Media Wars: #Ferguson, American Hypocrisy and a Hint of Spring

This was originally posted on my professional blog.

America has experienced an ugly spotlight reversal with the eruption of popular discontent into violence in its own backyard. Just a few weeks ago, international media was buzzing with reports of ISIS steamrolling the Iraqi military and Russian-supported separatists in Ukraine shooting down passenger airlines. Now, the US squirms uncomfortably under international scrutiny of Ferguson, Missouri, where the shooting of a young black man by a white police officer has once again raised the specter of racism and police brutality.

Obviously, the incident itself is complicated. Eyewitnesses – who have given conflicting testimonies – are the only window into what happened, since there was no dashboard camera. The initial description of Michael Brown, the victim of the shooting, as a “gentle giant” about to start college clashed with video footage of him stealing a box of cigarillos from a convenience store. Commentators have drawn parallels with the case of Trayvon Martin, whose mother has now reached out to Brown’s mother. Peaceful protests have given way to violence and looting, reporters have been arrested, and witnesses have complained of excessive use of force by the police.

Social media, which played a major role in bringing media attention to Ferguson in the first place, has played host to the battleground of ideological responses to the incident. The primary complaint from conservatives is that the uprising in Ferguson, and the underlying racial tensions it has exposed, don’t deserve our consideration because some of the protesters have been looting and vandalizing stores…

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…including a few gems that actually blame the community for the excessive force used against it.

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Meanwhile, people used the Twitter hastag #IfTheyGunnedMeDown to spar over which photos of Brown were used by traditional media (wearing a cap and gown vs. striking a “thug” pose) and post their own side-by-side pictures. Still others are expressing frustration at the fact that the vandalism and looting has been used as a straw man to distract from ongoing widespread racial profiling and policy brutality against blacks, including one refreshingly blunt protester at a rally in DC:

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What has been the most interesting to me is the global shock and horror at the incident and resulting fallout. The international community sees what many Americans are apparently missing: that the protests and unrest in Ferguson are the manifestation of a minority group sick of being oppressed and ignored. The UN High Commissioner for Human Rights drew parallels to South African apartheid, while several countries have been using the situation to take shots at America’s own human rights record when we so often criticize other countries. One might expect Iran and Russia troll the US over civil unrest, but as one friend of mine pointed out on Facebook, “When Egypt calls you out for human rights abuses, YOU’RE DOING IT WRONG.”

American police brutality, and the unwillingness of many police departments to be held accountable for their actions, have also been focal points. What happened to Michael Brown will unfortunately always be shrouded in mystery, since the Ferguson police department apparently prioritizes riot gear and tear gas over cameras for officers or police cruisers. They also seemed to have forgotten the meaning of “free press,” as they arrested and harassed several reporters who were trying to cover the protests. Interestingly, Obama was quick to condemn the bullying of journalists “here in the United States of America,” despite his own administration’s secrecy and aggression toward the press, including prosecuting a journalist who refused to identify the source of an intelligence leak.

Indeed, many observers have been quick to point out America’s hypocrisy at fingering human rights abuses outside our own borders when we have threads of discontent, similar to those found in the Arab Spring and other global protest movements, woven throughout our own society. A lovely little piece of satire from Vox portrays how American media might describe the events in Ferguson if they happened in another country.

When everything is said and done, America doesn’t look so much like a shining beacon of democracy and human rights – we just kinda look like everybody else.

Screwing Global Health for the Sake of Spying

Two weeks ago, my husband and I visited a couple that we knew from university that I hadn’t seen since before we left for Korea in 2012. The wife actually got her Master’s in international development and worked in DC for a few years after graduating, but returned to Texas with a general distaste for the development industry. “I always wanted to work for USAID,” she told me, “until I figured out that they were just a tool of US foreign policy. I felt kind of betrayed – I thought they just helped people!”

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Photo credit: USAID.

