Heat and Humidity

The Canadian summer has been hot and humid. I have never enjoyed humidity and so wonder why I managed to do summers in South Africa and Canada. The UN held a Climate Summit in September and there is increasing recognition of the environmental crisis we are facing. Earlier, in mid-September, the running news bar on the BBC was that the bird population has fallen precipitously in North America. In Waterloo there was a climate strike day on the 27th and people marched from the Universities to the town square. There were thousands of participants and I was proud to be among them.

Another running news bar on the BBC has been that ‘flight shaming’ means the growth in airline travel is expected to fall. Looking back more than 40 years I was so excited to take my first flight. I got a ride from Mbabane to Johannesburg, and boarded a flight to Heathrow to go to University. At 19, this was the first time I had been on a plane. I have a record of all the flights I took on a computer file, it is a bit scary.

Today when I board a plane I feel somewhat guilty. It is my intention to drastically reduce the amount of air travel and increase the amount of train travel. From Norwich to London is two hours by rail, and from there it is easy to get to Brussels or Paris. Plans for 2020 including going to Ireland (Norwich, London, Fishguard and the ferry to Dublin), and, perhaps, Amsterdam (Norwich, Harwich and ferry to Rotterdam). The possibilities are numerous.

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Frying in Norfolk

Anyone who denies climate change, and more specifically, global warming, is seriously wrong. At the end of August we had record temperatures in Norwich. Fortunately it cooled down in the evenings so sleeping has not been too difficult. However, this summer the rowan tree in the front garden died from a mixture of disease and heat stress. Ailsa has been using the water from the rain butts to keep some of her favourite plants alive, but it is an uphill battle. It presents a dismal picture and I really wonder what the next 10 to 20 years will hold. I am increasingly aware of my contribution to this crisis, particularly through flying, but I do not consider myself to be a flamboyant consumer of other things.

Having said that, I have to begin this blog by reflecting on my travelling over the past month. My final class in Waterloo was on 30th July. I had to complete the marking and submit the marks by 8th August. I was able to do this, and almost all of the students should have been pleased with the outcome. The temperatures and humidity gradually rose in Waterloo, and I was glad to be heading for Norwich. I did not realise how hot Norwich was going to be.

I travelled over on Sunday 11th August, flying via Amsterdam. Toronto to Amsterdam is not all that long, just 7½ hours. This is not long enough to take a sleeping pill, so I sat and watched the film ‘Red Joan’. This was about a British woman who became a Soviet spy in the 1940s and 50s. Oddly I was reading a book called ‘And Is There Honey Still For Tea?’, by Peter Murphy, set in the same time period and covering the same topics. It is hard to believe how much skullduggery there was going on then. I guess it is still happening, with electronic surveillance playing an ever-increasing role.

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Sunshine and students

There are three semesters at the Balsillie School, and across Canada. The Autumn term starts in September and ends just before Christmas; the Winter term is from January to April; and we are completing the Spring term which lasts from May to July. The terms are longer than in the UK and Europe at 12 weeks.

I taught two courses in the Spring and will teach two in the Autumn. Next calendar year (January 2020 to December 2020), I am on sabbatical and am very much looking forward to this. This is the first time I have been in Waterloo for the Spring term, and while it might have begun as spring it ended as summer – which is the one term we do not have. My word it was hot and humid for weeks at a time. Fortunately there were occasional thunderstorms that roiled across the region and brought some relief.

It has been very hot across much of Europe as well. We have a friend who has been in hospital in Norwich for some weeks now. The Norfolk and Norwich Hospital was opened in 2001. It was built on a greenfield site near the University, which means that UEA is able to offer medical degrees which was not the case when I was a student. It replaced a Victorian establishment in the centre of the city.

