The Round Table

Director of Peace Corps Visits Hopkins

2011-09-20T17:04:00.007-04:00

Peace Corps Celebrates 50

Aaron Williams celebrated the 50th anniversary of the Peace Corps with the first ever keynote address at the Bloomberg School of Public Health by the US volunteer program's top executive. Mr Williams, an Obama administration appointee, focused his speech on the founding message and vision of former President John F. Kennedy while providing countless examples of the strong partnership the institution has formed with the "citadel" of global health.

A simple word highlights the strongest motif that carried through the various speeches. Every person touched upon the importance of casting Peace Corps veterans as "Returned Peace Core Volunteers (RPCV)" rather than "Former Peace Corps Volunteers". The stress on returned over former focuses attention to the transformative and lasting experience that volunteers live out in their service and beyond. It is strategic branding of the finest order, but it was clear through the speakers that returned makes all the difference.

For my friends that are RPCV or current PCVs, I thought you'd find the question and answer session interesting. All three questions were from RPCVs, which made me think I should blog them for you. In order:

1. What has been the Peace Corps response to the recent negative Congressional testimony of returned volunteers regarding safety and support systems for victims of sexual abuse.

Williams skillfully handled the first question by focusing the attention on creating systems within Peace Corps to make it better. He emphasized that each person providing testimony stated their goal was to improve the institution and not tear it down. This was a point he argued the media neglected to reiterate. Lastly, he went through a litany of partnerships and outside "experts" who are working to create open channels and training on the issue.

It was clear Williams was very prepared for the hot-button question. His answer had a linear progression from level one framing of broader concepts to level three of details in place to address the issues, such as the creation of a "victim's advocate" within the Peace Corps hierarchy. His last step to highlight that all the plans are laid out on the Peace Corps website was a plus.

2. Given the current funding climate, what is Peace Corps future outlook?

Director Williams was straight from the hip in his assessment of Washington politics and the foreign aid budget, which he referred to as Budget Function 150. He expects Function 150, which includes USAID, PEPFAR, and Peace Corps to name a few, to be prime rib sent to the chopping block. However, his take home message was Peace Corps, unlike other entities in the Function 150, has bicameral and bipartisan support. Four elected officials (three Democrats and one Republican) are RCPVs and they meet with Director Williams every quarter to analyze and discuss continued funding support. He acknowledges impending cuts will curtail scheduled growth and require belt tightening, but does not envision a severe blow to Peace Corps.

I found this the most interesting part of the speech. I wonder what metrics or evaluations go into deciding which programs have the most impact per dollar spent within PEPFAR, USAID, and Peace Corps. It was clear that Director Williams thought PEPFAR and other International Affairs budgets will be disproportionately impacted by cuts simply based on the politics of Washington rather then effectiveness or results.

3. Peace Corps has seen an increase in trained volunteers over the last decades. Will Peace Corps shift away from being a place for graduating college seniors?

Director Williams stated 85% of Peace Corps volunteers are recent undergraduates. He acknowledged the growth of trained volunteers as part of the inclusive approach and high impact results of the program. He maintained that this balance of predominantly recent undergraduates will be held in the future. Interestingly, he noted an increase in former volunteers reapplying and he expects retired baby boomers to get back into the mix.

There you have it! I hope this brief overview of the speech is worth a read. I'd definitely be interested in what you thought of his responses.

Letter to the Editor published!

2011-05-08T18:00:00.001-04:00

Letter to the Editor in New Jersey Star Ledger

As a component to my Media Advocacy and Public Health course, I submitted a letter to the editor to the New Jersey Star Ledger regarding an editorial on HIV medication patent pools. I am glad to report that not only was it published but it was the featured letter in its own gray box. Below is a copy and paste of the Letter.

Jump into the pool

The Star-Ledger May 1 editorial “To save lives, Johnson & Johnson should jump into the patent pool” presents a challenging yet vital component in addressing the global HIV/AIDS pandemic. However, it misses one essential piece of the equation: Treatment saves lives and prevents infections.

A growing body of scientific literature demonstrates consistent HIV treatment is an evidence-based form of prevention and could be effective to achieve population-level reductions in new infections. One such study, across seven African countries, enrolled 3,408 HIV-positive individuals and their HIV-negative partners with results showing transmission was 92 percent less likely if the HIV-positive person was on treatment.

The science is clear: Treatment saves lives and prevents infections. However, 10 million eligible HIV-positive individuals worldwide do not have access to treatment — a million plus more than the entire population of New Jersey.

Johnson & Johnson already runs meaningful multimillion-dollar programs protecting the environment and deworming children in Cameroon. However, if it is true to its mission statement’s commitment to provide access to its products for people in need, it should follow the lead of others in the pharmaceutical industry and take a seat at the patent pool table.

Marco Ambrosio, Livingston

Letter to the Editor - (Scroll to Bottom)
Original Article

A special invite for World AIDS Day

2010-11-20T09:52:00.000-05:00

I've been asked by the African Public Health Network at Hopkins to partake in a World AIDS Day panel. It is an unexpected honor given the amount of MPH students who have conducted research or worked in numerous countries on this topic.

Given the workload and upcoming finals, I will post a more proper and informative blog of the occasion during Winter break. I'm guessing a little after the New Year will do it!

Intro to Linear Regression

2010-11-11T09:31:00.001-05:00

I stumbled upon this video last week when I was reviewing some of the concepts we are covering in biostatistics. The video is a great introduction to linear regressions, a concept that depicts the relationship between two variables. Linear regressions are a hallmark of statistical analysis and used in multiple fields that span from economics to medical research. With the biostats midterm two weeks away, I thought it could be helpful to others.

Economics of a Cupcake Factory

2010-11-07T15:59:00.001-05:00

My younger sister is using it to learn algebra. My father uses it to explain the stimulus package and now I use it to supplement my Budgeting and Finance course at Hopkins. What is it? It's Khan Academy, a free library of tutorials explaining binomials to biology to banking in one central website. Salman Khan, the voice behind the magic pen, has earned the title "Bill Gate's favorite teacher" and as an introduction I have chosen to post the "Economics of a Cupcake Factory". The series covers the fundamentals of starting and running a product based business and may help supplement some of our Budgeting and Finance lectures before the midterm.

Final Presentation for HIV/AIDS Course

2010-10-12T11:00:00.003-04:00

I am currently taking Epidemiology and Impact of HIV/AIDS with Dr Homayoon Farzadegan. As part of the course students present following a guest lecture.

My topic is "future issues" and in my allotted time I have chosen to present the Partner's in Health community health worker model as the future is already here. The argument is founded on my belief that addressing HIV/AIDS is based on three pillars: health, education, and jobs.

I've shadowed Partners in Health community health workers (CHW) in rural Rwanda and seen the central role they play in the community. As scholarly support for their strengths, I have relied heavily on a great journal article by JS Mukhurjee. Her study showed CHW increase access to hard to reach people, increase the social capital within the community, and act as successful referral agents.

In the face of a global recession and restructuring of PEPFAR funds, horizontal programs that integrate and strengthen health systems pose a real path forward. A leader in this field is Rwanda. They have chosen to scale up the Partner's in Health CHW model as their rural health system. Perhaps, no one explains it best then former President Bill Clinton at the 2007 TED Wish talk.

Follow Up to Round Table

2010-09-22T13:18:00.000-04:00

1st Round Table Update

Although I couldn't find a round table, the hour long event was full of active discussion and back and forth open exchanges regarding human rights as a means or goal of development and the role of international funds in low and middle income countries.

One specific question posed that generated a great dialogue was what should the priority be for international funds.

Over 20 people attended the inaugural event ranging from MHS, MPH and PhD candidates from Hopkins spanning US and international physicians, former Peace Corps members, and current medical students.

Given the positive response I am in the process of planning and piecing together the next Round Table.

1st Round Table Talk

2010-09-12T12:35:00.001-04:00

Monday (Tomorrow) 12:15-1:15pm W4019

The JHSPH Health and Human Rights Student Group will be hosting their first Round Table talk tomorrow at 12:15pm in room W4019. Round Tables will occur at least once a month and will follow a simple pattern - a short TED style video and then discussion. No lecturing but ideas, experiences, and points of view are welcome!

We will be screening a portion of a provocative Hans Rosling Ted Talk as a launch pad into a student led open discussion on health, human rights, and development. Afterwards, you'll believe the seemingly impossible is possible.

Food won't be provided, but a thought provoking atmosphere will.

Have an idea or video to share? For now send it over at MarcoAmbrosio32(at)Gmail.com or @Marcoambrosio

(We showed from the 10:30 minute mark onward)

Questions to discuss:
Do you agree/disagree with the + marks?
Is Human Rights a means or a goal? What about government?
Where should donor funds and local government funds be spent? Is there a priority?

Dr. Mark Rosenberg - Real Collaboration

2010-08-10T22:27:00.001-04:00

Guest Lecture from President & CEO of The Task Force for Global Health

"Collaborative partnerships have the best chance for success when members lay the foundation in the first mile for the last mile success and take mutual responsibility along the journey for leadership, management, and culture within the partnership."

Dr Mark Rosenberg MD MPP, author of Real Collaboration, guest lectured our "Making Change through Policy" course and focused on the art of collaboration. The Task Force for Global Health works with private and public sector partners to address health issues for the most vulnerable populations. Among many things, the task force currently leads the Global Polio Eradication initiative and is credited for creating "Pharmaco-Philanthropy". There were three take aways from Dr Rosenberg's lecture that can be summarized as one story, one line, and one list.

The Story
Dr. Bill Foege MD MPH, the epidemiologist who designed the global intervention strategy to eradicate smallpox, was the first head of the task force. In 1987, Merck approached Foege about donating Mectizan, a drug whose off label use reduces morbidity and transmission of river blindness. Mectizan is better known to animal lovers as Heartguard - a common medication for dogs. Merck was making enough profits on animal sales to donate large quantities for off label use. Coalition leaders fearing the partnership and backlash of working with the pharmaceutical companies advised Foege to not accept the offer. True to what I've come to learn about Dr. Bill Foege, he did it anyway; establishing what is called "Pharmaco-Philantropy". Twenty-five years later the program is responsible for treating millions and its continued efforts have made eradicating river blindness a feasible end goal.

The Line
"Collaborations are like marriages. Easy to get into and hard to make work"

The List - "The Initial Barriers: Seven Cs"

1. Culture – corporate, religion, location
2. Conflicting Goals – need to settle on the goal, a very clear goal
3. Confusion – about roles and responsibility
4. Control – no one wants to give it up (personal and organizational)
5. Capabilities – everyone has different skills, strengths and resources
6. Competition - who is going to get the credit, who is the biggest
7. Costs – people don’t factor in the costs (money and time)

Guest Lecture by the Eradicator of Smallpox

2010-08-07T11:22:00.000-04:00

Learning from a Living Legend

In 1796, the British Scientist Edward Jenner documented the first successful example of inoculating a person to prevent future disease. In this case, he used cowpox to protect against smallpox - an infectious diseased credibly traced back to ancient Egyptian mummies 3000 years ago. Jenner would call his work a vaccine (after the Latin word for cow - vacca), but it wasn't until 180 years later that US epidemiologist D.A Henderson led the global effort that eradicated smallpox from Earth.

A disease that plagued man all over the Earth for thousands of years was no more, surviving only in government labs in Russia and the US. The feat can be considered the golden point of science in the 20th century. D.A. Henderson's work garnered him the US Presidential Medal of Freedom, the Japan Prize, and Knighthood by the King of Thailand. Below I've listed three points that I found as takeaway messages from his guest lecture to my "Making Change through Policy Course"

1. Finding a Way
In countless examples, Dr Henderson mixed creativity or found exceptions to the rule to achieve results. After learning less than 10% of global vaccines met quality standards, Dr Henderson was told he could not mandate quality control ("it won't work"). Instead, Dr Henderson withheld World Health Organization funding unless vaccines met third party quality control standards. It wasn't a mandate, but it was one heck of an incentive.

2. Science and Evidence Trump Experts and Textbooks
There were four key examples in which Dr. Henderson and his team had to buck the stated norm or thoughts at the time. In each they set up experiments and tests to use science as their evidence against the textbooks. Each played a vital role in proving Smallpox could be eradicated. The first was proving smallpox did not spread easily meaning a vaccine campaign could work. The second was revaccination wasn't needed - a one time dose could work saving money, time, attrition, and follow up efforts. The third, smallpox wasn't stable in nature, thus eliminating it from humans could eradicate it.

3. Managing Guidelines
- Recruit good people who want a challenge
- Delegate authority and responsibility
- Adapt program to the individual country
- Get out from the desk (he mandated 1/3 time in field)
- Communicate regularly and frequently
- Harmonize practices
- Exceptions are necessary

I invite classmates to share any lessons learned or comments from the D.A. Henderson Lecture. What did you think?

Book Review: Polio - An American Story

2010-07-21T16:30:00.001-04:00

Pulitzer winning book depicts the inner workings of Public Health

Within the first few weeks at Hopkins multiple lecturers have defined Public Health. Some used online dictionaries, others quoted names not yet familiar to me, and still more drew up definitions from international organizations. Whenever the slide with the bold white letters and question mark would appear, my mind would drift to our summer orientation book - Polio: An American Story.

Public Health is perhaps a field more difficult to define than others. From the molecular level of cancer mechanisms or chemical toxins to macro concepts of land degradation, sustainable development, and alternative energy, there are varying areas of concern which draw upon the medical, legal, engineering, and humanitarian aid fields (just to name a few). The picture is rather broad, but Hopkins did a service to itself by choosing David Oshinsky's Pulitzer Prize winner.

Oshinsky's book elaborately brings a reader into the moment through rich story telling while not sacrificing the proverbial meat and potatoes. He chronicles the development of the polio vaccine with all the theory and understanding of how vaccines work, the ethics of trails, and the stepping stone discoveries that produce a successful vaccine. However, he brings the story to life by focusing on the pushes, the pulls, the rivalry, the pressure, and the pieces of the puzzle that often go unnoticed.

For instance, he brilliantly captures the campaign that mobilized a nation. The first half of the book is a "how to" for creating a movement. It starts with the personal story of Franklin D Roosevelt, a victim of polio, and his creation of the National Foundation for Infantile Paralysis (Polio). The foundation had two unique factors that played mighty roles - a sitting US president as its figure head and Basil O'Connor, the visionary put in charge. O'Connor took the newly created and still young public relations and advertising fields and brought on personnel to brand and develop campaigns. Before he knew it the Foundation became a Juggernaut.

Before President Obama's heralded fund raising machine, the foundation revolutionized the concept and approach to soliciting donations. Instead of focusing attention on large sums from the wealthiest few, they shifted for the first time ever on small donations from the many. They believed it had potential to generate more funds, a deeper connection, and a broader movement. With concerted effort at "relentless optimism", the foundation made millions around the country believe they could play a role in the vaccination against a virus that plagued innocent children and kept parents in fear of summer months.

With the help of the President, the foundation was the first organization to use celebrity power to spread the word and solicit donations. For instance, Eddie Cantor, the highest paid actor/comedian of the time, is credited with coining the phrase "March of Dimes", the eventual name the Foundation would take. Through radio campaigns, people were encouraged to mail a dime right to president Roosevelt. The inaugural event, still in the midst of the Great Depression, brought in 2,680,000 dimes alone; a whooping success. With each dime mailed in there was a psychology of "Yes We Can!"

Two other interesting strategies were the creation of a "poster child" and the polio blankets. In 1946, six year old Donald Anderson was hand selected to be the face of the polio campaign. His pictures and interviews become a rally cry for donations and increased support over night. It was controversial but a successful tool. It also organized volunteer groups to sew over sized Polio blankets for victims and their families. These blankets are thought to be the "forerunner to AIDS quilts".

Polio: An American Story pays heed to the traditional definition of public health; "the science of preventing disease, promoting health, and prolonging life with emphasis on populations rather than individuals". However, Oshinsky brings to light the wide ranging factors that affect the process and application. Science, politics, economics, culture, communications, and technology are but some of the players touched upon in this easy to read page turner. I recommend the book and I look forward to Oshinsky's upcoming visit in mid-August.

Revamped, Redesigned and Ready to Go

2010-07-07T23:10:00.002-04:00

Launching The Round Table

Fourteen months ago I sent in my deferral to Johns Hopkins School of Public Health (JHSPH). I knew I wasn't ready to take advantage of the one year accelerated program. Ranked #1 in the world, with renowned faculty and over four-hundred courses, I knew the program warranted a clearer path and more focus. Considering I raised all the funds for my previous work abroad, a year delay to work and draft a half a manuscript made sense financially and personally.

Along with my deferral notice came one regret; having to wait a year to be immersed in a rich atmosphere of movers, shakers, and individuals eager to make an impact on the world around them. It was the free flow of ideas, the debating, and the unique perspectives that would have to wait another year.

This past June 28th, the fast paced journey began and I can not think of a better way to share and record the opportunity than through this blog and my website. Revamped and redesigned, this blog will be highlighting lessons learned, take away concepts, and engaging ideas from some of the best and brightest Hopkins has to offer. From guest lectures by Pulitzer Prize winners, Presidential Medal of Freedom recipients, and titans in the field of public health to guest blogs by students and general topics of discussion, I hope the blog continues to inform, challenge and inspire.

As always remember to check the side archive for titles of interest

Museum Trip Update!!!

2010-02-27T12:16:00.003-05:00

This is the text of an email I've sent out to individuals that donated to the Museum Trip. The reasons for the trip, which celebrates African American History and Art, can be found here. Learn more on my website.

Thank you for contributing towards the Christ the King Prep (CTK) field trip! Within four weeks of the kick off date we raised over $700 with contributions from 24 individuals. I am happy to report that donations ranged from over 50 years in age, multiple states, and varying religious denominations; including all 3 Abrahamic faiths (Islam, Christianity, and Judaism).

In the wake of Haiti's devastation, I decided many weeks ago to call the Montclair Art Museum and pro-actively approach an agreement for them to cover the remaining gap in costs. Now that it is finalized, I can fill you in on the great news! The Museum will be covering ALL costs for not only the 86 Sophomores, but has invited the entire Junior class to join as well! The Museum was eager to provide CTK students the opportunity to explore African American Art of the early 20th century and engage in an amateur studio session. Expect photos and video responses from the students following their March trips.

Your donation will be used in another meaningful art endeavors. Cristina Lewis, a young muralist, has generously accepted to volunteer and work with six students on the creation of a "multicultural" mural at CTK. The students were chosen through a submission process and each one will play an active role in the development, sketching and painting of the mural. The first meetings have already produced great ideas and acted as a new outlet for gifted students to share their talents. The raised funds will cover the cost of this mural and perhaps a second. I will be documenting the process in a short video to share with you.

Thank you again for making this possible. Your impact will certainly be felt and your support is already appreciated.

Best regards,

Marco Ambrosio

PS More can be learn at GlobalSocialJustice.net

Cura Personalis - Educating the Whole

2010-01-09T11:14:00.003-05:00

Christ the King Prep and a Field Trip for Black History Month

“You will be the first ever Senior class at Christ the King, excited?” – Me

“Possibly” – Chris

“Care to explain?” – Me

“Well, yes and no – all we do is work and study” - Chris

It is not the typical answer expected from a high school Junior, particularly when speaking for the collective whole. However, this is no ordinary prep school. I knew that from the beginning. What I didn’t know was how best I could help.

Christ the King (CTK) is unlike many high schools. It is one of only twenty-four schools in the national Cristo Rey Network, an innovative urban education model started by Jesuits in Chicago. It seeks to provide quality, catholic, college preparatory education to economically disadvantaged urban youth with limited educational options. It utilizes a longer school day and year, academic assistance, work skills boot camp and counseling to prepare students for college. The biggest difference, as echoed by the above dialogue, is these students are working for their education – quite literally. Once a week they partake in corporate internships that lower the cost of tuition by 80%. Besides learning the value of an education, the internships cement the end goal – college. Nationally, the network boasts a 96%
acceptance rate to 2 or 4 year colleges.

After my first meeting with Administrators, I realized there were many more needs then I could possibly provide. So, I reflected on my own high school experience at St Peter’s Prep and tried my best to pinpoint what was most formative. I soon realized the majority of my memories were not confined to the walls of the classroom. Instead, it was the hours after the final bell that the school came alive. Whether it was planning a pep rally with friends at Fr Hoag’s SJ School Spirit Committee meeting, waiting around for an Emmaus Retreat Homecoming or Arrupe Evening Lecture, or figuring out rides to soccer practice and what train or bus to take home – they rounded out the experience. I learned that you can’t control time, but you’d better learn to manage it. I learned that academics only scratches the surface of a school. I learned that each person has a talent and it should be used to help the greater good. These were all equal parts of an education. In short, I felt overwhelmed by what I wanted to offer the CTK students.

What could I do? At this juncture the school is unable to fund the majority of activities that they recognize as part of the Jesuit motto Cura Personalis. It is a dictum for educating the whole person including physical fitness and a broad based education (think your college “core”). In the end, people should have a working knowledge or appreciation for the sciences, history, math, literature and the arts. Administrators and faculty have been very creative to fill the void. There are chess tournaments, basketball teams, and workshops and presentations from college professors and community artists. With a mix of flexibility and drive the school succeeds despite a very tight budget.

Since the school does not have the resources. I am reaching out to my extended network to sponsor a student for a two hour trip to the Montclair Art Museum for Black History Month. My goal is to take all 86 sophomores, the only class yet to leave the school, over the span of four days. The first hour will be a tour of the exhibit “Forces of Change: African American Art and the Julius Rosenwald Fund” and the last hour will be a studio art session. With no arts program, I see this as a great opportunity to introduce the sophomores to a local museum’s historically relevant exhibit while exploring their own abilities.

I am asking for whatever amount you feel comfortable with. This is entirely pro bono on my part and the ChipIn widget deposits all money directly into the school’s PayPal Account via all 4 major credit cards and paypal.

You can give in any increments. Every dollar counts as this is the only fundraising for the trip. $15 covers the entrance fee, the supplies fee and transportation cost of one student.

Your $15 by FEB 5th = 1 Student going to the Art Museum

I’ve contributed the first $15.

I promise this will be a new experience and something very appreciated by the students. I will be following up with pictures and video responses after the February trip.

Ad Majorem Dei Gloriam
Marco Ambrosio

The Shop of My Hope Video

2009-12-30T10:13:00.001-05:00

Video of La Tienda Mi Esperanza

Three years ago I sat with a handful of HIV positive Nicaraguans who had one goal - to establish the first official HIV self help group in the Occident Region of Nicaragua. For over a year individuals had been meeting at CISAS (a public health non-governmental organization) to talk through their problems, counsel one another, and collectively protest any abuses at the hospital. Together we planned radio commercials and designed banners to bring awareness that HIV positive individuals were meeting near weekly at CISAS to start a self help group.

The vision and drive originated from three HIV positive individuals who had varying life experiences. The following year I would return for World AIDS Day and see Maria, one of the founders, give a public declaration on her rights as a woman living with HIV. She, along with the president of a German NGO, the German Ambassador and CISAS would sign their vision into reality. The group was official and had its first funding grant to start an office and begin an income generation project.

The group struggled at first to get traction. The members were unaccustomed to having, accounting and allotting funds or working with specific titles of President and Vice President, which are elected two year positions. However, after reorganizing and creating the position of Treasure, this last year the group started "Tienda Mi Esperanza" (Shop of my Hope). When a product is purchased, 50% of the sale goes to the member that made the item and the rest goes back into the group for materials and supplies. This short video below will introduce the shop, the products, and give you a better feel of the sights and sounds.

(Editorial Note - María, founder and ex-president, plays an active role teaching members how to hand make bracelets and necklaces. Her help was vital in the bracelets order I made, which will be a topic of an upcoming blog.)

Next Blog - A Learning Experience: Using the Order as a teaching tool

A Rwandan in the City for Christmas

2009-12-22T11:10:00.004-05:00

Three days in NY/NJ for the first time - What to do and what to see?!

I returned from my trip to Nicaragua at 1am yesterday full of stories, videos and pictures of water projects in the rural countryside and income generation projects by the HIV/AIDS group I’ve worked with through the years. They are inspiring, insightful and informative but won’t be featured until the coming weeks. There are several reasons why, including Christmas travel, but a main reason is a special guest. A guest that I hope you’ll help me welcome with ideas.

When I was researching in Rwanda, a Jesuit named Pierre Cornielle Namahoro welcomed me to the country with open arms. He became a teacher and a friend willing to discuss the history, politics, and culture of his homeland. I would meet his younger brother Jean Luc during one of our road trips into the countryside. Given my propensity to interact with locals and start games for kids, Jean Luc became part translator and part photographer. The children quickly multiplied as the “Muzungu” (Whitey) started juggling and tossing balls to be caught.

Now it is a year and a half later and Jean Luc has been studying engineering and telecommunications at the University of Arkansas as a Presidential Scholar – a joint program by the US and Rwandan governments. He is visiting my family in NJ for a week – mostly to spend Christmas but also as his only chance to see New York City.

Yesterday coming out of the airport he was introduced to snow and was so taken by the “cold ash” that we went sleigh riding at night with my younger siblings before an authentic Italian dinner. Let’s face it Arkansas’ ethnic food can’t hold a candle to NJ and NY. For dessert we had a snow ball fight and my sister taught him how to make a snow angel.

So here is the question! If you had a few days in New York City and New Jersey what would you suggest are can’t miss things to do or see?! Pizza? Chinese food? Street Vendor hot dogs or chestnuts? Hot cider? An I Love NY winter hat? Let me know what's memorable for you. Below I have our itinerary… please leave your remarks, ideas, suggestions as comments – Thank You!

Tuesday
Museum of Natural History
Central Park
Times Square
KNICKS Game (my Christmas gift to Jean Luc)

Wednesday
Ground Zero
United Nations Tour
Rockefeller Center & St Patrick’s Cathedral
Metropolitan Museum of Art??? (good idea or something else?)

Sunday
Statue of Liberty
Ellis Island

Rise of Pentecostalism (Field Notes from Nicaragua)

2009-12-14T18:29:00.001-05:00

I will be working on this theme for a larger piece, as much of my previous and first research in Nicaragua focused on the cross sections of theology, reproductive education, and poverty. However, it can be stated that within the last few years there has been a noted increase in Pentecostal churches within the historic center of Leon - a location where nearly each corner has a cathedral dating as far back as the 1800s.

Through the years I've noted that on trips into the countryside and rural communities, evangelical churches apppear to be the sturdiest and newest buildings. Many of these chruches are built by religious or service delegations from the United States.

The chruches are nothing new to me. The location is. Leon is a colonial city built around the central plaza of the Cathedral. Built by the Spanish in 1747 this Cathedral is second largest in Central America. At one corner of the plaza what used to be a public theater has recently been transformed into a Pentecostal church (see above photo). If that is not evidence of change, one of Leon's largest night clubs (located a mere 4 blocks away from the Plaza) has been reborn into an Evangelical church.

The rise of pentecostalism is a topic of conversation with everyday Nicaraguans. I think the deeper reason as to why the change has been occurring is the more interesting story but there is one thing for sure. I hope they scrubbed the night club's floor real well before starting the renovations.

La Tienda de Esperanza

2009-12-10T01:04:00.001-05:00

The First "Order" for León's HIV/AIDS Self Help Group

Five of the last six years I have found my way to Nicaragua, the largest and poorest country in Central America. What started as a research project as a sophomore at Fairfield University turned into a self conceived summer internship that changed the path of my life. This larger story of transformation and discernment will be featured in a piece I am putting together for BustedHalo.com. What I want to get across (less than 10 hours from my flight) is why I am returning this time.

My summer internship in Nicaragua introduced me to a world I had not personally known. One of the projects I was assigned to work with was logistical and planning support for the city of León’s first ever HIV/AIDS self help group. I had never known anyone with HIV/AIDS let alone work with someone. Yet, on my first day at work I was brought to the hospital to meet María, the catalyst behind forming a group. María’s struggle to triumph is one I featured at my World AIDS Day presentation last week at Fairfield University. It merits its own entry and will be saved for another day.

A year after first meeting María her dream of the first ever HIV/AIDS self help group became a reality. They received a grant from a German non-governmental organization that officially cemented a joint HIV/AIDS self help group that bridged to cities in Nicaragua’s Occident region. From three individuals the tally at the inauguration, which I attended, was near 35 members. Within the last year the group has grown to 70 and started “Tienda de Esperanza” (The Hope Shop). It is an income generation project that addresses a major human and development need – a job.

I have been keeping tabs on the HIV group. Last March when I acted as a field aide for the research team from Fairfield University I brought students to meet the group members and, of course, become customers. I myself bought a few colorful bracelets that my sister wears all the time. Handmade with multiple colors and metal designs I know the bracelets are catchy enough to the eye. Yet the relatively new shop has had some difficulty building a market given their non-touristy location. Therefore, I have started the wheels turning on the first commissioned order for a product made by the group.

It is a process and learning experience for both myself and the HIV/AIDS group, but the final product will be sold at my speaking engagements. It will be a great connection since María and the group are often featured in my examples of individuals and groups creating hope in their community against seemingly endless odds. I look forward to sharing photos and videos of the process these coming weeks.

