November And December Highlights At HEARD

It’s been a few months of intense traveling and presenting research for HEARD staff. I participated in various conferences commemorating the 30th anniversary since HIV and AIDS was first discovered. Below are some of the event highlights and information on forthcoming conferences I will be attending.

2011 Caribbean HIV Conference

The 2011 Caribbean HIV Conference was held in the Bahamas from 18 – 21 November. The focus this year was given to sharpening the focus on HIV in the Caribbean, the region with the world’s second highest adult HIV prevalence. As a panelist at event, I presented What is Realistic ‘Sustainability’ within the Context of a Multi-country Regional HIV Response?: A Perspective from southern Africa. This conference presentation was prepared with the support of HEARD research intern Natashya Pillay and was well received. The key points were that the Caribbean has succeeded in controlling their epidemic and should be commended for this, the price of success is continued vigilance. There is diversity between the countries. One key lesson both ways is to build on regional organisations.

Focal points of the presentation:

  • Background/Introduction
  • An epidemiological comparison of hyper-epidemic countries in the Caribbean and sub-Saharan Africa.
  • Methodology/Experience
  • Sustainability; regional versus multi-country efforts; prevention, treatment and impact mitigation.
  • Results/Good Practices
  • In particular, lessons can be learnt from Swaziland, the sub-Saharan country with the highest adult HIV prevalence rate.
  • Conclusions/Recommendations
  • Efforts need to be concretized and regional integration is a way to achieve this. It will allow HIV and AIDS efforts to be mainstreamed.

Economic Reference Group Meeting (ERG) in Washington

HEARD organised the World Bank and UNAIDS ERG in Washington on 29 and 30 November. This meeting was attended by HEARD researcher Ilaria Regondi and Professor Whiteside. The meeting looked at financing of the AIDS response and the results of the RethinkHIV project.

Guest of the School of Public Health at the University of Alberta

In late November I travelled to Edmonto and was hosted by David Zakus, who is a Professor and the Director of Global Health in the Division of Community and Occupational Medicine Engagement of the Department of Medicine at the University of Alberta.I gave four presentations consisting of two lectures presented to a class of students: Aid for AIDS and Making Hard Choices: Prevention in the Global Crisis; and two public lectures Economics and HIV in Africa: Costs and Consequences and A Safe Sex/No Sex Month: Could it work? Innovative Responses for Preventing HIV Transmission.

AIDS @30 Symposium at the Harvard School of Medical Health- 1 and 2 December

I was also invited as a participant together with other international health leaders, elected officials, scientists, artists and activists. The meeting was convened to reflect on what we have learned from AIDS and how to apply those lessons towards ending the epidemic. There were presentations from among others, Julio Frenk the former Mexican Minister of Health and currently Dean of the Harvard School of Public Health and Anthony Fauci who is the Director of the US National Institute of Allergy and Infectious Diseases. Durban academics were well represented at the event.

Health Systems Workshop at the Wellcome Trust London

This workshop will take place on the 13 and 14 December 2011. This is the UK health funders workshop on health systems research in low and middle income countries.

Sunshine At Last: Early June 2010

I have had a busy few weeks in Norwich. I started writing this while sitting at the dining room table as Douglas read me poetry. He is preparing for his GCSE exams and I am here, firstly in solidarity, and secondly hoping to be of some help. His first major exam, where he had to sit and write for a long period, was English Literature. One of the good things is that I am hearing lines from poems I had long forgotten. For example, from WB Yeats, The Second Coming:

   Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world

This is where Nigerian writer Chinua Achebe got the title for his first book, Things Fall Apart, published in 1958, which we read at Waterford School, and found a real revelation. By then it had, I think, been published in the Heinemann African Writers Series. So it seems what goes around comes around.

Life here has been un-anarchic, albeit busy. We have been to the beach, about forty minutes away. It was most beautiful driving through the Norfolk countryside. The long winter meant the flowers have delayed their opening and all seem to be blooming together. On this road the sea appears in the distance with striations of colour: a muddy blue hugs the beach; then the aquamarine shades into gray in the distance; and shimmering patterns across the whole surface.

It was the first decent weekend and so the beach was busy. A few hardy souls ventured into the water. According to the data at the life-guard’s station, the sea temperature was only 14 degrees so I am filled with admiration. The North Sea is shallow, so there tend not to be big waves, indeed it would be accurate to say they ‘lap’ rather than break. Despite this there are always optimists who have body-boards and even, in one case, a surf board. We walked a few kilometers and went to the Beach Café for lunch. It is excellent, good food and a great view, most important they allow well behaved dogs. Didi had a great time chasing up and down on the sand, running into the waves, and pretending to be brave. The village website is www.mundesley.org and the café has a page on facebook.

