sometimes I wish I wasn’t:

A group of artists has been asked to lighten the faces of children depicted in a giant public mural at a Prescott school… designed to advertise a campaign for environmentally friendly transportation. It features portraits of four children, with a Hispanic boy as the dominant figure.

R.E. Wall, director of Prescott’s Downtown Mural Project, said he and other artists were subjected to slurs from motorists as they worked on the painting at one of the town’s most prominent intersections.

“We consistently, for two months, had people shouting racial slander from their cars,” Wall said. “We had children painting with us, and here come these yells of (epithet for Blacks) and (epithet for Hispanics).”

Wall said school Principal Jeff Lane pressed him to make the children’s faces appear happier and brighter.

“It is being lightened because of the controversy,” Wall said.

The faces were based on photographs of children, aged five to eleven, attending the school.

This all went down after Prescott City Councilman Steve Blair launched a campagin against it on his radio show, saying, according to The Arizona Republic: “To depict the biggest picture on the building as a Black person, I would have to ask the question: Why?” (Blair says he’s not a racist. His radio show has since been cancelled.)  

Via Wonkette.

Facebook group here.

I’ve got an article at the Atlantic about the new face of the African AIDS epidemic: about the generation of kids born with HIV who until recently were expected to die young, but are now growing up medicated and healthy to face a whole new set of challenges. How do you stick to your meds without letting your friends find out? What happens when you fall in love?

The article explores the experiences of two young Ugandans, a brother and a sister, who caught the virus from their mother. I’ll let you click through to read about them. In the meantime, here are a few of the takeaways:

 Sabrina Bakeera-Kitaka, a doctor at the Pediatrics Infectious Diseases Clinic in Kampala’s Mulago Hospital, remembers opening a clinic in 2003 for adolescents who had been wrestling with the virus since infancy. “They were really short, stunted, and very wasted,” says Bakeera-Kitaka. “You’d have a 16-year-old girl who hadn’t started her menstrual cycle, or who hasn’t developed any breast development, a 17-year-old boy who hasn’t gotten any pubic hair. They were riddled with all sorts of diseases: tuberculosis, recurrent malaria, persistent diarrhea.” But the drugs have changed all that. Today, Bakeera-Kitaka’s patients are indistinguishable from their healthy peers.

In 2008, the World Health Organization began recommending that all infants born with HIV be medicated immediately. As treatment continues to roll out, more and more children like Peter will have a chance to reach adulthood.

Yet the teenage years, when not-yet-mature patients begin to take responsibility for themselves, are perilous for bearers of a chronic disease. Doctors studying diabetes track hemoglobin levels to measure how well a patient is sticking with the treatment. These tend to shoot up as children approach adulthood. “Obviously they’re not taking as good care of themselves as when their parents were in charge,” said Laura Stoppelbein, a psychology professor at the University of Mississippi Medical Center, who has studied treatment adherence among diabetics. “Adolescents don’t tend to have a great appreciation for the long term. It’s more like, ‘My friends are here, and I don’t want to be embarrassed and have to get my blood checker out or take a shot, so I’ll skip it.’ As opposed to thinking, ‘In the long term, if I continue to skip, I’m going to have kidney disease or eye problems or circulation problems.’”

and:

As treatment for AIDS becomes more widely available, more and more children living with HIV will reach an age when they and their peers begin falling in love. “In the past, they would be so sick, they would be busy trying to keep alive for one extra week, for one extra month, for one extra year,” said Peter Mugyenyi, the head of Uganda’s Joint Clinical Research Center, the largest provider of anti retroviral drugs in Africa. “But now they are healthy. They are energetic. Their sexual drive is back. You have to start addressing sexuality in the era of AIDS treatment, as opposed to sexuality in the era of AIDS death.”