BVA - Alisa Miller's take on Media

2009-11-29T23:01:00.002-05:00

The Bi-weekly Video Award (BVA) is announced Sunday nights every other week. These videos are stamped with my "Guaranteed to Inspire or Inform" tag. Check out GlobalSocialJustice.net for more information.

Growing up in a first generation household from Argentina, I already new that Latin America was never on the radar for mass media or the evening news programs. Hurricanes, the drug trade and an occasional piece on a Latin American president – these were the stories. Likewise, being four years younger than Britney Spears taught me that pop culture always has an ace up its sleeve. Despite these understandings I was still taken aback by the sheer disproportion in news coverage as demonstrated by Alisa Miller, CEO of Public Radio International.

Given the global recession and nearly two years of social media and technological advances, it would be very interesting to see a new installment of this same presentation. For instance, print media has continued slashing costs with foreign bureaus and correspondents treated as fat rather than red meat. In addition, would the rise of twitter and internet news sites such as Globalpost and Huffington post alter the landscape, or would the fixed attention trends continue with the balloon boy or Michael Jackson simply replacing Anna Nicole Smith?

For shining a light on a topic often overlooked, Alisa Miller’s 2008 TED talk is stamped as “Guaranteed to Inform”

Three Presentations, Three States, All Welcomed

2009-11-16T18:14:00.002-05:00

I will be presenting “Faith in Action” the following days at Jesuit Universities. I invite students and individuals in the area to attend. I will be focusing on the theme of hope in global HIV/AIDS using stories and examples from my research in the field. The goal is to challenge, inform and inspire the audience to believe in the power of the individual to impact their communities.

I hope you can make one of the presentations.

Thursday, Nov 19 at 10am
St Peters College
Roy Irving Theater
Jersey City, NJ

Monday, Nov 30 at 7pm
St Joesph’s University
Philadelphia, PA
Location TBD

Thursday, Dec 3 at 7pm
Fairfield University
Fairfield, CT
Lower Lobby BBC

BVA - Power Shift: Australia

2009-11-15T18:56:00.003-05:00

The Bi-weekly Video Award (BVA) is announced Sunday nights every other week. These videos are stamped with my "Guaranteed to Inspire or Inform" tag. Check out GlobalSocialJustice.net for more information.

What do you get when you mix a Saturday Night Live hit skit, a "flash" mob, and young adults looking to spread a message? The answer is Powershift - the newest BVA installment.

Powershift is a global grassroots organization that lobbies politicians to take energy policy and alternative energy seriously. Their website and organizational model breed camaraderie through group portals and videos while allowing easy access to locate and contact local government representatives. You may be thinking, "Can students make a difference?" The department of energy (DOE) seems to think so.

In October, Newsweek featured a piece on the DOE biannual Solar Decathlon contest. Teams of college students build "a fully functional house powered by nothing but the sun". The grading rubric includes architecture, market viability, home entertainment and seven other categories. The underlying objective is best explained by Energy Secretary Steven Chu. In the piece he stresses the competition as a method of challenging the coming generation to innovate, collaborate and grow a green industrial revolution. They are stakeholders not bystanders.

Policy, grassroots advocacy and education are three pillars to achieve the much anticipated "new" economy. The DOE's contest is an example of expanding the application of lessons learned for college students. It is a valuable academic tool. Powershift is another example. It connects students across the globe to gear up for energy change. It has revved up the campaign in light of the fast approaching Copenhagen Climate Conference. December 9th the world will know if leaders are serious about climate change. If they want to feel the pulse of the younger generation or if they want a quick laugh at the lengths young adults will do to spread a message, I would recommend this video. It starts off slow, but gets

For showing how comedy and art can bring attention to a global issue, for organizing and motivating over 100 young adults to dance in public, and for getting young adults involved in the democratic process - this BVA goes to Powershift.

Sunday Commemoration of Jesuit Martyrs

2009-11-09T23:40:00.003-05:00

20th Anniversary of a Call to Action

They were two Spanish Jesuits on a mission in El Salvador. They were two dear friends who intensely felt a calling to act in defense of the oppressed and challenge the establishment. Together they would alter the meaning of a Christian university by publicly turning its research departments into active social change agents. One is Fr. Jon Sobrino SJ, a renowned Catholic author and a leading figure on what Jesuit higher education should look like. The other is Fr. Ignacio Ellacuría SJ, Sobrino's inseparable colleague, spiritual guide and visionary partner. Twenty years ago, one would be martyred and one would narrowly escape.

In 1982 upon the acceptance of an honorary degree from Santa Clara University, Ellacuría eloquently challenged the audience to believe in the power of a university. A university was to build academic excellence and intellectual capacity. These were the vital tools needed to address root problems of oppression. For Ellacuría the overarching goals were based on two fundamentals of Liberation Theology - championing a preferential option for the poor and embracing social justice.

Prophets speak truth to power regardless of the consequence and Ellacuría and his fellow Jesuits knew the dangers of speaking against the military. From 1977-1980 alone, seven Catholic priests were murdered. Over a decade later in 1993, the UN would confirm the assassination of beloved Arch-Bishop Oscar Romero was ordered by Army Major Roberto D’Aubuisson. Yet, Ellacuría’s views were fully absorbed and practiced at his university, Universidad Centroamerica José Simeon Cañas. During the El Salvador civil war the university and the Jesuits became the prophetic voice for the oppressed, the murdered and the poor. It denounced the military and produced studies on the effects of the civil war and poverty on the masses.

In his speech, Ellacuría bore witness to the consequences of challenging the establishment and advocating for the poor. “From 1976 to 1980, our campus was bombed ten times: we have been blocked and raided by military groups and threatened with the termination of all aid. Dozens of students and teachers have had to flee the country in exile; one of our students was shot to death by police who entered the campus. Our history has been that of our nation.”

Last year I had the privilege of hearing Sobrino lecture on the fundamentals of Ellacuría’s vision and pedagogy. It is an exercise in reflection that demands action. The poor and the oppressed are the crucified people. We must ask ourselves. What have I done to put them up there? What am I doing to help them down? For the UCA it meant releasing studies and pointing at structural violence and cycles whose chains never unlinked for the majority of the population. The more it denounced the military the closer it became a target.

On November 16, 1989, when Sobrino was luckily out of the country, armed men entered the Jesuit residence at the University and murdered six Jesuits, the cook, and the cook’s 15 year old daughter. Each Jesuit was shot in the head. It was meant to symbolize the erasing of these Jesuits ideas. Yet the murders would draw international attention and help propagate the message of Ellacuría. That message of speaking truth to power, analyzing root causes of poverty and acting in solidarity with the poor is championed to this day by Sobrino and alive in the hearts, minds and actions of individuals and organizations around the world.

If you are in NJ, I invite you to come celebrate the lives and messages of Ellacuría, Sobrino, and the UCA Jesuits this Sunday on the 20th anniversary commemoration of the El Salvador Martyrs.

SUNDAY NOV 15
2-5pm
8th Floor 89 Market St
Downtown Newark

$ 10 Donation
Speeches, Music and Food

BVA – Dove “Evolution”

2009-11-01T21:23:00.002-05:00

The Bi-weekly Video Award (BVA) is announced Sunday nights every other week. These videos are stamped with my "Guaranteed to Inspire or Inform" tag. Check out GlobalSocialJustice.net for more.

In President Eisenhower’s farewell address he warned the country of a “military-industrial complex” that could grow so large it would challenge our democratic principles and liberties. Eisenhower feared the influence and lobbying power this complex would have on government policies, decision and budgets. 50 years later the Congressional Budgeting Office divvies up 20% of the taxpayer pie to Defense. A closer look by warresistors.org places the percentage at 54 by including veteran benefits and the dual wars in Iraq and Afghanistan. Perhaps the President known for his highways and WWII heroism should also be recognized as a psychic.

In the last BVA, Annie Leonard tackled another industrialized system. This one was defined by corporate capitalism and relentless consumerism which are depleting resources, producing endless waste and valuing short term profits over long term sustainability. She picks up where Eisenhower left adding the largest multinational corporations to the list of undemocratic and potentially destructive influences.

This BVA installment attempts to shine light on materialism and manipulative marketing – two lifebloods of consumerism. Whereas Eisenhower alerted citizens to changes that could alter our democratic practices, consumerism, materialism and manipulative marketing affect the psyche of individuals. Marketing machines have nearly ingrained in our culture an insatiable desire for newer, better and bigger. Quick, go out and buy the latest UGG boots or wrist watch as if materials indicate someone’s worth or value. Buy that hair coloring product, anti-aging cream or spend a few thousand on botox shots. Don’t you know that age is the enemy? It brings me back to my research in Rwanda where a middle aged female US doctor said she would never color her grey hair again. Why? Because her patients taught her without a word that grey hair meant you were privileged to live a long life - a privilege to celebrate not hide.

The old adage maintains that beauty is in the eye of the beholder. Unfortunately the message is mangled by industries hawking items and portraying their own selective and near unattainable definition of beauty. I find it interesting how it can radically differ across cultural borders. For example, in Thailand women use skin bleaching creams and whitening techniques while in the USA it’s self bronzing lotions and tanning beds. How can a woman keep up?

This Dove video offers a glimpse into what every person, particularly girls, should know - beauty is not derived from external forces, marketing campaigns or doctored photos. I promise that you’ll never look at advertisement the same again.

Social Media to the Rescue

2009-10-29T19:24:00.001-04:00

Speaking to English Classes about Writing

I give a decent amount of presentations regarding “Hope & Global HIV” and “Faith in Action”, but talking about writing to 8th graders wasn’t in my crystal ball. Writing was a hassle in 8th grade. But years later during my research and travels it became my outlet. Now in the midst of a book manuscript it has become a large chunk of my life.

Faced with two 50 minute classes I turned to social media for advice. Through my facebook fan page and twitter account I was able to generate over 40 responses and comments on what people would stress to 8th graders about writing. Interestingly four of the five responses (Journaling, Creative Writing, Personal Style and Structural Elements) were within 6% points of each other. The most noted suggestion (by over 20 percentage points) was on how reading affects writing.

Keeping the poll in mind, my presentation flowed out of my personal experience in Thailand volunteering at a Buddhist AIDS Temple. Using “Importance of Touch”, I tried to get across three main points.

1. Writing is Important - If you can write well you are a valuable asset because you can express or articulate a clear thought. If you write poorly with spelling errors or grammar mistakes you can get passed up on a high school, college or job application. Writing can draw attention to an issue, move people to act or bring people to a higher level of understanding.

2. Writing is a Process – grammar and spelling is like a hoop and a ball – you need them to play basketball. Editing and drafting are the lay up and shooting drills that turn you into a skilled player. I’m no Michael Jordan or Steven King, but “Importance of Touch” generated attention and was read at mass and reflection gatherings at Fairfield University. More importantly, it came out of hours of journaling after struggling with the death of a patient at the clinic. It took three drafts and nearly all night because I wanted it convey and express the intensity of my feelings.

3. Don’t get Discouraged – Growing up in a predominantly Spanish speaking household has its pluses and minuses. English grammar and spelling are both negatives and don’t combine to make a positive. I noticed a good amount nodding their heads in agreement. The trick is to read. Find an interest and go for it. I challenged them. I said NYtimes.com has at least one topic or section that they must find interesting; then I let them in on a secret. You can double click on a word and the definition pops up in a new window. In the age of the internet reading shouldn't be a problem.

What's your opinion?

2009-10-22T15:39:00.003-04:00

Thank you to everyone who filled out this poll or left a comment. Over 40 responses gave me a good idea of what to focus on. I wrote a post "Social Media to the Rescue" about the results and how it affected the presentations. Thanks again.

Online Surveys & Market Research

Thank you for the help. The merits of writing is not a topic I usual present on, but I certainly blog about it afterwards.

BVA - "The Story of Stuff"

2009-10-18T21:34:00.002-04:00

The Bi-weekly Video Award (BVA) is announced Sunday nights every other week. These videos are stamped with my "Guaranteed to Inspire or Inform" tag. Check out GlobalSocialJustice.net for more.

At first I was hesitant to choose “The Story of Stuff with Annie Leonard” as a BVA because of its length. 21 minutes has become an eternity to grab attention on an internet video. However Annie Leonard makes each minute count with her creative style, informative statistics and thought provoking sketches. Granted the video seems targeted for young adults and adolescents but perhaps it’s on point for teens are impressionable and children can have a great affect on their parents’ spending habits.

In the “Story of Stuff” Annie tackles what could be considered the heart of American culture – consumerism. Economics has garnered a great deal of attention in the past year given the global recessions and large wall street bonuses. Less heard of are questions or investigations of how our system works, who benefits and at what cost to both humans and our planet. This video highlights a system of corporate capitalism that values maximizing profits and short term rewards over the general wellbeing of multiple stakeholders – workers, ecosystems and consumers alike.

The video paints a rather stark reality and uses a big brush. As a disclaimer, it makes some assumptions for the viewer and should not be written off as “liberal propaganda” - sustainability is everyone's concern. Many of the issues are more complex than depicted in the video. A former post of mine discusses one such instance – “Walmart – a Preferential Option for the Poor?”. However, with over 7 million views and tens years of investigative research the video seeks to draw attention to a major global issue and reshape the conversation. It has all the ingredients of a BVA.

Christ the King Prep

2009-10-15T16:54:00.000-04:00

Changing Inner City Secondary Education - One Job at a Time

The Newark Club is a beautiful venue to hold an evening event. Located on the 22nd floor in the heart of Newark’s business district the wraparound windows offer crystal clear views of New York City and Newark. With two lush bars and delicious (near endless) food Christ the King Prep President, Fr. Robert Sandoz OFM (Franciscan) made his message clear at the school’s gala – “Our greatest treasure is our students”.

In the political world no one dares discredit the importance of education. Everyone heralds education as a bedrock of our country, but the consensus agreement is that we must do better particularly in urban cities. It’s an issue that has been around for quite some time as the evening’s top honoree, Fr Edward Glynn SJ has dedicated his life to education in underserved populations. The real rub arises in how to bring about change. In today’s NYTimes, Nick Kristof highlights the growing problem, the counterproductive teacher unions and some researched based initiatives that are producing results.

The Christo Rey network stands as an example of how innovation and a shared mission can provide opportunity to students with very limited funds. What’s innovative? The students have longer school days and school years than others. They have a rigorous academic program that focuses on core subjects and lifelong learning principles like complex reasoning and collaboration. Other schools do this as well, but where the program differs is in its motto “The School that Works!”.

The schools recruit students whose families are living below the federal poverty line and only allow students whose families make up to 75% the per capita income of the local community. The network exists because of a novel idea to intertwine corporate America and high school education. Students are grouped together (in four or five) and work for a local business or organization (one student works Monday, another Tuesday etc). Their collective salary greatly defrays the cost of tuition. In turn, the students are exposed to an environment where they grow to recognize the value of their education. The bottom line is 99% of the students are accepted into college and many are the firsts in their family.

The Christ the King Prep in Newark is one of the newer schools in the network. Opening in 2007, their elder statesmen are the Junior class. Every Junior I spoke with at the gala highly valued the experience and often responded with an enthusiastic “great” when prompted about the working. What the school needs is more employment opportunities for the students. They say “Growth is Life” but here it’s “Jobs mean Growth”. Therefore, I encourage you to find the nearest network and look into the potential of employing a group. From medical clinics to law firms, each job brings a world of opportunity to a handful of resource limited teens.

The evenings other honoree was former Georgetown Coach John Thompson and in his address he focused on a core concept – “Faith without works is meaningless”. The Cristo Rey Network and Christ the King Prep in Newark have become the newest work of several religious orders combined. What was started by the Jesuits of Chicago has grown with the support of the Sisters of Charity, several Archdioceses and many Jesuit provinces. Together with the laity and the local communities change is coming to inner city secondary education – one job and five students at a time.

BVA - Playing for Change

2009-10-04T22:10:00.002-04:00

The Bi-weekly Video Award (BVA) is announced Sunday nights every other week. These videos are stamped with my "Guaranteed to Inspire or Inform" tag. Check out GlobalSocialJustice.net for more.

I have always been one to put money in the cases of musicians. After bailing out on the guitar and the sax in my middle schools years I learned to appreciate the difficulty, dedication and creativity needed to play an instrument and produce quality music. Most of the songs I tried to play were chosen because of the lyrics, a catchy tune or ease; "Stand by Me" is one such song. Ben E. King wrote and recorded "Stand by Me" in 1961. Since that time versions spanning multiple genres from Mo-town to Punk Rock have promoted the powerful lyrics in their own unique style. Greats like Otis Redding, John Lennon and Maurice White (Earth, Wind and Fire) brought added fame to the song, but no version is as moving or powerful as Mark Johnson's "Playing for Change".

The concept is simple - using music to bring people from all walks of life and different corners of the world together. The lyrics stress a fundamental human desire best described as genuine comfort; the knowledge that in good times and bad you are not alone. The beauty of the video is the universal theme pieced together with musicians and instruments from various traditions, ethnicities, and countries to reenforce the message. We are one community. We are one world. Here the message does not propagate from stars, rather it springs eternal from the faces and sounds found across the globe. It is a message that has found the right note in the online community as the video has over 14 million views on youtube.

Don't forget to leave a comment. I'd love to know which musician struck a chord with you. Enjoy!

The Playing for Change initiative is currently building musical programs in developing countries and touring in the USA and Canada. The website has other amazing videos and songs. I personally recommend reading the journey tab which includes how advances in technology greatly changed through the production years (smaller cameras, faster computers, uploading to the net etc).

Videos with a Purpose

2009-09-22T17:01:00.004-04:00

GlobalSocialJustice.net has added a new feature – Bi-weekly Video Awards (BVA). These videos will come out on Sunday nights every other week and have the “Guaranteed to Inspire or Inform” stamp of approval!

Andy Ridley, the Executive Director of Earth Hour, has been one of the creative geniuses behind an advocacy campaign that has turned the lights off in over 4,000 cities and 88 countries; all in preparation for the Copenhagen Climate Change Conference. By keeping the Earth Hour logo and creative open source, Ridley was able to take advantage of a undervalued resource – people’s own creativity and drive to push a message. The inaugural BVA was introduced to me during Ridley’s presentation at the Social Good Conference. As the lights go off around some of the world’s most recognized monuments and buildings one can not help the goosebumps that come with a unifying global call for action.

I choose this video to coincide with an “unprecedented” day in United Nations and perhaps global history. One hundred heads of state gathering at the United Nations for a day long conference solely focused on the upcoming Copenhagen Climate Change Conference. The backroom discussions and conversations coupled with speeches by key players makes this conference the barometer for who will sign what come December. So far I have been unimpressed with the TV media coverage given the importance of today’s gathering, but the NY Times has several articles and clips worth checking out.

Watch the video at GlobalSocialJustice.Net

Social Media for Social Good

2009-09-04T17:39:00.000-04:00

Mashable’s Summer of Social Good

Last Friday something happened that only a few years ago would not have been possible. What has changed? It’s a little bit of technology, lots of innovation and a new method of creating positive change. People from across the country converged at the 92stY in Manhattans Upper East Side for a day long conference on how social media is propagating social good. This capped a summer social media initiative that raised approximately $30,000 for three non-profit organizations.

Hosted by Mashable (think CNN for Social Media news), leaders from nonprofits and social media sites like Facebook highlighted the whos, hows and why of what has made social media a medium every sector is seeking to capitalize on. I am a NPR junkie in the car and thought no better way to depict the conference lessons learned by highlighting the “take away”… so with kudos to Adaora Udoji and John Hockenberry here goes…

o Mashable - My take away from my first conversation with Pete Cashmore, Mashable’s co-founder and CEO, was that he was reading “The Social Media Bible”. My second conversation – which started in the bathroom regarding his Scottish roots and rugby – taught me everyone likes to hear funny stories about my older brother the former professional fighter. The take away from second conversation was finding an online outlet for your writing takes time, contacts and a lot of “sticktoitness”.

o Facebook – Everyone knows Facebook is the big elephant in the room when it comes to social media. I was pleasantly surprised by Randi Zuckerberg’s presentation highlighting Facebook mobilizing social good across the globe: Virginia Tech (Memorial/Support groups), Colombia (No More Farc and kidnappings), Iran (Election fraud) and Saudi Arabia (Fighting a ban on women driving). The take away is that social media has again shrunken the world and that it is indeed a very powerful tool for advocacy, organizing and, yes, even action. Moreover, facebook pages are the present and near future for marketing (large, medium and small). She also gave a lot of advice on making your pages a success (driving traffic, increasing members and going viral – but you’ll have to email me for that info or wait for another post!)

o NonProfits – Some large non-profits have already figured out how to capitalize and utilize social media to generate support, promote advocacy, fundraise and manage their brand reputation (and this is only a short list). The most impressive was WWF. Not only do they sport a large in house social media team but they have a CEO who blogs everyday so employees and supporters know exactly what is going on. Other non-profits are still attempting to “figure” out the approach or catch up to the Jones. I came away with lots of best practices and ideas that are generating results for several of these non-profits and foundations.

o Beth Kantor – A do it all consultant, teacher and social entrepreneur. The take away is that technology has advanced so much that the world has shrunken and individuals can make an incredible and tangiable difference by themselves. Beth is a fireball of passion, action and creativity who got the wheels turning in my head. Her website is a must for anyone looking to utilize social media professionally. Period.

o Geoff Livingston – The take away from this straight from the hip speech was breaking through the “shiny object syndrome” (aka the massive amounts of white noise and clutter that grasps our attention) by targeting campaigns and brands as it relates to the specific audience. I could not help but think of the Jesuit concept of meeting people where they are throughout his presentation - perhaps further validation for Chris Lowney's book chronicling how Jesuit ideals and mottos reflect great business practices.

o Jonathan Greenblatt (co-founder of Ethos water, member of Obama transition team and president of allforgood.org) – I saved this one for last. I asked Jonathan what book he is reading and who his mentors were during his Q/A. The first question I ask everyone to see what I should be reading (the answer is “Here Comes Everybody”) but the more important question is the mentoring. Throughout college and even my global HIV/AIDS work mentoring has not been part of the equation. It has usually been an idea, some conversations and me working every angle or contact I can to achieve the goal. Along my travels, interviews and conversations I have been lucky enough to meet very passionate, driven and successful people, but with few have I thought “click” this guy would be a great mentor because he gets it. Jonathan’s pragmatism and perspective capture the new wave of leaders. People who recognize the value of innovation, creation, leadership and, most importantly, striving for the greater good. The economy of corporate creed makes way to the economy of integrity in Jonathon’s stance and his examples run the gambit - from Zipcar making people rethink if they need to purchase a car to Tom's shoes who donate one pair of shoes to people in need for every one they sell.

Next Post - Additions to the GSJ Website in Light of the Conference

Wal-Mart – A Preferential Option for the Poor?

2009-06-27T14:36:00.000-04:00

The Commitment to Justice Conference in Jesuit Higher Education was held at Fairfield University with Faculty, Jesuits and Administrators from over 32 national and international Jesuit Universities. I will be posting reflections from the different panels and seminars attended.

Fr. Stephen Rowntree SJ knew the session’s topic would generate a crowd. The standing room only classroom was there to hear his “What Wal-Mart Reveals about the Global Economy” presentation. Judging by the engaging dialogue post presentation one could say it did not disappoint.

The lens of choice for this academic exercise was simply justice. Is Wal-Mart a corporation that is doing justice work? It appeared the hole had already been dug as an early show of hands overwhelmingly found the basic view of Wal-Mart to be “somewhat unfavorable” with “quite unfavorable” as the closest second. What jumps to mind when you hear Wal-mart and justice? I immediately thought of low waged workers with limited (or no) benefits, no unions and small suppliers being run out of town.

Now imagine the intrigue when Fr Rowntree SJ in front of a cohort of faulty, administrators and alums of Jesuit universities called Wal-Mart a store that has a preferential option for the poor. It is no small reference as the preferential option for the poor is one of the core principles of Catholic Social Teaching and heralded as a rallying call by former Jesuit Superior Fr Pedro Arrupe SJ, referred to by one presenter as “the second founder of the Jesuits”.

Rowntree SJ acknowledges the lack of unions is a major problem in the equation but also staunchly supports the constructive benefits of the company. “Wal-mart employs 2 million people world wide, including 1.4 million in the US. The US work force is larger than the US Army" and it is the largest private employer in Mexico and Canada. He is quick to point out that it produces low skilled jobs for the young, the uneducated and the retired who otherwise would have difficulty finding work. In this light it is a company whose hiring practices are rooted in providing options to the many who have been left out of the capitalist system.

Wal-Mart grew from a single discount store in Rogers, Arkansas in 1962 to the world’s largest corporation (by sales) because of innovation – a favorite son of capitalism. According to Rowntree it revolutionized supply chain management by cutting out or squeezing the middleman. This may hurt the manufacturers and small suppliers but in a globalized capitalist system such is the way of life. Furthermore, Wal-Mart implemented a tracking/stocking inventory system that allowed it to lower its margins. Couple these innovations and what you get is the ability to greatly reduced the cost of the items sold. Here is where the second point is cemented. Wal-Mart has a preferential option for the poor due to its low low prices. Not only does it allow people to save money for goods they need and otherwise not be able to afford, but the money saved can be utilized for other spending or saving. Thereby, either further stimulating the economy or helping the costumer stay above water.

Although this was not mentioned in the session if we look at Wal-Mart’s new prescriptions for under $4 program and 90 day fillings for $10 we see the instant impact of Wal-Mart directly on access to cheap medications and medical savings in the community. “For instance, alendronate, the generic version of osteoporosis medication Fosamax, will be added to the list. Company pharmacies will fill 30-day prescriptions of alendronate for $9 and a 90-day supply for $24 at a comparison of $54 and $102, respectively, that women previously paid for the same amounts, the company said.” (Link to quote)

Of course like much of big business the devil is in the details and I have not research or studied them in this case. It is certain that beyond lacking health benefits, manipulating part time versus full time and the lack of unions are troubling, but the constructive creation that comes from the process has made the issues much more complex. The session did alter my view of Wal-Mart. It went from clearly “somewhat unfavorable” to a cloudy and murky “somewhat unfavorable”.

Open for Greed or the Greater Good?

2009-06-21T15:42:00.001-04:00

Reflection from First Panel on Commitment to Social Justice

The Commitment to Justice Conference in Jesuit Higher Education was held at Fairfield University with Faculty, Jesuits and Administrators from over 32 national and international Jesuit Universities. Over the next week or two I will be posting reflections from the different panels and seminars attended.

Panel Discussion on Bringing Social Justice into Jesuit Graduate Education

This discussion touched upon the challenges that face administrators in shaping a vision for a program, hiring faculty and getting buy in from all stakeholders particularly students (and prospective students). Led by a team from Loyola Maryland, the heart of the issue that put everything into perspective was - "Do we want a Jesuit Business School or do we want a Business School at a Jesuit University?".

Unfortunately, at first glance it would seem that these two concepts are polar. These days when we think of business it is corporate greed that wears the bulls-eye. Whether it is Eron's accounting tricks, credit default swaps that dropped AIG and others to their knees or predatory lending by credit card companies the examples of turning profits at the expense of the greater good has plagued the business community's image and seemingly produced a corporate culture that alienates the majority.

In March 2008, Jon Sobrino SJ challenged christian universities to play their role in maintaining a preferential option for the poor and building solutions that strived for the greater good. He argued that corporate capitalism and a consumer crazed mentality that stressed the accumulation of wealth were the antithesis of the Christian calling. Where were the economic models that kept in mind the rights of producers and consumers or made the system more inclusive and less exploitative? Who would produce the students that sought to tweak the model or shift the focus?

What I have learned is business is part of the answer and the statement holds true regardless of country, development index or regional location. Job and wealth creation are integral pieces of any functioning economy and put funds directly in the hands of people on the ground. Perhaps the most fitting example is Grameen Bank and other micro-finance institutions (MFI) lifting millions of individuals out of poverty. Individuals who had been left behind or exploited by the corporate capitalist system. It is a great example of for-profit business working toward a common goal for the greater good. The bank, which does has a non-profit subsidiary, has branches throughout the developing world and now even in Queens. Another popular microfinance organization is Kiva.org, which recently announced new initiatives for providing loans in the United States. Many of the recipients of these loans use the funds as entrepreneurs - seeking to build or grow their own businesses.

The most successful microfinance centers incorporate financial training and healthcare in their programs. It is one of the major reasons why all centers are not born the same, particularly given the rise in the industry. There are cases of manipulative policies and even debt collectors intimidating clients - but lets not throw the baby out with the bath water. The industry is still young and ratings systems are now trying to expose the bad apples. Similarly the panel described a relatively new approach of Jesuit graduate programs in the past two decades of "mirroring professional secular graduate schools". The feared consequences are the stress on prestige and success replacing core values of cura personalis (the education of the whole person - sound mind, sound body and sound spirit) and ad majorem dei gloriam (for the greater good of God). The expectation is that business schools at Jesuit University's put into practice their mission statements, strive to innovate and create solutions for the greater good and reproach the ideas of corporate greed and excess profits. In this way they would embrace Sobrino's message and become Jesuit Business Schools. But again, which is it that we want and how will it affect applicants, potential faculty and the Jesuit concepts of inclusion, diversity and meeting people where they are in life? All in all, it was a great start to the conference.

Can you go to Jail for having Sex?