The new hospital is ‘state of the art’, except that there is no air-conditioning! This is OK for 10 months of the year. When there is a heatwave, as there was in July, it means that everyone from the consultants to the patients really suffers. It is miserable and sadly I don’t think there is any way that AC can be retrofitted into the building. The other major problem is that the hospital is not easy for the public to get to. It is an expensive and inconvenient bus journey, while those who drive have to pay car parking charges.

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Hotting up in June

This posting is being written over a long weekend in Canada. It will only be posted on the website in early July. The reason is that I am one of the contributing authors to a paper being published in the journal Health Affairs and the article was released on Monday. That means we could put a link up, but not until 4 PM Eastern time on 1st July. Eastern time refers, of course, to the time in New York and Washington, not Moscow. The writing was led by Steven Forsythe, someone I have known for many years, and who did his Ph.D. at the Liverpool School of Tropical Medicine. Apart from him there are another seven named co-authors. The title is Twenty Years Of Antiretroviral Therapy For People Living With HIV: Global Costs, Health Achievements, Economic Benefits. It will go on the reading list for my students.

The other activity I have been extensively engaged in over the past couple of weeks is editing The African Journal of AIDS Research. I am the Editor-in-Chief. This means that I read every article that gets through the review process to approve it for publication. We are now getting about 260 articles submitted every year, we only publish 40 (and these I read), and so there is quite a lot of work involved. On the other hand it is does give me a forum to express views in editorials, should I wish, and keeps me up to date on current writing. Hopefully the last issue of 2019 will comprise papers presented at the International AIDS Economics Network meeting just ahead of the International AIDS Conference in 2018. To some extent this will be a ‘development’ issue as some of the authors have not published before. Steven is one of the two guest editors for the issue.

I am teaching two courses this term and am increasingly aware of the importance of equity in health. It is quite clear that, in the near future, a number of countries will not be able to afford to have their citizens on antiretroviral therapy. Donors are paying for it and may step back. This will raise a series of moral questions and it will be deeply interesting and concerning to see how they are addressed. My belief is that donor agencies will agree to continue funding people who are on treatment, but they probably won’t initiate new patients.

The big news from Waterloo is that the light rail service is finally in operation. This means that there are spanking new two-car trains running from a mall to the north of Waterloo to one to the south of Kitchener. I find it quite telling that the endpoints are shopping emporia. The train has been free of charge for the first 10 days of operation, giving the local citizens the opportunity to try it. In general I believe large infrastructure projects are critical for long term development, although it may not seem so at the time.

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Pollen and polling

In my blog, posted at the end of March, I described the surgery I underwent in Durban. I also talked about going out a couple of times, with friends, to a really delightful little bakery/pizza restaurant in the neighbourhood. It does not even have a liquor licence; and this does tend to mean the evening is cheaper as one takes one’s own wine. Among those friends was Jurgen Brauninger and his family. I wrote in that blog:

‘On a personal level it is interesting to see my cohort, friends and colleagues ageing into their 60s, for the most part with grace and dignity. It is however a shock to us all – but, as I said to one friend, ‘it is better than the alternative’.’

Within two weeks of these dinners we learned, out of the blue, that Jurgen was not well. He was suffering from pancreatic and liver cancer, and was having difficulty in eating. After various consultations he was scheduled for urgent surgery to ease pressure on his duodenum. While this was not a cure, it was expected to improve the quality of his life. The surgery was carried out on 26 April (by the same surgeon who did my hernia); Jurgen did not recover and died on 6 May.

I want to pay tribute to a dear friend and colleague, a talented musician, but above all a devoted family man. I know Tania, Hannah and Brigitte will be torn apart by grief. Sitting in Canada I have felt very distant, but no less sad. I wish I had deep and meaningful forethoughts about this but I don’t, I just know I will miss him enormously. Andrew Marvell’s lines “But at my back I always hear, Time’s wingéd chariot hurrying near”, were not written about death; they do seem very apt though.