My friend’s complaint is common among development professionals. Many in the industry believe that US foreign assistance should come without political strings attached to it, and they object to practices such as obvious branding of foreign aid supplies and using aid as a tool to strong-arm other countries into going along with American foreign policy moves. Personally, I get that foreign aid is one of many tools in a country’s foreign policy toolkit – it may not be ideal, but it’s at least logical.

What’s not logical to me, however, is the use of aid – specifically, of global health interventions – as a cover for intelligence operations.

Development types will remember the uproar over the CIA’s use of a vaccination drive as a cover for collecting DNA in a (failed) effort to locate Osama bin Laden in Pakistan. (Widely reported as a polio vaccination drive, the CIA scheme actually used hepatitis B vaccine.) Pundits predicted – correctly – that it would set polio eradication efforts back and put aid workers in danger. Luckily for us, the CIA has now promised not to do it again – which is lovely, but a shame that it took three years for them to get around to doing.

Now it would seem that USAID is trying its hand at endangering global health efforts through half-baked intelligence schemes. Last week, the AP released its major investigative journalism report on a USAID operation that used young and inexperienced Latin American activists to try to stir up dissent in Cuban civil society. Aside from major issues such as the fact that the Latin American youths were poorly trained (and paid!) and not prepared for the risks they faced (particularly when USAID’s management of the scheme was utterly amateur), or the fact that this really is not USAID’s job, development professionals have been irate that yet another government covert operation has jeopardized global health – in this case, HIV/AIDS prevention efforts, in response to the revelation that one of the operatives used an HIV workshop to “recruit promising individuals”:

The choice of a U.S.-sponsored HIV workshop in Cuba is an interesting one, since Cuba’s HIV infection rate is one of the lowest in the world, and one-sixth that of the U.S. But it appears the disease was not necessarily the focus of the workshop, which was attended by 60 people. Fernando Murillo, after returning from Cuba, put together a report detailing his activities for Creative Associates, the USAID contractor hired to work against Cuba’s government. His only mention of HIV says it was “the perfect excuse for the treatment of the underlying theme,” meaning anti-government organizing.

In a press release, Congresswoman Barbara Lee (D-CA) blasted the program. “As co-chair of the Congressional HIV/AIDS Caucus, I am particularly concerned by the revelation that HIV-prevention programs were used as a cover,” she said. “This blatant deception undermines U.S. credibility abroad and endangers U.S. government supported public health programs which have saved millions of lives in recent years around the world.”

Frankly, I am scratching my head at why USAID thought that this kind of operation, or the “Cuban Twitter” called Zunzuneo that was uncovered earlier this year, was a good idea. Perhaps they are fighting to stay relevant in an era of US global health policy when the State Department and the White House are also jockying for position, but it’s no excuse. Jeopardizing global health programs, particularly programs that target HIV/AIDS – which is universally acknowledged as at the top of the global health agenda – is just a way to shoot yourself in the foot. In the end, they only lose credibility – and USAID, as a development agency, should understand what that can cost. They should know better.

Let’s Get Ethical: Giving Untested Experimental Drugs to Ebola Patients

West Africa is in the throes of the worst Ebola outbreak to date. Ebola virus disease, the hemorrhagic fever caused by the Ebola virus, has been seen in small but often deadly outbreaks in tropical sub-saharan Africa since its discovery in 1976. Though researchers are fairly certainly that it is transmitted through bush meat, and fruit bats are suspected, no animal species has been confirmed as a reservoir. Combined with the fact that the virus is highly contagious and so often deadly (usually because there is little to no medical infrastructure in areas where outbreaks occur), it is the source of international fascination and fear. It is the perfect plot device for outbreak movies and sensational media reports – a mysterious ailment from the heart of darkness that could rear its ugly head in our packed population centers at any moment.

Although it’s not quite as scary as movies like “Outbreak” would have you believe, the havoc that it is currently wreaking in West Africa is most definitely real. The most recent update from WHO puts the death count at 932 and the number of cases (both suspected and confirmed) at over 1,700. Guinea, Liberia, and Sierra Leone have been battling the virus since the spring, and last week it made its way to Nigeria and there was even a suspected death in Saudi Arabia. We all know that international air travel means that these types of illnesses are only a plane ride, which raises the question of why we haven’t made more progress in developing a vaccine or treatment for such a devastating disease.

