Doctor Mehret

So in this ever growing experience of interactivity and sharing I have started a new section to this blog called Dr. Mehret TV. Please check it out. I am also going to add it to the front page the minute I can figure out how to do this. Dr. Mehret TV will be an ongoing “vlog” as they say. It is being hosted through: drmehretmandefro.blip.tv

This TV show also has an associated podcast via (drmehretmandefro.blip.tv/rss/itunes/). Just subscribe using this URL through your iTunes player.  Let me know if you have any problems.

I have been thinking very deeply about “solidarity” post-Mexico. It’s a word that is used widely in human rights and social justice circles to mean partnerships that are horizontal, and not vertical. Solidarity takes a lot of work. Most shy away from the challenge, and avoid the accountability at all cost, often using force and/or violence. This is why in a lot of ways, solidarity is also about keeping people safe.

Safety has weighed heavy on my mind since attending a session on sexual violence in conflict zones at the XVII International AIDS Conference. The stories from the Congolese and Zimbabwean women were unforgettable… transformative really. If you didn’t care about sexual violence, there was no way you could have left that room without becoming an ally. It is this process of becoming an ally that I cannot stop thinking about. Of all injustices women experience, sexual violence is by far the most traumatizing and costly to a women’s health. This makes accountability for these atrocities the number one objective for women’s rights advocates.

A large part of becoming an ally is demanding accountability for wrongs committed and creating paths for this accountability to happen. The truth is that many will never know the pain these women experienced in the conflict zones but we don’t have to - to say enough. No more exploitation. All we have to do is put our experiences to the side and create room for theirs. The implications of this statement are far-reaching. It means new voices at the table and a new table.

The latter encompasses the last presenter of the session who was a HIV positive woman talking about organizing for peace. She made the point that since the casualties of war are often the women and children, then the best thing to do is to prevent the wars from happening in the fist place. “A safe world means safe homes, and safe women,” she said. I couldn’t agree more. The intersections between violence prevention and HIV prevention are profound. Until men feel safe on the streets and women feel safe at home, we are all in trouble.

As a woman who has never experienced threats of personal violence, taking care of traumatized patient who had, forever changed the way I thought about HIV prevention and solidarity. Hearing the stories from the Congo, Zimbabwe and Kenya reinforced this connection further and invoked the same feelings I had thinking about these issues in the South Bronx. What does it mean that so many can continue to suffer with so many watching and so many trying to “help”?

It means solidarity is missing.

There were over 22,000 delegates at the XVII International AIDS Conference. As I prepare to head back to Philadelphia, I am overstimulated, exhausted, and excited. The past week has been intense and hopeful. I have recorded much audio and video footage that I will slowly post over the coming weeks to share all the lessons learned. Highlights include: attending an amazing bridging session on the interplay of political crisis, sexual violence and HIV in Zimbabwe, Congo, and Kenya; meeting Congresswoman Barbara Lee and Dr. Keven Fenton; filming an innovative “Truthaids-esque” community dialogue about changing cultural norms about gender in Zambia. More to come, soon.

The XVII International AIDS Conference set a precedent. The United States AIDS epidemic was contextualized within the larger global epidemic unlike ever before. The new statistics revealing the disparities regarding HIV incidence rates were presented alongside protesters who reminded us that the U.S. has no national AIDS strategy. The authoritative report released by the Black AIDS Institute, Left Behind (Black America: A neglected priority in the global AIDS epidemic) added fuel to the fire. The United States health disparities were squarely placed on the international stage for all to judge.

The world watched, listened and made some recommendations. At a regional dialogue, where thirty women of the Global North and South met to discuss solidarity, more than one woman from the Global South mentioned the unique opportunity the United States has to learn from the PEPFAR recipients.

These comments resonated deeply with me. The thought of the United States actually learning from the countries it is trying to help reflects a massive opportunity to build transnational solidarity. PEPFAR recipient countries have been engaged in scaling-up national AIDS programs in difficult circumstances that have much to teach about how you implement a national AIDS strategy.

The question is: will we listen? And more importantly, who will be at the table deciding?

As a physician who works in West Philadelphia, where violence is high, economic opportunities are low, and HIV prevention is about building healthy communities, the parallels to my Global South colleagues’ experiences are not dissimilar. Yet, the links between domestic and global health are nascent. Somehow, our mental schema has not allowed for the connection.

Moreover, I have a hard time imagining a U.S.-led delegation would visit a PEPFAR recipient country, with the intention of learning something new to bring back home. Somehow, the arrow of learning rarely points in this direction. It’s usually “our way or no way”, if not worse, when considering U.S. involvement in countries outside of the G8. In fact it is often the latter. Haiti’s history serves as a devastating reminder of what U.S. involvement can mean for the fate of a poor country and its consequently high HIV rates.

However, times are definitely changing and increasingly there are Americans that are holding the government accountable to new standards. The Honorable Congresswoman Barbara Lee is leading the call for a domestic PEPFAR. She was unstoppable and uncompromising in her claims during the conference. “This is a political struggle,” she said, “The stars are aligned and we must capitalize on this opportunity.”

As the United States begins to think through a domestic AIDS strategy, it has a unique opportunity to build authentic transnational solidarity with countries in the Global South. We can collectively shape a new power paradigm that begins to redress the injustices of the past by including unrepresented voices at the table and also listening to what their experiences teach. Building on shared experiences results in solid partnerships that are mutually respectful, equitable, and transformative for our world. This new power paradigm will have ripple effects that lead to the end of the global HIV/AIDS epidemic.

(As posted in: www.AIDS2008.com)

I am busily preparing to meet the world in Mexico.

The last time I attended this conference was 2000 in Durban, South Africa. I was a bright- eyed medical student and the world had gathered demanding treatment access for the developing world. Judge Edwin Cameron gave the First Jonathan Mann Memorial Lecture and I cried quietly as the world remembered the teacher who changed my life. I was not alone in my tears. There was not a dry eye in the room. He had changed many people’s lives through his vision. His vision was big. Real big.

The atmosphere in Durban was electric. My heart was exploding with ideals of justice and health. I was with my favorite medical school professor and turned to him and said: “I think the world is changing.” He shot back a skeptical look and said: “maybe”

Eight years later, as I prepare for Mexico as a full-fledged physician, a lot has changed but much has stayed the same. The unprecedented growth in global access to treatment is undeniable. But HIV continues to be a global epidemic with an outcome gap between rich and poor, and Mandela’s call for action in Durban is still the most pressing item on the agenda, as reflected in the Mexico city conference theme: Universal Action Now.

Action is about change. This is profoundly political. The late Jonathan Mann, father of the health and human rights movement, had a deep understanding that the HIV epidemic presented “a challenge to the political and societal status quo.” He taught an undergraduate course called Public Health, AIDS and Human Rights that I took during my junior year in college. He ended the first day of class with: “This is a course for those who believe the world can change.” Simple, and to the point. I was hooked. I have been marching down the same road ever since. Following the connections.

This brings me to Mexico. I can’t help but think about Jonathan’s vision. It’s about change and how change comes. We need a movement, and movements are built by people. Not just the leaders, or experts but the citizenry. It’s all profoundly political. Yet, dealing with individual risk and personal responsibility is much more comfortable for the status quo. Therein lies the challenge.

Part of the solution is expanding the voices at the table who get the political message and that is what I intend to do. I am taking David Jenkin’s story with me. I am an official blogger for the AIDS 2008 community site (www.aids2008.com) and have posted my first video entry at: http://www.aids2008.com/blog/david-piano-player-notes-frontlines-life

Check it out and let me know what you think. Onwards and upwards.