The Brauningers lived a few houses up the road from us in Manor Gardens. Their children were similar ages to Rowan and Douglas. We celebrated many milestones together; Brigitte did the most amazing Easter lunches for the university crowd and others. The families went away together for a number of short holidays in the province. Everyone enjoying each other’s company, even braaing under umbrellas during a heavy rainstorm. Their home was an original ‘wood and iron’ house, this is one of the first Durban houses and relatively few are left standing. Jurgen, I and Ullie, one of his friends, purchased the house next door when it came on the market, in order to preserve it and the jungle of a garden for a little bit longer. Jurgen and Brigitte had just moved a few kilometers to a more modern house and were planning their retirement when this devastating event occurred. This has been a deeply sad time.

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Autumn and Spring Showers

The month of April began in the Cape and ended in Canada via Norwich. In the first week we ran the scientific writing course in Stellenbosch in the Cape. There were 19 participants from across Africa. Tim Quinlan did most of the teaching and the event was excellent. We are beginning to see results in submitted and published manuscripts from earlier years. I hope the project will be renewed, but if it is not then we have achieved a great deal. As my travel was from the southern to the northern hemisphere, I experienced autumn one day and spring the next. In England the daffodils have bloomed and are past their best. In Canada, or at least in this part, they have yet to blossom and it is still decidedly chilly.

Of course visiting Cape Town is also a chance to see family. My brother and sister-in-law were away but I caught up with my aunt, various cousins and a niece for Sunday lunch. I felt that I had not talked properly to niece Sarah, and she was good enough to join me for lunch on the Monday before I flew back to the UK. We walked across from the City Lodge to a new restaurant right next door. It was good to have a decent conversation and catch up with family news. Because the flight from Cape Town is so late (after 11 pm), I only watched one film: The Great Buster, a biopic of filmmaker and comedian Buster Keaton. He was one of the few stars who transitioned successfully from silent films to sound. It was not demanding so was good to watch in the small hours.

I had a relatively short spell in England. My sister came up from London for Easter and her birthday. We went to a show at the Norwich Playhouse, where Rowan works. It was an amateur production of A Sound of Music. It was outstanding. There were a few wrong notes, but not many at all. The set was imaginative and the acting most impressive. I think amateur productions can be excellent because people really throw their hearts into the show.

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Shiselweni Reformed Home-Based Care

Shiselweni Home-Based Care (SHBC) is an NGO based in the southern (Shiselweni) region of Eswatini (formerly Swaziland). The aim is to provide basic care to communities in the deep rural areas of Shiselweni. These people would otherwise be forced to rely on their own resources which, in many cases, would inevitably lead to impoverishment and starvation. SHBC trains volunteers in these communities in the skills needed to give holistic care to people in need. It specializes in the care of people living with HIV and AIDS, bringing hope into their lives by addressing stigma, referring people to go for testing, and helping them to adhere to HIV and TB treatment.

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Surgery and Sunshine

I was offline for a few days in March, an interesting experience especially during the time of crisis in the UK. It was my birthday on the 18th and I celebrated by returning to South Africa on the 16th for a series of elective medical procedures. I took the 06h15 KLM flight from Norwich to Amsterdam where I connected on the 10h15 flight to Johannesburg. The journey takes nearly 11 hours. My case was one of the first to be unloaded and appear on the carousel, these little things matter.

There are no connecting flights to Durban that late. My standard operating procedure is to stay in a hotel at the airport and connect the next day. Normally the travel agent’s opening proposal for the connection is a plane at an absurdly early hour, 07h00 for example. On this trip I was sensible and got a flight a little after 13h00. It allowed me ample time to sort myself out, and have a leisurely breakfast.

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More Climate Change

February in England was mild and dry, in my view clear evidence of environmental change. It is five minutes to midnight on the Doomsday clock. It is not surprising the birds and insects are reacting to this warm spell (between 5 and 10°C above seasonal averages). There was a robin singing its little heart out, on a tree with bare branches, yesterday evening. Robins are not shy, but it was unique to see this bird so clearly silhouetted against the very blue sky. We are not taking the urgent and dramatic actions needed to address what we are doing to our natural world. I fluctuate between optimism and despair.