Frankly, most global health and development professionals know the answer – if the only market for potential drugs is among the poor in central Africa, commercial drug companies won’t exactly be lining up to put money into the research:

The factor preventing such trials in humans, though, has been cost, said Dr. Daniel Bausch, an associate professor of tropical medicine at the Tulane University School of Public Health who is currently stationed at the U.S. Naval Medical Research Unit 6 in Lima, Peru.

That’s because, while the National Institutes of Health and the U.S. government often fund the early animal safety and efficacy testing of a vaccine, pharmaceutical companies typically fund the human clinical trials to take a drug or vaccine to market.

“When you have a population or situation with Ebola where it only sporadically occurs, and it occurs really in the world’s poorest populations, it’s not exactly an attractive candidate for the pharmaceutical industry on the economic side,” Bausch said.

That all changed, however, when two American aid workers who were treating Ebola patients in Liberia fell ill with the virus themselves. Dr. Kent Brantly, a doctor working with Samaritan’s Purse, and Nancy Writebol, a nurse employed by Service in Mission, are now all over U.S. and global headlines as the first Westerners to contract the virus – and, because of their privileged status, as the first people to receive an experimental treatment in the early stages of development before being flown back to Emory for medical care (despite objections from Donald Trump and Ann Coulter).

Though several people have raised objections to bringing Americans back stateside for treatment (particularly at what it probably cost), Emory is probably the safest and best-equipped facility to treat and contain the patients. Samaritan’s Purse is footing the bill for transporting them, so no government funds are being used. Bringing them back to the states for treatment is not so much of an issue, in my opinion – but using an experimental drug which is untested in humans is another matter.

At first glance, an outbreak of a disease with a high fatality rate (usually 40-70%) and no cure seems like the perfect situation to bypass the standard drug testing and approval process, which can take several years. However, it is the recklessness generated by precisely this type of desperate situation that raises ethical dilemmas. Does informed consent really count when patients are panicked at the prospect of imminent death? What if the drug is administered to the afflicted on a large scale and turns out to be toxic, or causes long-term disability? Who determines which patients to prioritize and how to protect those most vulnerable – such as children or pregnant women – who may react very differently to the drug?

Additionally, the fact that the drug has only been given to the two Westerners raises a very different, but equally important, problem. The international community has struggled for years to bring critical medicines to populations with the greatest need, who are simultaneously the least able to afford them. The fact that this experimental treatment was given to two aid workers – who, unlike their patients, have the support of large and wealthy organizations and will be more able to access the needed high-quality supportive care than their own patients – raises some disturbing questions.

The WHO has announced that it will convene a panel of medical ethicists to discuss and provide guidance on the issue. The pharmaceutical companies that develop and manufacture the drug are, naturally, chomping at the bit to get a large production run funded in order to provide ZMapp, the experimental serum, to a large number of Ebola patients. It is unclear how the global health community will move forward. But perhaps it can serve as a lesson to the pharmaceutical industry to take a more active interest in developing therapies for diseases that may not seem lucrative at first glance. Perhaps then we’ll be prepared for an unexpected multi-country outbreak – instead of having to scale up an untested drug developed by a tiny biopharmaceutical.

Spotlight on Brazil: The World Cup and More Doctors

The World Cup ended on Sunday and with all the controversy surrounding host country Brazil, I found myself wondering about their health care system. I knew access to basic health services was one of the main points of protest against the Brazilian government’s spending for the World Cup, but I didn’t know all the details.

A few quick searches online provided me with the information I wanted and led me to this video from the Pan American Health Organization (PAHO) documenting the impact of the arrival of doctors in two Brazilian towns that previously had no doctors. According to the World Health Organization, there is a serious shortage of doctors in Brazil with 1.8 physicians for every 1,000 people. Although the Constitution calls for free health care for all citizens, the reality is that there are major inequalities in access to health services with 700 neglected municipalities and a lack of local primary health care.

