IN SEARCH OF THE MOMENT

DOCUMENTARY MEDIA BY DANIEL LOMBARDI

 

 

 

 

NEGLECTED TROPICAL DISEASES

This story was first written for the Deseret News

At this point, to anyone following the headlines, the Zika virus feels like a full-blown pandemic.

And in some ways it is. The mosquito-borne virus has rapidly spread across the Americas, caused infections in more than 26 countries and led to an emergency meeting earlier this month in which the World Health Organization declared the outbreak a "public-health emergency of international concern."

While trying not to stoke fears, President Obama requested more than $1.8 billion from Congress to combat the Zika virus this week. The funding would expand mosquito-control programs and boost vaccine research.

The Zika virus is just one of many diseases that health experts call Neglected Tropical Diseases (NTDs) that are found predominantly in poor communities and affect more than 1.5 billion people around the world. Despite causing immense disability, NTDs are not generally fatal so they are often neglected by the health community. Though there’s no immediate treatment for the Zika virus, many NTDs are treatable and progress is being made against them. Still, NTDs like the Zika virus and others pose a threat to the U.S.

Schistosomiasis is a parasitic NTD, more commonly known as Bilharzia, that causes internal organ damage and is found in tropical fresh water around the world. Left untreated, it causes malnutrition and can be fatal.

Boniface Opinya is a young fisherman who says his life depends on Lake Victoria, where schistosomiasis is common. Every morning Opinya pushes his bright green boat into the lake and spends his day in and out of the water hauling in his nets catching tilapia and Nile perch even though he knows it’s making him sick.

“Lake Victoria water — we interact with so many diseases inside there. We know that we get diseases there but there's nothing we can do,” Opinya says in a video for End Fund, a nonprofit working to eliminate NTDs around the world. "I lost three of my friends because they didn't know they were suffering from Bilharzia."

Opinya describes the symptoms of Bilharzia after it ravaged his small village. “You feel that you are tired,” he says, adding that other symtpoms include a headache and fever. “The stomach swells. People will have thin legs, hands that are very thin and the stomach is coming out as if he’s pregnant.” Stomach bloating and internal organ damage can result from the parasite's eggs getting trapped in body tissue.

Bilharzia is the most deadly of all NTDs, killing close to 300,000 people a year in Africa alone, according to the Centers for Disease Control and Prevention. But generally, NTDs are not very deadly compared to more well-known diseases like malaria, HIV or tuberculosis, which is one of the reasons why they’re neglected by the global health community.

Ellen Agler, the CEO of the End Fund, says that because NTDs are less deadly they receive less than 1 percent of the global health budget. However, she thinks the deadliness of NTDs is underestimated. “NTDs cause more disability than mortality, but still it’s estimated that 500,000 people die per year from NTDs. Malaria causes about 490,000 deaths per year, so when you think about it, NTDs really should be in the same category as malaria in terms of mortality.”

The global health community focuses on five main NTDs including intestinal warms and bilharzia.

Stephanie Palmer, a program manager for integrated control of NTDs at Helen Keller International, a global health nonprofit, says that people who regularly work around water face a particularly high risk for this specific NTD, but in general NTDs hit poor communities without clean water the hardest. “These are poor people living in difficult circumstances and the diseases are making them even less productive and that drives them deeper into poverty. It’s a vicious cycle.”

Once treatment was provided to Opinya's village, people began to feel better right away. “That medicine helped so many people here,” says Opinya. “I can tell you — people changed. The stomachs just started going down, down and back to the normal size.” In most areas a single pill taken annually is enough to treat Bilharzia.

Opinya says the yearly treatment is very important to his community because without any other job opportunities he has no choice but to go fishing in the lake, even though he knows the parasite is in the water. “There's no way that I can prevent myself from going there. If I stopped going to the lake, then I’d become a thief. I’d have to start robbing people in the village.”

People aren’t always so eager to receive treatment. “You know, you would think it would be simple to go into a community and give someone a pill and they would take it,” says Palmer. “But it’s not that simple.” There are two major hurdles when it comes to administering drugs to treat Schistosomiasis. The first is trust. “They might not trust the person or know what the drug is.”

"The second challenge is people not being at home. When a distributer comes to a community to distribute the drug, there are a bunch of people who, for whatever reason, aren’t around and often the person administering the drug only comes around once, so if you’re not there then you don’t get treated.”

