics I write about comes with a harsh dose of reality. Today was one of those days.
I’d spent the afternoon working on an article I’m writing with some colleagues on AIDS exceptionalism. Essentially, in the last few years a number of researchers, academics and policy wogs have argued that AIDS gets too much attention, too much funding, and is causing other important health and development issues to be ignored. In rebuttal, we argue that yes AIDS rates in much of the world have stabilized, but that doesn’t mean we stop what we are doing, especially if it might be working, and that you can’t in Steven Lewis’ words “trade the health of some for the health of others.” Yes, other health and development issues need attention and funding, but they need it in addition to AIDS, not instead of AIDS. So we spent the afternoon hashing this rather polemic, academic, full of fancy words article in hopes it will contribute to the roar of protest over any reduction in AIDS funding. At the end of the article one of my colleagues wrote the comment, “Remember - one death is a tragedy, a million deaths are a statistic.” It resonated with me – people have become so used to AIDS statistic that all of a sudden the fact that there are 33 million people living with HIV and AIDS, instead of 40 million leads some to think we can pack up and quit!
So I was milling over these thoughts just as I arrived home, when my phone rang. I hear Daniel’s soft voice on the fuzzy Kenyan phone line, “Did you get my text message? S [name removed in respect of privacy] is in the hospital.”
I gasp. I know S developed resistance to his anti-retroviral therapy (ART – AIDS treatment medications) last spring and developed tuberculosis. I know the doctor was starting him on second line ART, but that it is very hard to balance the two medication regimes, especially in children, and the side effects are severe. As these thoughts run through my head Daniel says, “It’s not serious.” And I know he just doesn’t want me to be upset.
I speak to S and his voice seems quiet and far away. I have a photo of him and another boy in a frame on my desk and I look at it while he tells me he is feeling a little better. In the photo he is laughing and playing with a dog. I speak to Daniel, who tells the doctor is concerned that S’s blood sugar is high. He might have diabetes. We speak for a few more minutes until the line wavers and cuts out.
At moments like this I wish I didn’t make it my business to learn more about HIV and AIDS – it just makes me angry. I wish I didn’t know that ART only extends the life of an HIV positive person in Africa, on average, by 5 to 6 years, while in the Western world someone on ART can live decades. I wish I didn’t know that TB greatly reduces even this time span. I wish that when Daniel told me he had taken S to the ‘good hospital’ instead of the ‘bad hospital’ I didn’t think, “Crap, that is going to cost Emmanuel Center a lot, where will they get the money.” I wish I didn’t read today that UNAIDS predicts donor countries will not honour their commitments to AIDS funding, using the economic crisis as an excuse, and as a result children like S may not have access to ART or TB treatment and care.
I compare this last point to the situation at Emmanuel Center. The staff there never say to a sick child, “Sorry cash is tight [and it almost always is]. We can’t help you. You’ll have to suffer and probably die.” But it seems the rich world has not problem saying essentially the same thing to the poor world. I ask myself what is the difference I decided it is compassion. I think back to my colleagues comment - to many people the millions of people who die from AIDS are a statistic. To those of us who know them though it is a tragedy – it is an exceptional tragedy.
And I am exceptionally grateful that Daniel is sitting by S’s bedside right now. That Emmanuel Center will find the money to pay his hospital bill, and that in all likelihood he will be up and playing again soon. Because AIDS doesn’t have to be a tragedy where there is treatment and care – and above all compassion.

A long over due update

I realize I haven't updated this blog in 'ages.' It's not that I haven't any thing to write, but that I've been writing too much. Besides that pesky dissertation I'm supposed to be working on, I've been very busy at HEARD learning all sorts of things. In fact I've been missing the good old days in Bradford where I had weeks to write an essay. Here I just have days!
Not that I'm complaining. I'm loving every moment of it. Here is what a typical day is like during the week for me in Durban. I wake up at 6:45 and make my coffee. By 7:30 I'm on the street corner waiting for my lift to work. I live in a lovely leafy neighborhood called Glenwood and every morning I see the same old gentleman walk out to get his newspaper and the same school boy rush by in his uniform.
Monday mornings depress me because they are garbage day and as I stand, with my travel mug in hand, outside the safe and clean apartment buildings, street kids pick through the garbage that has been left out by the likes of me. They are very organized: they never make a mess and each group of kids seems to have their own block. They carefully rifle through the bags, removing anything that can be reused or sold. I guess it is a very efficient, if informal, recycling program, but its such a blatant display of the inequality that grips this country (the discarded excess of a few is the desperate livelihood of the rest), that I can't help but feel a bit sick watching the process.Once at the office I sit down at my computer and am sucked into what ever project I am currently working on. At noon my stomach reminds me to pull my sandwich out of my bag and eat it while I work. I realise sitting at a computer conducting research sounds a bit boring to most people, but the issues and people I get to engage with thrill me. I get to work on projects with some of the big names, contribute to advocacy pieces that can make a difference, and I learn a whole lot in the process! For example, right now a colleague and I are puling together information on HIV and AIDS funding, in order to make a case for predictable funding commitments from wealthy countries. In light of the current economic crisis this is crucial. In many African countries AIDS treatment is dependant on international aid; if countries start giving less (as we expect they will), people won't have access to treatment and will develop drug resistance (AIDS meds must be taken consistently otherwise resistance develops), and will die. In endemic regions (like in Durban where HIV prevalence is 30%) this would be a humanitarian crisis.
But don't let me get carried away…. I might start writing an essay instead of a blog…. suffice it to say that my days generally blur by in mosaic of reading, writing and talking about HIV and AIDS. It's like AIDS research bootcamp!
But don't worry, I still make time for fun. I went to the Tri Nations Rugby game and watched South Africa beat New Zealand! I spent last weekend in the Drakensberg Mountains, where I saw the second highest waterfall in the world, and visited the mountain kingdom of Lesotho.
Now I've survived yet another week in the office and it is Saturday morning. I’m doing a few hours work and then am off to Ushaka Marine world where one can swim with the sharks if one is brave enough (not sure yet if I am or not)
I hope you are all, wherever you are, also having a lovely weekend.
x. Julia