The PAHO video focuses on Mais Medicos (More Doctors) – a program between the Brazilian and Cuban governments that allows Cuban doctors to work in under-served Brazilian communities for three years. I did some more searching online and learned that the program is part of an initiative by President Dilma Rousseff to import 13,000 foreign doctors in order to address the shortage of medical professionals. The program has been criticized and although I agree with some of the points of opposition (How are their foreign credentials vetted for local standards? How does this translate to a long-term plan to address the larger issues with health care in Brazil?) I think the reception of Cuban doctors by local Brazilian doctors was too harsh.

Despite the controversy surrounding the program, the PAHO video illustrates its positive outcomes through patient testimonials about improved access to health care, fewer journeys to far away hospitals, and increased treatment and service quality. Residents in the two remote communities featured in the video are quite happy with the program and appreciative to have basic health care.

What do you think? Does the program provide enough value to balance costs and outweigh the risks? Watch the video and share your thoughts in the comments below.

IHSC June 19th Conference Call with Dr. Pablo Ariel-Mendez, USAID

Please see the following announcement from Mary Carol Jennings of the newly-formed Student Committee.


The International Health Student Committee of the APHA IH Section is the section’s newest student group. As part of the core group of leaders, I wanted to plan a nationwide series of virtual events and conversations about leadership and career decisions in international health. Another group member, Nila Elison, has recently joined me, and together we’re starting the IH Career Development Sub-Committee.

I believe that organizations like APHA can play a valuable role in introducing new public health practitioners to potential mentors. I myself am not following a perfectly straight career path. I’ve worked in community organizing, policy, clinical medicine, and now am finally, formally, in public health, in my second year of the general preventive medicine residency at Johns Hopkins. Only recently have I started to find mentors in people, who like me, have taken similarly non-linear paths.

To set the stage for the upcoming year, our first guest speaker is going to talk about his own career path and his insight on leading a large global public health organization.

Dr. Ariel Pablos-Méndez is a public health physician who serves as the Assistant Administrator for Global Health at the U.S. Agency for International Development. Appointed by President Obama in 2011,  his work involves implementing the mission of the Global Health Initiative. His impressive resume includes leadership and experience within the World Health Organization, The Rockefeller Foundation, and Columbia University in New York City.

Dr. Pablos-Méndez will join the International Health Student Committee on June 19th from 4-5pm EST, and we hope you’ll take part in the conversation about developing your own career in international health.

We had previously closed registration, but because we want to share the conversation with those who are inspired by this blog post, we have re-opened the RSVP form until June 15th. We also welcome your sharing this with your classmates and school communication forums.

RSVP link: http://bit.ly/1n9J1Xc

A few twitter hashtags: #IHSCspeakers, #GlobalHealthSpeakers #IHSCCareerDevelopment

Details about the conference line number and access code will be sent to your RSVP email.
Follow the IH Student Committee!
APHA connect http://connect.apha.org/group.htm?igid=257321
Facebook https://www.facebook.com/groups/APHA.IHSC/
Twitter @APHA_IHSC

Mass Shootings and Important Conversations

Elliot Rodger, a disturbed rich young man went on a shooting spree in Isla Vista, a wealthy district in Santa Barbara, California. Thanks to the joys of social media, both his written and videotaped “manifestos” were able to go viral. The reasons he listed for his killing tour included his parents’ divorce, lack of luck with the ladies, and being short.

I get the divorce and the sexual frustration, but being short? That one was new.

Predictably, this has set off all manner of commentary in the public sphere. First and foremost, of course, comes the discourse on gun control. Gun control advocates have pointed out that all of the guns that Rodger used were legally obtained. The Brady Campaign Against Gun Violence has spoken out on the need to tighten controls on obtaining firearms, and one of the victim’s fathers blamed “craven, irresponsible politicians and the NRA” for his son’s death. To be fair, three of the six people who died were actually stabbed to death, but Rodger had plenty more ready in his car that he could have used.