2009-06-02T17:48:00.004-04:00

Whether it is listening to the sexually explicit lyrics of today's popular music or watching the frequent commercials where "sex sells" is the underlying message, the United States is more than waist deep in the culture of sex. But in what some have branded the age of sexually transmitted infections, what happens if you can go to jail for having unprotected sex?

More specifically, what are the legal repercussions of a person passing the HIV virus to another? The last eight weeks have seen three major stories come out of North America. In Toronto, a man was convicted of two counts of first degree murder and ten counts of aggravated sexual assault. He infected twelve women two of which died of cancer that spread from their compromised immune systems. In May, another Toronto man was charged with attempted murder for not disclosing his status to his partner and allegedly transmitting the virus. Lastly, a man in Texas was charged with six counts of aggravated sexual assault with a deadly weapon.

People who knowingly break laws and inflict harm on others deserve to be prosecuted under the law. However first-degree murder is one of the highest forms of convictions in common law systems and generally requires establishment of a certain state of mind, such as pre-meditated or malicious intent. Therefore the crux of the issue lies in intention and knowingly putting the partner at risk without disclosing ones HIV status; both are not cut and dry. The probability of passing the virus during unprotected sexual contact is not 100%. Much of it has to do with viral loads (the smaller the viral load, less chance of transmission). What if a HIV positive male indiscriminately slept with multiple partners without using protection but never knew his status (remember statistics estimate 20% of the US population with HIV does not know their own positive status – roughly 200,000 individuals). What category would he fall into if a partner (who agreed to consensual sex in the first place) pressed charges? Do both parties assume the risk if no condom is used? What if his last HIV test was negative so he thought it was safe not to use a condom? Well, it takes two to eight weeks for the body to build the antibodies to HIV for a test to signal positive. I think you get my drift. The issues are complex and need to be determined on a case by case basis, which is why public health and HIV/AIDS aficionados are hoping a precedent has not been set with the recent Toronto cases.

The public health voices understand that combating HIV/AIDS within a community is a combined effort of treatment and prevention. To ensure success many criteria need to be met, one is strong emphasis on getting tested. In other words, we should be encouraging testing. In resource rich countries increased testing can be argued to reduce the spread of the virus because more people will be on HIV medications. For instance, getting as many people on medication will lower the viral load within a given community - an argument made by Partners in Health with their "Public Health for the Public Good" approach. If a precedent for attempted murder or first degree murder charges has been established it will only frighten people from getting tested. Why know your status, better to plead negligence.

Another concern is fear of discrimination. It cannot be missed that these high profile cases increase the stigma associated with HIV. We should recall the hoopla following one inmate's conviction of attempted murder for spitting at an officer (no case has ever shown transmission through saliva). It can also not be lost in the media attention that cases in which HIV positive individuals intentionally and knowingly transmit the virus are the fringe minority. In the Bottom Billion, Paul Collier argues if you take a large enough sample of any population you are going to end up with the normal percentage of psychopaths and mentally disturbed people. Do we want these few creating an even deeper hole for the HIV positive community to climb out of?

How do we establish intent or malice? Can we prove without a shadow of a doubt that one person infected another? Do we mandate disclosure? What about civil damages? What if someone passes on multidrug resistant tuberculosis? The majority of these questions will come to light at some point in the future as more and more cases come forth in the criminalization of HIV/AIDS. I caution that each case be treated as independent where the facts and sentencing coincide accordingly. What all people, HIV positive and negative, should take out of these stories is the absolute necessity of being responsible if you chose to be sexually active. What is responsible you ask? It's the topic of next week's blog.

*** Footnote From the CDC ***
The proper and consistent use of latex or polyurethane (a type of plastic) condoms when engaging in sexual intercourse--vaginal, anal, or oral--can greatly reduce a person’s risk of acquiring or transmitting sexually transmitted diseases, including HIV infection.

Emily C. Specchio Foundation Announces Ambassador Program

2009-05-06T10:22:00.000-04:00

The following is the transcript of my speech at the 3rd Annual Emily C. Specchio “Night with an Angel”.

Good Evening Everyone,

My name is Marco Ambrosio, I am one of Emily’s cousins. In fact we were one year apart and spent family affairs usually laughing together. I have been asked tonight to briefly explain the Ambassador program. For those that are unfamiliar with my family – brief and explain are at opposite ends of the Ambrosio spectrum – but I promise to break the mold. Now, the Ambassador program comes directly out of my work, my partnership with the foundation and Emily’s passion for life and helping others.

Last year I spoke at this event a few days after returning from Rwanda. I spoke of my Hope & Global HIV Project that also took me to Nicaragua, India, Thailand, and San Francisco. In the past year, I have furthered my work in global social justice having completed a manuscript based on the project. I am currently looking for a publisher and a literary agent – and any leads would certainly be welcomed! I should add that I designed and created a website that supports my various activities and speaking engagements. Everything I say tonight can be accessed on my website – GlobalSocialJustice.net

Since speaking last year, I helped the foundation create the Ambassador program. The reason for this program is simple – there is no better way to remember Emily than by helping young people to challenge themselves and see what kind of impact they can make. When I first approached John and Eileen, I was a soon-to-be college grad with an idea, a passion and contacts. I needed to cement my credibility and find a way to solicit donations. In short, the foundation enabled me to be the change I wanted to see in the world. Now, the foundation is looking to enable others.

New Jersey residents aged 18-25 are eligible to apply. The applicants must demonstrate a clear vision for a community outreach project to be started & completed within a year. Those chosen will receive 2 to 1 matching funds up to $5000 from the foundation for money they raise and – as importantly – mentoring from foundation members. The project can be designed for a domestic or international cause. We decided on matching funds instead of grants because we want to attract inspired and self-motivated applicants. The Ambassador will be chosen through an application process (which is available online at the foundation and my website globalsocialjustice.net) and we encourage you in the audience to spread the word before the September 1st deadline.

The Ambassador must maintain an active blog or website to promote the work and allow the foundation and all of you to follow along as well. Kate and I will provide mentoring and training to accomplish this goal. This requirement is based on my own experience with my blog, which has had entries read at churches and schools and is followed by people in multiple countries. One entry was even posted online by the Rwandan Ministry of Health.

The foundation will arrange a minimum of five speaking engagements for the Ambassador to promote both the project and a powerful tool for social justice. At each of the speaking engagements, the foundation will make a micro-loan administered through Kiva.com. Almost two years ago I started my project focused on healthcare and human rights, but my research and travels have taught me how complex issues like HIV/AIDS and development are tied to healthcare, education and jobs. Microfinance is the best way to foster self-employment and empower entrepreneurs in developing countries. These loans change lives – I have seen it in Nicaragua, in rural Rwanda, and Central Thailand. The grandfather of microfinance organizations was started by Mohammed Yunus – a Bangladeshi economist who won the Noble Peace Prize in 2006 for starting Grameen Bank. This past January, the bank - which uses micro-loans to help eradicate poverty - has started its first branch in a developed country. Where? Across the river in Queens, NY. I urge everyone here to investigate how making a loan to resource poor people can change the world – again the links are on my website.

I personally look forward to expanding the Ambassador program with each year that passes. After many presentations of my work at universities, high schools and churches I have been approached by students looking for the type of opportunity that I was able to establish. All too often students lack the mentoring, funding or belief that they can make an impact – this program is a first step.

Before I leave, I would like to announce two things. The first is that I have produced an educational DVD that highlights inspiring stories of individuals and organizations from each of the countries I have researched for my work. Secondly, I am currently running social media solutions events in Lyndhurst. The topics range from staying in touch with family and friends, small business solutions and one in particular on my global HIV/AIDS work (which is May 13). The events are hands on, experiential and a chance to get all your questions answered about twitter, facebook, and social media.

Both the DVD and registering for the social media events are available through my website. Colorful information sheets on the social media events and the actual Ambassador application are located on the table where you checked in this evening.

Thank you for being apart of this night and be prepared for the Ambassdor’s presentation next year – I for one hope it will not be brief. Thank you.

Hearts and Minds

2009-04-23T14:33:00.003-04:00

"Working for Global Justice - Conference Exhibits Power of Collaboration"

Newly ordained Archbishop Timothy M. Dolan of New York put the day’s events in perspective with one line. “We’ve seen here today the head and the heart of the Church”. At yesterday’s Working for Global Justice Conference, Fordham University and Catholic Relief Services (CRS) celebrated ten years of collaboration in a way befitting to their common interests and missions.

The Catholic Church and, in particular, the Society of Jesus have long had a role in higher education. Whether it is St. Xavier’s in Mumbai, the Universidad de Centroamerica in Managua or Fordham University in the Bronx, when one walks through the campus grounds you will see Ad Majorem Dei Gloriam (AMDG) chiseled in the walls. What does it mean? Well literally it means “For the greater glory of God” but its significance is the life blood that fosters the success of both Jesuit schools and CRS.

The beauty of a Jesuit education goes far beyond commitment to academic excellence. It is cemented in the core concept of putting what you have learned into practice toward the betterment of the common good. In a previous post I commented on a lecture I heard by Jon Sobrino SJ at Boston College. Sobrino challenges Jesuit and Christian universities to produce people who have a moral obligation to the poor and a deep rooted sense of social responsibility. It is a goal that transcends religion and one that epitomizes the collaboration between Fordham’s graduate program in International Political Economy and Development (IPED) and CRS.

Students of the IPEDgraduate program put their course work into action as fellows or employees of CRS – an organization rooted in Catholic social teachings. CRS is a multinational humanitarian organization providing care and programs in countries all across the world and employs people of all traditions, religions, and creeds. Most importantly they operate with what I have come to learn is the most successful approach. They do not dictate terms. Instead there is an emphasis on conversation - taking into account cultural and religious sensitivities. Moreover, they seek partnerships with local field organizations and community leaders, which creates greater effectiveness and reach with programs. In my eyes, CRS has adopted the core teachings of Catholicism – that ours is a world tied by common humanity and shared wants, needs and dreams. Their goal is not conversion; it is development, solidarity and a shared sense of action.

The head and heart are major topics in western philosophy. The brain often symbolizes intellgence and thought while the heart passion and love. Decartes said "I think therefore I am". St. Thomas Aquinas said "Love takes up where knowledge leaves off". The majority of us hope our hearts and minds find a synergistic path that builds a vocation beyond our careers. Just as blood is the life line between our brains and hearts, what unites IPED and CRS is their shared commitment to the greater good - synergy at its finest.

A Website Worth Visiting

2009-04-13T19:38:00.002-04:00

GlobalSocialJustice.net

A Website Dedicated to Challenge, Inform and Inspire Action

Monday Launch Time

2009-04-11T09:19:00.000-04:00

I will be officially launching my new website on Monday. The website will serve as a resource tool and a central hub for my work. Featuring resources, like websites and video presentations, and different ways to get involved with social and economic justice initiatives, the objective is to challenge, inform, and inspire action.

More to come Monday

Life Project for Africa

2009-04-08T15:44:00.002-04:00

Russell Simmons Challenges the Audience to Give More Despite the Times

“It is in giving that we receive. When we give - we get.” Sitting in the lap of luxury at the Prestigious Trump National Golf Club, an estate owned by Donald Trump, Russell Simmons found the words to convey a poignant message.

Russell’s words struck at the heart of my initial unease. The country club is an exquisite example of opulence – marble bathrooms, statues galore, myriad chandeliers, and everything Trump-like you can imagine. Yet, the evening was devoted to raising funds to create access to water, access to medication, access to education and the basic necessities – the things that really matter.

The organization running the fundraiser was Life Project for Africa (LPA), a young but successful group that understands the importance of a comprehensive mission. By building and equipping a hospital and tackling issues like education and water, LPA has begun the process of changing the lives of a population of 120,000 in Tanzania. What started out of the efforts of a Catholic Church’s parishioners, led by Tanzanian priest Fr Stephen Mosha, has grown into a separate non-profit organization with the vital mantra of “together we are hope”.

The mantra is not lost of the evening’s event. It is important to note that LPA is entirely volunteer run and operated and that the event was held at the country club through the generosity of Donald Trump. In doing so LPA was able to attract a very broad and resourceful audience. Throughout the delicious hor dourves, fine foods, and dancing the gala goers were lured into the world of people struggling through everyday life in Tanzania. Most importantly they were shown how the funds generated from previous evenings had impacted the lives of people on the ground seven thousand miles away.

Russell’s parting words put the evening into perspective. He acknowledged that he and other people in the room had lost and have been losing quite a sum of money over the past 12 months. He continued saying the circumstances do not mean they should be giving less. To paraphrase - these are the times people with resources should be giving the same as they always have and even raising the bar. In many ways Simmons challenged the audience to think deeply about what they have and how they can use it to benefit others. It is a simple message with profound implications – one that LPA has grown to embody.

There is a great video on the LPA website that I recommend watching

Life Project for Africa Gala

2009-04-03T15:15:00.003-04:00

I will be attending the annual fundraising gala tonight for Life Project for Africa. The volunteer based and run organization seeks to address health and education issues in Tanzania and other parts of sub-Saharan Africa. I will be attending as a guest of Fairfield University's Department of Religious Studies.

I will follow up with a full entry on the organization this weekend. In the mean time I invite you to check out their website and watch the introductory video.

G20 Summit in England

2009-04-01T10:22:00.004-04:00

The G20 started in 1999 as a response to the financial crisis of the 1990s. It is an extension of the G8, which started in 1973 after the oil crisis. Many hail the G20 because it is a better representation of the world economy post globalization. With the additions, particularly India, China, and Brazil - "the G20 economies account for more than 80 percent of the global gross national product, about 80 percent of world trade and some two-thirds of the world population.” (Newark Star Ledger) What this summit represents is an opportunity for world leaders to shape the present and the future.

Here is a short list of questions that will flow through the G20:

1. What is the future of globalization? One finance commentator on CNN put it bluntly, “Western Capitalism is on its knees”. The free market is in free fall as countries are throwing stimulus packages and propping up teetering banks and multinational corporations.

2. “Cold feet” and protectionist policies can bring the global economy to even lower levels. Countries have already started the process of banning certain imports (China in particular) or creating tariffs. If markets start closing businesses will suffer greater losses.

3. Will the off shore banks that act as accounts to evade taxes and hide corruption be forced to open their books? This has been a hot topic issue, one that G8 members point to countries like Switzerland and Luxemburg – often throwing bricks before examining in-house. It is well documented that states, such as Delaware and Nevada, have reduced regulations and heavy incentives to attract corporate accounts.

4. What will come of the bilateral and scheduled side meetings? Not often are 20 heads of state together at a summit. Side meetings set the ground work for policy and the road ahead.

a. USA and Russia
i. Agreed today to reduce number of nuclear arms
ii. Can they find common ground with engaging Iran and what about Afghanistan?
iii. Russia is attempting to establish a “sphere of influence” over many of its former soviet satellite countries (US base closings in Kyrgyzstan and Uzbekistan). What is the diplomatic response?

b. USA and China
i. China has been financing much of how the US does business over the past decade. The stimulus package and bail outs have generated such vast amount of new money that inflation is surely to hit at some point. China has remarked that the US dollar should not be the world’s standard reserve.
ii. Trade policy, regulation, and human rights are all major issues that will be on the table when President Obama meets with Chinese President Hu Jintao

c. USA and the EU
i. Angela Merkel (Chancellor of Germany) and Nicolas Sarkozy (President of France) have both been publicly critical of the US stimulus package citing the high cost of spending. What measures come out of the summit will be interesting as all have suggested that collaborating and working together will greatly expedite the recession

Presenting at Montclair State University

2009-03-23T20:13:00.003-04:00

"Hope & Global HIV" presentation at the 3rd annual Peace Conference at Montclair State University

I would like to invite you to the 3rd annual Peace Conference at Montclair State University. I will be presenting "Hope & Global HIV" in the 4 -5:15pm time slot. It is free and open to the public. There are several presentations throughout the day ranging from the global water crisis (11:30am), the power of acupuncture (1pm), and a 2006 grammy nominated musician/yoga professor(6pm). There will also be workshops as well for free sample acupuncture and magnet treatment. (View Schedule Here)

Through photos, videos, stats, and stories I will seek to challenge, inform, and inspire. I will be focusing on my research in Rwanda - a country that has come from the depths of despair to a fragile state of hope.

Please consider yourself personally invited.

Marco Ambrosio

(This post will remain until Tuesday to promote the event)

PBS World Focus Report on Nicaragua

2009-03-19T17:26:00.002-04:00

“Anti-Americanism fades and business booms in Nicaragua”

Please view the World Focus clip here

This is indeed an interesting piece by World Focus. Instead of writing a blog I’d rather let some of the people I know comment on the piece…

Some of the points that stood out to me were:

1. Grenada
Historically Grenada is the hub of the Conservative Party (the title comes from the rich that favored direct trade with Spain and opposed “liberal” trade policies) and the city has long rumored to have greatly benefited from the Conservative governments that ran the country from 1990-2006 (particularly post Violetta Chomorro). Any pair of eyes that has been to other cities besides Grenada can easily note the differences. There are a host of US franchises, brightly painted walls, cropped landscapes, and a sheer focus on “looking the part” for tourists. These are characteristics generally not found in other cities/towns. Grenada is old wealth and lots of US ties – a mixture that affords its pristine picturesque central plaza.

2. Violence
Nicaragua is said to be the safest of the Central American countries. A strong reason is the lack of gangs and drug cartels that plague countries like Mexico, El Salvador, & Guatemala. However time and time again I have been told how crime has increased dramatically, particularly in Managua. Life has become even harder since the rise in gasoline prices and the global recession. Burglary has come to the point where taxi drivers in Managua will not go off the main roads when entering certain districts of the city. In Leon, people in the market to rent or buy a house will look first at the houses with a bank on the block (banks have an overnight watchman). Others streets have programs with each house on the block putting 100 Cordobas a month ($5) for a security man to ride his bike slowly through the streets overnight. His calling card is the whistle he blows every time he passes the street that pays (at least once per hour).

3. Business Friendly at what Cost?
Many of these corporations in the Tax Free Zone simply adopt a new name or leave before their 10-15 year tax break is finished – so the country seldomly collects on the business tax end. A larger, more complex question (which will be the focus of another blog) that comes forth in all countries is whether it is better to produce one job at a “just” wage or two jobs at a lower wage.

4. Tourism
Tourism has steadily risen because Nicaragua has many things going for it. It is culturally rich with friendly people and great music. It is naturally blessed with beaches, volcanoes, fine rum, and famous cigars (although these seeds come from Cuba). Lastly, it is practical – very cheap and three hours from Miami and Houston. One can understand the spending on tourism, but it is important to note the malls, restaurants, and hotels that have been built in the country are used only by the forgienors and the wealthiest of Nicaraguans. When 75% of the country makes less than $2.50 a day, when there are 4 doctors per 10,000 people, one would hope more funding would be placed in health clinics, schools, and food production over elaborate malls and resorts (which by now are numerous).

Central American Presidents

2009-03-16T17:29:00.010-04:00

Two Leftist Presidents Starting Off with Opposite Foot Forward

The revolutionary parties of the 1970s and 1980s have taken their fight to the polls in Central America and after over a decade of heavily conservative pro-USA governments the left is winning. It took 16 years but Nicaragua's FSLN party was voted back into power in 2006 and as of last night the FMLN party of El Salvador is getting its first chance at assuming the reins since the 1992 peace accords that ended its bitter civil war. Nicaragua and El Salvador share a difficult road toward development and a similar history of US intervention, but a brief examination of the two men elected as president depicts an importance lesson in international politics.

President Daniel Ortega of Nicaragua is a polarizer that brings a great deal of experience (or baggage) to the political table. He is often said to be a shoot first personality that praises the limelight over deft diplomacy. Ortega wears his politics on his sleeve. A speech seldom goes by that Ortega does not denounce the imperial United States and praise Hugo Chavez as the second coming – a comparison used by Ortega in several speeches. The staunchest of Sandinistas support Ortega, but many also understand that he will do anything to remain in power (see recent interview with David Frost). Historically Ortega has ostracized all contenders or challengers within the FSLN. Even the closest of political allies and highest officials are labeled traitors if they attempt to contest his leadership (see Herty 2006).

Take a short boat right across the Gulf of Fonseca and you will find the opposite of a military man – a CNN journalist. That is the personal story of Mauricio Funes the new President of El Salvador. Perhaps his past work in the media lends itself better to being politically savvy, but it can not be lost that the FMLN chose as its figure head a candidate that did not partake in the civil war. The decision displayed an air of progression. Instead of a guerilla commando like Ortega, Funes appears to understand the importance of nuanced and subtle statements. Yes Funes is “Left” but he understands that to be successful he will have to blur the line. Yes he will re-open trade with Cuba and engage with Chavez, Ortega, and Morales. Yes he will look to run socialist programs and with massive levels of poor housing, poor wages, and poor healthcare the programs are needed. Although fresh faced and new to the political game Funes has proven to start on the right footing - he welcomes relations with the US, he wishes to remain business friendly (but with more strict tax rules), and he has openly stated that his objective is to follow in the footsteps of Latin America’s most respected politician – President Lula of Brazil.

When Ortega won the election it automatically brought forth a sense of “here we go again” among many Nicaraguan locals and the international community. The Bush administration quickly released statements questioning the validity of the election win and strongly made suggestions as to what path Ortega should follow. Instead, the Obama administration has congratulated Funes on his victory and started the way for an open dialogue. The Left clearly won the election but it will remain to be seen if Funes will have the political capital to govern Center-Left a la Lula (a move President Obama is familiar with).

After reading through the NY Times, CNN, BBC, Al Jazeera, and a few Spanish news outlets, I believe this article from the AP on NPR does the best job highlighting several important issues of the Funes win.

CISAS HIV Awareness Clown Troupe

2009-03-13T11:33:00.003-04:00

This past Monday the CISAS HIV Awareness Clown Troupe put on an awareness show in the central plaza of Leon. They put on the show as a personal favor and unfortunately given the short notice only a third of the Troupe was able to attend. Furthermore, I only had a limited amount of memory left on my video camera so the Troupe did their best to squeeze the normal 45 minute show into 20 minutes. I promised to put this video up ASAP because the clowns have very very few videos of them "at work".

The show is in spanish, but much of it is self explanatory given the props. The Troupe consists of young adults who have been recipients of CISAS' education and environmental programs for over eight years. It has proven to be a great method to create strong advocates within the youthful population. In my previous trip to Nicaragua I spent a good amount of time with the Troupe and helping with shows. No matter where the Troupe starts by the end they are ringed with people. More importantly, people leave with a basic understanding of how HIV transmits, how it doesn't, and how to properly use a condom.

Without further ado I present a fraction of the CISAS HIV Awareness Clown Troupe...

I added this clip from last year of a typical show by the clowns... note the microphone, drum set, speakers, and the number of clowns

Conversations and Headlines

2009-03-10T10:05:00.001-04:00

This is a list of a few interesting tidbits I have come across in recent conversations and newspaper headlines in Nicaragua

1. Gov'ts Christmas Lights cause a Stir

This link tells of the political christmas trees that dot the capital. The interesting part is the government is paying (US$12 a day) and feeding people (three meals) to camp out, show support, and wave the flag. An article in one of the two national newspapers blasted the government's spending on the christmas lights and "the prayer-ers" calling it a waste of spending and a political ploy that only benefits Sandinistas. Articles highlighting wasted or political spending and the recent fraud in local elections is creating a rift in the country. From taxi drivers, to social workers, and Nicaraguan friends President Ortega is increasing seen as no longer exuding the principles of the Sandinistas and some have begun to call his supporters Danielistas instead.

2. President Ortega the next Putin or Chavez?

Al Jazeera's David Frost (from the famous Frost/Nixon interviews) recently interviewed President Daniel Ortega. Frost is the first person to get Ortega to speak on his personal political future. The answer is disheartening considering the democratic values the Sandinista founders professed and depicts Ortega's goal of holding on to power as long as he possibly can. There are two possible paths that have already been paved as examples - Russian's Putin who hand picked a successor and rules as the prime minister and Venezuela's Chavez who on his second attempt with in a year's time was able to remove term limits by amending the constitution through referendum vote. (According to wikipedia - the resolution passed with 54% voting in favor after 94% of the votes have been counted)

3. Walmart International

There are two supermarkets in Leon. The bigger and more popular one is called El Union. It was brought to my attention that it is owned and run by Walmart International. Some foreign items are produced in country and have a low cost compared to the average US 7-11 store - for instance Powerade is 50 cents and a large Gatorade is a dollar. Fruits are seasonal and many signs, particularly for fruit and the various coffees, promote the item as "export quality" or the name of the exporter (such as Avocados "exported by Hess").

Life after the Storm

2009-03-06T14:26:00.004-05:00

Video Journal Focuses on the Rural Community of Goyena and Education

In the aftermath of Hurrican Mitch many Nicaraguans found themselves without posessions, villages, or a place to go called home. Landslides and torrential downpours pummeled the country for ten days. One displaced community was transplanted and created the South district of Goyena. The village is nearly surrounded by cash crops and has rock and powdered dirt roads that cause traveling into the city to be a slow, arduous commute. Here in this video journal I touch upon some of the realities of Nicaraguan life and try to relate it to the three focal points of development - education, healthcare, and jobs.

This time of year is known for dust storms (as you can hear the wind gusting in the audio). Talking to the mother of the baby in the video coughing spells, asthma, and respiratory infections are recurring problems in the community. There is a health clinic in Goyena that serves both north and south districts and it is generally considered accessible (I was unable to visit). Access to education has been an enduring struggle for north Goyena, one that has been slowly addressed by the combined efforts of several players including the addition of south goyena, the women of the community and the Leon-New Haven Sister City Project

When I asked why I saw so few men the answer struck at one of the hearts of development - jobs. The only jobs are the back breaking and grueling work of the sugar cane fields. Four buses come every morning at 3am and then drop the men back at 3pm. The second largest group of men are in Costa Rica working odd jobs or construction and come home once every 2-3 months to leave money and see their families. (previous blogs have touched on migrant labor being a transporter of HIV back into the home community)

Transportation has long been a barrier to secondary education and university. Before the high school was started in February 2009, the only option was to take a bus to the city - a $3 cost not including lunch money. (This is still the case for university) The difficulty of getting into the city is more realized when we look at the numbers. The community leader, Maria Eugenia, said each houshold brings in an average of US$75 a month. However, each household has 12 people on average so per capita income per houshould is roughly 20 cents a day per person - a mind boggling figure.

The key to Nicaraguan education is that public school education is free, but students have to pass a test to get to the next level and also pay small fees along the way (blog to come on education fees soon). Besides the schools themselves the women of the community are most proud of the success rates of their students. I was repeatedly told they are passing at a much higher rate than the country - especially for rural communities. Much of this success stems from the "education reinforcement" program run by the sister city project.

After the Fairfield University students finished doing their research, I was again reminded of the welcoming and giving nature Nicaraguans posess. This time it was embodied in a thank you production the south Goyena community put on for the group visiting with the sister city project. It consisted of three folklores dances and then a play on women's rights and domestic violence. I will end with the traditional folklore dancing by four young girls of the community.

Murals of León

2009-03-04T21:17:00.002-05:00

The murals of León are famous throughout the country and much of Central America. The murals express the political, historical, social, and cultural voice of the nation. Here I explain the largest section in the country and focus particularly on one of the most famous murals in the country (pictured below) at the end of the video.

The American Dream?

2009-03-03T20:54:00.006-05:00

Microfinancing - an Opportunity and a Chance

Sunday I witnessed the American Dream. A young family – a couple with a very young toddler – operating a growing small business in their recently built house. Their recent past would show a struggling family with lower quality of life and living conditions. In a few years they have come a long way. Yet, I am in San Juan Oriente a small town near Mayasa roughly 25 minutes from the capital of Nicaragua. On my first field visit to Nicaragua I learned quickly not to label myself as an “American”. The response from my Nicaraguan friend said it all “I am American too” - perhaps it was not the only title that could easily be blurred. If we are to believe that the “American Dream” is based on the United State’s reign as the “Land of Opporunity”, then perhaps its borders are not confined to land approaching Mexico and Canda.

My travel and research has taught me that the beauty of the United States rests in its equal protection under the law, its system of checks and balances, and the sturdy foundations created in the Bill of Rights. However, if you ask Nicaraguans (and other Latin Americans) many will answer the American Dream is a combination of employment and opportunity. Nicaragua, like many developing nations, suffers from underemployment and lack of opportunity for the masses. 75% make less than $2 dollars a day. Of the children that enter primary school one-third graduate and take an average of 10 years to finish the 6 required. Jobs and education (two of the three key factors of development) have struggled for over a generation.

During the presidential elections both candidates stressed the entreprenurial spirit of the everyday American as the backbone of the country – we have heard even more given the slow flow of credit from the large banks that have hurt small business, entreprenuers, and indidividuals seeking loans. In Nicaragua, like countries all over the world, microfinance is providing the ability to reach the American Dream. Small loans to small business, start up funds for an idea, and access to capital that previously was unavailble or non existant. This young family has prospered (in relative turns) in the past two years given their work with Nitlapan - a microfinance organization started at the Universidad de Centroamerica ( Jesuit run).