Though funding lags dramatically behind the need, treating NTDs is not nearly as expensive as treating other diseases. “The other thing on NTDs to remember that the treatments for bigger diseases, like malaria, are a lot more expensive than treating NTDs,” says Agler. “For the five most prevalent NTDs, the medicines to treat them are being donated by the drug companies. The real gap in funding is for delivery rather than for the medicines themselves.”

And the payoff for treating NTDs can be significant. Experts say keeping kids healthy helps keep them in school and better community health can spur economic growth. According to a 2012 WHO report, every dollar invested in fighting NTDs brings a return on investment of more than $50.

Failing to deal with NTDs in places like Africa could be dangerous for public health in the U.S. Experts say a key to keeping disease outbreaks under control is by building strong global networks between national health programs. Whether it’s Zika or another NTD, the key is working together. “NTDs were something that was considered as off the radar before but more and more we are realizing that we are always connected,” says Agler. “We saw this with ebola, we need to work as a global network.”

Indeed, with the spread of the Zika virus, the threat of NTDs in the U.S. has already made headlines. But Zika is not the only NTD in North America. Dr. Peter Hotez, of the National School of Tropical Medicine at Baylor College, says already in the U.S. he estimates “there are 12 million people living with neglected tropical diseases mostly in the poor areas of the Southern U.S., especially along the Gulf Coast.” He says high levels of poverty, combined with the effects of climate change, have allowed parasites and mosquito-borne diseases to move into the Southern U.S.

Agler, who has been known to bring vials of parasitic worms to dinner parties, believes this is an issue that everyone can agree on, they just need to learn about it. “People can really rally around the end to these diseases that bring so much suffering to the world. 1.5 billion people suffering from NTDs is something that everyone should care about.”

Ethiopian Government Denies Extent of Drought

This essay was first written for the Deseret News and you can read it there if you'd like. 

The Horn of Africa is facing its worst drought in 30 years due to an El Niño weather pattern, according to the United Nations. More than 8 million people are in immediate need of food aid, and that number could rise to 15 million by early next year.

The drought was the subject of a recent report from the BBC’s Clive Myrie. The report documents harsh conditions in Northeastern Ethiopia and features the story of Bertukan Ali. The video shows the tearful mother explaining that her son, Abdu Mohammed, had died of malnutrition as a result of the drought only a few days before.

BBC video: Drought takes terrible toll in Ethiopia

But the Ethiopian government has strongly denied the severity of the situation and reportedly attempted to censor charity and media organizations soliciting international aid.

According to a report from All Africa, Ethiopian Deputy Prime Minister Demeke Mekonen, when asked about the BBC report, said “There is no such thing as famine in Ethiopia these days.”

The Ethiopian Embassy in the United Kingdom denied the BBC’s claim that two children are dying from malnutrition on a daily basis and called the report “sensational.”

Less than a week after the BBC’s report, the Ethiopian government brought Bertukan Ali onto a state-run television network where she changed her story and claimed that her son died not of malnutrition but of “sudden illnesses.”

Another article from All Africa says that charities in Ethiopia have been told not to use the words “famine, starvation or death” when appealing for donations. Additionally they have been warned not to claim that children are dying on a daily basis or to refer to a widespread famine but to instead describe the drought in Ethiopia as “food insecurity caused by a drought related to El Niño.”

In a conversation with All Africa, exiled Ethiopian journalist Argaw Ashine said there is a reason behind denying the dire situation. Ashine said the government does not want to admit that the country's rapid economic growth has not benefited everyone. "It costs them politically. The success story they fed to Ethiopians and the international community falls severely short after an exposition of the hunger."

Yared Hailemariam, an exiled human rights advocate, also claimed Ethiopia's growth has not benefited everyone. "The so-called development is not humanitarian based — rather, it is based on numbers and the economic aspect."

Writing for the Huffington Post, Dawit Ayele Haylemariam recently wrote that the Ethiopian government has made these denials “because there is no incentive for the government to work hard to avert famine.” He wrote that the ruling Peoples Revolutionary Democratic Front (EPRDF), has been in power for 25 years and has no threat of being voted out of office because they rule by force. In the spring of 2015 the EPRDF won 100 percent of the seats in parliament.

Famine has been a recurring problem for Ethiopia, where the famine of 1984 left 400,000 dead, according to another BBC report at that time.

According to the international aid organization OxFam, a famine results from a “triple failure” of food production, food access and political response. “Crop failure and poverty leave people vulnerable to starvation — but famine only occurs with political failure.”

