World AIDS Day

Today is World AIDS Day.  There is a big event in DC planned to pay lip service to ending this horrible disease.  Bono will be there.  President Obama will be there.  Former Presidents Clinton and Bush will be there.  It’s too bad that this comes on the heels of the announcement that for the first time since it was founded ten years ago, the Global Fund to Fight AIDS, TB and Malaria has cut funding to poor countries.  This funding is essential for programs in these countries and its absence will have devastating consequences for millions of people.  This is literally a question of life or death for millions of people.

The Global Fund now directly keeps alive 3.2 million people on anti-retroviral treatment.  (Together with other funders that means that around 6.6 million people are now on these life-saving drugs.) It has financed 8.2 million courses of TB treatment and the distribution of 190 million insecticide-treated nets to fight malaria.  We are seeing a historic turn in the progression of these pandemics.  — Jeffrey Sachs, Politicians just don’t care enough to tackle this scourge.

Health care is a basic human right.  That’s just my opinion.  That’s part of the UN’s Universal Declaration of Human Rights.

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

This is not the time to withhold funding vital to programs that are working.  Malaria prevention efforts are starting to have a real impact in places like Africa.  We tend to think of certain infectious diseases as being other people’s problems.  They strike in poor countries, far away from us.  The problem with that thinking — other that the callous nature with which we view the world through the prism of how does this impact me personally? — is that is is just wrong and shortsighted.  Infectious diseases, for instance, that kill people over there, are just as deadly when they strike here.  These are often diseases of poverty, we have that here.

Over the past year, I have been working with a nonprofit health organization — they develop and deliver medicines for infectious diseases such as visceral leishmaniasis, which is nearly 100 percent fatal when left untreated.  Like AIDS, it destroys its victims immune system.  Our military personnel are being infected because they are fighting in areas where it is endemic.  New studies also show an increasing number of co-infections – -VL & AIDS.

TB is a scourge in the US, too.  Washington, DC has one of the highest rates of infection in the nation.  What’s worse is that many cases are of the drug resistant variety, a side effect of a treatment that can take up to two years is that people don’t follow through with the full treatment.  (Topic for another day is how our antibiotic abuse is making them less effective. short version, if your doctor doesn’t give you one for the sniffles, don’t demand one.)

Other, less famous diseases such as Dengue Fever are making a comeback in the US as well.  The mosquito that carries the potentially deadly illness has been found as far north as North Carolina.  Mosquitoes don’t care about borders.

The bottom line is that if a disease can strike anywhere, it can strike anywhere.  We risk losing important ground gained over the past decade because we lack the political will to do the right thing.

“Wars exist to teach Americans geography.”

Someone said that, though I will admit that I do not know who.  You can look it up.  Although her political future may be unclear right now, Governor Sarah Palin proved several things.  She appealed to many people because she seemed to be like ‘average’ Americans.   If some reports and plenty of anecdotal evidence is to be believed, her knowledge of geography may be one area where she and the many of us are in sync.  While her ignorance of facts like that Africa is a continent and not a country and what countries are in North America is particularly scary because she could very well have become the president, that we care so little about the world outside our borders, state or national, is depressing.  (http://www.cnn.com/2006/EDUCATION/05/02/geog.test/index.html)

Much of the world celebrated Barack Obama’s win along with us and that is a good thing.  We may not know who they are but they know us.  What’s more disturbing about the report above is this:

Fewer than three in 10 think it important to know the locations of countries in the news and just 14 percent believe speaking another language is a necessary skill.

When I sat down to write something about this topic I wanted to write about the current crisis in the Democratic Republic of the Congo.  I was going to start by talking referencing the situation there with my experience as a UN employee and mention that while the US become more and more focused on Iraq and the atrocities Saddam Hussein had committed I was focused on a more dire situation, that of the DRC.  Then, like now, rebels were killing innocent civilians and the reports I saw were too horrible to repeat here.  At the time I did what I could to get the US press to care but in the year I worked on this, only one paper wrote an article (the Denver Post) and I think that was just to shut me up.  Maybe we can only focus on one international issue at a time.  Maybe it is because few people could find it on a map, though few can find Iraq on a map, too.  I think it is because we have this idea that Africa is a dark and dangerous place.  We expect them to kill each other so we are not surprised when they do.

As with the Rwandan crisis in the 1990s, a lot of coverage of recent events has focused on the ethnic aspect and once again we hear it repeated that these people have been fighting since the beginning of time.  As I have said before, this is not true but we all know that doesn’t matter.  We look for reasons not to intervene and cling to them.  Granted we have a lot on our plate right now, with the economic crisis, the wars in Iraq and Afghanistan, even the Middle East peace process is taking a back seat to more pressing issues.  I do not want to see American troops deployed all over the world but I would like to see people take a greater interest in the planet we all inhabit.  Not only would greater understanding help in times of crisis but in better times.  It should go without saying that we have a vested interest in learning more about the world but I guess not.

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“We wish to inform you that tomorrow we will be killed with our families.”

This is the title of Philip Gourevitch’s book about the Rwandan genocide.  The quote is from a letter from some Tutsis who were hiding in a church to their Pastor.  They had been informed they were going to be attacked and wanted him to intervene.  There are two versions of his response.  He said either, “Your problem has already found a solution.  You must die.” or “You must be eliminated.  God no longer wants you.” Most of the people were killed by the Pastor and armed militias.