The work of Nitlapan and it’s effect on a a group of artisan families in the Mayasa state has been documented and aided by the consulting of Fairfield Unversity – mainly through the efforts of Professor Winston Tellis and student projects. Recently Tellis, a information system professor and development guru, had a group from Fairfield University shoot a short documentary that captures the who, why, and how, but most importantly it captures the what is happening and how it has affected the individuals seeking the credit. (view video clip here)

Microfinance initatives have sky rocketed in the last five years. Websites like Kiva.org have created portals and channels for individuals to make a direct difference in the lives of others. It must be stated that microfinance organizations are not all cut from the same cloth (think average Joe vs a top flight athelete). Some charge high fees to make up for capped interest rates (remember it is a business not charity) and there are even examples of unethical methods of collecting debts owed. However, when run properly microfinance has the ability to provide captial, opportunity, and what many people in the Western Hermisphere believe is the “American Dream”.

Sunday I witnessed the American Dream and I was in San Juan Oriente, Nicaragua.

Field Notes from Nicaragua

2009-03-02T16:20:00.000-05:00

(I have not had time to properly put together an entry but these are some of my field notes. I will have a blog on a microfinance initiative up tomorrow with photos)

1. Gas has not lowered like in the United Sates - the price is around $3 a gallon. (considering 75% of the country makes less than $2 a day - it is quite high)

2. Many people are scared that the recession in the United States is going to greatly affect the flow of remittances (family members sending money home) flowing into the country (a figure that is estimated as 12% of the GDP)

3. The group of college students doing research had a presentation from a former Maryknoll priest who highlighted the current political climate in the country and the current events. It appears that the latest rounds of municipal elections were widely fraudulent and caused quite the stir in the population. The votes (which are done through tabling under the watch of an elected official from each party are supposed to be posted in public via the internet and voting cites) were called after reporting from the major Sandinista regions were in. However, other parties have amassed the carbon copies (signed by each of party observer) and with 97% reporting they show different results for certain seats.

4. Crime, already a problem, has sharply risen in the capital. I spoke with taxi drivers who do not drive into the poorer districts of the city for fear of robbery. Others will pay to take a taxi for short rides as to not be walking after the sun goes down in Managua.

5. Every Nicaraguan mentioned how over the last year things have gotten slowly worse – less work and high prices are leading to even more difficult living conditions.

6. People have a very positive view of President Obama – the most common responses are - intelligent, honest, and ¨not Bush¨. It seems many people in my circle (friends and social workers) know about the difficult situation occurring in the United States. The news and newspapers (widely read) have been running stories of the recessions and banking troubles.

Nicaragua part Duex: Follow Ups, Researching, and Connecting

2009-02-27T10:25:00.002-05:00

Follow Ups

I will be spending time at CISAS (the organization featured in the manuscript and DVD) and following up with the HIV Self Help Group and the individuals I interviewed last year. (See photo album on side bar for Nicaragua)

Researching

Besides updating my research, I will be paying particular attention to the local perspective of Obama and the economic crisis. Also, what effects the locals have seen since the economic downturn (reduced numbers of people leaving, less money being sent home, people returning etc). Lastly, I will be meeting with a microfinance center that works with Kiva to learn more about how they operate, the relationship with the organization, and to see if there are any Kiva fellows around to interview.

Connecting

1. I will be helping a group of college students from Fairfield University with their field research during the week. There are two students researching women’s roles and rights post Sandinista revolution and another comparing the HIV incidence rates between Honduras and Nicaragua. I have set up meetings and interviews as resources for the students. I will be joining the group from time to time for field visits, group presentations, and introducing them to the famous Sandinista music and spirit of León.

2. I will be blogging, facebooking, and tweeting (under ID - Marcoambrosio) everyday while in country. It will be the best way for anyone to ask questions, comment, or contact me. I will also be traveling for the first time with the much buzzed and raved about Flip Video Camera . This will allow me to post videos of cultural notes, historical notes, and advocacy events of CISAS.

Make sure you visit because until March 10th there will be something new everyday (barring any electronic or technical misfortunes)

Emailed Question

2009-02-23T15:28:00.002-05:00

I recently received an email from a senior sociology major from Southwestern University in Georgetown, TX. This is an exceprt from her email. "I would love to know more about your research and about your experiences. What interested you in doing such research and what methods did you employ? It seems a bit incredible to have conducted so many interviews across such distance. I look forward to hearing from you and about your experiences." - I decided to post my response.

Hello Tristine,

Thanks for the email. As you can imagine the answer is quite long. But in regards to methods and interviewing - I had separate meetings with an HIV/AIDS sociologist from Fairfield University, two infectious disease doctors (one of which ran a clinic in East Africa), and lastly a few phone conversations with a journalist from the Wall St. Journal. The sociologist helped me with setting up the depth and scope of the interviews, the doctors with research questions they thought would be relevant, and then the journalist taught me the "rules and standards of the trade". Each person looked over the consent forms that I created to make sure both the research and interviewing was done with expressed written consent given the personal nature of the work. I am happy to report that many interviewees have consented to use of identifiable pictures which provides a personal connection for the reader. It is the individuals I have met and interviewed that make my work special. Their voices, pictures, and stories are challenging and powerful.

Much of my questions stemmed from my personal experience interning in Nicaragua during college at CISAS and my work with FACEAIDS - a student run initiative to combat HIV/AIDS in Africa and conduct advocacy/fundraising in the US. They do a marvelous job at keeping students informed with the latest studies. They also make sure the human component and socio-political underpinning reach their audience.

I would be happy to answer any questions you may have or share any experience with the research. It would appear a daunting task to conduct research in these different regions of the world but I have worked diligently to personally raise the funds, connect with the proper organizations, and count on the support of family, friends, and donors to continue my work. I am particularly indebted to the Emily C. Specchio Foundation who opened an account for my fundraising efforts and the Jesuit community. Many of my stays abroad have been through the vast Jesuit network.

Lastly in regard to the project. I invite you to use the photo bar on the right to locate past entries of my time in each country. Also I am proud to have produced an educational and inspiring DVD that features individuals and organizations I have covered around the world. Much of the DVD is comprised of my own photos, videos, and interviews. So far it has been purchased by people across the country (CA, MN, NJ, & CT).

Thank you for the email. I look forward to continuing the conversation.

Marco Ambrosio

“HOPE & GLOBAL HIV” DVD

2009-02-11T12:50:00.003-05:00

Educational and Inspiring DVD Seeks to Promote Hope in the Global HIV Struggle

Ever since I started traveling the emails and the Facebook messages have come in from people wanting to know more about the country I was in, the organization I was covering, or a story that I found profound. They wanted more than the writings and photos on the blog. They wanted a deeper connection. I thought what can I do? The not so secret answer is the “Hope & Global HIV” DVD.

I produced the DVD through the videos, photos, and interviews I conducted while in country. It will not win a Hi-Definition award for best documentary but I promise it will intrigue, inform and move a viewer. It has two objectives. The first is to educatethe audience about global HIV/AIDS but to also provide interesting cultural and historical notes on each country. It is also full of links and country specific music providing depth and launching sites for independent googling later. The second is to inspire by highlighting the story of an organization or an individual that is building hope through action. The Ruths of California, Marias of Nicaragua, and Daxas of India will provide poignant examples that we must never underestimate the power of the individual to greatly impact their community.

Each of the five countries has there own chapter in the DVD and I have shown the Rwanda, Nicaragua, and San Francisco chapters at presentations in Massachusetts, New York, New Jersey, California, and Connecticut to the exact reviews I hoped for. “Wow, I didn’t know that” or “Powerful”. I have already sold a third of the first production batch and I am immensely proud of the reviews and feedback from the DVD. Anything that both high school teenagers and adults find intriguing and powerful is a feat by itself!

I have personally raised all funds for my research and work. Much of it has been channeled through the Emily C. Specchio Foundation to ensure tax-deductible donations. The DVD is available for $20 and can be purchased via credit card on the Right Side Bar or if you wish to make it tax-deductible then it can be purchased via a donation to the foundation that clearly marks “Ambrosio HIV Project”. Thank you for the continued support!

Speaking Updates

2009-02-05T12:08:00.002-05:00

Future
I am pleased to announce I will be guest lecturing at Fairfield University twice in February.

Feb 17 – Course: Nursing
Topic: Researching in Nicaragua: Expectations and Cultural Sensitivity

Feb 18 – Course: Justice in the Developing World: Nicaragua
Topic – Healthcare in Nicaragua: Role of Non-Governmental Orgs.

Past
Last week I presented “Faith in Action” to the Senior Class at Regis High School in NYC. I was very impressed with the service learning and service opportunities afforded to students at the school. I am currently working on a blog entry regarding my experience at Regis. The entry is a reflective piece stemming from a question I routinely get following a presentation - How did this all first start?

I've added the Twitter feature to the side bar and invite people to follow me on the newest rage in social media. My twitter name is Marcoambrosio

Science and Rice – A Mixture Saving Lives

2009-02-02T14:45:00.004-05:00

Genetic Engineering a Valued Partner in Fighting Hunger, Famine, and Death

During yesterday’s Super Bowl a commercial stated 1 in 3 children are overweight in the United States. Almost immediately I thought of the countless children I met in the streets of Nicaragua or villages in India who had red patches in their hair – a universal mark of protein deficiency. It is said that nearly half of world’s population depends on rice as a staple food. Rice equals life for an alarming percentage of that half. It is at times one of the few barriers between life and starvation or starvation and death. If so many people, including the worlds poorest consume rice then how can we make it go further and do more? Scientists, particularly geneticists, have moved into the forefront to answering these questions.

Applying advances in science to real life use is sometimes controversial. Say the word genetic engineering and cloned sheep may jump to mind, but science when used for the greater good (admittedly a matter of perspective and relativity) can wind up to be a match made in heaven. If countless millions of men, women, and children suffer from malnutrition, chronic illnesses, and die due to lack of access to food, then should not science be used to answer the call?

One breakthrough response has been “golden rice” – rice that has been genetically altered to contain (express in genetic terms) beta-carotene. The beta-carotene provides vitamin A to the eater. According to the World Health Organization, vitamin A deficiency is responsible for 250,000 to 500,000 children going blind a year; half of which die within a year as a result of their blindness. The project’s objective is to provide a day’s worth of vitamin A in rice rich societies through enhancing what they already have available. It is worth visiting the Golden Rice Project to read about the how, why, and what is next of the work.

In 2008 soaring rice prices, due to higher energy costs (think fertilizers and transportation costs) and failed crop yields (both droughts and floods), left many developing countries and international food programs in dangerous and life threatening scenarios. One hopes the tipping point has been reached for renewable energy sources but one auspicious answer to the failing crop yields is “flood-tolerant rice”. In this case, geneticists have been attempting to alter genes to increase resistance of rice succumbing to flooding from the normal three days to up to seventeen. Scientists say flooding is responsible for ruining an “estimated 4 million tons of rich each year; enough to feed 30 million people”. Targeting flood prone sectors and introducing the genetically altered rice could present a viable solution for increasing access to a vital basic staple.

Perhaps the biggest hurdle in both Golden Rice and flood tolerant rice is passing the taste test of the locals and yield productivity measures of the farmers. Both projects took several years going through testing and trials because as with any gene altering or biotechnological project substantial testing and quality assurance is critical in both protecting the consumer and the local ecosystem. Unfortunately at times confidence wanes when programs are driven by profits and not social and corporate responsibility. It seems daily we are reminded of irresponsible acts of profit driven business executives or FDA announcements of salmonella outbreaks in tomatoes and peanut butter. Finally, one can not forget the viral video on Youtube of diseased cattle in the meat packing line. It makes understanding the delay and the lengthy debates regarding biotechnology understandable, but the future of hunger and malnourishment changes with each potential experiment.

Whether it was with red beans in Nicaragua (known as Gallo Pinto), curry and cilantro in India, plain in Rwanda, or as a bed for other foods to be served on in Thailand, the ubiquity, demand, and importance of rice left quite the impression on me. Food plays such a vital role in maintaining health and a dignified level of life that my experiences made realizing the breakthrough potential of these discoveries an a-ah moment; one where it seemed to make clear sense. The advances of science utilized to address such basic global and human needs, particularly food and health remind me of a quote that summarizes much of my outlook on science that has stayed with me throughout my education: “Talent is a loan from God for relief of man’s estate”.

Something Old, Something New, & Something Yet to Be Determined

2009-01-19T18:17:00.004-05:00

Reflection on the Legacy of MLK Jr, Former President Bush, & President Obama

Dr. King’s proud smile is all I can think about. On the heels of Martin Luther King Jr day, I can only wait in celebratory anticipation as our country’s highest honor will soon be filled by an American of color, but more importantly of high intellect and character. In landslide fashion it would appear that the dream of Dr. King has broken through as "the content of a person’s character outweighed the color of their skin". Yet my mind harkens back to the concept of legacy. Much has already been written about soon-former President Bush and President elect Obama but a legacy forms many years after the dust has settled.

I spent the morning rereading a few of Dr. King’s speeches. In them, as countless radio and television shows have documented today, a reader finds a voice of social consciousness – an immobile moral compass with a compassionate heart and prophetic calling to speak truth to power regardless of the consequences. Dr. King is etched in the annals of US history as a champion of the civil rights movement. A man who used non violent civil disobedience, encouraged social activism, and symbolizes the greatness of the American spirit. (Nonetheless after much controversy it was not until 2000 that MLK Jr Day was officially observed in all 50 states)

Often overlooked is the outspoken Dr. King - the anti-war advocate who sought to bridge the civil rights and peace movements in the mid 1960s. Often forgotten is the backlash Dr King received from the media and cherished supporters like the NAACP. In "Beyond Vietnam: A Time to Break Silence", Dr. King stressed the weight of his Nobel Prize as one of the catalysts of his broader mission. In that address at the historic and storied Riverside Church in NYC, Dr. King’s full arsenal is on display as he inspires and challenges the congregation to think critically and compassionately. What does he use as his thought provoking device? It is none other than Vietnam’s history and the plight of her people. This too is Dr. King’s legacy. However King’s words and mission did not find much support because reconciling the truth is often a road too hard for many.

As President Bush affixes “former” to his title, writers and commentators have already begun the molding of his legacy. President Bush will undoubtedly be remembered for the catastrophe of Katrina, the 9/11 terrorist attack and the response (War on Terror, Patriot Acts, Gitmo, and Abu Ghairb all remain prominent), and the economic meltdown under his eight year watch, but there are meaningful positives that at times go unnoticed. The measuring stick for some will be that no terror attacks took place on US soil. Others, like Bill Frist(R), will point to the unprecedented and bold President’s Emergency Plan For AIDS Relief (PEPFAR) programming that has given hope and life to millions fighting HIV/AIDS in Africa and the Caribbean. I have personally witnessed and documented in this blog how PEPFAR funds have lifted entire communities and made the US a popular country in sub-Saharan Africa. Lastly it could be argued that Former President Bush helped pave the way for equal opportunity and a black President. In Colin Powell, Condi Rice, and Alberto Gonzales, Bush appointed citizens of color and different ethnicities to the forefront of his cabinet and the highest leadership roles in the country. He provided the younger generation with the belief that mobility is possible and the older generation with a more representative face of the country.

Some people may be quick to think the inauguration closes the book on the civil rights movement, but undoubtedly Dr. King would only think a chapter has closed. As President Obama assumes command of the Executive Branch of government, all that is needed is a glance into the failng inner city school systems, the minority filled prisons, and the heavily disproportinate HIV/AIDS statistics to understand Dr. King’s words would ring true. As history has shown and with many of Bush’s biggest initiatives unfinished, it will be at least a generation until his legacy is near complete. Yet another legacy, joined by the smile of a great American from above, is in the meantime off to an auspicious beginning.

Looking Back, Looking Forward

2008-12-31T15:28:00.004-05:00

A New Year's Reflection, Resolution, and Prayer

The New Year gives a person time to reflect on their past and perhaps set a plan for their future. In that light…

I would like to thank the many people who have made my work possible. Ranging from family to peers, priests to government officials to former teachers, and Indian to Rwandan, each has played their own vital role of support. Over the year I researched for 5 weeks at a time in Thailand, India, and Rwanda. Each location with faces, names, stories, and experiences that taught me the meaning of compassion, fellowship, and development. My tribute to them is witnessed in all of my presentations and the “Hope & Global HIV” DVD. Too often against seemingly endless odds these people, their stories, work, and struggle, go undocumented or unnoticed. They have taught me the power of the individual to impact their community and create change. Whether acting as individuals or in concert with others, we must never underestimate the power of the individual.

My New Years resolution is already underway. I am in the process of developing a self sustaining and reproducible model that links local communities to ones I have covered throughout this last year. A full post will be dedicated to the overview and logistics of the project in the coming month.

I will leave with this Christian prayer that I have said numerous times over this past year. In each country across language and cultural barriers, I found myself hoping that I was achieving these words. For it is in them that I found much of my motivation and direction. The words espouse a deep sense of personal responsibility and call to action by making the individual the channel, the enabler. With this in mind I wish all a Happy New Year. One in which they can embrace the truth that we all have the power to make a difference.

Prayer of St. Francis
Lord, make me an instrument of Your Peace.
Where there is hatred, let me sow love;
Where there is injury, pardon;
Where there is doubt, faith;
Where there is despair, hope;
Where there is darkness, light;
And where there is sadness, joy.
O, Divine Master,
Grant that I may not so much seek
To be consoled as to console;
To be understood as to understand;
To be loved as to love;
For it is in giving that we receive;
It is in pardoning that we are pardoned;
And it is in dying that we are born to eternal life.

Coming Full Circle

2008-12-05T17:22:00.002-05:00

Keynote at Fairfield University Highlights Hope in Action in Global HIV/AIDS Struggle

It is a presentation I have given three times in the last two weeks. The statistics, key points, and stories flow easily as they come from the research and work I have done over the past year. The names and faces forever planted in the fields of my mind. However, this time it is different. This is my alma mater and I am speaking as the keynote for AIDS Awareness week and as the inaugural speaker for the MLK Jr. Lecture Program. The cozy and tech savvy room is full of students, friends, and former professors.

The goal of the presentation is two-fold and centers on the broader concept of hope. To begin we must draw attention to two key factors that fall into the category of grabbing the attention of the audience. The statistics that come out of the global HIV/AIDS pandemic are more than alarming. They are mind numbing: 33 million infected and 25 million deaths. And if we look at who is getting infected it is frightening – the voiceless, the marginalized, married women and young generations. But attention has two sides. We must remember the long way from which the story started. Although treatment is still not a reality for the majority of people infected, over the past five years people put on treatment in sub-Saharan Africa has increased 40 times over. We are making progress, but it is not time to rest as for every TWO people of treatment FIVE are becoming infected. In every presentation the balance has to be kept in check to instill the second goal – inspiration.

It is usually a person, sometimes an organization, but always people looking to make a difference. It is the tangible sign that action can overcome and inaction is unjust. At each speech I show a clip from the DVD I have produced to give the audience an example of both real life people living with HIV/AIDS and people making a difference in their own way. The reoccurring theme that comes through my voice and the DVD is the power of the individual to impact their community.

This night I focused on the movement already started in Rwanda. A story underreported and seldom told. A movement that sees a government working closely with international and domestic organizations and US PEPFAR officials. My voice speaks to the witness of Partners in Health’s (PIH) work providing healthcare to hundreds of thousands in rural Rwanda who before had no options. It also highlights the combined efforts of over 190 different FACEAIDS chapters across the US to raise funds for PIH and awareness of HIV/AIDS in sub-Saharan Africa.

The presentation should show that hope is tangible but requires action. I want to inspire all people to see HIV/AIDS as a social justice issue where all can make a noted difference. I want to call attention to the issues, engender a link for advocacy, and inspire action. All people want to make a difference sometimes it is only the how, the confidence, or the first push that is needed.

Note:
The educational and motivational DVD is compiled mostly of my own photos and highlights stories of individuals and organizations creating hope in their communities. It is meant to challenge and inspire a viewer. Follow yellow texted directions on right panel to learn how to get a copy.

World AIDS Day

2008-12-01T10:50:00.007-05:00

I will write an entry about World AIDS Day after my presentation at Fairfield University this Wednesday. Details of the event can be found here on the University’s website. The Wednesday night keynote will be part of the University's AIDS Awareness Week. I will be sharing from my experiences abroad and focusing on the messages and tangible stories of hope in Rwanda. It is open to the public.

I have accepted an invitation to be on the David Smith radio show. It can be heard via the internet on this website < www.wicc600.com > or on AM600 if you are in the Connecticut area. It will be on Wednesday from 1:30pm to 2pm.

A very well written and insightful article commemorating the 20th anniversary of World AIDS Day can be viewed on CNN.com. It is titled "Much Done: Much to Do" and is by Dr. Anthony S Fauci – Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. It highlights the significant advances that have been made over this time but calls attention to the continuing struggle.

World AIDS Day is a time to remember, to reflect, and to pray. I hope you will join me in this day's calling.

After Note:

I have produced an educational and motivational DVD documenting stories of hope meant to inspire and challenge. The DVD is mostly comprised of my photos from each location and stories of individuals and organizations I have met along the way. Donate $20 or over to the Emily C Specchio Foundation, email me your address , and I will mail you a copy of the DVD. Donation is tax deductible less amount DVD cost to produce. These funds will support my work and the launch of a 2nd project called "Attention, Advocacy, and Action".

Power of a Pin

2008-11-13T20:23:00.010-05:00

FACEAIDS Pin Changing Lives and Inspiring Students

130 plastic beads and a safety pin are breaking barriers in rural Rwanda and inspiring students from across the country that they can make a noted difference. It is a simple beaded pin, but the message and power behind it is inspiring. Wherever and whenever I speak – the pin is on my lapel because this pin is changing lives in rural Rwanda and campuses across the United States.

As individuals we can feel powerless by seemingly overwhelming or daunting issues. Half the world's population live on less than $2.50 a day. Stats like this serve to inform us and even command our attention; yet, they often are beyond our comprehension. $2.50 – no matter how managed - can not provide sufficient food, basic healthcare, adequate housing, and educational expenses to lead a dignified life. In the face of such glaring numbers I try to stay grounded.

The truth is people have a great heart. They want to help or make a difference, but the difficultly is often the how. Kiva.org, Partners in Health, and FACEAIDS all provide the elusive answer. Muhammad Yunus (the father of microfinance) and Michael Milken (the convicted wall street felon turned philanthropist) recently shared on Charlie Rose the 3 issues that they believe are key to eradicating poverty and giving all people an opportunity to lead a dignified life – healthcare, education, and a job.

Breaking down each of these necessities could fill volumes – instead I will focus on a woman I met in eastern rural Rwanda. She, like many in the east African country, has lost family members to the 1994 genocide and stands to lose more from HIV/AIDS. A few years ago a doctor – let alone HIV treatment - was not available near her village. Partners in Health has since built a clinic and now a full hospital – healthcare has become a reality for her. She made a living making and selling banana beer but struggled with the labor of the process and could not make enough to provide for her family the way she would want. She is now part of the FACEAIDS pinmaking cooperative. She takes great pride in her work. When I asked her what she does with the extra income her face lit up. FACEAIDS makes her save a portion so she will be able to purchase a goat. A goat that will provide milk in a land where protein is a necessary staple that many cannot afford. She wants what all parents want – opportunity for her children. Her FACEAIDS work provides the extra funds to afford the school fees to give her eldest son a chance to break the cycle of poverty. Healthcare, education, and a job gave this family the chance for a better life.

For the last three years every Fall at Stanford University sees a wave of college students from across the country come together on a mission centered on these pins. It is the National FACEAIDS Conference where students will brainstorm new ideas to increase advocacy and raise funds for Partners in Health’s work in rural Rwanda. Much of the focus will be on social justice, human rights, and development issues, but an underlying theme will be the power of a pin.

A Speech for the History Books

2008-11-08T09:44:00.002-05:00

Obama's Victory Speech - Full Text

Hello, Chicago. If there is anyone out there who still doubts that America is a place where all things are possible, who still wonders if the dream of our founders is alive in our time, who still questions the power of our democracy, tonight is your answer.

It's the answer told by lines that stretched around schools and churches in numbers this nation has never seen, by people who waited three hours and four hours, many for the first time in their lives, because they believed that this time must be different, that their voices could be that difference.

It's the answer spoken by young and old, rich and poor, Democrat and Republican, black, white, Hispanic, Asian, Native American, gay, straight, disabled and not disabled. Americans who sent a message to the world that we have never been just a collection of individuals or a collection of red states and blue states. We are, and always will be, the United States of America.

It's the answer that led those who've been told for so long by so many to be cynical and fearful and doubtful about what we can achieve to put their hands on the arc of history and bend it once more toward the hope of a better day.

It's been a long time coming, but tonight, because of what we did on this date in this election at this defining moment change has come to America.

A little bit earlier this evening, I received an extraordinarily gracious call from Senator McCain. Senator McCain fought long and hard in this campaign. And he's fought even longer and harder for the country that he loves. He has endured sacrifices for America that most of us cannot begin to imagine. We are better off for the service rendered by this brave and selfless leader.

I congratulate him; I congratulate Governor Palin for all that they've achieved. And I look forward to working with them to renew this nation's promise in the months ahead.

I want to thank my partner in this journey, a man who campaigned from his heart, and spoke for the men and women he grew up with on the streets of Scranton ... and rode with on the train home to Delaware, the vice president-elect of the United States, Joe Biden.

And I would not be standing here tonight without the unyielding support of my best friend for the last 16 years ... the rock of our family, the love of my life, the nation's next first lady ... Michelle Obama. Sasha and Malia ... I love you both more than you can imagine. And you have earned the new puppy that's coming with us ...to the new White House.

And while she's no longer with us, I know my grandmother's watching, along with the family that made me who I am. I miss them tonight. I know that my debt to them is beyond measure.

To my sister Maya, my sister Alma, all my other brothers and sisters, thank you so much for all the support that you've given me. I am grateful to them.

And to my campaign manager, David Plouffe ... the unsung hero of this campaign, who built the best _ the best political campaign, I think, in the history of the United States of America.

To my chief strategist David Axelrod ... who's been a partner with me every step of the way. To the best campaign team ever assembled in the history of politics ... you made this happen, and I am forever grateful for what you've sacrificed to get it done.

But above all, I will never forget who this victory truly belongs to. It belongs to you. It belongs to you.

I was never the likeliest candidate for this office. We didn't start with much money or many endorsements. Our campaign was not hatched in the halls of Washington. It began in the backyards of Des Moines and the living rooms of Concord and the front porches of Charleston.

It was built by working men and women who dug into what little savings they had to give $5 and $10 and $20 to the cause. It grew strength from the young people who rejected the myth of their generation's apathy ... who left their homes and their families for jobs that offered little pay and less sleep; from the not-so-young people who braved the bitter cold and scorching heat to knock on the doors of perfect strangers; from the millions of Americans who volunteered, and organized, and proved that more than two centuries later, a government of the people, by the people and for the people has not perished from this Earth. This is your victory.

"I know you didn't do this just to win an election and I know you didn't do it for me. You did it because you understand the enormity of the task that lies ahead. For even as we celebrate tonight, we know the challenges that tomorrow will bring are the greatest of our lifetime, two wars, a planet in peril, the worst financial crisis in a century.

"Even as we stand here tonight, we know there are brave Americans waking up in the deserts of Iraq and the mountains of Afghanistan to risk their lives for us. There are mothers and fathers who will lie awake after their children fall asleep and wonder how they'll make the mortgage, or pay their doctor's bills, or save enough for college. There is new energy to harness and new jobs to be created; new schools to build and threats to meet and alliances to repair.

The road ahead will be long. Our climb will be steep. We may not get there in one year or even in one term. But, America, I have never been more hopeful than I am tonight that we will get there. I promise you, we as a people will get there.

AUDIENCE: Yes we can! Yes we can! Yes we can!

OBAMA : There will be setbacks and false starts. There are many who won't agree with every decision or policy I make as president. And we know the government can't solve every problem. But I will always be honest with you about the challenges we face. I will listen to you, especially when we disagree. And, above all, I will ask you to join in the work of remaking this nation, the only way it's been done in America for 221 years _ block by block, brick by brick, calloused hand by calloused hand.

What began 21 months ago in the depths of winter cannot end on this autumn night. This victory alone is not the change we seek. It is only the chance for us to make that change. And that cannot happen if we go back to the way things were. It can't happen without you, without a new spirit of service, a new spirit of sacrifice.

So let us summon a new spirit of patriotism, of responsibility, where each of us resolves to pitch in and work harder and look after not only ourselves but each other.

Let us remember that, if this financial crisis taught us anything, it's that we cannot have a thriving Wall Street while Main Street suffers. In this country, we rise or fall as one nation, as one people. Let's resist the temptation to fall back on the same partisanship and pettiness and immaturity that has poisoned our politics for so long.

Let's remember that it was a man from this state who first carried the banner of the Republican Party to the White House, a party founded on the values of self-reliance and individual liberty and national unity. Those are values that we all share. And while the Democratic Party has won a great victory tonight, we do so with a measure of humility and determination to heal the divides that have held back our progress.

As Lincoln said to a nation far more divided than ours, we are not enemies but friends. Though passion may have strained, it must not break our bonds of affection.

And to those Americans whose support I have yet to earn, I may not have won your vote tonight, but I hear your voices. I need your help. And I will be your president, too.