We got to see the ‘British changing style’. You clutch a towel round the waist, (which usually seems rather small by this time) and attempt to put on a dry costume, or even worse, takes off a wet one. In Durban, a couple of months ago, I was sitting on the beach with Rowan, her boyfriend and one of her friends; a group of German tourists arrived. No modesty for them, it was stand in a circle and strip to put on their swimming costumes.

A week or so ago I had the crucial flying lesson. This was the third since I returned and it took me to over 20 hours of tuition. The essential goal was: learn to land. Up to four lessons ago landing was not crucial – David, my instructor, would do this. However, as we know, pilots have to be able to land. It is not easy. I was lucky, the wind was very light, and straight down the runway. I walked away from this lesson thinking that I could actually do this. I went back a few days later to consolidate what I had learnt, this time in rather a strong wind. It was gratifying to find I can, indeed, land.

At the moment I am ‘in the circuit’, which means taking off and making a 90?; leveling of; setting the power and trimming the plane; turning another 90?; flying parallel with the airfield; turning into the approach; gently putting the wheels on the tarmac; then taking up the flaps; going to full power and going round and doing it again. The whole time one has to know where one is. My landmarks are not assets to the Norfolk countryside. The first turn is over the pig farm: little tin huts; barren ground and tubular pink bodies; then over the gravel pit, a scar in the landscape with mounds of yellow soil; and finally aim at the factory chimney. They may not be attractive, but they do stand out. I have even been practicing with Google Earth.

Does that sound simple? Well it is not! There are controls, speed, angles of bank, radio calls and checklists that all have to be included. The most difficult part is the touchdown. I am supposed to fly parallel to the ground, gradually taking the power off, holding the nose up while the plane sinks gently onto the runway. This is a ‘flare’ and takes judgment and experience. It has to feel right. David had said: “I can teach you to fly, but I can’t teach you to land, this is something that you have to get through experience.” A key is to get the approach right: the rate of descent and the speed; the line-up, so the plane is actually pointed at the runway; then, at the right moment, take the power off. The website for the flying school is www.nsf.flyer.co.uk.

That describes the non-work life here. My main work activity has been to get to grips with the Political Economy of Swaziland book. There has been definite progress on this. I want to describe how the history of Swaziland has lead to the current situation with regard to the politics, economics and HIV/AIDS epidemic.

Going to see a live production of Alan Bennett’s The History Boys at the Theatre Royal in the city last week was very helpful. A quote from the play on what history is: “How does stuff happen, do you think? People decide to do stuff. Make moves. Alter things.” This is exactly what happened in Swaziland and this is story I hope to tell. Over the past weeks I have been looking at the political trends in the region which have been crucial. In the 1980’s Swaziland and the other countries in the region benefited from the fact they stood against South Africa. Since then they have been quite ignored, and additionally they have slightly more wealth and so fall into the lower-middle-income country category, giving them less access to international resources.

Books

Joseph O’Neil, Netherland, Harper Perennial, 2009, 300 pages

This is a most unlikely topic. It is the story of a Dutchman, Hans van den Broek, living in New York, where he has been abandoned by his wife and child. He is a cricket player and the game comes to dominate his life. It is played mainly by immigrants from the former British colonies: the Caribbean Islands; Sri Lanka and India. Hans becomes particularly friendly with Chuck Ramkissoon, a charismatic Trinidadian entrepreneur and clearly criminal. It is his murder that leads to the reflection giving rise to the book. This book portrays a part of New York and the people living there, that is murky and subterranean. It is also a story of hope and friendship. At the end he and his wife are back together in London, attempting to make a go of their relationship. I had been looking at the book on airport bookshops wondering if I buy it, a week ago I was at the local library so I was pleased to be able to borrow it.

Andrea Camilleri, The Inspector Mantalbano series. These books have has their central character a tortured police inspector in Sicily. He is the local commander of a police station, staffed by a range of equally extraordinary characters. Camilleri is apparently a very well known Italian writer, but I have just been introduced to his books and am really enjoying them. They are published in paperback by Picador and are translated by Stephen Sartarelli. Obviously the translation is crucial in ensuring that the book remains good when it is put in another language.