When Sabrina Bakeera-Kitaka polled HIV-positive adolescents in her clinic, she found a wide variety of sexual experience, but little sexual knowledge. One in four of the patients she surveyed reported having had sex. One respondent counted 13 partners. Three couldn’t remember how many partners they had gone to bed with. Of the 800 adolescents enrolled in her program, more than 40 girls were expecting children or had already become parents. “Some of them have this thing, that ‘I have to leave a legacy,’ ” Kitaka said. ” ‘Mother died, and who knows if I’m not going to die?’ Some have insinuated that people at home are pressuring them to get babies. In some societies in this country, if you don’t have a baby by 18 years or so, then you’re not a woman.”

Bakeera-Kitaka’s study also found that the patients in her program understood little about the risks to which they were subjecting their sexual partners. Some boys thought that semen did not carry HIV; some girls thought the virus would bleed away during menstruation. Most alarming, some said they wouldn’t disclose their infection to their partners, out of fear of rejection–and that they preferred partners who were HIV-negative.

I reported this story a while back, but it turns out to be pretty timely. There’s a lively debate going on about whether the funding provided by the United States, which has made this transformation possible, should be extended. From the Boston Globe:

Obama administration officials say they are not capping the number of patients receiving antiretroviral drugs, but they acknowledge that they are seeking to control the ever-rising costs of the program, known as the President’s Emergency Plan for AIDS Relief, which has grown from $2.3 billion in 2004 to nearly $7 billion this year.

“People are struggling to find resources to honor the commitments we have made,’’ Ambassador Eric Goosby, US global AIDS coordinator, said in an interview. “We’re not at a cap point yet. If it gets worse, we’ll have another discussion.’’

The effects of the cost-cutting measures are beginning to be felt in parts of Africa. For patients arriving at some front-line AIDS clinics in Africa, the limits have the same effect as a cap, critics say.

“Virtually every day, we have to turn away patients who need treatment, including breast-feeding women,’’ said Dr. Peter Mugyenyi, a prominent AIDS specialist in Uganda. “We have to tell them ‘There is a freeze.’ ’’

I for one am hoping the program can be extended to save more lives. The new challenges being posed are huge, but in comparison to what was going on before (and still is going on for the large majority of the virus’s victims) they’re good problems to have.

http://www.flickr.com/photos/jdlasica/ / CC BY-NC 2.0

As a foreign reporter, I’ve always been fascinated by comparisons of how a country is portrayed in the media versus what it’s like to actually visit the place. One measure of how well we’re doing our jobs as journalists is the breadth of the gap between the two. Are the things that are called to our attention by the media the same things that stand out on a first visit?

For instance, when I first visited Liberia during the last days of Charles Taylor in 2003, what I knew to expect from its portrayal in the media was vibrant greenery, gun-pocked buildings and child soldiers in wigs in dresses. Much to my surprise, that turned out to be a pretty accurate portrayal; I saw all of those in the first trip I took out of the city center. In contrast, most portrayals of Turkey include pictures of women wearing headscarves. But while many Turkish women do wear scarves, many don’t. And there’s so much more going on in that country that scarves really aren’t very high on the first things you notice. It’s more like photographer shorthand for: “We’re in a Muslim country.”

So now that I’m in Israel for the first time, on a reporting trip, here are my first quick reactions.

• The National Language: I knew intellectually that people here spoke Hebrew, a language the creators of the Israeli state basically brought back from the dead. But I guess I didn’t have a gut feeling for how diffuse it would be. I’m not sure what I’ve found so surprising about it (perhaps I suspected that like the Dutch most people here would have a complementary mastery of English), but I’ve found it to be a striking expression of Israel’s incredible nation-building effort.
• The Settlements: Much as with the language, I didn’t expect them to be so omnipresent. I suppose that when I’ve read about the Israeli settlements in the West Bank, I pictured lonely outposts, each one far from the others and far from Israel proper. Instead, they’re all over the place. Now admittedly, the area through which I traveled—from Jerusalem towards Ramallah and down into the Jordan Valley north of Jericho—has some of the highest density of settlements, but it’s striking to what extent they literally dominate the landscape.  
• The Women: I’ve been struck by how beautiful the women here are, but then again I’m not sure I remember visiting a country where that wasn’t the case.

