World AIDS Day: Remember, Support, Learn

According to the World Health Organization, more than 60 million people have been infected with HIV, and over 30 million people have died of AIDS since the beginning of the HIV/AIDS epidemic in the early 1980s (WHO, 2012). Today, it is estimated that 34 million people are living with HIV, most of whom do not know they are infected with the virus (WHO, 2012). Developing countries, particularly those in Africa, carry the burden of HIV prevalence, as shown in the figure below (WHO, 2009).

This Saturday, December 1, marked the twenty-fourth annual World AIDS Day. This day is designated to unite and remember those who have died of HIV/AIDS, support people living with the virus, and increase awareness of effective HIV/AIDS prevention and treatment. In recognition of World AIDS Day, the Richmond Global Health Alliance would like to acknowledge organizations that employ this spirit in their daily work.

Fan Free Clinic

Richmond, Virginia

Since 1970, Fan Free Clinic has provided free health care to those in the Richmond area who have limited access to care. In the 1980s, Fan Free Clinic spearheaded the state's first community-based HIV/AIDS outreach program and remains a leader among local HIV/AIDS advocacy and health organizations today. They provide free testing, education, and support groups, and are at the forefront of spreading HIV/AIDS awareness in the Richmond community. Last year on World AIDS Day, the Fan Free Clinic organized RVA Remembers, a community-wide campaign that received national media attention. At 12p.m. on December 1, 2011, four-hundred red umbrellas opened in the shape of a red ribbon to symbolize remembrance of the victims of HIV/AIDS and to commit to HIV/AIDS education and prevention.

Here is a video of RVA Remembers 2011: 

VCU HIV/AIDS Center

Richmond, Virginia

The VCU HIV/AIDS Center provides clinical, research, educational, and support activities throughout the state of Virginia. Their services reach a number of diverse audiences, including individuals living with HIV/AIDS, medical providers (physicians, pharmacists, nurses, psychologists/psychiatrists, dentists, etc.), social workers, substance abuse professionals, and case managers. The overall goal of the VCU HIV/AIDS center is to prevent the spread of HIV and improve the lives of those living with HIV/AIDS. 

TED

TED is a world-wide nonprofit organization that is dedicated to "ideas worth spreading." Essentially, the organization gathers thinkers and doers from all over the world to share their ideas in a talk lasting 30 minutes or less. TED then posts videos of the talks on its website, which are available to the general public at no cost. TED has hosted a number of talks on HIV/AIDS prevention, treatment, and impact from individuals in a variety of academic and professional fields-- from photography, law, and economics, to biochemistry, psychology, and epidemiology. Some of our favorites are below. 

Elizabeth Pisani

Sex, Drugs, and HIV-- let's get rational

Shereen El-Feki

 HIV -- how to fight an epidemic of bad laws

Hans Rosling on HIV: New facts and stunning data visuals 

Cited sources: 

World Health Organization. (2012). Global health observatory: HIV/AIDS. Retrieved from http://www.who.int/gho/hiv/en/index.html.

World Health Organization. (2009). Global health observatory map gallery: HIV/AIDS. Retrieved from http://gamapserver.who.int/mapLibrary/app/searchResults.aspx. 

Update: 2013 Trip

This summer, RGHA will launch outreach efforts in Pampas Grande and Cusco, Peru. The RGHA team will travel to Pampas Grande in mid-June, where we will spend a week carrying out our medical and social projects (clinic, pediatrics, women's health, dental, joint pain, emergency medicine, music, art, community health workers, and greenhouse). We will then travel to Cusco, where we will stay at a hostel that supports a local children's clinic. RGHAers will be able to volunteer at the clinic and a nearby orphanage. These new plans (in contrast to our past spring break trips) allow us to spend a longer time in Peru and to extend our outreach to health and social advocacy organizations in Cusco.

Partnerships with VCU School of Medicine's HOMBRE ,University of Richmond professor Dr. Rick Mayes, and the University of Richmond School of Law's Tara Casey have made these plans possible. First, HOMBRE has recruited three first-year medical students and one first-year pharmacy student from VCU to join us on our trip. We hope to provide these students meaningful, hands-on public health learning. Second, the University of Richmond undergraduates' time in Pampas Grande will be supplemented by Dr. Mayes's public health policy class and further volunteer work in Cusco, for which they will receive academic credit. And last, Tara Casey has helped us recruit a law student for social justice efforts in Pampas Grande and Cusco.

We are excited about the plans for the 2013 trip and will continue to work to promote our mission, vision, and goals. More updates to come!

Cusco's Plaza de Armas (photo by Blair Armistead, 2009) 

"Othering" and Global Health

The act of "othering" involves identifying an individual or group of individuals as different from oneself or from the mainstream. Discourse on othering is ubiquitous in global health, as international health efforts (by definition) involve communication and cooperation among different cultural groups. Othering becomes problematic in any context (especially health) when it leads to the marginilization of any particular group through the introduction of a power dynamic. In other words, when people who are "othered" become inferior to those who are othering, disasterous outcomes can occur.