And to all those watching tonight from beyond our shores, from parliaments and palaces, to those who are huddled around radios in the forgotten corners of the world, our stories are singular, but our destiny is shared, and a new dawn of American leadership is at hand.

To those who would tear the world down: We will defeat you. To those who seek peace and security: We support you. And to all those who have wondered if America's beacon still burns as bright: Tonight we proved once more that the true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals: democracy, liberty, opportunity and unyielding hope.

For that's the true genius of America: that America can change. Our union can be perfected. What we've already achieved gives us hope for what we can and must achieve tomorrow.

This election had many firsts and many stories that will be told for generations. But one that's on my mind tonight's about a woman who cast her ballot in Atlanta. She's a lot like the millions of others who stood in line to make their voice heard in this election except for one thing: Ann Nixon Cooper is 106 years old.

She was born just a generation past slavery; a time when there were no cars on the road or planes in the sky; when someone like her couldn't vote for two reasons _ because she was a woman and because of the color of her skin.

And tonight, I think about all that she's seen throughout her century in America _ the heartache and the hope; the struggle and the progress; the times we were told that we can't, and the people who pressed on with that American creed: Yes we can.

At a time when women's voices were silenced and their hopes dismissed, she lived to see them stand up and speak out and reach for the ballot. Yes we can.

When there was despair in the dust bowl and depression across the land, she saw a nation conquer fear itself with a New Deal, new jobs, a new sense of common purpose. Yes we can.

AUDIENCE : Yes we can.

OBAMA: When the bombs fell on our harbor and tyranny threatened the world, she was there to witness a generation rise to greatness and a democracy was saved. Yes we can.

AUDIENCE: Yes we can.

OBAMA: She was there for the buses in Montgomery, the hoses in Birmingham, a bridge in Selma, and a preacher from Atlanta who told a people that We Shall Overcome. Yes we can.

AUDIENCE: Yes we can.

OBAMA: A man touched down on the moon, a wall came down in Berlin, a world was connected by our own science and imagination. And this year, in this election, she touched her finger to a screen, and cast her vote, because after 106 years in America, through the best of times and the darkest of hours, she knows how America can change. Yes we can.

AUDIENCE: Yes we can.

OBAMA : America, we have come so far. We have seen so much. But there is so much more to do. So tonight, let us ask ourselves _ if our children should live to see the next century; if my daughters should be so lucky to live as long as Ann Nixon Cooper, what change will they see? What progress will we have made?

This is our chance to answer that call. This is our moment. This is our time, to put our people back to work and open doors of opportunity for our kids; to restore prosperity and promote the cause of peace; to reclaim the American dream and reaffirm that fundamental truth, that, out of many, we are one; that while we breathe, we hope. And where we are met with cynicism and doubts and those who tell us that we can't, we will respond with that timeless creed that sums up the spirit of a people: Yes, we can.

Thank you. God bless you. And may God bless the United States of America.

The Movement

2008-10-18T14:33:00.003-04:00

Student Global Health Conference Inspires Advocacy and Action

When citizens think about movements they generally recall the women’s suffrage, civil rights, and anti war movements. However, the world has shrunken with the advent of the internet, increased travel, and evermore accessible telecommunications. This has created the ability for larger movements but also allows for some to get lost in the fray. Facebook causes, mass emails, blogs, and twitters have created an overwhelming abundance of information and myriad issues to track. At times what is missing is the commitment to action – arguably the most important step.

It was in this spirit of expanding upon a movement that the Students for Global Health Conference (SGHC) achieved its objectives – increase attention, focus advocacy efforts, and commit to action. Held at Boston University School of Public Health the day after the Partners in Health (PIH) symposium, the conference offered a chance to both students and young professionals to network, learn, and be inspired at what can be achieved together.

The conference began as an idea by a group of PIH interns to run after their positions ended. The small and dedicated group planned, programmed, and ran the conference as students and young professionals volunteering for a cause they believe in. With over 200 students pre-registered and speakers from PIH, Harvard’s FXB Center for Health and Human Rights, and Physicians for Human Rights the days event were beneficial to all in attendance.

The final piece of the conference saw small groups of students coming together based on issues and producing tangible commitments in the given field. My group (Women’s Health Equity) chose to raise funds and awareness for kiva.org (a highly effective and popular microfinance organization) and start a letter campaign to promote full appropriations for the PEPFAR reauthorization bill. Eleven students from seven schools can hopefully create a network that achieves what I call the AAA: attention, advocacy, and action.

Curtis Peterson, the conference leader, had much to smile about at the end. The conference proved yet again to him that the commitment and investment from people is out there. Movements require masses of people from all walks of life working in concert toward a common cause and goal. What I might add is that we are in the midst of the next great movement – rights based healthcare – and weekends like these have helped and continue to help rally different paths to the same goal.

If you would like to join our group (SWEET= Students for Women's Economic Equity Today) on Kiva.org, make a small microfinance loan, or simply view our goal - click here. Thank you

Addressing the Problems of Poverty

2008-10-08T11:50:00.003-04:00

Partners in Health’s 15th annual Thomas J White Symposium

In the storied walls of Harvard’s Memorial Hall, Partners in Health (PIH) held their 15th annual Thomas J. White symposium and reaffirmed their commitment as an organization driven by a preferential option for the poor – a phrase and meaning developed by the Jesuit Gustavo Gutierrez during the liberation theology movement in Peru. From the first speaker to the last, the day’s agenda was clear – clarify the mission and build on the movement.

The founding of PIH and the story of their early work is best illustrated in Tracy Kidder’s Mountains Beyond Mountains, but at this symposium the characters leaped off the pages utilizing humor, sincerity, and a clear rationale that runs throughout the organization’s work. Ophelia Dahl, daughter of famed writer Roald and executive director of PIH, started by stating what may not be obvious to an outsider. Although PIH is internationally renowned for their HIV work – they are not an HIV/AIDS organization. The title would be limiting because the heart of their work is based on addressing the problems of the poor. These problems, which certainly include HIV/AIDS, are rooted in economic and social human rights violations. Is it a coincidence that people without access to clean water, adequate shelter, or jobs (let alone healthcare) are the ones most affected by the major diseases of our world? The PIH answer is simply no.

PIH has long held a rights based approach to healthcare that attempts to correct the root causes, such as poor housing or access, while addressing the symptoms, like malnutrition or HIV infection. At their core they are community builders and focus their attention and resources on the two pillars of any society – health and education. Fundamentally they profess the commonalities between all people and dispel “the accident of where we are born” should dictate who suffers, who is oppressed, and who dies.

On paper what PIH has accomplished is clear. They have established centers in 7 countries in 5 global regions. They see millions of impoverished or marginalized people as patients, and they have taught, trained, and employed the locals to effectively assume the majority of the operational tasks. However, a similarly vital success has been the overall movement – a word heavily emphasized throughout the speakers. PIH’s revolutionary approach changed the mentality that high level healthcare could not be achieved in poor settings. They are, dare I say, true mavericks. The ripple effect was best portrayed in the event’s four keynotes. The first two were former refugees who are now doctors. They have both returned to their homelands to start similar rights and development based clinics, Tiyatien Health in Liberia and Village Health Works in Burundi. The other two keynote speakers represented the student movement. First was Dave Ryan, the president of FACEAIDS (an advocacy and fundraising student group highly featured in this blog) who spoke of the importance of initiative, action, and results. A similar message was espoused by Matt Cone, a high school professor of contemporary issues at Rock Bride High in Missouri. His class has not only raised over 100 thousand dollars for PIH, but it has done so by incorporating a sense of attention, advocacy, and action in the curriculum of the course.

The movement has already formed and focuses people on the economic and social justice path to creating change, development, and dignified living. The tangible results are there – Adeline Mercon, a Haitian mother, spoke through an overqualified translator (Dr. Farmer) and stated I am the 2nd Lazarus and I am celebrating the 10th year of my second life. Her story started with her father asking Dr. Farmer for money to buy his daughter’s coffin and ended with her strong enough to work and care for her children. Somewhere in Peru, Gustavo Gutierrez is nodding his head in agreement because the movement is growing and the results are adding up.

Please refer to the photos on the sidebar and blog entries from April for my experiences documenting Partners in Health in Rwanda.

Commitment - The Key to Change

2008-09-24T18:54:00.002-04:00

Clinton Global Initiative Places Change Makers, World Leaders, and Funders Together

Commitment [kuh-mit-muh nt]: involving yourself, pledging support, the most necessary step toward action. A college professor, and long time United Nations insider, once told me the General Assembly opening session speeches are a nice part of the United Nations, but the real work goes on in the small meeting rooms nestled in the nooks and crannies of the famous building. It represents one of the rare opportunities heads of states get to talk national interest agendas and weigh support of foreign policy issues face to face without the media or work up of official state visits. In the professor’s words, “It’s where the ball really gets rolling”.

Bringing these world leaders together is a great benefit unfortunately at times missed by mass media. Some reporters and news outlets focus attention on President Bush and President Ahmadinejad speeches billing the headline as “The Great Showdown”, as if Monday Night Football coverage translated to the diplomacy and international relations arena. These two speeches, though important, and excerpts of interviews with Ahmadinejad were ubiquitous across media channels as the only coverage of the day’s events north of Houston Street in New York City. Nonexistent is coverage for a four day conference this
week that takes advantage of the UN’s high ranking guests and gets the ball rolling on the critical issues that face our world.

“Over 80 former and current heads of state, hundreds of top CEOs and non-profit leaders, major philanthropists, and 10 of the last 16 Nobel Peace Laureates” will attend the Clinton Global Initiative meeting this year and focus on four of the great challenges of our time and world: education, poverty alleviation, global health, and energy & climate change. At this invite only conference leaders of the different sectors gain the ability to meet, view, and discuss concrete opportunities through panels, breakout sessions, and an internet platform that allows for a free flow of ideas, dialogue, and support.

What this conference seeks to build and guarantee is commitment. Since starting in 2005, “CGI members have made nearly 1,000 commitments valued at over $30 billion to improve more than 200 million lives in over 150 countries.” It places together innovative and highly effective change makers and non-profits with the people who are enablers. Nothing gets passed with more success through any government or corporation than a bill the president is moved to create or support. He or She will find the funds when they see results are attainable. Getting these types of members on board, talking, and part of the equation are fundamental to the creating the success the Clinton Foundation strives to develop. Former President Clinton established the CGI to “help turn good intentions in to real action and results.” He understands the essential nature of this link and his post presidential legacy will be cemented through the works and actions of his foundation and centered of the most important word – commitment.

The CGI meeting is viewable by internet. Schedule. Featured Commitments.

A Game Changer in HIV Education

2008-09-11T15:14:00.002-04:00

Culturally Sensitive and Scientific Approach to HIV Education

My question, “What would the reaction here in India be if schools taught a culturally sensitive science and fact based approach to sex education”. I had asked the question in all five countries to officials, doctors, and the directors of each organization covered. The responses always extolled the great impetus such an approach could have at removing stigma, creating understanding, and empowering a population with life saving knowledge. However what usually follows is the realization that such programs or practices simply do not take place in large scale. The reason is steeped in taboos stemming from culture, religion, or governmental bureaucracy and no example was more palpable then in India.

Although India is the world’s largest democracy and developing at a pace nearly unforeseen, it still has traditions that some interviewed referred to as “backwards”. Whether it is divorced or widowed women completely ostracized from the community, or raped women thought to be worthless and ill suited for proper marriage, women’s rights is a hard fought battle in India. Furthermore, premarital sex is almost unspeakable and “a big No-No”, which comes across slightly innocent given the provocative nature and displays of sexuality in the highly popular Bollywood scene. Of course it was with this reality that I awaited the answer from the director of the Community Care Center (CCC).

The response, “For god’s sake if you even utter sex education they will chase you out and throw you into the river!” Despite the taboos the organization pursues a course of action. “Call it health education or life education and then go in and teach them whatever you’d like. This is what we do and it works.” The need for HIV education is desperately there. In their 2006-7 “Needs Assessment Study” the Gujarat State Network of Positive People (GSNP+) reported 70% of the 766 people living with HIV interviewed knew nothing of HIV before testing positive. How does one protect himself or herself from a virus they have never heard of - let alone understand how it transmits?

It is corporations’ social responsibility programs, such as the CCC, and non governmental organization, like the GSNP+, that are left with much of the responsibility in educating the population on HIV/AIDS. Through awareness outreach, solidarity programs, and advocacy campaigns the state of Gujarat is slowly showing changes in levels of understanding on HIV. However there may be a game-changer. Whereas my question was only hypothetical, it has now become a reality through Stanford University and the hard work of Piya Sorcar. Their model teaches the issues through facts and a culturally sensitive approach. It absorbs the culture and integrates it into the material without sacrificing the essential messages. Their three point mantra is the foundation everything is built on. The HIV virus spreads from only three mediums: sexual fluids, breast milk, and blood. The beauty of the program is the simple and clear language and the utilization of graphics and media works to both engage the audience and reflect culture. Lastly, it even comes in Indian male and Indian female versions to address some of the hesitancies and sensitivities within the various religious orders within India.

Besides India my research has also taken me from the hills of Rwanda to the golden coast of the United States and the heat of Nicaragua to the temples of Thailand. The potential for teachaids.org’s programs can be tweaked and geared toward each of these countries garnering tangible results. Each country has its own culture and that is the beauty of the program; keep the facts and alter the dressing. Experts talk about the two sides of the HIV/AIDS epidemic as treatment and prevention. Both go hand in hand, especially in developing countries where costs of treatment can be a pressing issue for both patient and government. This computer based model can make a great difference in addressing one of the biggest issues concerning HIV – awareness, prevention, and understanding.

For more blogs about the CCC, GSNP+, or India please go to February and for photos see sidebar.

A Family Field Trip

2008-09-03T17:11:00.000-04:00

Innovative and Interactive Exhibit Shows Future of Health Education

Seated in front of a large screen, my younger siblings grab hold of the controllers and attack the microbes and foreign particles that enter the blood stream. “Look Marco I’m a macrophage” - atypical words flowing from the mouth of a soon to be seven year old. Yet this is the future - both in HIV awareness and our population. Here at the Liberty Science Center’s “Infection Connection” children and teens get a highly interactive and stimulating approach to learn about the body’s immune system, various viruses that attack it, and social issues surrounding particular infections.

The video game lasts several minutes but it’s obvious their interest has been peaked. When the game ends they briefly argue as to whose role was more important – the macrophage who engulfs the pathogen and calls for the T-cell or the T-cell which does the “killing”. As we watch the brief 5 minute HIV video the real winner is revealed. Both children have a sense of how the HIV virus enters the body and can cause AIDS. As we see the T-Cells slowly wiped out, they know that the immune system is losing its “power” and defense mechanisms. The video focuses heavily on the science behind the virus utilizing clear language and visual effects. It also includes important statements which highlight the stark reality behind global HIV – highest percentage of infections worldwide are in sub-Saharan Africa, 11.4 million AIDS orphans in Africa alone, and 1.6 million deaths worldwide in 2007.

The video does not harp on transmission because the audience may be too young for so much at once, but the science behind the virus and some context of global implications seemed to stick with both siblings. Venturing by myself I found several miniature exhibits each one dedicated to noted diseases, such as influenza, lymes, and malaria. Of particular interest was “Bedroom Secrets”, which focused on sexually transmitted infections, condom usage, monogamy, and opening communication lines. Press a button next to one of the pictures and hear a teenager talk about a visit to the doctor’s office. The section uses accessible language, drawings of real life situations, and subtle tones of prevention, awareness, and responsible actions. Tucked away in a corner it gives a sense of privacy to absorb its messages from peers and professionals.

In each of the countries I have participated in awareness work through the organization documented. In India, I played a UNICEF board game geared toward harm reduction and HIV awareness. In Nicaragua, I passed out pamphlets and condoms as clowns gathered an audience for a show on HIV transmission methods. In these endeavors and pursuits the goal is to change the near future by educating and working in the present. The mentality in each location is linear and direct. Increase awareness of how the virus does and does not spread, thereby decreasing stigma, number of new infections, and thus reducing the number of people on treatment.

Discussing and explaining the issues and facts behind HIV in such an interactive and science based approach made the lesson come to life. In place of a lecture, a general understanding of the basic foundation is gained in an engaging and de-stigmatizing manner. I could not help but wonder what effect this type of programming could have in some of the resource poor settings where I have traveled - areas where displays of technology, such as a slideshow or PowerPoint presentation, generate crowds from intrigue or relative limited access. The potential for such programs is far reaching, especially when geared to specific populations and taking into account cultural and social norms. A future blog will be dedicated to one such model developed in the USA being tested in India.

Back at the Liberty Science Center I finish the infectious disease train ride which highlights interviews of people living with TB, Dengue, and HIV in countries of high prevalence. As I exit my train car a clear and powerful message is announced - “choices we make as individuals, communities, and governments weigh heavily on the lives of others. Are you part of the problem or the solution? The future is unwritten”. The future is unwritten and with more interactive and accessible programming and continuing the course of governments, corporations, and NGOs working together the complex problems presented by the global HIV pandemic can be reversed and addressed.

Project Update

2008-08-26T15:42:00.002-04:00

I apologize for the silence. I have been drafting chapters of the book, applying to graduate schools, and setting up speeches in the Tristate (NJ, NY, and CT) area.

I am pleased to announce the International HIV/AIDS Alliance Ukraine will be the final research site for my book. They are financed by the Global Fund to Fight AIDS and will represent a harm reduction model that focuses on the relationship between intravenous drug usage and HIV infections. The organization is one of the strongest in Eastern Europe and is responsible for two of the largest HIV initiatives in the Ukraine. It will be a privilege to cover and document their work. More details will follow once logistics are finalized.

I will be posting at least one entry per week until further notice. I invite you to view the keynote speech I gave at the Emily C. Specchio Foundation on YouTube. The speech highlights successes and hope encountered in each country stemming from individual empowerment and personal action.

"Anchors Away . . ."

2008-06-06T17:16:00.005-04:00

The Rwanda Women's Network and the Village of Hope

As I make my way into one of the offices I see a wall full of photos and immediately my curiosity is peaked – why so many mug shots of children? The board is sectioned into categories: both parents living, one parent living, and child head of household. With each face comes a different story – a painful reality of loss – mostly attributed to the genocide or HIV/AIDS. My questions are answered by two of the directors of the Village of Hope both of whom are Rwandan by ethnicity. Their paths are dissimilar yet they converge at this one organization and seek to create hope through action and empowerment. Peninah came back from Uganda a month after the genocide hoping to find any of her countless relatives alive, but her empty stare and heavy eyes alone foreshadowed the grim response to my question. Winnie grew up in Uganda and received her masters in social work in Britain. They say the change they have witnessed in the women of the Village anchors them to the organization. The omnipresence of the genocide and this anchor would soon become recurring themes throughout the day.

I started out in a room learning about the countless programs that are run through the Village of Hope. The comprehensive work done here delves deep into the cyclical nature of poverty, most often created as a product of the genocide or the HIV virus. I have come to learn poverty denies the access of three vital human needs - income generation, education, and health. The Village of Hope attempts to address these issues, and the sheer amount of area women (over 4000) who utilize its services speak to its success. As I step outside I meet a group of women from one of the Village-run income generation programs. They are the bedcover makers and they half-jokingly tell me I must visit the store before I leave. The materials, training, and sales location are all provided for by the non-governmental organization that runs the Village and only the cost of the material is subtracted after an item is sold. Generating income is perhaps one of the biggest steps toward empowering an individual and changing the life of a family. As I finish interviewing one of the women I make my way to a group of children who are trying on school uniforms (see photo). Although primary school education in Rwanda is said to be universal and free, Stephen Lewis states in A Race Against Time that hidden fees for uniforms and scholastic materials are the main deterrent to school enrollment in Africa; thus severely limiting individual opportunity and economic development. The Rawandan Women’s Network (RWN), the organization that founded and runs the Village, pays these hidden fees for over 100 primary school children. Furthermore, the Stephen Lewis Foundation and PEPFAR send over 150 teens to secondary or skills schools. In regards to health, the original initiative of the RWN is the Polyclinic of Hope, established in 1994. Here, women and children (and also some men) receive medical services including HIV testing, HIV counseling and nutritional support for HIV/AIDS.

When housing was deduced as one of the major threats to the post genocide women and orphans, the Rwanda Women’s Network sought funds to build the Village of Hope. In 2000, Japanese funds built the village center and the Clinton Foundation erected twenty houses. The RWN consulted with all the stake holders, from social workers to the women themselves, to select from the most vulnerable amongst them to live at the Village. These houses (see photos for details) are built for six but often house seven or eight – there is no shortage of street children or orphans. Alongside each house is a kitchen garden for which the women receive seeds and are taught the techniques of how to cultivate the various fruits and vegetables. The abundance of potatoes, cabbage, avocados, carrots, and onions plays an integral part in providing nutritional support and access to food.

The RWN established The Village of Hope in an undeveloped outer district of Kigali and many women who depend on it relocated or built small houses to live within walking distance. However, Rwanda’s new reputation as one of the hopes of Africa due to its good governance and safe atmosphere has created a land premium in Kigali as both ex patriots and foreigners build new houses. The Village now finds the bush that separated them from the main road into the city strewn with hundreds of US style mansions (costing approximately $150,000 US). Many of the women dependent on the Village are approached daily to sell their lots but must weigh the consequences of relocating further away. The RWN’s advocacy, networking, and educational awareness programs provide the knowledge base needed when it comes to vital issues such as property rights.

The success of the Rwanda Women’s Network can be directly linked to empowering the individual through programs that address basic human rights. Their Village of Hope is much like the famed roads of Rwanda. They have a plethora of programs that like the highways, which branch out to all corners of the country, cover key sectors for creating a just life – income generation, education and health. All major roads in Rwanda lead back to Kigali and all the work of the RWN comes back to empowerment and unity. There is no Hutu or Tutsi mentality. The mantra is “We are all Rwandans”. Women whose husbands were murdered have come together with women whose husbands did the murdering in the name of development for their children’s future. The approach and work of the RWN has won it accolades in the form of two prestigious international awards. Its success looks to continue forward as the process of scaling up and going nationwide has already begun. After a full day at the village I understand why it was recommended as a “must-see” by ranking government and UNDP officials. Moreover, after interviewing some of the women and teenagers who benefit from its services, I have seen why Perniah and Winnie have dropped anchor in a landlocked Village of Hope.

Shadowing an Accompagnatuer and Community Health Worker

2008-05-12T07:17:00.007-04:00

Rural HIV Care House Visits

Whether you look left or right, banana trees consume your view. Intermittingly along the rough and rocky dirt road women will be walking with their cultivated produce balanced on their heads, children with their family’s yellow containers preparing to fetch water from the nearest well, and men with three bushels of bananas strapped to a bicycle that they are pushing. This has been the view for much of the 45-minute ride for rural HIV care house visits. This day I am shadowing an accompagnatuer and a community health worker – two mainstays and vital parts of Partners in Health’s (PIH) framework.

The idea is simple. A person in a community is trained to “accompany” another in their treatment of HIV/AIDS and their general wellbeing. It fosters a strong link in the community, acts as a referral process to the clinics, and has incredible results for adherence to treatment. It is a highly organized system in which accompagnatuers are responsible for their individual clients and then the community health workers monitor the progress with periodic joint visits. This day is one such visit. The accompagnatuer has six patients that she visits once a day at the same time to directly observe their morning antiretroviral dose and give them the medication for the afternoon. The furthest one lives 2km from her house, approximately a fifteen minute walk.

Our driver stops the creaking truck at a narrow path cut into sectioned off vegetation patches and at first I see no houses (see photo). As we continue down the path children begin to gather wondering what a “muzungu” is doing in their tiny and secluded rural community. A smile, a wave, and a greeting in kinyarwandan will be returned with brighter smiles, enthusiastic waves, and increasing curiosity. It is a recurring event that breaks initial barriers and reminds one of the simple beauties in life. We arrive at the desired mud house and exchange greetings, handshakes, and laughs at my attempts at the local tongue. The husband and wife give us the wooden bench and bring in a dried leaf mat for them to use on the floor. It is a simple gesture but it speaks volumes about the culture here and also the importance of the health workers in the eyes of the people.

The community health worker goes through a three page comprehensive questionnaire. The format is heavily geared for check marks and numbers therefore allowing me to follow along quite well. The husband and wife are both HIV+ and their first five kids have tested negative. There is a hesitancy to test the two-year-old child, which both workers attempt to address. The wife tested positive during a prenatal check up with that child, and the husband followed suit. This particular visit is evaluating the husband’s health. The questionnaire also contains other factors that are fundamental to health and are valuable resources for PIH’s social workers. Some of the alarming issues are that he eats one maybe two meals a day and that there are no mosquito nets over the three beds in the house. Positives are also noted, such as the house and metal sheet roof are in good condition and the cooking is done outside of the house. This last note is important because everyone cooks with coal, which when used inside living quarters can create numerous health risks. There are no complaints or illnesses reported and the community health worker neatly writes her findings and conclusions at the end of the last sheet.

After fifteen minutes the house visit is over. More importantly this family of eight in the deep rural areas of Eastern Rwanda has received attention that is potentially life changing. It is difficult for these people to get to a clinic so instead PIH branches out deep into the surrounding district in a proactive fashion. In essence they are trying to find the problems and bring the people in before they get worse. It is vital to understand that the mentality, which is common in many developing countries, is a visit to a doctor or clinic is only after ailment has become a serious problem. For instance the husband’s first CD4 count, the measure of the immune system’s strength, was 35 and he only got tested because his wife tested positive. To put this number into perspective HIV treatment starts at 200 and as high as 350 in malnourished populations. Less than two years later, his count is 1056, which is well within the range of an HIV negative adult. This is two more years that six children had a father and a family had a breadwinner – intangible positives that some times do not make it in statistics or reports.

The success of the accompagnatuers program has proven to be beneficial to the patient through varying areas – medical, social, and even psychological. The effect of the system and the relationship between the people in the room are highly visible. However, the meeting cannot go on too long because there are more houses to visit. After the thank yous we turn outside and are greeted by an even larger group of children. The path back to the truck is lined with string beans, bananas, and potatoes. A look around will show mud houses and endless cultivation. This is the setting, and this is the future of healthcare in rural areas of Rwanda.

Partners in Health

2008-05-07T11:31:00.004-04:00

The Approach, the Vision, and the Results

It is difficult to explain everything that Partners in Health (PIH) does in Rwanda. The simple reason is their programs are too vast and comprehensive to fit in one, two, or ten blog entries. I think the better way to explain what is being done here – in the rural countryside of Eastern Rwanda – is through the philosophy and the approach that has made this non-governmental organization world renowned. PIH is an organization that functions under a human right based, development driven, and comprehensive approach. Now let me clarify that statement through tangible examples.

To call PIH a healthcare or HIV/AIDS non-governmental organization would be limiting. It is very true that they provide unparalleled healthcare, especially with treatment of HIV/AIDS, in research poor settings, such as Haiti, Rwanda, and Lesotho, but their real gains are in addressing the root of many of the problems they encounter – poverty. How do they tackle such a large yet critical component of the human condition? Of course the answer is through healthcare, but that is only the beginning. Healthcare is not only a basic human right in this organization because they don’t stop at the “standard” or the international expectation. Whether it is the successful chemotherapy treatment for pediatric Hodgkins Lymphoma (perhaps a first in the rural districts) or the mixed cocktail antiretroviral therapy that is criticized as not being cost effective, the standard here is that patients deserve everything possible just as if a member of the doctor’s staff where in the same predicament.

Of course there are other human rights that are vital in establishing a just life; education, a livable wage, housing, food are but a few. Many of these key rights are included in the practices and programs on the ground. It fits accordingly to the vision of development. If we talk about education, PIH pays for over a 1000 primary school fees for area children. If we talk about a just wage, the absolute majority of the paid staff (ranging from doctors to cooks) are Rwandan and paid above what the established wage would “normally” be (such as the same position with the Ministry of Health). The concept here is human capacity building. Above all, the over arching goal is to create a model and system that can be run completely by Rwandans in the future, much like PIH’s renowned Haiti program. To attain such a goal, training of local personnel becomes a high priority. It does not stop with medical training. They also run several income generation programs, such as teaching and providing tools for carpentry and sewing. When it comes to a dignified living space, PIH utilizes it many social workers to identify the most vulnerable or needy cases and then works to fill the need, such as a coagulated tin roof or an entire home from scratch. One doctor put it so bluntly that I had to write it down. To paraphrase - if some one has TB and they have a roof that is leaking then the TB is never going to go away. We go in, patch the roof or cover it with a plastic tarp, and now the patient gets better. So simple, yet unfortunately deemed “radical”.

The last example I will provide is perhaps one of the most essential of basic human rights – access to food. It is a topic of international importance and tragedy as the global food crisis continues to plague the world’s poorest. An extra 50 cents for a bagel gets a full page in a Connecticut newspaper, but the impact of the raising of prices effect in the developing world is the difference between eating twice a day to once or worse. In a country that is ravaged by malnourishment, PIH runs several food programs that are aimed at providing the life saving nutrients needed for survival. For instance, the pediatrics ward estimates half its patients are a result of malnourishment. The visible symptoms are so common they have a local name – “Kwashiorkor”. The eyes get puffy, the cheeks get overly chubby, and belly swells. The treatment – food of course – is two months supply and then revaluation after that period expires.