WHITE PRIVILEGE

Macklemore, the rap music star who grew to fame for a song about shopping at thrift stores, made headlines this week for a new song about racism and white privilege.

White Privilege II” was released last week by Ben Haggerty (Macklemore’s real name) and Ryan Lewis and features the poet and singer Jamila Woods. The song is almost 9 minutes long and moves between rap verses, snippets of news and conversations and singing, ultimately questioning the role of a white person in the struggle for black justice. “White Privilege II” is the sequel to a song Macklemore released in 2006 and is quickly attracting opinions of all varieties.

“Macklemore and Lewis’s ambitions don’t quite live up to the scale of the track,” Alyssa Rosenberg wrote for The Washington Post. She went on to say that it “is not a particularly listenable song,” and that the Seattle-based hip-hop duo have sharper taste in politics than in music. The song is “a perfect illustration of an emerging pop culture market, one where political compliance is valued more highly than artistic transcendence.”

The track starts with Macklemore describing his uncertainty while attending a Black Lives Matter protest march in Seattle. "It was the night of Darren Wilson's non-indictment, and I remember streaming it, watching the non-indictment, and feeling sick, physically sick, frustrated and angry,” Macklemore told Rolling Stonefor an upcoming feature. “I was like, 'What is my place here? What am I doing? I feel this overwhelming sense of injustice in my bones and I don't know what to do about it, and I feel compelled to do something. How do I show up in an authentic way and be in solidarity?'”

Though it’s recently been brought to the front of a national conversation about race in America, white privilege is not a new idea. The term first showed up in 1988 when a women’s-studies scholar named Peggy McIntosh wrote a paper called “White Privilege and Male Privilege,” where she lined up 46 one-liner examples of white privilege. A few examples include, “I am never asked to speak for all the people of my racial group.” And “I can be pretty sure that if I ask to talk to the ‘person in charge,’ I will be facing a person of my race.”

White privilege is the social advantage that comes from your race being seen as the standard in society. “It smooths out life, but in a way that’s barely noticeable — unless it doesn’t apply to you,” Christina Emba explained in The Washington Post last week.

“Obviously not all white people are wealthy, and obviously many minorities are rich and powerful. It's the fact that simply by virtue of being a white person, of whatever socioeconomic status, you get the benefit of the doubt,” Emba said. “Pointing out that white privilege exists isn't the same as accusing every white person of being a racist. And acknowledging that you might benefit from such privilege doesn't mean that you're apologizing for being white."

Throughout his career comedian, Louis CK, has used his comedy to bring attention to the generally unspoken benefits of being white.

Another place white privilege was also brought into the national conversation last week was when DeRay Mckesson, a leader of the Black Lives Matter movement, appeared on Stephen Colbert's talk show.

Later in the song, Macklemore brings up the subject of cultural reappropriation by questioning the motives of white musicians. "You've exploited and stolen, the music, the moment, the magic, the passion, the fashion, you toyed with, the culture was never, yours to make better. You're Miley, you're Elvis, you're Iggy Azalea,” Macklemore sings.

Talking with Rolling Stone, Macklemore acknowledged that, as a white rapper, he has benefited from the appropriation of rap music. "I think that, as a white person stepping into doing any sort of anti-systematic-racism type of work, asking yourself, 'What is your intention?' needs to happen on a consistent basis. Check yourself,” he said. “You call out yourself. And you talk about cultural appropriation. But at the same time, you're benefitting from the same thing you're calling out.”

Jamilah King, writing for Mic this week, joined a chorus of other black writers who say, regardless of his message, Macklemore’s music just isn’t that good. But, she said, the topic of white privilege is part of “a conversation that's long overdue.” Jamil Smith expressed a similar sentiment in the New Republic, “Macklemore has a new song about white privilege that you should listen to. Especially if you’re white.”


The Ethics of Portraying Others

The ethics of development photography is something I have researched and written a lot about. Read some of my work on it here or here. I want to retouch on it quickly because I have not summarized it very well before and its incredibly important to me.

When I take a picture of someone, whether they are from a far-away cultural minority or from across the street, I am invading their space and they are giving me a small piece of themselves. This is a tremendously sensitive and intimate thing to do and its why I love photography. I like coming away with pretty images, sure, but the connections I make with people are the ultimate reward.  

Through my work I try to portray others in an empowering way. I seek to represent those who would not be otherwise represented. I want to give a voice to those who would otherwise have no voice. The greatest challenge in this task is to fairly, fully, and accurately tell the story of the subject. Its not always easy and I am sure that I do not always succeed... However, I do always take it seriously.