In their book, Stories in the Time of Cholera: Racial Profiling During a Medical Nightmare, Charles Briggs and Clara Mantini-Briggs discuss how othering facilitated a cholera epidemic among people living in the Orinoco Delta in eastern Venezuela. While the authors present examples of blatant racism and the exertion of power and superiority over people living in this region, the accounts of othering by well-intending public health officials and aid workers are particularly startling. Without being completely conscious of the outcomes of their words or actions, many people who were fully dedicated to assuaging the epidemic actually facilitated it by connecting cholera to culture. In doing so, they shifted the blame from factors such as lack of access to care and inadequate plumbing systems to the people who contracted the disease themselves.



Briggs and Mantini-Briggs present a strong case for the significance of critical thought and consideration of the outcomes of othering when working with people different than ourselves. As the late Dr. Edward Said described in his concept of Orientalism, people often other automatically, making it easy to introduce a power dynamic in the process.

While it might not be beneficial (or even possible) to eliminate othering, it is essential for people providing services to be aware of any power dynamic introduced during the process of othering. As Briggs, Mantini-Briggs, and Said describe, doing otherwise could lead to marginalizing people, even where explicitly unintended.

Investing in Women

In her talk for TEDxWomen (below), author and journalist Gayle Tzemach Lemmon creates a profound argument for investing in women entrepreneurs: It's not about doing good, but about global growth. Lemmon asserts that women are overlooked as key economic players, too often pegged with the narrative of the victim, rather than the survivor...the exception, rather than the example. 

 

The benefits of providing economic opportunity for women are hardly new concepts. From the work of Mohammed Yunus, to Nicholas Kristoff and Sheryl WuDunn, to USAID (see the infographic below), there is plenty of evidence to suggest that investing in women benefits individuals, families, communities, and countries, particularly in post-conflict and developing areas. Investing in women is a no-brainer.

Why, then, does it remain difficult to invest in women? Are there factors outside the simple pathway of supply and demand which affect the growth of a woman's business? Sexism? Racism? Paternalism? Lack of legal framework? Lack of health resources?

What do you think?

Getting to the Town above the Clouds

The locals call Pampas Grande "El Balcón Suspendido entre el Mar y el Cielo," translated as "The Balcony Suspended between the Sea and the Sky." Once you're there, you understand why. On a clear morning, you can see all the way to the Pacific Ocean. But later in the afternoon, when the clouds roll into the valley below, you realize that you're quite literally standing in the sky.

Getting to the balcony is no piece of pastel. This year, Sean Byrne collected GPS data on the last leg of our drive up the mountains, which is summarized in the image below. As you can see, while this portion of the drive was just over 57 miles, it took us about 4 hours to reach Pampas Grande-- meaning that our average speed was 14.5 mph. This tortoise's pace is more understandable when you see that we actually went 2 and a half miles upward. (See all the zig-zags?) It's no wonder that we're gasping for oxygen by the time we arrive.

Sean's GPS data shows us just how geographically isolated our site is from...well...everything. For people that live here, this makes finding and getting to health care a challenge. Even people that live just a 15 minute's drive from Pampas Grande often travel over 2 hours by foot or donkey to see the physician in the health post in Pampas Grande.

We've been trying to come up with ways to combat this geographical barrier to health care. For instance, this year during our visit, Dr. Paula Tamashiro, a physcian from Peru with whom we work closely, arranged for our van to go to each of the nearby villages to transport people to the health post. Additionally, University of Richmond students have donated a truck to be used as an abulance, should anyone from the community need to be transported to the hospital in Huaraz.

Check out this article about the efforts of the Institute for Electrical and Electronics Engineers to set up an infrastructure for telemedicine in remote areas of the Peruvian jungle: Providing Telemedicine to Peru's Medical Outposts. Perhaps this model could be used in Pampas Grande to increase access to medical specialists in Lima or other areas of the world. It is certainly an idea to explore further!

RGHA Retreat and BBQ

RGHA members gathered last Sunday for a group organizational meeting that involved discussion about future projects, partnerships, and goals. Here are some of the highlights:

- For next year's trip, RGHA is considering going to Peru during the summer, rather than during spring break. This will allow our group to stay in the country longer and explore other communities.

- The RGHA website is underway!

- RGHA will host a number of different community outreach and fundraising efforts, including a museum event, a trivia night, guest lectures, and restaurant profit shares.

- RGHA is looking to partner with people from diverse professional backgrounds, including law, dentistry, education, accounting, nutrition, computer science, business administration, and marketing.

- RGHA will continue to work with and improve upon established projects (derm, women's health, greenhouse, joint pain, crafts, clinic) with the help of returning undergraduate student leaders.

After business was complete, RGHA members enjoyed great food, company, and spring weather at the annual post-trip BBQ.

Sid on grill duty

Our young supporters ready for cake

Beautiful and delicious RGHA cake (made by Kakealicious)

Lively dinner discussion


Stay tuned for more RGHA updates!

Our Experience in Photos

On this year's trip, so many people in our group went above and beyond to capture our experience in Peru. In fact, two students, Jigna Solanki and Stephanie Stahl, have entered some of their breathtaking photos into the University of Richmond's Spiders Abroad Photo Contest (found here.)

Enjoy these photos, and visit our Facebook page for more!