A Texan with a Saviour Complex -- Image by AFP/Getty Images via Daylife

I want to elaborate on yesterday’s discussion of whether Africa needs to be saved. For anybody interested in the subject, I highly recommend the discussion going on over at Texas in Africa. It’s a solid critique of an aid industry that can be self-serving, self-perpetuating, inefficient, bureaucratic, patronizing, cynical, and sometimes even harmful. My only worry is that in concentrating on the bad we risk dismissing a lot of the good.

I last lived in Africa in 2005, when George Bush’s PEPFAR aids program was just rolling out. At the time of my departure, I had met very few Africans who were able to afford anti retroviral AIDS medication, and those few I had met were on them thanks to the generosity of a foreign friend or employer. So I was stunned when I visited Uganda a year later and met ordinary people whose lives had basically been saved by Bush’s program. An army sgt., a woman selling bread by the side of a country road—these were people who never could have never afforded the drugs. And yet, suddenly, almost over night, their lives had been saved.  

Now there is quite a bit to criticize in the PEPFAR program, but there’s no doubt it’s literally done a world of good for a lot of people. And there’s also no question that its creation is the result of an impulse to “save Africa.” Admittedly, I’m a bit deep in this subject because I’ve got a long piece coming out that looks at the way the epidemic has been transformed by the rollout of medication. But especially today, as the PEPFAR program seems to be losing momentum, it’s worth remembering that “the savior complex” can sometimes be harnessed to make real positive changes in people’s lives.

Africa doesn’t need your saving. That’s an argument making the rounds of some of the better blogs covering the continent, and perhaps nowhere more so than in one of my favorites: Texas in Africa.

Where did it come from, this idea that we in the privileged West are supposed to “save Africa?

In one sense, the booming interest in Africa and in “doing something” to help people there isn’t new. It’s been there ever since European colonizers, soldiers, and missionaries figured out how to live on the continent without dying of malaria.
…
And yet. In recent years, something has without a doubt changed with respect to Western attitudes about Africa, especially from where I sit in the states. When I was a university student in the 1990’s, people didn’t know much about Africa. And, to be honest, most of the people I knew didn’t really care. Africa was far too exotic, unreachable, and of the “other” to be of relevance. When I announced that I was going to study abroad in Nairobi, just about everyone I knew thought I was insane. It took a year to talk my parents into giving the okay.

Fast-forward fifteen years and the picture is quite different. Students flock to the continent for study abroad programs. The declaration that one wants to “save Africa” or “help Africa” is a powerful marketing tool, and there are dozens of organizations dedicated to doing so.

As you can tell from the tone, she doesn’t think this is a good thing. Africa doesn’t need to be saved, she says. It needs to be “empowered.” That is, we shouldn’t be sending in Western rock stars to pose with hungry children, we should be training local health care providers. And enough with the catered conferences. We should be promoting Africans to positions of responsibility, tapping into local skills, and making sure that every project is concieved and cared for by the people whom it will be benefiting.

It’s all good stuff and hard to argue with. But what if there are some areas where Africa really does need saving? Take AIDS medication, for instance. The price of the most basic treatment has dropped dramitically in the past decade, to something like $300 a year. But in a continent when many make less than a dollar a day, that’s still far out of reach of many of the virus’s victim. Nor is epidemic something that the continent’s governments can handle on their own.

There are roughly 22.4 million people living with the virus in sub-Saharan Africa. Thanks to donor programs, more than 2 million of them are recieving treatment, and that’s just a fraction of those who should be on the life-saving drugs. I’m not saying that local skills and local talent have no roll in this battle. They most certainly do. But one thing is clear: No matter how many local nurses and lab technicians you train, somebody has to pay for the pills. After all, there are lives to be saved.

[update: continued here.]

 Coming soon: A lot of Africa bloggers really don’t like Nick Kristof. I’ll take a stab at defending him.