The comprehensive aspect is illustrated through the “accompagnateur” system that first made PIH “famous” in the public health world. It is best explained as a person who the organization pays to daily visit a set group of people in their community to directly assist and make sure the patient is taking their HIV or TB medications. This direct approach has many benefits. First, it accounts for an amazingly high adherence and successful continual treatment rate. Secondly, it creates a leader and a network within the community. Thirdly, it provides as a mechanism for referring someone to the clinic or hospital if they are having complications or other illness. This same practice, which started on the central plateau of Haiti, is now being used thousands of miles away in the rural countryside of Eastern Rwanda.

The Health Ministry has realized that the philosophy and approach of PIH is not only addressing healthcare needs, but in the process it is conducting development initiatives through empowering the locals. The two have partnered to scale up the rural health care sector of the country. It is a new endeavor and challenge for PIH, but not many organizations have the vision or approach to accomplish such a task.

Rwanda’s Fight on HIV/AIDS: Strengths, Challenges, and the Catalyst

2008-04-30T13:35:00.007-04:00

Interview with Highest Ranking HIV/AIDS Official in the Rwandan Government

High level executives at the UN Development Program described her as a wealth of knowledge. A Senior Advisor for PEPFAR praised her for her detailed approach and drive. An administrator from Partners in Health said she is the exact person you want to talk to. In every one of these meetings I thought - who is this Dr. Agnès Binagwaho? Well, she is the Rwandan government’s highest official in the field of HIV/AIDS. Her title reads Executive Director of the National AIDS Control Commission but she is much more than that. She is personable and insightful in her speech, straight forward in her talk, and pragmatic in approach.

I got the chance to interview Dr. Agnès during the break of a conference on monitoring and evaluating international aid effectiveness. Every African country was represented at this conference as its importance is crucial for achieving sustainable development. Money wasted literally costs people’s lives for many of these countries. It was in this setting that I got to discuss three key issues with the foremost authority on HIV/AIDS in Rwanda.

In a previous interview, the UNAIDS Rwanda Director highlighted the decentralized approach of Rwanda as one of its greatest successes. Dr. Agnès reponse built on this foundation. “What I am telling you is the government vision – we want to harmonize, to align people behind one unique action plan designed according to the needs of the country.” Some foreign governments, above all France, have been overly critical of the leading party, and in the past, some painted them as a new dictatorial regime. But how was this national plan created? “We put together all the constituencies, like the civil society, the development partners, the new private sector etc, and we ask them to tell us their needs”. Identifying needs is important, but what about the decision making? “They each have their own priorities but we try to figure out what we can work on at that time. They also decide with us what to take and leave out of the plan. It makes sure people are working with less frustration when they are part of the decision.” I stop and can not help smiling at the wisdom of that statement.

The National Strategic Plan is the heart of the successful approach, but where are the arteries and veins that circulate the vision and action? In 2006, Rwanda went through an administrative adjustment. It restructured its many districts into 30 larger ones and created 5 provinces (named in their relationship to the fifth province – Kigali City). The strategic plan is entirely implemented through the district level. Everyone at the above levels are coordinators and managers instead of implementors. Each district has an HIV/AIDS committee that is comprised of a multilateral membership. The director of each district’s health program, hospital, education, and gender initiatives are included and the committee is rounded off by two vital and crucial members of “civil society”; a religious leader chosen by the different denominations (mainly Catholic, Anglican, and Muslim) and a person living with HIV elected by the local network of people living with HIV. This committee is led by two officials that report directly to the mayor (who has the authority to make decisions but in conjunction with the national strategy and policies). This approach has led to a remarkable level of success throughout the entire country. Many of the measures of success, such as testing and people receiving treatment, have more than doubled since 2005.

There are a plethora of successes, but what are the challenges? Rwanda after all is one of the poorest countries in the world, and is heavily reliant on foreign aid; now ‘there’s the rub’. Although Dr. Agnes agreed with the UNAIDS Rwanda director that evidence and data are needed to target at-risk groups, she focused her response on the issue of foreign aid. “The big challenge is what is going on in this meeting right here. It is alignment harmonization of partners in our true priorities and action plans. People come and say we have come to do statistics but okay. They don’t come in and say, ‘We have come and want to help you. We have this amount of money. Where do you need to put it.’ This is the support we need. That is how you may have some critical sectors that are not funded. Without this approach it will be very difficult to create sustainable development and you can not fight AIDS without sustainable development.” What she is really saying is that their officials understand and have worked diligently to access and prioritize the needs of their own country. The call is for budget support and not vertical giving that is targeted based on the funding organization's priorities.

Dr. Agnes singles out PEPFAR as an example of the good that can come out of foreign aid working within the framework of the government. “PEPFAR is one of the success stories because PEPFAR here is aligned to our national strategy. They don’t do a vertical program. They integrate where they have to be. We still don’t like the way they break down the money and the cost of everything because it is not totally clear but they do it within our strategy. This is only because we had the political will to oblige them to do so.”

It leads right into our most interesting topic – what was been the catalyst for this united vision and this successful program on HIV/AIDS? Her simple two word answer is one that has stayed with me from a FACEAIDS conference keynote by Jim Kim – political will. She emphasizes that programs and initiatives that will help reach the Millennium Development Goals and other goals will be implemented. Politics used to be a deadly game in Rwanda, but this is the new Rwanda. “Really we never go for pockets, we always go for national. This is important to note also – it is because the previous regime before 1994 was based on exclusion and discrimination. The new orientation is inclusion and participation, which means no place in the country is left out, no portion of the population is left out, and everything is national. What is good for the north is good for the south. What is good for me is good for you. This is a policy that is implemented for the community and that is the difference. There are no pockets.” “No pockets” is another way of saying – favoritism and ethnicity no longer apply here.

My interview with Dr. Agnès was refreshing. It was a reminder that vision is vital to solve any problem and that a pragmatic approach can create hope even in the depths of devastating tragedy. Rwanda certainly has many challenges that lay ahead, but it can point to its health sector as a symbol of success. A symbol of something designed and coordinated by Rwandans for Rwandans with financial aid coming from an international community that perhaps is attempting to literally pay for past indifference.

Postmark: This entry has been published onto Rwanda's National Government AIDS Website

The Rwandan Genocide Memorial and Education Centre

2008-04-27T05:01:00.003-04:00

A Range of Emotions . . .

You make your way up the steep hill on a road that looks like any other in Kigali – a dirt wall on one side and a beautiful scenic overlook of the city on the other. However this road is different because half way up you see a large modern white house with spacious terraces that is set a part from anything else in sight. It is Kigali’s Gisozi Genocide Memorial and Education Centre – the final resting place for over 250,000 Tutsi and moderate Hutus.

In an attempt to supplement this entry I would ask that you read this article to gain some of the historical perspective of what happened in 1994 and why. It is not thorough and is somewhat slanted but it at least covers a good deal of events. I will concentrate on the range of emotions that come out of the path set out by the exhibits.

Anxiety -
I knew the time to write about the Rwandan genocide would come, but I find it hard to explain in only a few paragraphs. The story is too complex to breeze over, too important to not do it justice, too recent a memory to be forgotten. Everything in Rwanda comes back to the genocide. How can it not? 1.2 million men, women, and children murdered with bullets, machetes, and clubs in less than 100 days.

Disbelief –
Neighbor kills neighbor, friend kills friend, and family kills family. How can such acts take place? 300,000 children left orphaned. A UNICEF study estimating 99.9% of children witnessed violence (rape, torture, or murder). A youth militia death squad brainwashed, trained, and armed by the government to wipe out a piece of the population.

Sorrow -
Videos of mass graves, actual chains used to bury couples alive, skulls and bones of those murdered, thousands of photos of men, women, and children who lost their lives for simply being “Tutsi” or a “Hutu that was a traitor”. A traitor may be spared death, and was any Hutu who married a Tutsi (a very common thing) or helped/befriended Tutsis.

Shock-
Mass killings took place at churches, even catholic churches. The church went as the priest did. Some accounts told of priests who died trying to make peace or hide Tutsis. Others depicted priests that rounded up their congregations in their church for shelter and then worked with the militias to slaughter their own people.

Anger –
Anger over the amount of carnage and the sheer evil and vile nature of the organized killings of people based on their “ethnicity”. Anger at how easy it was to pre-register the Tutsi, block off the main roads, and then proceed house to house with death squads. Anger over the idea that one group should wipe out another. Women and children were excessively targeted as the most important aim was to make sure no new generation would emerge.

Despair –
“The Tutsi and Hutu are one people, one history, and one language”. The first documented violence (occurring in 1959) between the two came as a direct result of European colonizers creating – I repeat creating – a racial division between them in form of identity cards. Historians and military call it indirect rule through divide and conquer. Despair over the fact that the French armed the extremist government after peace accords were signed in 1993. Despair over the countless eye witness stories of French soldiers getting those hiding to come out and then quickly leaving before the militia arrived. Despair over the international community disregarding eight ethnic massacres from 1990-1994. There were plenty of warning signs. It does not stop there. The United Nations refusal to acknowledge the term “genocide”, which would have legally obliged them to enter and punish the perpetrators, the withdrawal of peace-keeping troops, and the “never again” acknowledgment of their “sin of omission” all strike a resounding and familiar chord with the past year in Darfur, Sudan.

Discomfort –
A funeral was taking place as the remains of two recently found and exhumed bodies were laid to rest at the memorial. Before the funeral the memorial became filled with Rwandans. Screams, heavy sobbing, and cries filled the rooms creating an intimate and pain filled atmosphere in which I felt like nothing more than an intruder. These were survivors. People who lost their loved ones in heinous acts and crazed ideology.

Respect –
The use of the gacaca courts, a traditional tribal way to deal with transgressions. 250,000 local judges were given training on law and judicial ethics and the perpetrators of the genocide were given town hall style trials with at least 15 judges and 100 witnesses to make quorum. The most important stress is on identifying the victims (which many knew personally by name) and then establish the extent of the crime. A truly remarkable approach that has its critics but has led to starting the healing process. Click here to learn more about it.

Hope –
No one in Rwanda is allowed to say the genocide did not take place. Since the genocide Rwanda has not backed down from its stance that the international community completely and utterly failed its country. It has focused on the fact that all Rwandans lived peacefully and together before the colonizers came and created the divisions. It is now known as one of the safest countries in all of sub-Saharan Africa and unity wins out over division. Moreover because it knows the chaos and pain of genocide, it has sent a piece of its army as part of the peace-keeping initiative in Darfur.

Rwanda

2008-04-24T09:13:00.003-04:00

Pre-visit Research Meets First Impressions

“The hills are alive…” but it’s not the sound of music. Instead we find many sturdy houses, mostly accessible roads, and hordes of people going to and fro. Kigali, Rwanda’s capital, is a city built on several hills marked by trees, greenery, and beautiful scenic views.(see photo) It is known as one of the safest cities in all of sub-Saharan Africa and it is a symbol illustrating the amount of change possible when leaders, organizations, and people are willing to work together toward a common goal.

When I started my background research on Rwanda I did not know what to expect upon arrival. The facts that I usually look into (recent history, life expectancy, health risk etc) were not too encouraging. Recent history focused on the 1994 extremist genocide that saw 14% of the population brutally murdered. For a perspective driven juxtaposition: 14% of the US population would be 45 million people and Rwanda is only slightly larger than New Jersey. Life expectancy read: women 45 / men 42 (nearly 66% that of India). Health risks were plentiful: a nasty form of malaria, an HIV prevalence rate of 3%, and a slew of warnings about cholera, meningitis, and yellow fever. Switch gears to providing care - are there enough healthcare practitioners to combat or address these needs? Well the figures show 3,900 people per nurse and 50,000 per doctor. These stats should jump off of the page, but the point I emphasize is what I am seeing in light of what I read.

One cannot glance over Rwanda’s status as a developing country (its 2007 GDP is 1/10th of New Jersey’s 2007 state budget). Needless to say the country is very dependent on foreign aid. Moreover, threats and struggles are realized in varying arenas, such as border tension with the Congo, the growing global crisis on staple food prices, and the everyday ills of poverty, that make Rwanda’s successes fragile. For instance, poverty in Kigali is not as visible, or “in your face”, as in Mumbai or Surat, but that certainly does not mean poverty is not a problem or it does not exist in large numbers. Perhaps it is better hidden or more likely a layered issue that takes some time to piece together? With only four days in country I can only comment on what I observe. What I see is many beautifully groomed main roads lined with trees, trimmed bushes, and freshly cut grass. More importantly, I see direct responses or positive steps toward addressing my previous fact-finding results. I see HIV awareness billboards all over the paved streets (see photos). I open the newspaper and read about the government launching an integrated health system through Partners in Health and the Clinton Foundation. A measure that will train 21,000 health advisors and rise to 40,000 as time goes on. It is a joint style that believes in high quality medical services for all people and focuses on holistic approaches (infrastructure, provisions of water, electricity for health facilities etc). Also of note is the daily public reminders of the genocide but the approach is meant to build unity not make excuses or deny the past, which are jailable offenses.

Many of the daunting facts that built an impression before stepping foot in Rwanda are present in the media and appear to be an issue that a plethora of organizations are combating together. In all my travels I have never seen such a presence by the international community as I do in Kigali. Visibility is of course enhanced by Kigali’s small size, but it does not dismiss the shear volume of organizations. There is still much work to be done, but there is a sense that the direction and ingredients are here on the ground.

Setting the Stage

2008-04-20T03:45:00.003-04:00

A Movement in Rwanda is Catalyzing Hope

The first piece of the three-stage flight to Rwanda is complete. I write from Amsterdam’s international airport with a looming 4 hour lay over. This gives me the opportunity to do something I normally do not – set a stage before arriving.

When I began planning this project I knew that the sub-Saharan portion would most likely be the most difficult. It would prove the most challenging to plan, the most expensive to price (an airline ticket is nearly double the cost of any of my other flights), and perhaps the most telling in the effects of HIV on a community, a country, a region. The efforts of Partners in Health in Rwanda has been something I have wanted to see, witness, and document since helping raise thousands of dollars for its cause through my FACEAIDS chapter at Fairfield University. We would get emails from the field and personal stories of success making Rwanda this intimate yet intangible part of our motivation. The culmination of why over 120 universities had FACEAIDS chapters was exemplified in Dr. Paul Farmer’s keynote address at last November’s national conference.

Farmer’s speech highlighted the unified efforts of the Rwandan government, the Clinton foundation, and Partners in Health (PIH) to develop a national healthcare system that maintains the model that has made the Boston based ngo the gold standard of HIV treatment organizations. It was the message of a combined effort that resonated with me during his talk. So many players on this stage, yet one clear mission – creating and implementing a healthcare system that brought health, development, and human rights together. The “story” is best explained in this recent article from the Boston Globe. It is full of insight and spirit and best explains why it is a privilege to document the work being accomplished. I only hope my writings from Rwanda capture the same vivid message of what I call a movement.
I was introduced to the “movement” through Partners in Health’s projects, but the more I researched about work being done in Rwanda I saw that many entities are invested in making a difference in the country. It is this movement that is bringing hope to the “Land of a Thousand Hills”. It paves the way for a bright future that no one could have predicted following the 1994 Rwandan genocide. In the aftermath of 800,000 Tutsi and moderate Hutu deaths Rwanda has found a way to reconcile and move forward with the goal of the whole in mind.

In two weeks time I will be onsite at PIH’s countryside hospital/clinic. Before that I will be in the capital of Kigali meeting with representatives of the United Nations Develop Program, the Rwandan health ministry, and the US President’s Emergency Plan for AIDS Relief (PEPFAR) as well as other organizations, such as Orphans of Rwanda and FACEAIDS. The meetings will focus of how each of these entities plays a role in the movement. It is with great anticipation and over two years of “hearing, reading, and fundraising” that I embark on this leg of the Global AIDS Project.

On the Hill

2008-04-03T12:51:00.006-04:00

Two Days at the Capital give Insight into the World of the Public Sector and HIV

I have had the privilege to document some of the most effective models of providing HIV treatment and prevention around the world. I will soon be departing for Rwanda to cover Partners in Health’s famous model that addresses the HIV epidemic through development and working with local communities and the Rwandan government. The United States of America is responsible for much of the increased funds that support and foster the progress that has been made throughout the world in combating HIV. Both the public sector, through programs such as PEPFAR (The President’s Emergency Plan for AIDS Relief), and the private sector, such as the Clinton and Gates Foundations, have made great strides in addressing the vital components of treatment and prevention. However there is a startling rise that is calling our government officials to take a deeper look domestically and maybe learning from programs abroad.

The Washington Post ran an article covering a recent report, which in the words of government officials I ate dinner with, shocked the Hill. One would think the story was about an exposed affair or high level corruption charges but it was not – it centered on the alarming rise of HIV in Washington DC. When people think about an HIV epidemic and children infected during birth, their minds travel to “other” places, such as India and sub-Saharan Africa. However, the study reports DC in a “modern epidemic” and shows cases of infection through birth; something unthinkable in the states because of readily available drugs that can greatly reduce the transmission rate from mother to baby. Lastly, the report strongly emphasizes that there is a clear racial component to being HIV infected in DC – the subtitle reads “More than 80% of HIV Recent Cases were Among Black Residents”.

This Washington Post article on the rise in HIV infection was followed by a recent announcement by the CDC that "1 in 4 teen girls has at least one sexually transmitted disease". The core facts of the study show that there is a serious issue of sexually active teens who are at risk of dangerous consequences, such as infertility, cervical cancer, and HIV. Many factors play a role in the alarming figure. The taboo nature of discussing sex within families, schools, or churches, the inadequacy of many health education programs to cover the in depth issues of STDs and condom use, the sex drive of teens, and simple myths or misunderstanding create an arena where HIV and STDs can flourish.

Given these two reports that highlight HIV on the rise and the prevalence of sexually transmitted diseases, I posed a question to US Senator Tom Coburn of Oklahoma and Congresswoman Michele Bachmann of Minnesota if they would support universal sex education that approached the issues in an objective fact based scientific manner. Their responses spoke volumes. Coburn, an obstetrician by trade, acknowledged the reports as very serious and concerning. His response focused on the difficulty of presenting all the issues properly, such as that condoms do not always protect a person from HPV (the virus that causes cervical cancer) or herpes. Congresswoman Bachmann spoke of the role of family values and her strong support of science but did not delve into anything of substance. I attempted to push the issue and discuss the merits of empowering teens through teaching about transmission of STDs and the role of condoms in preventing HIV. However, her assertion that science has not shown condoms can completely prevent HIV transmission left me dumbfounded. Was she arguing that condoms do not have a 100% yield or did she simply not know her science; after all the CDC has hailed latex condoms as “highly effective when used consistently and correctly” for deterring HIV transmission.

The prevalence of STDs and the alarming fact that HIV cases are both rising in some cities and are heavily racially disproportionate depict the importance of the public and private sector to reassess how we address HIV and STD prevention. One non elected official spoke candidly how we can learn from the successes of the projects abroad and implement them here in the states. It caused me to think back to the various organizations that I have covered. Though differing in region, culture, and religion many of them maintained the approach that to affect change in a population you must start with the individual and community. Here the goal is the empowerment of the person through education and awareness and it is a concept that can find support in both the public and private sectors. Unless we expect our sex-sells culture to change or the biological sex drive of teenagers to disappear, then the answer for prevention has to be found in obtaining a level of understanding about STDs and the various methods of prevention, such as male and female condoms, abstinence, and faithful monogamous relationships. I would heed Senator Coburn’s advice on the challenges that sex education can present but I would assert that a comprehensive lesson plan can be achieved and should be achieved.

Famous Jesuit Challenges People

2008-03-21T10:57:00.009-04:00

Keynote at Boston College Sees World Renowned Jesuit Challenge Christians for a Better World

If a Jesuit university is not being persecuted, then something is wrong!" Father Jon Sobrino made this statement at Boston College this past week at the end of his keynote address entitled "Jesuit Catholic Universities in the 21st century". It encompasses many of the virtues and beliefs espoused throughout his lecture. Father Sobrino is the renowned Jesuit theologian famous for his life long struggle against injustices and human rights violations in El Salvador. He was the spiritual advisor to the martyr Archbishop Oscar Romero. Romero who was shot dead by a right wing death squad on March 24, 1980 while celebrating mass and is heralded as the Mahatma Gandhi of Latin America. Father Sobrino narrowly escaped assassination at the university in El Salvador that he founded. He was away giving a speech abroad when six Jesuit faculty members and two lay workers were murdered by the army for teaching and preaching against the establishment (the government, the military, and people of privilege) on behalf of the poor who were suffering blatant human rights abuses during a vicious civil war.

Some people may think 'persecution' an odd choice of words but when you listen to Sobrino you cannot help but feel you are in the presence of a modern day prophet. In Catholic pedagogy prophets speak truth to those in power. Although his tone was softer than his written words, Sobrino's passionate discourse challenges the very core of American culture. He contends that consumerism and capitalism are flawed and that Christians (he believes the term Catholic is too narrowing) and especially Jesuit Universities should be attempting to come up with different or altered economic models. His argument is based on Jesus' preachings of the 'here and now' reign of God on Earth as stated in the Lord's prayer "…on earth as it is in Heaven…". Sobrino warns us that consumerism and the capitalism in practice today are overwhelmingly exclusive and wrought with injustices. He observes that consumerism causes people to extend themselves, live beyond their needs, and excessively use resources. The capitalism that he denounces preaches the accumulation of wealth and the building and building of capital often at the expense of others. Rather, he espouses a model that "rejects the accumulation of wealth and capital and is based on providing basic needs and the pure word of development".

While I believe both 'isms' have their positive aspects (e.g. helping to create and maintain the overall economy and support the private sector), each has the potential to be gravely misused. In the USA, whether we look at energy consumption, the role of corporations and corporate capitalism, or our foreign policy, it is evident that a disproportionate amount of our wealth and power is concentrated within the hands of the few. A recent CNN article notes "US income disparity reaches highest since 1920s". With all the excessive gains and wealth created by the US and world economies there are still billions living without access to clean water, dignified living space, or the rights to quality education or healthcare.

Sobrino challenges all people and especially Christian universities to have a mission of "influencing society in the right way". He speaks of the "crucified people". These are the overwhelming majority of the world population that live in poverty or face human rights violations that keep them oppressed. He challenges us to look at these people as Christ on the cross and to do two things. First, reflect on why these people are up there and if we did anything in anyway to aid in the process. Second, ask ourselves what are we doing now to help that person down. How do we do this? Sobrino would say through solidarity and "a compassion that lights the dark spaces of the world". Some may dismiss him as a communist or socialist but they would be stuck in the past and not understand his message. He is talking about humanity and how the social institutions should have a mantra of "research with reason": Look at what is wrong with this system and tweak it or develop a new one. Perhaps instead of stressing accumulation of capital, the stress should be on pure development and basic needs. Perhaps multinational corporations that have long been accustomed to running rough shod over foreign governments and labor markets should have to take into account universal labor rights and environmentally friendly approaches. Perhaps instead of giving CEOs 50 million dollar bonuses the money could be used to create new jobs or run corporate social responsibility programs.

Sobrino's message brings hope but focuses on reflection, the courage of action, and social responsibility. It puts less stress for change on the institutions and large entities and more on the person and the individual. It transcends religion and is a cause that anyone can take up.

The Power of Individuals

2008-03-10T00:01:00.007-04:00

Speech at UN Focuses on Two Women Who are Changing their Communities

“Can you link your experiences to give a speech about women peace builders?” The answer is yes, but how to do it became quite the internal debate. Who do I choose? How should I present the issues? All I knew is that the audience would be members of the International Movement of Catholic Students – Pax Romana and the location would be at the UN plaza. Hailing from all over North America and with representatives from Ivory Coast, England, India, and Bangladesh, I took my seat and began to tell the stories of Daxa and Maria.

In a perfect world I would have had an opportunity to show the audience the four photos I had selected, but then again in a perfect world their would be no story to tell. The first two photos were simple full body pictures. Maria is there in a plastic multicolored hammock with jeans and a t-shirt. Leaves from a banana plant provide shade and in the background one can make out the red metal sheets of her out house style bathroom. Daxa’s photo shows her in a beautiful white sari with her traditional gold nose piercing and dark red wedding mark on the middle of her brow. A mere glace at the photos would convey the differences between the two women. Religion, culture, appearance, even continent, nothing would lead someone to initially create parallels.

Pictures are said to be worth a thousand words, but rarely do they provide the viewer with the story. Everything that unites these women comes as a consequence of their status as HIV positive and what links them is their struggle. Both Maria and Daxa had “normal” lives in their communities. They committed to a relationship and remained faithful to their partner. However neither expected to become HIV positive from their spouse and neither expected what could come from such news. Maria’s church criticized her, her family disowned her, her employers fired her and the hospital, the place that should have understood the situation best, treated her as if she had the plague and did not keep her status confidential. Daxa too was not spared ill treatment at the hands of those who should have known better. She was provided no counseling when she tested positive as a pregnant mother and went through an abortion because she thought her baby would die soon after being born. Furthermore, the hospital attempted to overcharge her various services because she was HIV positive. Between the heavy stigma and the ostracization, Daxa and Maria could have given up or succumb to the depression that clouded their minds. Instead, we would flash to the last two photos and see what path they have chosen.

Maria and Daxa made a decision somewhere in this journey to stand up and be a pillar for those who were in similar situations. Both were instrumental in beginning HIV support groups and networks that have given HIV positive people a fighting chance to, at least, not struggle alone. The first picture is of Maria addressing the audience at the official inauguration of the city’s only HIV self-help group (see December "Inauguration" post). Her group does not have a working relationship with the government and finds it’s support coming from a local NGO and its funds coming from a German NGO. The group has had some difficulty recruiting members and had 15 members for the entire city last November. However with each public speech and awareness campaign the visibility of the group increases and, hopefully, any stigma maintained by audience members decreases. The services they provide run the gamut from hospital visits to group declamations for violations of rights. Daxa’s photo shows her giving the inauguration address at a TB/HIV Center that unites NGOs, the government, and India’s largest corporation with the positive people network that she heads. The group now has grown to over 3,000 members and has an office in one of the hospitals for counseling and testing. She wants no pregnant woman to go through what she did. Last year they were responsible for getting 2,051 people HIV tested and they still do house to house follow ups and awareness programs.

Within only four pictures and brief explanations the audience can see the power of the individual. Maria and Daxa have dealt with and lived through many hardships, and have responded with dignity, courage and an impassioned voice. Maria’s wildest dreams would include the success that Daxa’s work has achieved, but her access to resources does not allow it thus far. However, they both would agree that success is based on individuals and not raw numbers. The importance of providing a physical place to call their own, a place where there is no discrimination or stigma, has not been lost on either women. Both women are not professionally satisfied as the presidents of the groups and still face very real personal struggles. Maria struggles to find work to feed her family healthy portions and also to buy secondary medications for opportunistic infections. Daxa meets children who are HIV and relives the pain of aborting a child that she now knows could have been born HIV-. Her health is also an issue as her medications have been increased after adverse reactions to the previous ones. However, these women understand that life is about struggle and responding to it – if not for yourself, then for others – and this is why I label the presentation “Women Peace Builders”.

Political Violence in Mumbai

2008-02-22T11:40:00.000-05:00

Dispute Illustrates One of the Key Issues India Faces

The cell phone rings and my Indian friend’s expression changes. I ask what happened and in a frantic voice he replies, “They are screwing foreigners! They are screwing foreigners!” The driver quickly turns down a new street because the voice on the cell phone says a riot has broken out on one of the main roads we would soon be on. After learning about what was going on, who would have thought that the “foreigners” are actually Indians themselves.

The migration “problem” is interesting for an American to view because whereas in the states it is the illegal international immigrants that garner the dubious honor of receiving the blame, in India it is proper Indians from other states or areas of the country. This causes a huge rift in the nation because after all, India is a constitutional democracy that states “India for all Indians”. However India’s deep rooted history, which includes states warring between states, empires fighting empires, and religions battling religions, has created an atmosphere that is at times state over country.

What did this experience teach me? Well for starters, the importance of internal migration is at the forefront of India’s present and future and India’s rich diversity is not accepted by all within the country. The atmosphere lends itself for unsavory politicians to take advantage of small percentages of the city’s population. For instance, Raj Thackeray, the leader of one of the Maharashtrian parties, provoked and rallied his supporters to literally beat up any North India they found in the city. The news highlights showed taxi drivers ripped out of cars, beaten by ten men, and then their cars broken.

Why is this happening? The core answer is jobs. There is a huge crunch for jobs as India’s population is over 1 billion and unemployment is a pressing issue. With the tremendous growth in the economy cities have become a center for migrants from all around seeking work. One side claims the migrants are taking jobs away from locals and that they are responsible for much of the poverty in the cities. They point to the migrants additional strain on the already overwhelmed public infrastructure and resources, such as energy and water. The migrants argue that they are doing work no locals want, or have shown interest in, and furthermore that their cheap labor keeps prices low for everyone. Lastly, their most important rallying cry, which thankfully has been reiterated in the media and by public officials, is they are Indian and have the right to be there working.