 

One argument the international community made during the genocide of 1994 was that the Hutu-Tutsi fight had gone on for time immemorial. It was a problem that was very much like an act of God or nature – like an earthquake – that could not be prevented or stopped.  This is what we say whenever tragedies occur for which we do not want to act.  I HATE IT!!!  By saying this we abdicate our responsibility to help other people but this does not absolve us of any guilt.  It also isn’t true.  It wasn’t true in WWII or Bosnia and definitely not Rwanda.  In fact, the opposite argument can be made about Rwanda.  The Hutu-Tutsi divide didn’t really exist until the Belgians took control of the country in the 1920’s.  That is not time immemorial.

 

There are three ethnic groups in Rwanda; the Twa, Hutus and Tutsis.  The first people to arrive in Rwanda were the Twa, pygmies who started living there about 35,000 years ago.  Afterwards they were joined by the Hutus (majority) and Tutsis (minority), who now make up most of the population.  These two groups intermarried, lived and worked together and got along.  It was not unusual for Hutus to be mistaken for Tutsis and vice versa.  This all changed when the Belgians took over in 1923.  They used the different groups to reinforce their rule.  To do this they set criteria for determining who was who.  The Tutsis were taller, lighter and had different facial features (longer and thinner noses.)  They required everyone get an ID cards showing their ethnicity.  They also said the Tutsis were descendents of the Abbysinians and made them rulers of the country.  Even then the country remained peaceful until 1959.   In the 1950’s anti-colonial sentiment was growing in most of Africa and Rwanda was not immune.  The Hutus resented the Belgians and the Tutsi aristocracy and both groups started political parties aimed at emancipation.  By 1959, tensions were running high and when Tutsi Mwami (King) Mutara III Charles died.  He died after receiving a vaccination but the Tutsis thought he had been assassinated and their forces went after a Hutu politician.  The Hutu response was swift and thousands of Tutsis were killed and many others fled into Uganda.  Again, this was in 1959 AD.  That’s thirty-five years before the genocide.  http://en.wikipedia.org/wiki/Rwanda

 

In the 1990’s Rwanda was led by President Juvénal Habyarimana.  He was a Hutu and a dictator.  Around this time the Rwandese Patriotic Front (RPF) began a revolt from Zaire.  The RPF was made up of Tutsis and moderate Hutu.  In 1993 both sides sat down Arusha, Tanzania and signed a peace agreement that would have given the RPF a say in the Rwandan government.  They would never get that chance as President Habyarimana died when his plane was shot down on April 6, 1994.  The government then told the country to kill all the Tutsi ‘cockroaches’ and moderate Hutus who supported the Tutsis.  Over the next few weeks “Hutu Power” forces murdered at least 800,000 people.  This took approximately 90 days.  Assuming the 800,000 figure is accurate, and most groups think it could really be as high one million people, that is 8889 people a day or 370 an hour making it one of the most efficient killing sprees in history.

 

The Gourevitch book is so good because he is such a skilled writer.  The book reads like a novel, though the brutality shown in Rwanda is beyond the scope of any fiction writer.  He recounts stories of people seeking refuge in churches and being butchered there.  One church, NyarubuyeRoman Catholic Church in Kibungo Province, saw between 5000-10000 deaths in about two days in April 1994.  The site has been turned into a memorial to the genocide where the dead were left where they died.  It sounds gruesome but when you think about it, how else can you really capture the horror these people suffered?

 

This horror was compounded by the international response before, during and after the genocide.  Nothing was done to stop or prevent the killing, in fact the French actively supported the Hutu Power forces by giving them money and weapons.  When it was over, refugee camps turned into breeding grounds, training centers, money making apparatus and just about everything else for Hutu Power forces.  They actively prevented Hutus from returning to Rwanda and launched attacks on the country from outside.  Kofi Annan, former UN Secretary-General, was the head of the UN Department of Peacekeeping.  He has admitted that he could have done more and didn’t.  He has called this the UN’s biggest failure since it was founded.  He is right.

 

One might ask why I read all these very depressing books.  I do it because I think it is important to look and see where we failed and how things could have been done differently.  Not everyone went along with the killing.  Paul Rusesabagina, a hotel manager, is a well known case of someone who helped other people.  He didn’t set out to save 1,000 or more people but he did.  Since then he has said that he wasn’t special, he just made the right choices and he cannot understand why others didn’t.

 

The problem we have is that countries like the US lack the political will to step in to prevent genocide.  The US response in Kosovo was the most vigorous response we have ever mounted in a situation like this and that was pretty anemic.  The take home message needs to be that we can make a difference and prevent cruelty if we want to.  Studies have been done on mob mentality and how people’s actions influence each other.  If there is a group of people and someone needs help if one person acts to help, others will do the same and if no one does anything is just reinforces everyone’s behavior.  Making sure people do not get away with mass murder also deters future murders.  Stalin said “One murder is a crime, one million is a statistic.”  He was right.  We don’t know how to deal with cruelty on the level of genocide but we should.

 

Back to your regularly scheduled programming…

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