The feminist response to the “manifesto” (can we even call it that? should we?) has been swift and furious, pointing out the misogynism woven through it and drawing attention to his links to the usually peculiar, occasionally violence-embracing “Men’s Rights Movement” (which, by the way, is what exactly?)

But it also denies reality to pretend that Rodger’s sense of masculine entitlement and views about women didn’t matter or somehow existed in a vacuum. The horror of Rodger’s alleged crimes is unique, but the distorted way he understood himself as a man and the violence with which he discussed women — the bleak and dehumanizing way he judged them — is not. Just as we examine our culture of guns once again in the wake of yet another mass shooting, we must also examine our culture of misogyny and toxic masculinity, which devalues both women’s and men’s lives and worth, and inflicts real and daily harm.

Outspoken feminist writers have pointed out that this is not the first time a shooter has claimed similar motives, and Laurie Penny, in her usual no-holds-barred style, has dubbed the attack as the latest example of misogynistic extremism.

Last, and perhaps least, is the quiet conversation about mental health that seems to only experience half-hearted revivals when these tragedies strike. Mental health advocates speak up to point out that mental illness and seeking treatment for it are stigmatized in our culture, so social awkwardness and becomes anger without productive outlets which then warps into repressed rage. The media usually turns its head for a bit, shrugs, and then moves on to montages of grieving members of the community and talking heads interviewing NRA spokespeople on CNN. Unfortunately, this shooting has pitted feminists and mental health advocates against one another – as if Elliot Rodger the misogynist and Elliot Rodger the mentally unbalanced were mutually exclusive.

As both a feminist and a public health advocate, that makes me sad.

However, I think these are all important conversations to have. I much prefer them being featured on prime-time television in shows like Law and Order: SVU and Scandal than to have them forcibly thrust into the spotlight in the wake of a tragedy, but they need our attention nonetheless – and not at the expense of one another. While I’m not quite with the NRA on (lack of) gun control, I do think it’s something of a straw man in this case – California is one of the strictest states when it comes to gun ownership, and preventing mass killings goes beyond cutting off access to handguns (which, for better or worse, cannot be kept from citizens per the Supreme Court) – but conversations about gun violence segue into discussions about poverty and equity, which badly need to be confronted. We need to scrutinize sexism and gender violence as much as society’s assumption that a man’s worth is based on his sexual prowess – all of which hurt men as much as they hurt women, but in completely different ways. And we need to stop sweeping mental health advocacy under the rug, so that people don’t avoid treatment for mental illness for fear of being unable to get jobs in places like the military or the federal government.

Rather than fighting each other for the spotlight, let’s share it together.

Upcoming Panel Discussion: Hunger in the Age of Climate Change (Washington, DC)

When: Wednesday, May 14, 2014, 1-3pm (Lunch available starting at 12:30pm)
Where: 425 3rd St. SW, Suite 1200, Washington DC 20024

 Today the White House will announce the release of the Third National Climate Assessment.  This report is already garneringnational and international press; climate change is one of the president’s primary areas of focus.  What does the report say about climate change in the United States, and what do these findings mean for hungry and poor people in the United States and globally? Join with members of the faith, environmental, and anti-hunger communities to discuss how we can work together to provide adequate nutrition even as the climate is changing in ways that require new methods of growing, storing, and transporting food.

Invited panelists include:

  • Katharine Hayhoe, one of Time’s 100 Most Influential People and author of A Climate for Change: Global Warming Facts for Faith-Based Decisions
  • William Hohenstein, USDA Climate Change Program Office
  • Lewis Ziska, USDA Agricultural Research Service
  • Jan Ahlen, National Farmers Union
  • Sam Myers, Harvard School of Public Health
  • Margaret Wilder, University of Arizona

Please circulate this invitation among your networks, and RSVP by May 9 at www.bread.org/climate.

Questions? Contact Stacy Cloyd at scloyd@bread.org