Get to Zero

Today is World AIDS Day! On this date last year this blog had its first post commemorating the global day of solidarity in the fight against HIV/AIDS and in the last year – when the world marked 30 years of AIDS – I’d like to hope that I’ve contributed, in very small ways, to our communal effort of getting to zero.

With the Trust for America’s Health and amfAR I collaborated on research and policy development for structural and environmental prevention innovations for gay and bisexual and other men who have sex with men in the U.S. – changing the risk environment and the national structures that are inhibiting prevention for that population.

With the Organic Health Response(OHR) and the Ekialo Kiona Center(EK) I’ve continued my connection with the communities of Mfangano East, Lake Victoria, Kenya – primarily through assisting community grant writers to improve the well-being of those living with HIV – to turn the tide of HIV in this corner of the World. Through social solidarity, biomedical and agriculture innovations, and community driven vision, OHR and EK are changing the standards and definition of a “community-based organization”. And transforming the way people live with HIV.

So it wasn’t much, but something…

Now it is time to get to zero. Zero new infections; zero discrimination; and zero AIDS-related deaths. Getting to zero takes prevention and treatment and policy and community. It takes Health in All Policies and nutrition and the built environment and linkages to NCDs and sexual health and biomedical innovations and cultural competency. It takes many small contributions, from just about all of us.

*Want to make your own small contributions? Check-out the Whitman Walker Clinic and OHR for volunteer opportunities!

Image: Author’s own. Ekialo Kiona Center, Mfangano East, Lake Victoria, Kenya.

Being Thankful

Today is Thanksgiving in the U.S. and I’m finding myself far away from home. I’ve been in this position before – sometimes by choice and sometimes by circumstance – and its always an odd feeling to be away from your family and many of your friends on a holiday.

For those of you who pay any attention to this blog, you’ll remember (and see below) that I said I would be back at it in late September/early October… It is now late November, funny how life goes. I’m afraid I don’t have anything witty or insightful or even interesting to say today, but I needed a nudge to get back to writing and Thanksgiving was it.

There are certainly things to talk about, however! New country, new job (prevention, NCDs, the built environment, HiAPs…), continued work with OHR, World AIDS Day coming-up next week, and new thoughts on community prevention and well-being. Looks like maybe its time to get writing..!

I am thankful for many, many things this year, not in the least my brilliant, interesting and supportive family and friends. I am also thankful for the opportunities I have to travel, and try new things, and read interesting stories. I am thankful I have the means to enjoy a large Thanksgiving meal this weekend. And I am thankful for the chance, in my small ways, to help those in our communities who can not.

The Women in Our Lives

Today is International Women’s Day – a day to celebrate the strength and uniqueness of women around the World, but also to acknowledge our daily challenges (yes, I’m a woman!)  I have been fortunate in my life to be surrounded by strong and diverse women – my mom, my grandmothers, aunts, cousins, sisters-in-law, friends, teachers and mentors.  They are mothers, students, scientists, doctors, swimmers, cooks, travelers, musicians, photographers, soldiers, volunteers… I could keep going, but you get my point.

Women in different cultures have varying opportunities, priorities, and worldviews.  Yet, in one of those fantastic twists of humanity, there is a thread of commonality among us.  As the world’s health systems evolve, this commonality among women must be a priority – effective and appropriate prevention and health care for all women.

In the US, this means a commitment to Health in All Policies that address transportation, food and health care access, education, and child care needs.  In Kenya, the establishment of sustainable food security for women affected by HIV.  And in many places in the world, the ability for women to make their own decisions about their bodies.  The health and education of women, as most of you already know, has an exponential impact on the well-being of children and communities.  A well-being, how ever you define it, that is a right.

I have stated before that being part of a given population should not be a negative determinant of health and I’m going to say it again – being a woman should not be a negative determinant of health.  In far too many places in the World, it is.  The women in our lives (“fascinating, if not a little bit scary”!) and their well-being are a cause worth our defense.

Images: Author’s own.  Matriculation day (University of Oxford, UK) and members of the EK Sisterhood Exchange Program (Mfangano Island, Lake Victoria, Kenya).

In the News: All Aboard

*Today, England’s Department of Health announced their plans to promote Health in All Policies (HiAP) through a new government entity – Public Health England. This is just another move by a leading economic nation (including the US through the National Prevention Strategy) to explicitly state that health, well-being, and the promotion of infrastructures which allow for healthy choices through the life course, should be a matter of national importance. Hopefully England will move forward with these policy initiatives in appropriate and culturally humble ways – recognizing the unique nature of individual communities.

Honoring Health in All

Today is a day we remember, thank and honor those who have served our country – many of whom have and continue to come home with visible and not so visible scars. A new study out this week, and highlighted in the NYTimes “The New Old Age” blog, highlights the struggles of not only Vets, but those who care for them. In addition to traumatic brain injuries and loss of limbs, many Vets face severe post-traumatic stress disorder (PTSD) and depression. Rates of suicide among recent returning service members are on a staggering rise. Stress from being the primary caregiver to an injured veteran is on the rise too, and can have a detrimental affected on those they care for, their communities, and themselves.

While the VA (Veterans Administration) provides some of the best health care in the U.S.,  there is more to be done to create communities and environments which are supportive and accessible to all Vets and their families. Communities need to be accessible, both through universal and sustainable design (i.e. sidewalk cut-outs) and through affordable and safe public transportation. Vets and their caregivers risk isolation, from their communities and the services they need, increasing stress and depression.  Homeless and minority veterans face further challenges, many returning to communities already facing health disparities – poor housing, lack of health and educational services, little access to fresh and affordable foods, and other elements considered important to “recovery” and well-being. Being a veteran should not be a negative social determinant of health.

Caregivers come in all forms, and often rise to the occasion with their own strength and courage when faced with adversity. There have been many innovations in care and rehabilitation for injured Vets (yoga, guitar, amazing prosthetic technology, scuba diving, etc.), but our communities are not adapting to the new realities they and their caregivers face. Health should be for all, and in all we do, and should be part of our national tribute to those who chose the greater good over themselves.