After the turmoil, Raj was arrested and let out on bail despite of the injuries sustained to north Indians, the fear that terrorized the city, and hiccup it caused in the local economy. He has a temporary restraining order against holding rallies or giving strong quotes to media. I doubt this type of punishment will stop future attempts, but one thing is surely evident, many Indians from all across the country have clearly spoken out against Raj and his intentions at causing rifts within Indian society.

A Catch 66?

2008-02-14T11:22:00.006-05:00

3 Different Entities Have Tough Decisions to Make

When the government run National AIDS Control Organization (NACO) implemented its new Phase III initiative it did not take into account its own country's laws. Sounds confusing right? Let me try to explain.

Well, the issue arose when NACO decided to change the targeted groups for its programs of intervention and awareness from the "high risk" population to the "core" population. This switch namely means from truckers and migrant workers to commercial sex workers and men who have sex with men. The switch seems logical - after all one sex worker can be responsible for infecting a good deal of men. Also targeting the "core" is agreed to be the best way to address the increasing prevalence rate in some of India's hardest hit states. To accomplish such feats, NACO has asked its state and district subsidiaries and reputable non-governmental organizations to choose a local commercial sex worker and homosexual man to receive proper training by NACO. These two individuals can lead the outreach work through their personal experience and connections to the different target groups. Part of this plan is to register the individuals to make sure they get the attention and help they deserve.

Now here comes the rub. While this all seems pretty logical, the grassroots people responsible to implement the Phase III initiative are walking on egg shells. According to Indian law it is illegal to be a commercial sex worker and, interesting enough, it is not illegal to be a homosexual but it is a jailable offense to engage in homosexual acts of intercourse.

So now we have three entities entangled in Joseph Heller's famous "Catch 22": the government, the NGOs, and the core group representatives. The government needs to further address the growing HIV issue and engaging the core group is the most effective approach of doing so. Including members of the core group as part of the solution will greatly increase the success rate and efficiency because they have invaluable insider knowledge. However, current laws will surely hamper the new program and any attempt by the government to alter these laws in the slightest will cause chaos with the heavy religious and conservative voices in the country.

The NGOs float in the same lake but are in a different boat. If they do not support the decisions of NACO or reject the projects as illogical, they run the risk of biting the hand that feeds them; after all, NACO provides a great deal of the funding for HIV NGOs. If they do support the measures then they run the risk of exposing their core group workers to arrest or some other potential trouble. The same is true if they are required to register the people who they are trying to help at their facilities.

Lastly, the individual core group workers that NACO demands spearhead the projects at the local level are stuck between the proverbial rock and a hard place. If they do choose to accept the position, they get a chance at a paying job, helping people who they know, and saving some from what they understand is a difficult and sometimes lonely future. However, aside from the potential of being arrested now or later, coming out and saying you are a homosexual or a commercial sex worker is not going to make anyone's life any easier anywhere, especially in India. Both face great amounts of discrimination and they also run the risk of "disgracing their families" (a one way ticket to horrible karma in Indian culture and Hindu religion). For example, I have met homosexual men who would rather say they are HIV positive than admit they are homosexual. Hopefully this shows how hard it is to take such a bold step as this job requires.

All three of these parties have a lot to think about before the Phase III initiative can be as effective, efficient, and successful as possible. NACO has forged ahead hoping that volunteers will not fear any type of repercussions. However, after talking to some of the organizations it appears that involved people, especially homosexual males, are not exactly lining up for the positions. Also another consideration that NACO may have overlooked is the education level of the commercial sex workers. For instance, one NGO is teaching their representative how to write before she goes to the training session. Decisions have certainly been made and only time will tell if they are on the right path or if phase III is already set for failure - stuck in a triple “catch 22”.

From a Distance

2008-02-12T08:00:00.001-05:00

Providing Free Care in the Villages

I step off the truck and dry sandy Earth greets my shoes. Immediately a cloud of smoke from the dirt makes its way up my pant legs. We have arrived at the village center but I only see one person waiting for the free care. Where are all the people?

The person is an elderly man whose poor condition and back problems are obviously more than the staff of one doctor and two helpers can manage. The man uses a walking stick and is hunched over like a frail Quasimodo. I begin to think about how long this man must have been sitting here waiting and again my mind drifts to the question of where are all the people; after all these services are free.

I look around and only see dirt roads going in all directions. I look closer and can see the people slowly coming to the village center. From far away I can make out the beautiful saris, which are full of vibrant colors and elegant designs. Yet as they approach, the contrast of the saris and women’s physical conditions make a lasting impression. Some have light coats of dirt from the walking or skin that is very dry. Only a quick glance at the feet will bring a sense of reality back, many are bare or have such cracked skin that it is painful to look at. The first two people are a woman who is holding hands with a young child. The next two are a grandmother holding a two year old girl in her arms (See Photo). Two by two they slowly come for free treatment provided by Reliance Industry Limited. This is the village’s method of receiving primary care – a weekly visit by a RV truck. The doctor, who is stocked with only brand name drugs to insure quality, doles out medication for fungal infections, skin problems, fevers, coughs, and several other non-emergency problems. If it is serious, such as TB, they get referred to the TB/HIV Community Care Center. Also patients must present their list, which costs 2 rupees (10 cents) that shows their history of ailments and treatment. I inquire about the fee and the doctor tells me that even the most miniscule of fees has shown to make patients value and adhere to the medication.

I spend my time either sitting with the doctor or walking around the village centers trying to get a feel for the life of the village. There is a line of patients now (See Photo) and many appear to be joking around or lost in conversation. Some of my observations and questions are met with easy responses. “The men are working in the fields or in the city that’s why you don’t see any”. Others take a little longer to process. Many of the women and older children come to get “heel cream”. The bottoms of their feet and their heels are cracked, split, and extremely dry. I am told it’s due to working in the damp fields and farms and that a fungus is the culprit.

After 2 hours the doctor (See Photo) has seen a total of 63 patients, mostly women and children, from two villages. Two by two the villagers walk back from where they came. As they get farther and farther, once again, all I can make out is the beauty of their saris. Yet, this time I know there is much more behind the colors and designs.

25 Orphans get a Day of Relief

2008-02-09T11:40:00.001-05:00

Reliance Ladies Club Biweekly Matches Families with In-Need HIV/AIDS Children

The concept is simple - those who have, help those who don't. It is not a way to solve India's development problems and it is not a long term solution for children struggling with HIV, but it is a way to supply a child in need with a month worth of nutritional food and a chance to play for an hour.

Reliance women's club, which consists of approximately 50 wives of officer level employees, have paired their members with 25 HIV positive children who are either orphaned or coming from a single guardian family. I use the word guardian because many of the children have lost their parents and are cared for by their grandmothers or relatives. The in-need families are coordinated by the GSNP+ (Official State HIV Self Help Group) and the transporation is arranged by Reliance SUVS.

Physical scars, like decayed teeth or blotchy skin, are not the only toll on display for a first time visitor. As the children and the guardians pile out of the truck, it is obvious that most of the children are battling more than HIV. Some have tattered clothes and others are barefoot, but when you dig a little deeper the emotional scars begin to surface. You notice that some are very shy and others have a look of depression in their eyes and demeanor.

Whether I was ready or not I am paired with a toddler and a young lady. The littly girl was at most four years old and her chubby cheeks and Pooh Bear sweater reminded me of my kid sister. The girl stares with no hint of emotion at the young lady. Her parents have both passed from AIDS and her aunt, a girl no older than 22, has taken her in. The doctor shows me the scar on her belly from when they had to remove her gall bladder due to a serious infection. I resort to childish antics in an attempt to break the ice and overcome the inherent language barrier, but I do not find success until I pull out my camera. I place the camera in her hands and together we take a photo of her aunt. At last, she smiles! She moves onto my lap and we take a few more pictures; always making sure to stop after each one to discover what magical screen will show. She still has not said a word but her shy smile says she is enjoying her time. If that were not enough of assurance, she offers me her chocolate bar from her gift basket as a sign of friendship. I break off a chunk and place it in her mouth. If I have learned one thing in my travels it is that all children like chocolate.

Fast forward past 40 minutes of playing with all the children and as everyone gets ready to leave my new friend runs up to me, gently grabs my hand, and in a tiny voice says her first words to me - "Ow Joe". Her little feet quickly return to her aunt and as quick as she left she returns with the translation - "Bye Bye". I begin to smile and, when one of the coordinators tells me that all the children have now learned to say "Bye-Bye", it turns into a laugh.

A Plan for Success

2008-02-07T13:18:00.000-05:00

A Comprehensive Approach and Unified Effort Illustrates How a Program Can Flourish

Over the last week I have been dabbling in different areas of the Reliance Industry Limited's Hazira HIV/TB Center that has received so much international praise from the United Nations and Business Magazines. I use the word dabbling because it is nearly impossible to cover all that they do in a matter of six days. HIV organizations usually excel in either prevention or treatment because both require a great deal of attention, dedication, and manpower. The Hazira program is one of the special ones that has managed to do both, and do them very well.

In regards to treatment, they take a holistic approach and understand their community’s needs. Poverty is a major issue and the majority of the clients deal with the everyday struggles that it entails. A very poor living condition is only one of the obstacles faced in daily life. Understanding this the Center provides HIV, TB, and opportunistic infection treatment – all at either 50% cost or free of charge. Widows, children under 15, and anyone who is deemed temporarily unable to physically work do not pay for any services, lab work, or drugs provided. The system set up with the government has the center paying for all second line drugs and opportunistic infections treatment (namely TB) while the government provides all the first line medications and prophylactics. Furthermore, Reliance has given a truck to the Center to do two pick-ups from a central hospital in the city. This truck comes packed with at least ten people for both trips. Without it treatment would not be an option for some because the 20-minute travel to the Center would simply be too much to afford.

Now you may be asking what the holistic thing is all about. Well, for starters they provide pre and post test counseling to infected persons and families and no one is placed on treatment until they have gone two rounds of counseling that stresses the importance of medication adherence. Taking your medications on time and never skipping doses is the best possible way to limit the chances of developing resistance and having to move to the next class of drugs, which are much more costly and stressful on the body. In addition, they have a yoga class set up that is specifically designed for HIV positive people. They play light music throughout the sick wards and try their best to provide a family atmosphere. For orphaned children they have set up a family partnering system that sees Reliance families helping the children with costs of education, food, and odds and ends. Lastly, a garden is in the process of being created for HIV positive people to grow vegetables and the majority of staff employed is HIV positive.

The Center’s partnership with a local NGO and the Gujarati State Network of People + has taken prevention literally to the streets. While the NGO officials do talks and counseling with sex workers and migrant labor shanty towns, the Network follows up each new case with one on one meetings and support groups; therefore providing the safety network that is invaluable for individuals faced with the stark reality of being HIV + in a developing country. The Center does its share of prevention work as well. All of Reliance’s nearly 10,000 Hazira site workers must go through an HIV and TB learning session to get their worksite IDs validated and they also do annual check ups. Truck drivers are welcomed to the gates of the Hazira site with an HIV pamphlet and a three pack of condoms and lastly one Thursday a month the head staff go to three factories and get the CEO to sign legal documents that state HIV workers rights and prevention campaigns to workers.

Like I said in the beginning it is difficult to immerse yourself in all that the Center does, but it does not go unnoticed or unwritten. The results over three complete years are concrete. Over 1800 HIV positive people registered at the clinic. Over 2200 STDs treated. Over 500 people on Highly Active HIV medication (HAART). Over 250 people on TB treatment. More over they have begun to change the culture of HIV and the stigma surrounding the disease through all the prevention work. In summary, the most important thing to take from this post is the accomplishments that can be achieved and realized when different entities come together with a common goal and each one contributing with their own strengths.

Corporate Social Responsibility

2008-02-05T11:17:00.000-05:00

The Concept that is Developing a Country

What if I told you one of India's largest and most important corporations is behind one of its biggest HIV success stories? You would think there is a catch, but with the good publicity comes great work that is transforming an entire city.

The story starts with a notion that is simple in sound and proven effective in action. The concept is what experts coin "Corporate Social Responsibility" (CSR) and, for whatever reasons it is initiated, it plays opposite to corporate capitalism, something Americans are unfortunately all too familiar with. In this model the corporate world goes past philanthropy and donating to charities, and instead bases its practices and focus on human rights. It sounds idyllic and the jury is still out on the successes and pitfalls of such work, but some examples illustrate the type of vision that can foster positive change.

The secret to this recipe is mixing the right amount of ingredients and letting the flavors of each spice blend and not overwhelm the pallet. One part corporation for the business smarts of management and efficieny, one part government to utilize the experts in the various ministries, increased resources, and its ability to coordinate with different sectors, and lastly, non-governmental organizations to run the grassroot initiatives and provide added man power. After all this you have what is know as "public-private partnerships" that are responsible for much of India's development in the social sectors, such as health, education, and even infrastructure.

Coming from a corporate capitalist society I was quick to ask questions and fact find when I met with an official from the Bombay Chamber of Commerce. There has to be a catch or esle why would these large corporations committ such amazing amount of capital. Well, good publicity and favorable public relations can certainly account for some of the good will, but the top corporations that have embraced the idea really take it to the next level. The official explained a key concept ingrained in Indian society - repayment of debt (and no I do not mean the bank). A further explanation was given by the Chief Medical Officer at one of the coporations. He said one of the most important concepts for Indians is karma and reincarnation; therefore repayment of debts, especially to your parents and teachers, is a vital component of life. This is achieved by taking care of your parents in their old age and putting what the teacher taught you into practice and good use.

The higher ups and decision makers have all witnessed the change that has happened within the last few decades in India. The large corporations have grown almost exponentially in the last 10 years and to whom do they owe their debt? Well the answer given was India and they see their duty is to repay it by running development programs.

One of the India's biggest corporate success stories is Reliance Industries Limited (RIL), which last year accounted for 12% of India's Exports and 2.7% of India's GDP, and it is also a paradigm for the corporate social responsibility model. They run a plethora of programs meant to increase healthcare, education, local infrastructure, and the enviroment (which seeing a petro-chemical factory with a large "green" zone is quite interesting to say the least). Perhaps the most internationally celebrated one is the HIV program they run, which is cited as a "Global Best Pratice" by the United Nations Global Pact. This is the program that I will be documenting for the book and my next post will attempt to highlight why such praise has been bestowed upon them.

Mumbai It Is

2008-02-02T07:52:00.000-05:00

First Impressions of India

Indian cuisine and culture are things that I have grown accustomed to through family friends and reading international news. However, I knew after a few dozen pages into my travelers guide that it would be quite impossible to familiarize myself with "all that is India". The history and culture are simply too rich and deep to understand the quagmire that is India, but the realities of Mumbai offer quite a crash course. Here is what two days of Mumbai has taught me:

My first lesson was taught quite early on as I was still in the Airport. People here know how to deal with crowds. Bumping, pushing, and aggressive maneuvering are all part of the lesson plan, and if you take offense, and they notice, a sorry or excuse me always greets your American urges to bump back! This lesson continues throughout your daily activities as you are never away from loads of traffic, markets, and people. The human density that makes up Mumbai is simply remarkable - 16 million people, no less on an island of course.

The second lesson comes as a result of the first. My teacher was a sign at the hostel I am staying at which is run by Jesuits. The sign tells patrons that water is an extremely valuable resource so it must be used only when needed and that energy is only available from shared outlets outside of rooms. Water and energy are items often taken for granted in the States but here they are resourses that are often discussed in local politics. The amount of people have led to a crunch that is something I have never witnessed before. Infrastructure expenditures are where much of the money is being spent in Mumbai and it is understandable but hotly debated. Roads, bridges, subways are only some of the things being built to ease the immense amount of traffic and the endless commutes through bumper to bumper metal. However, affordable housing is a topic that must be addressed as many sources say 55% of Mumbai's population live in slums. The most famous has more than 1 million people in 1.7 square kilometers.

My third lesson is that India has got a great deal of money coming in and floating around its country in large corporations. A topic I will be writing about later is a development driven enterprise that is called "private-public partnerships" that puts together large corporations and government ministries to run service programs. The amount of growth that is being seen is quite remarkable. Immense bridges, fortune 500 companies, open markets, and bollywood, they all show that wealth is being created, but it appears to be in the hands of the few and surely not reaching the grand majority of Mumbai's population.

My fourth lesson was perhaps the best glimpse into India life. I have never seen religion play such a major role in the life of a city before. It is quite obvious who are mulsim, who are hindu, and who are catholic. Of course other religions are abundant as well. For instance, the Parsi community, which seem to be responsible for much of the philathropic works of the past and present, is always a popular topic of discussion. The impact of religion will be something that I undoubtedly will return to after experiencing more because its impact is immeasurable.

My last lesson is a vital part to understanding India. Indians are extremely friendly and honest people. Every person I have met through the foundation, churches, and families have shown me that hospitality and a friendly demeanor is something that is fundamentally at India's core, but that still does not mean a taxi driver won't try to charge you double!

The lessons will continue and the next post will share more about the organization that I have chosen to include in the project. Check back on Monday.

A Story of Shakespearean Proportions

2008-01-28T06:51:00.002-05:00

A Wheel Chair Ride That Speaks Volumes

I sit behind her and can only think that I have traveled into the world of a Shakespearean tragedy. The rollercoaster ride has death, love, suffering, and now prayer. The words begin to come out of her mouth. She speaks aloud to the dead body and then folds her hands to her head to signal she is praying. A calmness sets in, but an uneasiness enters. A chill runs over me as I stare and try to imagine myself in her shoes.

It was the start of my second day and already I knew my back and hands could not take another full day of giving massages. I remembered seeing wheelchairs the day before near the bathroom and thought I could shuffle in wheelchair rides to give my body a slight break. However the physical strain was only transferred to my mind and emotions.

It started simply and in the middle became quite challenging. A nurse brought me to someone she thought would want to go outside and informed me that the patient had "a slow brain". The woman barely spoke a word to me the day before and her facial expressions did seem a little abnormal. I helped the woman into the wheelchair and started to go outside. Something was obviously up as she pointed to the left. A female french photographer greets me outside and asks if I was going to take her for her daily tour. She took my puzzled look as a sign to explain further. She continued by telling me that a Maryknoll priest had been volunteering at the Temple for almost six years and had taken the woman out every morning to pray and see her boyfriend. However, the priest has since been stationed inTanzania and the morning ritual has gone away with him. From what I have been told no one else had taken interest in continuing the ritual.

We begin by stopping at a small shop and she asks for a energy drink with two raw eggs in it. The photographer ques me in on the story and outlines the "stops" before going off to finish her work with TIME magazine. The woman came to the Temple over eight years ago with her husband. They both had HIV and the husband soon passed away. Over the years she fell deeply in love with another HIV positive man at the Temple. He passed away as well and in an act of despair she attempted suicide by jumping off a roof. She broke her hips, damaged her mouth, and did some nerve damage as well, which explains the "slow brain" and her inability to walk or stand. When I heard this story I could not help but think it was a plot from a depressing and twisted movie; one that depicted a rollercoaster of emotions and in the end left the main character bedridden and alone.I am told that she shared a deep and affectionate relationship with the man she met at the temple and soon they became "the couple" all could see constantly together.

By this time we had already stopped at the Buddha shrine and she has prayed using the traditional three sticks of incense (see photos on sidebar). We make our way to the infamous Life Museum and I hesitate to enter. The photographer sees my hesitation and points to one man on display and says . . . that is him! She leaves as quickly as she came and I am torn on what to do. Does she really want to be rolled into a room full of dead bodies who succumbed to death from the same virus she has? Does she really want to be locked into a seat a few yards from the naked and partially decayed body of a man who she passionately loved and attempted suicide over? Even if it were torturous, how would I know what she is saying or trying to communicate? The questions flooded my mind as I lifted the chair over the step and then finish locking the wheelchair in its place.

She has not been here in almost a month and all I can do is think about what she is saying out loud. After ten minutes she claps three times and rubs her head - it's the signal that she is done. She opens up as we leave the life museum. She laughs and starts to talk as we make our way to the stand at the front gate. Once there I buy her some of the plastic bracelets that she loves to wear. During this time she gets to talk to some of the vendors, who are HIV positive as well. It's her only time to socialize because in the infirmary attention is not something she is accustomed to. I bring her back and realize after 40 minutes and 2 dollars that what started as a way to take a break ended up making someone's day in way I would never have expected or anticipated. Now when I first walk in she looks at me and signals to the door with a smile. Sadly every time I bring her back I can not help but wonder if after I leave she will be resigned to the bed and never get a chance to go for what some might think is just a wheel chair ride.

The Life Museum

2008-01-25T10:13:00.000-05:00

A Stunning Example of How East and West Differ
(Photos included in Sidebar Slide show)

If controversy arose from the Bodies Exhibit that opened in major US cities, then I can not imagine what response the Temple's Life Museum would garner. The differences between East and West are ever present when one enters the museum. Whereas the Bodies Exhibit was heralded as a new scientific approach at illustrating what I would say is the miracle of life, the Life Museum makes no such attempt or approach. It is quite simply twelve former patients, ranging from old to infant and sex worker to buddhist monk, who have a few things in common; they are Thais, they died because of HIV, they are completely naked, and they have been dead for years with all the signs of death you would imagine.

It is obvious that as a westerner one views the exhibit in a state of shock. The sheer morbidity and the deceased naked bodies remind you of just how fragile life is and what eventually awaits us all. The bodies are held up by metal clasps and no display case or boundary separates the viewer from the body being viewed. Next to their petrified bodies is a sheet that states the name, occupation, date of birth and death, and how contracted HIV. A knot turns in my stomach as I approach the three infants of the exhibit. You do not want to look or imagine what this child's parents or gaudarians went through six years ago when she passed away.

The volunteer coordinator explains to me that she knows the museum is very controversal to westerners. I have already noticed some that walk out quickly with a face that shows exactly what they are thinking. Yet, many thais and asian visitors stand in the museum snapping photos and bring children of all ages all for the ride. Why such a discrepancy? The sign that rests in the corner of the room attempts to tackle the reasoning.

Personally, I see the entire exhibit as a challenge to try to wipe the slate clear and just absorb and observe with a fresh and non-judgemental mind. It is extremely difficult but it must be done. What you learn is that one tradition is not "better" or more "right" than the other. They simply are different and approach fundamental issues through differing lens.

I will end this post with the aforementioned sign because the Buddhist monks have captured the essence of the story better than I can. The sign reads . . .

"The Spirit of those who have died here teach us how to think about our life today and in the future. We understand that life is all around us. But sometimes we forget that we are connected to all of life. Death is a part of life and we forget to accept this truth. Death leads to the birth of new life. We invite all of you who come to this place to be silent as you experience what you see here. This museum has many bodies that shows how death affects all of us. Leading us to the truth that in life we must do good for others."

Mai Pen Rai (Don't Worry)

2008-01-22T06:55:00.000-05:00

Interviewing Dr. Alongkot Dikkapanyo

I shake his hand and tell him that I did not understand a word from his mouth; but it was obvious he was speaking sincerely and from the heart. Weeks of emails and phone calls had gotten me and my Thai host no where as many attempts to contact him always failed. Even though I had never seen him, it was like I already knew him. His photo, either alone or with patients, is all over the temple including over some patients' beds. We had just spent nearly two hours with him, which I knew was something unique and special.

I was already in my fourth day of volunteering at the Temple and I wanted to introduce myself. Word comes back that I can see the Abbott Sunday at 3pm. I rush to call my interpreter because I am told that my interview should be done at this time. Flash to 2:55pm and we are waiting outside his small building. Accompanying us are over 25 pairs of shoes. I learn Sunday is the day villagers come, make donations, and then get to see the Abbott. While we wait I get versed in the proper way to address the Abbott and reminded of both how important he is and the respect that all must show him.

The door slides open at 3:15pm and we are invited in. The room is furnished with golden Buddhist statues and other elaborate decorations (see photos). I quickly tell my interpreter, Aoh, there is no way I can interview him in front of all these people. Before I know it I am told it's our turn. Aoh asks if I know the proper greeting. I stare at him with confusion and realize all around are on their knees bowing. I quickly get down but do not touch my head to the ground as the others. The Abbott is sitting peacefully in his burnt orange robes, the signal of meditation monks. It is time to think quickly. I slide in front of the monk, graciously bow my head, and begin to introduce myself in a very slow and clear voice. I feel as though I am in an Indiana Jones movie -

"Sah Wah Dee Khrup Lauwpaw Alongkot, my name is Marco Ambrosio and I have come from America to include your Temple's story of compassion in a book I am writing". I know I only have a few other moments so I inform him of all my contacts that suggested I come to his temple and let him know I have been volunteering at the infirmary. He smiles kindly and welcomes me.

A huge sigh of relief rushes over me as a slip up or negative response from the Abbott would have ended my time at the Temple and weeks of planning and funds. All my excitement is crushed as I see Aoh talking in Thai and looking quite frazzled. He comes back to tell me that they will give me 15 minutes alone for an interview. I know and Aoh knows that the interview takes at least an hour and fifteen minutes. I simply decline. We reiterate that I have come from America with this specific goal and need enough time for the interview. The response . . . the Abbott will be free after his speech at the site of Project II.

Great! Right? Wrong! I find out the site is over an hour away and we have no way there or back! I am told that it will be my only chance to interview him as his schedule is full for the week. Aoh works some magic and befriends a crew from National Geographic. They are in the same boat but they have a life raft - a car. The entire time I am in shock that a scheduled appointment that was confirmed would end up this way, but then I recall a famous Buddhist saying "Mai Pen Rai" (Don't Worry/No Rush). Three hours later I found myself sitting next to Dr. Alongkot the person. No kneeling or intimidating shrines or followers bowing all around. Instead when we rise for photos he is swarmed by over ten different children who live at the facility with HIV and a group of dogs that call the site home as well. In the end, "Mai Pen Rai" was right.

Importance of Touch

2008-01-20T09:32:00.004-05:00

When Words Fail (or Can't Be Used)

Difficulty in communicating was something I anticipated when conducting this project abroad. However, the degree is amplified when you spend the majority of your day in an AIDS hospice infirmary. "How do you feel?" and "Is there anything I can do to help?" are things I can only wish to say to the person lying in the bed. Instead it is a smile and a bow. When I do try to speak, the best Thai that comes out is hello, my name is Ma-Ko (the R sound is difficult for Thais) and I am a writer from America. Honestly, who cares about any of that. I had to think of other ways to say I am here or you are not alone because these options were just not enough.

Then the massages started. I signed on to do "physical therapy", which is really nothing more than a gentle massage with an Icy-Hot style cream. I was certainly nervous to say the least, and the sweat that accumulated in my gloves was an easy indicator. Me, nervous? A person that knows the way HIV spreads! I was almost ashamed at myself. After the first person the trepidation subsides and the pure observations begin. The majority of the patients are covered in small scares - old lesions and new, the legs and arms are spotted like a leopard. I soon realize that I am in for quite the day as every time I finish there is a new person that wants a massage. It must be for the attention or the touch of someone besides to take their blood pressure or change their diaper. Surely I am not the world's best masseur, especially in a country renowned for its massages.

I have been told that the hospital ward is a mixture of very seriously ill patients but also moderate and mild cases as well. They are not separated but it is usually pretty obvious by their weight and skin. Some are skin and bones. You massage expecting to feel a muscle and yet your fingertips are greeted by flappy wrinkly skin and a hard bone. The skin is very dry and pieces of hair fall out during the massage. I would think that I was hurting or boring them if it were not for the smile or some indication that they want me to continue. However, when tour groups come into the hospital, about three do a day, you feel utterly connected to the person. The pictures and videos are taken and you try to ignore them by continuing with the "physical therapy", but usually I am overwhelmed by putting myself in the patient's shoes. Some talk to the visitors, many of which bring small gifts or cash handouts, and others simply stare off or do not pay any attention. They never turn down a photo, but then again many are never given the chance. When not asked I try to squeeze a little harder or rush to a new spot attempting my best to grab the patient's attention because no one wants to be treated like a side show or exhibit.

A massage is certainly not an answer to any of these people's problems, and I know that there is very limited, if any at all, medical benefit coming from massaging legs and feet. I can not hold a conversation to talk about things that interest them or even get to know them. They remain a person, a fellow person and I can try my best to show they are not alone. I finish a massage and, like always, their hands go up in a praying manner to their forehead and they say thank you. So many words build up inside me waiting to flow out but the only thing I can say is "Thank you" with a smile and a bow.

Standing Up to the Challenge

2008-01-19T04:11:00.001-05:00

Then and Now of AIDS Temple

Nestled in the foothill of mountains roughly 5 km from a main avenue, you can find a Buddhist Temple that brings the word compassion to life. Although the temple sits 120km north of Bangkok, in its confines all of Thailand is represented. Its reputation holds true to this statement, as the majority of Thais that learn of my project have made sure I know of its existence and location.

In 1992, the temple turned into a small 8 bed AIDS hospice after Buddhist monk Dr. Alongkot Dikkapanyo witnessed the death of an AIDS patient at a nearby hospital. The initial people that entered the temple were in the late stages of AIDS and had been abandoned by all they knew. Dr. Alongkot's goal was simple - provide solidarity through compassion and let the people pass with dignity. A simple goal was met with more than emotional costs.