It was an interesting month from the productivity point of view. I managed to complete and submit two pieces of work: an article and a book chapter. More importantly I did something long overdue that will, hopefully, improve my efficiency. Sometimes as I write I think to myself ‘I have said this before, but where?’ Over a morning I made a list of everything I had published, or drafted, since the beginning of 2016. This included the table of contents, a list of figures, tables and maps, and an abstract. My memory may be bad, but at least now I know where to look. I also listed ideas I have had and not properly developed, these could be revisited and turned into articles.

The month began with a visit to the Robert Bosch United World College in Freiburg in southern Germany. The founding headmaster of the college was the head at Waterford for many years. Indeed, I was the first governor to interview him in 1998. This was at a time when we were desperately looking for a new head. What had happened is we had appointed a man who turned out to be a disaster and who, fortunately, served only one contract. He was probably a good educationalist, but he did not have a grasp of finances. Because the reporting was not adequate, by the time the Governing Council realised what was going on, the school was deep in the red. We were lucky to get a couple from the UK to come and act in the Principal’s role while we went head hunting. Then we were lucky to get Laurence!

Laurence Nodder and his wife Debbie took up the position in 1998 and stayed for close to 15 years. He was then invited to establish the new United World College in Freiburg. That meant supervising building work, some new and some conversions of existing buildings, as well as recruiting staff and students. This was challenging, even in efficient Germany. As I saw walking around the college, they have done a remarkable job. I felt very lucky that Laurence invited me to come and give a public lecture to the school and community.

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“January brings the snow: makes your feet and fingers glow”

(Title: Michael Flanders and Donald Swann’s ‘A Song of the Weather’)

The first half of January was exceptionally warm for winter. We are told not to ‘cherry pick’ weather events to argue global warming is real. When they come one after the other, however, the evidence seems to be stacking up. The weather maps showed high pressure over the UK and to the south, so the fronts seem to be further north than usual. Scotland got a battering. Sadly the potential advent of Scottish independence won’t help that situation – weather is bigger than politics.

The rest of the month saw a few hard frosts, grey days and wind and rain, as well as some gloriously sunny spells. Even in the depths of winter the sun shining through the window can be warm enough to warm the south facing rooms. We have wood / coal burning stoves in the living areas and I must admit to getting a great deal of pleasure in laying and lighting the fire: paper, kindling larger pieces of wood and the coal. If I do it right we use 10 kg of coal for four fires. It warms both the room and the house very nicely.

If January weather was not enough to keep us depressed, the all-consuming topic in the UK is Brexit. Theresa May presented her deal to Parliament in mid-January, and it was soundly defeated. In fact the margin was astonishing: MPs voted by 432 votes to 202 to reject the deal. Labour leader Jeremy Corbyn immediately tabled a vote of no confidence, which, unsurprisingly was not passed. If it had been it would have led to a general election.

The problem is both the Conservative and Labour parties are both deeply divided on leaving the EU and the deal, so there is no consensus. An election would not help, unless the smaller parties did really well, which is unlikely. It is all a terrible mess. There have been, in past few days, more votes in Parliament and the situation is even more uncertain at the end of January.

The papers, or at least the ones I read, are full of commentary on the rise of the right in global politics. This is clearly happening, but just as worrying is the growth of incompetence in leadership. The events of the past few months in the USA seem to epitomise this. When this is combined with the lack of vision I worry even more.

“A politician thinks of the next election. A statesman, of the next generation.”

I knew the quote and I was writing this letter I decided to see where it was from. The answer is James Freeman Clarke (April 4, 1810 – June 8, 1888) an American theologian and author. There do not seem to be any great works by him but lots of very good quotes.

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