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Africa

Reporter

Tonight I finished watching the documentary Reporter (2009).  From it's web site:

REPORTER is a feature documentary about Nicholas Kristof, the two-time Pulitzer Prize winning columnist for the New York Times, who almost single-handedly put the crisis in Darfur on the world map. The film puts the viewer in Kristof’s pocket, revealing the man and his methods, and just how and why real reporting is vital to our democracy, our world-awareness, and our capacity to be a force for good. But REPORTER has a second agenda. By tracking a newsman, we track his news.

I give it 4 out of 5.

Invictus

200px-HumanFactorInvictus Last night I went with friends from work to see Invictus (PG-13,2009).  From ScreenIt!:

The newly elected President of South Africa hopes to begin reconciliation among his black and white constituents by urging them to unite behind the nation's rugby team in the World Cup.

Over coffee afterwards, one of my friends talked about what it was like experiencing these events first-hand as an Afrikaner in South Africa.  She said the film brought back so many memories.  First of all, she was impressed with Freeman’s and Damon’s accents…saying they were spot-on.  Also, she indicated that the filmmakers did an excellent job of capturing the spirit of what the South Africans felt and experienced during that time.  Her family had gathered to celebrate her 21st birthday and watched the match together on a big screen.  Although they didn’t realize it at the time, she said that when Mandela walked onto the field wearing the #6 jersey of the Springboks (South African national rugby team, a deep-rooted symbol of Apartheid) it was a major turning point for their country and its racial reconciliation.  The celebrations in the streets afterwards were the first time they had done so without fear of violence and riots.  She said her parents have made big changes in their outlook since then.  On the other hand, her brother has not (still doesn’t want to use the same facilities as blacks, send his kids to school with blacks, etc.).  She said that the black middle class is growing and that it’s not unusual to see blacks buying homes in previously-white-only neighborhoods.  Unfortunately, the shanty towns are still prevalent.  Despite the fact that the country’s old flag (another symbol of Apartheid) was not banned, you never see it flown at sporting events any more.  She said the rugby was very realistic too, and she wanted to jump up and cheer during the film.  She wondered if the rest of us (who didn’t share that same personal connection with the story) would find it boring.  We didn’t.

I’m a sucker for sports movies and a sucker for movies about racial reconciliation, so I didn’t stand a chance.

I give it 5 out of 5.

The Pope, AIDS, and Condoms

From The Wall Street Journal:

Pope Benedict XVI said on his way to Africa Tuesday that condoms weren't the answer in the continent's fight against HIV, his first explicit statement on an issue that has divided even clergy working with AIDS patients.

Pope Benedict had never directly addressed condom use. He has said that the Roman Catholic Church is in the forefront of the battle against AIDS. The Vatican encourages sexual abstinence to fight the spread of the disease.

"You can't resolve it with the distribution of condoms," the pope told reporters aboard the Alitalia plane headed to Yaounde, Cameroon, where he will begin a seven-day pilgrimage on the continent. "On the contrary, it increases the problem."

Not surprisingly, Benedict's statements elicited much criticism.  It was easy to imagine that the Catholic church's teachings about contraception were dictating his viewpoint rather than a rational assessment of the situation on the ground.  Criticism of his statements acknowledged that condoms aren't foolproof and sometimes fail either due to operator error or loss of integrity (link).

Then the official transcript tweaked his words to make it a little less extreme, indicating that condoms risked increasing the problem (link).

Then Edward Green came to the pope's defense.  I assume Green's views on this subject are controversial, but he does have some credibility (link):

Edward C. Green is one of the world's leading field researchers on the spread of HIV and public health interventions. He's the director of the Harvard AIDS Prevention Research Project, and is a leading advocate for evidence-based interventions.

I understand Green's point, and I think it's a good one.  If condoms are the answer for AIDS in Africa, we should be able to see it in the data.  As he said (link):

We have found no consistent associations between condom use and lower HIV-infection rates, which, 25 years into the pandemic, we should be seeing if this intervention was working.

How could condoms contribute to the problem?

...the best evidence we have supports the pope’s comments. He stresses that “condoms have been proven to not be effective at the ‘level of population.’”

“There is,” Green adds, “a consistent association shown by our best studies, including the U.S.-funded ‘Demographic Health Surveys,’ between greater availability and use of condoms and higher (not lower) HIV-infection rates. This may be due in part to a phenomenon known as risk compensation, meaning that when one uses a risk-reduction ‘technology’ such as condoms, one often loses the benefit (reduction in risk) by ‘compensating’ or taking greater chances than one would take without the risk-reduction technology.”

In an interview with Christianity Today (link), Green commented further on what he thinks is and isn't working:

We are seeing HIV decline in eight or nine African countries. In every case, there's been a decrease in the proportion of men and women reporting multiple sexual partners. Ironically, in the first country where we saw this, Uganda, HIV prevalence decline stopped in about 2004, and infection rates appear to be rising again. This appears to be in part because emphasis on interventions that promote monogamy and fidelity has weakened significantly, and earlier behavior changes have eroded. There has been a steady increase in the very behavior that once accounted for rates declining — namely, having multiple and concurrent sex partners. There is a widespread belief that somehow Uganda had fewer condoms. In fact, foreign donors have persuaded Uganda to put even more emphasis on condoms.

I can buy that it's possible that on the level of populations the focus on condom distribution might counter-intuitively fail to reduce the prevalence of AIDS and that this complexity may be underappreciated.  Complicated issues are often over-simplified into inaccurate or incomplete sound bites. 

On the other hand, I think that the pope's and Green's comments are also an over-simplification because they seem not to acknowledge this fact (as others have pointed out): an African woman for whom monogamous sex with an uninfected spouse is not an option is much safer if her spouse uses a condom.  That's the difference between considering the efficacy of condom availability on the individual versus population level.  We should be concerned about both.

Part of the issue is also probably that passing out condoms makes someone some cash and is much easier than the hard work of significantly changing a culture's views regarding sexual fidelity.  It probably makes sense to start with the easier job...but not just stop there either.

Amputee soccer tournament

From the current issue of The Week magazine:

West African amputees got to cheer on their own this week at the first All-African Amputee Football Championship. Thousands of West Africans had their arms or legs hacked off by rebels during Sierra LeoneÂ’s brutal civil war, which drew in militias from neighboring countries and spread across the region before ending in 2002. AngolaÂ’s civil war, which also ended in 2002, left thousands of buried land mines that continue to maim civilians. Amputee soccer teams from Ghana, Sierra Leone, Angola, Liberia, and Nigeria are competing. Each team consists of six one-legged players and a one-armed goalie.

This is a nice story about people who have been devastated by war in Africa finding a way to move on with their lives and not let their injuries be a limitation. I also have to think it would be a curious soccer game to watch.

Building a Memorial to a Son, One Child at a Time

Mike Cope points to a NY Times article of the same title that tells of the story of what some of his relatives are doing to help improve the lives of children around the world. This is something that's been on my mind a bunch lately. It's hard to imagine any better use of one's time and energy than giving mercy to a child.

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