It is tradition for buddhist monks to go into the streets with an empty bowl. In this bowl people put money or food that is then pooled together at the Temple to feed the monks. The people gain merits for their prayers, loved ones, and ancestors and in return the monks are provided with sustainance. Townspeople lacked any information about HIV and feared the idea of having an AIDS hospice set up in their area. Would the large corn fields that separate the temple from houses get the disease? Could we get the disease by getting close to Dr. Alongkot? As a result, no one put food in his bowl! The fear and task would normally appear daunting.

Through the hard work of the monks, none more than Dr. Alongkot, the temple has grown to 400 beds, 3 separate projects, and a source of pride for the town and Thais from around the country. Some even say that it is the best HIV/AIDS organization in the country and I am sure everyone will ask (just like I did), "What makes it so?". In two days I have learned the answer. For starters, the AIDS temple does treatment and prevention to the best of its ability while receiving the majority of its funds from private donations. It receives around $3000 from the government annually and yet has found a way to build quite a facility. The infirmary holds 33 beds, which includes an adjacent 6 bed TB wing, separate housing for HIV positive males and females, family style housing for couples, advocacy museums that see class trips and families as visitors, and a newly constructed orphans village located quite a distance from temple grounds. Now flash to Saturday January 19, 2008 and you will see people throughout the day coming in to drop off donations that range from rice, rubbing alcohol, and stuffed animals.

Coming Tomorrow: Volunteering in the AIDS Temple Infirmary

Wat Phra Baht Nam Phu

2008-01-16T22:09:00.000-05:00

The Famous Buddhist AIDS Temple of Thailand

I will be spending the next 10-12 days at the AIDS Temple with the goal of incorporating their work into the project. Their story is quite unique and moving to say the least. The Temple began as a place to gain a dignified passing as a buddhist monk began taking care of people in the late stages of AIDS who had been abandoned by much of society, family and friends included. His goal has always been to bring compassion back into the lives of those who, in essence, need so much.

The temple has grown immensely since it's start in 1992. It has developed three separate projects, including housing for families affected by HIV. I hope you visit their website to learn more about their work (http://www.aidstemple.th.org/). This entry will win the contest for shortest, but I assure you it is because the three hour bus ride north to the temple is preceded by an unanticipated hour trip to the bus terminal.

I am not sure if Lopburi will have internet access but assure you that upon arrival there will be much to read. (edit update: I have found an internet cafe within walking distance from the hotel I am staying at in Lopburi)

Long Live the King

2008-01-12T04:16:00.000-05:00

Thailand's King - A People's King

If you went up to the majority of my friends from the United States and said “Long Live the King” they would probably think you are studying a Shakespearean tragedy or getting into an Elvis groove. However here in Thailand everywhere one goes the King is ever present and they would not have it any other way.

Simply put I have found in my days here in Thailand that Thais love two things – food and the King. What do I mean? Well for instance, when the 80 year old King was not feeling well last year, the people organized a campaign to wear yellow on Mondays. Over a year later it is still in full effect as more than half the city of 12 million people wears yellow. It has become a staple to show unity and respect for their beloved head of state. The idea is very Buddhist in nature. The belief is centered on how the thoughts and goodwill send positive energy to the King. It does not stop with wearing the King’s color on Mondays. His flag is flown next to where ever the Thai flag hangs and large tributes and posters of him in various stages of life line the main avenues and various buildings (See photos).

In the States, the idea of a king in the 21st century would probably be greeted by a New York catch phrase, but when you dig deeper it makes sense in this country. The King is seen as a humanitarian, an honest man, and someone who always has the best intentions for the people of Thailand. This belief is unquestioned and uniform throughout all of Bangkok. The Buddhist temples praise him for his demeanor and spirituality. The older generations revere him and have grown up with him as he as reigned for over 60 years. The younger generations love his calls for action and admire how he accepted advances in technology. It is not difficult to understand why. In 2006 when the prime minister was deposed and replaced by the military, it was the King’s diplomacy that made it bloodless and a smooth transition. It is the King who challenges the government on how it spends the people’s money and the work they do in the name of Thailand. It is the King who created and runs a large scale project to support small agricultural communities.

In a developing country, where economics and politics are usually crazy and the majority of people are living in poverty, the King remains the beacon of hope and pillar for what is right. He is the voice of reason and a whistleblower. Unafraid of the consequences he speaks from experience and has the support of the entire country. It certainly becomes difficult to find a similarly popular and righteous person who plays the same kind of role in the States and I unfortunately did not find this type of figure in Nicaragua.

Who comes to mind? Well, in no particular order - Oprah (women’s school in South Africa), Al Gore (global warming), Bill Clinton (Foundation’s HIV work), and then there is Hollywood, such as George Clooney’s public stance on Darfur. However, it is still not comparable because these people are often heavily criticized and none really touches all the areas that the King addresses. Understandably this is a different culture, and I am not saying that I think the US needs a king, but having someone that is so important in the public eye and that person being beloved and seen as the vanguard of the nation is quite a unique experience.

The Impressions Continue: Transportation

2008-01-08T22:53:00.000-05:00

Traveling Around Bangkok

Bangkok is a city that is full of hustle and flow. The highways and avenues are full of traffic, there is a smog that settles in and fights the sun’s rays in the morning, and the streets are full of food stands, people, and various types of taxis.

That being said, transportation options are numerous throughout the city. Within the last 10 years the Skytrain (similar to the famous Disney Monorail system) and the Metro subway have greatly eased the flow of traffic and transformed Bangkok into a more modernized city. Combined, both systems cover approximately 40% of the urban city and they are very clean and high tech; for example, commercials and advertisements run on loop on flat screen monitors in Skytrain cars. I spoke with my host about the effects and usefulness of the systems and the answer is two-fold. It is very obvious that people utilize them as business workers of all ages, students, and tourists are ever present, but it lacks in the number of places it touches and in the amount of the city it spans.

The transportation systems are supplemented by the bustling taxi system of Bangkok. A traveler can choose from a regular metered taxi, a metered boat taxi, or spend less and haggle with the notorious tuk-tuks (think open air three wheel motorized carts) and moto-taxis (riding on the back of a motorcycle). Although the tuk-tuks are noisy and give the passenger little to no fresh air, tourists flock to them because they are something out of the norm. I followed suit and can testify to the noise and helter skelter that is the tuk-tuks. However when it comes to open air riding the tuk-tuk is the furthest I will go. Moto-taxis, the cheapest option, could be its own extreme game show on Fox. Drivers zip through any opening in traffic they can find in the busy streets, sometimes lodging themselves in between lanes and buses. I would say if a passenger is carrying while on the moto-taxi they run the risk of losing the carry a long or losing the health.

An interesting development will be if they decide to expand the systems. With so many Thais earning a living working as various types of taxi drivers, one must wonder what kind of effect an increased system would have on the employment rate. It touches upon some of the key aspects of development. At what pace should a developing and modernizing take place? You must keep in mind the general population and if they are able to meet the changes that will come; i.e. finding a new job if there is taken by a computer. Furthermore, a topic that will be touched upon in other posts, what is the happy balance between development and maintaining culture. A topic of great importance in Bangkok, where tradition and religion are steeped deep into every facet of daily life.

Sa-Wa-Dee Khrup ( Hello )

2008-01-06T22:19:00.000-05:00

First Impression of Thailand

I should begin by saying Merry Christmas and Happy New Year! It has been more than two weeks since my last post and I apologize for the gap. However, I am back on the road conducting what is now the 3^rd leg of the project. Since Thailand is very different to anything I am accustomed to I thought it wise to begin with “First Impressions”.

My first contact with something Thai would have to my 16-hour flight from NYC. It sounds much worse than it really is. With a personal TV every passenger has access to hordes of movies, music, and games (ranging from Super Mario Brothers to chess to learning Thai). Everything in the plane is shades of pink and purple to match the important Thai Orchid and service is top-notch. With three above average square meals and sandwiches and fruit by request, it is no wonder why some refer to Thai Airlines as Stuff You Air. Move over British, the Thai know how to fly.

Upon landing it is very evident that Bangkok is a busy International hub. At the immigration check point I waited for 30 minutes because within an hour range of my flight more than 10 other international arrivals had landed (JFK, Boston, London, Taipei, Tokyo, Hong Kong, Etc.). The International feel is continued as my host Mike and I drive through “Downtown Bangkok”. Would you care for gelato at the Italian Ice Cream store? You could stop for drinks at the Heineken roof top bar or eat at any of the authentic Vietnamese, Japanese, Chinese, Thai, Italian, and the list goes on and on for restaurants. For those who need their American Coffee or Slurpees, I counted three Starbucks and two 7-11s on the roughly 2 miles we were on the main avenue.

I would be mistaken not to mention the obvious language barrier. Thai is a remarkably difficult language to grasp. Even when the spelling is written phonetically you are not guaranteed success because the tone is generally flat and certain letters go unpronounced, such as the ‘h’ when preceded by a ‘k’, ‘p’, or ‘t’. After less then 24 hours here, I am nervous to say hello (sa-wa-dee khrup) and thank you (khop-khun-khrup). ‘Khrup’ is the word males add to the end of sentences to show courtesy and proper form and the female equivalent is ‘Kah’. I imagine taking taxis will have to wait until I learn some more of the basics. Luckily Mike lives approximately a mile from the famous Thai Sky Train system. It was built is 1998 and can take you around the heart of Bangkok in a cost effective and time efficient manner because rumor has it and guides profess it – traffic in Bangkok is bad and driving is even worse.

The last thing I want to mention is the advanced technology that I have seen so far in Thailand. Cell phones here make the States look like the developing country. The Apple iPhone is probably the only US phone that can hold its own in comparison but it is incredibly over priced. Here cell phones work on prepaid systems. You buy any phone and then prepay for the services you use (forget about roll over or unused minutes and contract termination fees). Also, little things make my experience in this developing country much different from the last. For instance a flat screen TV in front of a few street elevators or people with personal handheld screens that carry photos, planners, and everything else you would need were not things I saw while in Nicaragua. Needless to say I was impressed by the technology that is evident and available to Thais in Bangkok.

I will be returning to my pattern of writing at least every 3 days, but judging from the amount of notes I made from just one day I will probably post every other day. Any questions are always welcomed.

Religion and Politics: Good Thing It is Not a Dinner Party

2007-12-20T17:30:00.000-05:00

The effects of the Abortion Ban and Why it Got Passed

In 2006 the Nicaraguan Legislature voted in a law to out right ban abortions – even if the mother’s life is at risk. Former president Enrique Bolanos signed this law into the record books after much contested debate. In conversations and in human rights publications it became apparent that the timing of the vote was the critical factor.

The issue of abortions was thought to be completed as the law was already conservative in nature, an abortion could only be obtained after three doctors confirm the mother’s life is at risk. However, the issue was revisited in the months prior to the Presidential Election of 2006. UN representatives and Nicaraguan medical associations pleaded for the bill to be postponed until after elections but their voices fell on deaf ears. The Sandinistas, the former revolutionary party that has always maintained the rights of the people as its battle cry, decided to support the proposed bill in fear that they would lose the votes of the Catholic and religious groups, which are numerous throughout the land. Current President Daniel Ortega, a long time advocate of limited-abortion rights, crossed aisles and used the issue to unite himself with the Catholic Church, something that many agree won him the election. This is simply an example of politics done wrong, or sadly right, and it's not limited to Nicaragua. Political leaders changing stances or building platforms to gain votes and not because they believe it is right or just for the many. What has come from this bill?

Many women’s rights group have launched campaigns that profess the bill as limiting the rights of women. A rare victory that received national headlines in 2003 was the dismissal of criminal charges against the parents of a 9 year old rape victim and the doctor who performed the abortion. The issue still remains as a topic of closed quarter conversation. One banner that stayed in my mind was across from the public university and read “Adolescentes that are pregnant were violated, give women their right and say yes to therapeutic abortions”. Women of all ages have suffered from the banning of therapeutic abortions. One women’s rights group uses the story of a 22 yr old woman named Olga who died from complications of an entopic pregnancy, which is when the fertilized egg nests outside the uterus; thus losing any chance of survival and gravely putting the mother’s life at risk. Doctors in the hospital hesitated to act stating that they felt their hands were tied.

In regards to HIV, I was told about the plight of one of the women living with the virus who does not have many options to consider. While struggling with the everyday battle against poverty and the mental anxiety of finding out one’s HIV status, the woman has found out she is 2 months pregnant. Her fears are serious. What if the baby has HIV? Who will take care of it if I succumb to the disease? Can my body take the start of treatment with being pregnant? How will I afford the costs of supplemental medication and food with raising a child? In her mind she has decided that a therapeutic abortion is the only answer but where can she go? She does not have the money like some of the wealthy to fly to the USA or other countries to get the procedure done. She does not have the money to hire a lawyer to plead her case in the courts or pay for a doctor at a private clinic to secretly conduct the abortion. The most realistic option she has is to get what is called a “back-alley abortion”. These illegal and unsanitary methods directly put the woman’s life in danger and can lead to horrible birth defects if not successful.

This abortion ban is only one example of the aligned relationship that takes place between the church and the state in Nicaragua and, as a result, women, impoverished women to be more precise, are the ones paying the real price. Instead of the $500 for a plane ride to the USA and how much an abortion costs, the Nicaraguan woman who can’t afford this pays the price of putting her life in danger because of a law that was passed in fear of losing votes. Sadly this has become the nature of politics; do whatever will get the vote or keep you in office.

Inauguration Marks Big Step Forward

2007-12-13T11:00:00.000-05:00

I had the pleasure of attending the inauguration of the project entitled “Talking about HIV and AIDS, Strategy for the Empowerment of People Affected”. Before I comment on the afternoon I should first explain the jist of the project. This project formally establishes the HIV Self Help Group that is run in the region known as the Occidente, the three northwest regions of Nicaragua. The project is funded jointly by a German NGO, Arbeiter Samariter Bund Deustschland, and the German Government; both had representatives that addressed the crowd that had gathered and the members of the HIV group. The group’s office has been established in CISAS-León and will be autonomous. That said, the group will count on CISAS’ continued support to coordinate events and maintain a high level of performance.

Having a peer group of support is a vital component to living or battling any disease or ailment. This becomes even more essential with HIV and AIDS because of the heavy stigma and perception that abounds throughout any culture and place in the world. This group already has served as a guiding light and a place to gain hope battling for one’s rights. It is the hope of all the parties involved, that the existence of this group will mark a change in the way HIV is perceived in these communities and in Nicaragua.

The Group’s coordinator, a woman who has become a beacon of strength for many in the Group, addressed the crowd about the importance of solidarity and their goals. It was a speech full of passion that marked the objectives of the Group, but more importantly, it acknowledged that the rights of people who live with HIV are the same as those who don’t.

Both German officials that spoke touched on the power of solidarity, be it local or international, and did so in a manner that was heartfelt. The segments of their speeches that stuck with me depict certain truths about HIV both globally and locally. The representative from the German Embassy stated how for the first time in a long time HIV rates rose in Germany, and how it shocked a lot of people. He acknowledged that the fight and struggle against HIV and AIDS is perpetual and demands continued attention. In the face of the pandemic complacency is simply failure. The other German was the NGO representative and he closed his speech in an eerie manner that demonstrates the reality of living with the virus here. He stated that they know some of the group members will no longer be alive to see the end of the project, which is three years from now. The matter of fact style did not sit well with me and no one can ever blame the gentleman for sugar coating the truth.

This Group is much needed and the work they have already done and will continue to do is inmeasurable. I want to stress that the inauguration was a success and a reason to celebrate. However, the last thing I want to mention was something that I continually thought about while seated in the front row. During the speeches and the songs I imagined myself seated with a few of the HIV positive friends I made at Open Hand and the people I interviewed. I could only imagine their response to some of the choruses to the songs and the closing line by the NGO official. The songs, created for the event, seemed to me to be a little out of place. A good deal emphasized the fear one should have of contracting the “terrible HIV virus” and how if you contract it all your “happiness will leave”. These MAY be true (especially when treatment is adequate at best), but with all the HIV positive people in the crowd and the marking of the HIV Self Help Group, I believe all the stress should have been on living with HIV, solidarity, the breaking of stigma, and to the assurance of equal rights. However, I soon realized that I was not with those same people, and the mindset they have is unfortunately not realized here yet.

La Purísima - Halloween Meets the Virgin Mary

2007-12-09T15:50:00.000-05:00

National Holiday Celebrates the Immaculate Conception of Mary

I already know that Halloween gets its origins from being on the eve of all Saints Day, so the background is semi based on religion. However, somewhere through the years the focus changed to the tales of witches and ghosts and the doling out of candy. Kids get dressed up and yell " trick or treat" laughing. Now flash to the feast of the immaculate conception of Mary. It was made official by Pop Sixtus IV in 1476 and has been celebrated in Nicaragua for 150 years. Something tells me that not much has changed with the feast.

Boom Bang Boom . . . The fireworks, bottle rockets, and firecrackers start ar 6am and ring for 15 minutes. This will go on every 6 hours for the next 2 days no matter if day or night. Sporadically throughout the day you hear them fired and pop, but nothing as exciting as the first noon on the first day of celebration. Boom Ding Boom Ding... At noon the fireworks are accompanied by the bells of the churches that have towers in Central León. This signals to all that it is time to break from work and prepare for the Purísima.

For the 4 hours that we are at work nothing at all gets done. The excitement has been building all week. This year the 2 day celebration starts on a friday and is marked as the 150th anniversary. Moreover, this city is where the first ever celebration took place and the Church from which it started is one block from my house. Everyone asks me time and time again if I am going to yell today. At first I kid and say of course not, and I am met with an inquisitive "but you said you were catholic?". Well, I had to learn the jist of things and of course what to yell.

You subsitute "trick or treat" with a phrase "Who causes so much happiness?" that garners the response "The Conception of Mary", then you reply "Long live the Virgin". Whereas on Halloween the houses who are participating leave their lights on or some sign that they are Halloweeners, such as a Jack-o-Latern or tombstone, here the houses are signaled by an altar dedicated to Mary. Rich or poor the people put together ornate altars that feature christmas lights, fake flowers, painted backgrounds, and statues of Mary and Saints (see photos). Also instead of getting candy everywhere you go, "yellers"(as they are called) get everything from socks, pens, candles, to little sweets. Perhaps the most telling thing I recieved was from the Church of the Mother of Mercy, which handed out peeled sugar cane. It is a symbol of Nicaragua´s past, present, and future. From the sugar cane comes Nicaragua´s orld famous rum and also sugar, which in the future could be used such as in Brazil as fuel. It turs out to be quite the tastey treat, and something traditionally done for over a century. The Church also had an altar which had a painting of God with a halo of Red and Black, the traditional colors of the Sandinista political/revolutionary party.

I am not sure how to react to the entire 2 day feast. It is pretty obvious that their is very little separation between Church and State here. The TV channels and radios continually yell the phrases and President Ortega does so as well on TV and even has hundreds of people yelling at his house as he hands them bags of treats and then they are shoved out of the line. All these people are hailing the mother of Jesus and venerating her purity and sanctity, but then again women´s rights and the rule of Machismo plague civil and social society. On the one hand it is nice to see so many peope celebrating a holy day of obligation, but then again the churches are not exactly filled. In the end it would appear that a good deal are talking about Mary, whose feast day celebrates her sinless life, but just thinking about booze, free gifts, and having a good time.

Joining the Effort

2007-12-04T19:13:00.002-05:00

Door to Door in Rural Nicaragua

Nothing prepares you to face poverty. Everywhere you go, you are surrounded by flies and the smell of burning dried leaves. You turn a corner on a dirt road and you have a 3yr old boy with no shirt and no shoes by himself staring at you in bewilderment because of your complexion or presence in his tiny town. I walk up to him, smile and rub his head. A group of kids 8 - 11 in age come prancing along smiling ear to ear as I start with an hola amigos. Their smiles and laughter roll back my memory. The CISAS clown troup had dotted my nose and cheeks with red paint before I began my rounds with the Ministry of Health workers and CISAS volunteers.

House to shack, door to rusted metal leaning over the opening where the door should be, we go distributing a pamphlet that tells the bare bones of what HIV is, how it is transmitted, how we can protect ourselves, and how to properly use a condom. Along with the paper comes a pair of condoms. After doing 3 houses in pairs, I am told to take a pack of both and start down a 4 foot wide path that is lined with fences on both sides made of barbed wire or cactus. I´m with Oscar, the most well built and tall Nicaragua I have met thus far. A bartender by night and a community health intern by day. As I walk the path, making sure not to step in the stream that resides in the middle, my mind goes back to Mountains Beyond Mountains and the story of Dr. Farmer doing just this, but instead of only providing awareness and 2 condoms, he brings life saving medicine and years of medical expertise.

I struggle through my first house. The 20 year old male would rather talk about the Bronx and whats up on MTV then Sexually Transmitted Diseases. I get him back on track when I tell him about the free condoms. Mission accomplished - he asked for 2 more pamphlets for his brothers and extra condoms. My next house, like many here, are little shops in the front to get drinks, snacks, candy etc, and then the living room behind the counters. I turn to the older gentleman and Oscar turns to the woman selling him an egg and dry rice. I try to explain the science behind how the elderly man should not be using two condoms at a time. As I talk, the woman laughing says, give him all he needs he sleeps around too much with girls that are in their 20s. His leathery and worn skin smiles displaying only a handful of teeth. Is this the face of a man that a 20 yr old woman is going to give herself to? Do I dare mention the rights of women? I spend extra time telling him how a condom is really the only protection if you are going to be sexually active. He smiles again, asks for 10 condoms and thanks myself and Oscar for the advice.

On the half hour ride back to León, Oscar and I discuss how there just weren´t enough pamphlets and condoms, but that doesn´t mean there is no hope. We over hear one of the women from the ministry of health speaking about a 20 yr old girl who actually told her how HIV is transmitted and told her to save the condoms for others in the neighborhood that will need them; in her own words, "I have plenty of those trust me".

World AIDS Festival

2007-12-02T19:10:00.000-05:00

Festival a Success Despite Distractions

Picture this, a two lane street a block away from the heart of the town plaza, where the biggest church in Central America resides. On one side of the street is one of the many buildings of the UNAN (Nicaragua’s public university), which is the site of the Global AIDS Festival. The other is the Church of the Mother of Mercy (the patron saint of the city).

The festival begins with the reading of participating groups and then an address from the leader of Leon’s self-help group for people living with HIV. With great courage and charisma she stands in front of the microphone and delivers a speech promoting the solidarity needed to face this virus that affects the person, community, and the world. She thanks all for coming and putting on this festival to acknowledge World AIDS Day. She leaves to the sound of applause while two 7 year old girls dressed in brightly free flowing dresses take the stage. This is the first of what will be 4 different groups of girls dancing the traditional folklore steps that Nicaraguans take great pride in. After resounding applause the CISAS clowns get introduced. Five minutes into the act, the bells of the Catholic Church of Mercy begin to clamor creating a battle of sound waves between the voices of the clowns and the sound of the bell. The bell tolls for approximately ¾ the show, obscuring some of the vital information being brought to the audience and people passing by. “Tattoos (DONG) that aren’t (DONG) cleaned before (DONG) ….” I am sure you get the picture.

The clowns put on the same show as in the terminal, but this time also added a demonstration on how to properly put on a condom, take off a condom, and throw away a condom. They also got a volunteer from the audience to replicate the procedure for a prize. When there is very limited sexual education in the school systems, and the culture does not lend itself to families talking about sexual relations and practicing safe sex, then upon who does it fall on to obtain life saving information? In this instance it is the world of non-governmental and non-profit organizations.

Throughout the 2 hour festival the bells ring on and off to the point that some people begin to laugh. Would the church blatantly have the bells ringing to overshadow the speakers directed toward the crowded streets? Why did the bells only ring during the clown show and other acts that had something to do with HIV awareness? Did the bell ringer just like folklore music and that’s the reason why the bell was silent during those acts? I had plenty of questions, so I marched into the church! I had a hundred different things that my Catholic education has taught me swirling around my head. Matthew 25, Jesuit mottos, the golden rule, all emphasizing on how this church should in no way be attempting to silence what is taking place outside its door. I walked through the beautiful wooden church doors in search of a simple answer to a simple question; do the bells normally ring like this? The head priest was saying mass and the best answer I could get stated that mass was going on and that there is no rhyme or reason to the bells – they just ring. I thought of the many Catholic priests, nuns, and the different orders, like the Jesuits and the Maryknolls, that would be greatly dismayed if the bells were utilized as a means to silence promoting World AIDS Day or educating the people.

A Clown Show with a Serious Message

2007-11-29T19:58:00.000-05:00

Community Health Promotors Doing Their Part

A 40 year old man:
¨Vamo Amigo, ¿solo uno? Necesito otro¨
Translation = ¨Come on friend, only one? I need another¨

A 10 year old boy:
¨Por favor, quiero traer una a mi madre¨
Translation = ¨Please, I want to bring one to my mother¨

What it means...

Reproductive and sexual education is having an affect on people when the issues are brought to them and resources are provided.

I had the priviliege today of watching the younger generations of Nicaraguans attempt to change the future of their country by reaching out to teach their community. After a 20 minute program, adolescents came to get the free phamplets and condoms. Middle aged men followed asking for extras, and lastly the women approached slowly and quietly asking for some as well. By the end, over 200 condoms had gone out, 150 Awareness phamplets, and 100 larger cartoon style booklets.

As we walked through the streets people stared at the brighly colored faces of 10 teenaged nicaraguans. The stares continued as we entered the dimly lit market that welcomes you to the bus terminals. Along with the market comes the smoke and smell of fried food and the street children from 8 to 11 selling oranges or asking for a cordoba (1/18th of a dollar). I turned to see the line of intrigued people of all ages follow our crew of clowns. We settled in the middle of it all and the show began.

Sí!!! or No!!!! That is what was yelled in unison after short skits about how HIV is transmitted. Props like plates and cups showed that HIV is not transmitted through sharing forks, cups, or through saliva. Sneezing, handshakes, and using a public restroom were among the skits that followed. The Sí concentrated on sharing needles (see side bar slideshow) and the use of condoms to pratice safe sex. I was pleasantly surprised at the response after the show ended. In the face of poverty free things are either eagerly grabbed for or hesitantly accepted or denied. However, having a 40 yr old man ask me for a second condom, a bus driver asking if he could have 25 phamplets for this passengers, an elderly woman ask me for two condoms for her daughters, and then two teenage males asking me how they can join the clowns, it left a mark that shows how even the most serious of conversations and causes can be done in a creative and imaginative way.

First Impression is Impressive

2007-11-28T18:36:00.001-05:00

Lots of Progress in 16 Months

I entered the office I sat in 16 months ago. The feel was the same, the atmosphere was the same, but it was evident that things have changed. For starters, in the past it was myself, Martha, and Ingrid talking and working on two out dated computers that were not connected to the Internet. Now the same room was filled with 7 people and 4 work stations; 3 of which boast computers connected to the Internet. The next thing was the people. They have added paid staff and their numbers of volunteers has increased, both in terms of locals and forgieners. 7 people in room that used to be 3 - 2 from Germany, 1 from Spain, 3 from Nicaragua, and 1 from the USA. All speaking spanish and planning different programs, flyers, and activities to promote health in León and in the rural communities.

Tomorrow I will go along with community health promotors who will be handing out condoms, awareness phamphlets, and putting on a clown show about the methods of transmission. A common misconception among some Nicaraguans is the transmission of HIV through public restrooms, which is an area I have been told is incorporated rather comically in the skit. When I last departed this group of promotors and ´clowns´were beginning their training, so it will be extra special to see how they have come full circle.

The progress at CISAS has also had its effect on the HIV Self Help Group. Today I had the chance to talk to one of the ladies I had originally met at the start up of the HIV Self Help group. The shy woman I had met in the past was gone. She had been transformed into a leader, a spokeswoman, and she spoke about the changes that have come over the last year with pride. Although they have lost some members due to the virus and some even because of arguments, the group has grown significantly and even has a second group in the city of Chinandega. Chinandega is a more rural city that is notorious for its poverty and garbage dumps. On Dec 6th the self help group will be opening their new office, which is a room upstairs and connected to CISAS. She was very excited about the new room and the phone line being put in to establish a HIV hotline for people to call with all kinds of questions or concerns. Something as simple as a phone number to dial can make a world of difference, especially in a place where the fear of discrimination and isolation runs so high.

Tomorrow: Promoting HIV Awareness in the Streets of León

2nd Stop - Nicaragua

2007-11-27T17:05:00.001-05:00

An Experience, A Catalyst, A Return

The international leg of the project will begin with Nicaragua. I will be volunteering at an non-governmental organization (NGO) based in Leon called CISAS (Centro de Informacion y Servicio de Asesoria en Salud).

This is the organization in which I interned two summers ago for a month working in two different projects. The first was drug prevention through sports for street teens. The second was aiding a newly formed HIV self help group. It is also where the bulk of my idea for this book arose. I was conducting a service learning project that would allow me to understand how NGOs are run, funded, and some of the services they provide. The stories I heard in my daily conversations with one of the projects stayed with me upon my return. These stories were very different and yet similar to the ones I heard in Connecticut or Newark while volunteering at soup kitchens or doing HIV awareness campaigns. One day in my car after a long discussion with Fr. Ric Rsycavage SJ, a lightbulb went off and the project was born.

When I set up this project I looked forward to coming back to CISAS and capturing the spirit of the people and the story of their lives. It is with much anticipation that I return.

Tomorrow's Blog: Returning to CISAS