The ethics of this kind of work can be complicated and gray. This kind of photography is often done very unethically: See my post: Before They Pass Away. At the other end of the spectrum watch this TED talk where Phil Borges photographs endangered cultures and then provides the children of these cultures with digital storytelling courses.  

I really believe that Westerners can use their cameras to help other people but we must not assume that snapping away will do good regardless. More often the good must be done well after the images are captured, through real activism, organization, promotion, and communication. 

I encourage you to consider the the ethical guides outlined below and comment or email me if you have any others.  

Joey L., before taking a photo, asks himself what the image will say about the photographer and about the subject. Learn more about his ethics and process on this NPR interview. 

Nomadic Matt the travel blog writes interestingly about travel photography ethics - there the author Lola Akinmade argues that 1. Locals are not scenery. 2. Make an effort to communicate. 3. Observe their daily lives. 4. Smile. 5. Show Respect.  -- True words if I do say so! 

There are some great books out there on this subject as well. I would recommend checking out this one right away. 
 

The development blog, WhyDev.org, also has some interesting thoughts on the subject. The author, Christie Long, generally argues against the objectification of people and for photographers making connections with their subjects. I think she's right on! 

If you read my paper on Cross Cultural Photograph Ethics you might remember this paragraph about the purpose of such photography: 


Another point of importance to consider when documenting across cultures with photography is that of purpose. Every photographer who finds themselves with the responsibility of telling someone else’s story or documenting a culture to which they do not belong should consider the ethics of their pictures and should consider serving as a platform for expression. Photographers who serve as a platform for expression to their subjects do not inject themselves into the story but instead provide the tools (beautiful pictures and a mass audience) for the subject to tell their own story. In this way the photographer acts as a megaphone or soapbox allowing important stories to be told. Just as a megaphone enhances the voice in a story, a photographer acting as a platform for expression, can enhance their subject’s ability to be heard.

  

US Ranks low on the Commitment to Development Index

This essay was first written for the Deseret News and you can read it there if you'd like. 

The United States placed low on a ranking of how well nations help the poor despite spending $32 billion a year on international aid, more than any other country in the world.

The Center for Global Development released its annual index this week ranking the world's wealthiest 27 nations on how their policies "help or hurt the world’s poorest people." The CGD is an independent think tank working to reduce global poverty through research and policy activism and has compiled the index each year since 2003.

The U.S. ranked 21st out of 27, behind a three-way tie between Hungary, Luxembourg and the Czech Republic for 18th and just ahead of Switzerland, Slovakia and Poland. The top position went to Denmark followed by three other Scandinavian nations: Sweden, Norway and Finland.

CGD Vice President Owen Barder, speaking on the organization's podcast, explained the low ranking for the U.S. "We don't reward bigger countries for being big. We're looking at the effort countries make relative to their size."

Barder explained that the index doesn't only consider the dollar amount spent on aid but also how efficient the aid is and its share of a country's gross national product.

The U.S. spends 0.18 percent of its gross national product on aid and top-ranked Denmark spends 0.85 percent. In that context, Barder says, "the U.S. is rather a stingy donor."

Since 2009, the Kaiser Family Foundation has conducted a poll to survey what Americans know about foreign aid and every year the public widely over-estimates the country's foreign aid spending. Last year's poll found that the average American thought "that spending on foreign aid makes up roughly a quarter of the federal budget." More than half (56 percent) believed the U.S. spends too much on foreign aid. After being told the United States spends less than 1 percent of the federal budget on foreign aid, only 28 percent still thought it was too much.

Popular science educator, Bill Nye, worked with theGates Foundation to create a short video addressing the misperceptions around foreign aid spending last year.

The CGD index doesn't just consider foreign aid spending. The index also considers six other categories including finance, trade and migration. According to NPR, the United States scored below average in several of the categories.

A particularly low score for the U.S. was on secrecy in financial institutions. "That secrecy makes it easier for corrupt officials and tax evaders in developing countries to hide their ill-gotten gains in the United States," NPR quoted Barder.

But the United States didn't do poorly in all areas. "There are lessons for every country from some other country in here," Barder told NPR. For instance, in the trade category the U.S. ranked sixth by keeping some of the lowest trade tariffs on the index.

You can learn more about how the federal government spends foreign aid on this interactive website:www.foreignassistance.gov

All content created by Daniel Lombardi. Copyright 2017.