These are a shortened alteration of words written by Martin Luther King Jr, the famous American Civil Rights leader. They are words that have always struck a chord with me. In quoting them here, I researched where they came from and it’s an interesting story. In Birmingham Alabama in April 1963, during demonstrations against racial segregation, Luther-King was arrested and imprisoned for eight days. During his imprisonment someone smuggled a newspaper to his cell where he read an opinion piece by a group of white clergymen criticising the illegality of the civil rights protests. Luther King replied to them via the same newspaper. In his reply he talked of the legalities of genocide in Hitler’s Germany compared with the illegalities of various historical civil disobediences which have changed the course of history for the better. He outlined the difference between just and unjust laws. He also addressed the accusation of the clergymen that “outsiders” were traveling to Alabama to cause trouble, by explaining his unity with fellow humans wherever they may be. It’s an excellent although wordy letter, the full text of which you can find here http://www.africa.upenn.edu/Articles_Gen/Letter_Birmingham.html.
Ohio State University are currently running a (free) online 4-week-long Human Trafficking course via www.coursera.org which puts this philosophy at the fore of my thoughts as I learn about some of the horrific existences many people we share our world with live, day-in-day-out. It is estimated that almost 30 million people around the world today are held in slavery, which includes child trafficking, debt bondage, forced labor, sexual and criminal exploitation and domestic servitude. Organ trafficking is also a big issue, with people from rich countries traveling to poorer, less- and un-regulated countries to purchase organs from live donors, many of whom are either not fully-informed, or not donating of their own free will.
In East Timor two years ago I worked alongside an English woman who had spent some years recently in Bangladesh, entering brothels to provide condoms and health education to prostitutes. Most if not all of these women were held against their will by individuals or syndicates who had often procured the women by dishonest or violent means, usually tempting them out of desperate and impoverished circumstances with fraudulent promises of a better life. This colleague told me a little about the stresses of her work in Bangladesh, where she and those she worked alongside had to suppress the urge to help individuals escape in order to protect both the safety of the women collectively, and also their own access to the brothels, in order to continue their work of protecting the women’s health. Coming from a safe and comfortable existence where front page news usually highlights the latest celebrity marriage, pregnancy or divorce, outrages from the latest reality television shows and how to make the most out of your next overseas holiday, at the time I was horrified to learn that such things are occurring in our world, today.
More than any of the poverty and suffering I have observed in those around me here, which shakes me up and spits me out almost daily, the biggest impact of my experiences in East Timor and Cambodia is the awareness I’ve developed of my own incredible privilege. Given that truly understanding others is ultimately a fairly futile pursuit as we can only ever view the rest of humanity through our own filters and perceptions, then all life experience really only ever allows us, is to develop insight into our own character and purpose. During an interview fifteen years ago for a position working with indigenous people in Central Australia, my indigenous interviewer asked me to explain my understanding of cultural awareness. My answer was very brief – that being culturally aware has nothing to do with understanding other cultures and everything to do with having insight into our own culture and how we might be perceived by others. (He liked my answer and employed me!). My opinion on this has never really changed after years of living and working alongside people with very different worldviews. What has changed, is that I no longer only know in theory that I belong to the richest and most advantaged 5% of people in the world. This fact has become blatant and tangible, pervading my everyday experience like a seventh sense.
With that privilege comes an evolving sense of my purpose in life. I feel even more privileged that I can live this purpose, which is again, thanks to the entitlements I was born into through sheer luck. Most of the people I encounter in the third world also have a purpose, but are so busy surviving that such ostentatious ambitions can only be fantasised about. Not to mention the fact that the burden of poverty is almost entirely carried by the poor. By this I mean that those of us coming to the third world to work and contribute are not the main contributors to alleviating third world suffering – that accolade belongs fairly and squarely with the neighbours, grandparents, older siblings and various other community members and local or national organisations who feed, clothe, house and care for the needy in their own society. This further disadvantages already-struggling populations as the strongest citizens carry burdens instead of focussing on their own personal aspirations.
Even my colleagues whose families have dedicated time and money to expensive educations in order to increase their prospects, can only dare to dream about the opportunities that I take as a given. When they ask me about my plans after leaving MSF I find the answer awkward as I am aware of the picture of affluence that it paints, to talk about traveling overseas for a year without working. I’ve also started questioning these plans – to have lived the past year amongst hunger and adversity, do I really want to put myself in New York City and be hedonistic and self-centred? Doesn’t it go against my supposed new sense of purpose? Most people cannot imagine having such First World Problems and here I am, listening to Simon and Garfunkel croon about New York at me while I ponder whether my heart really is in New York, or if my goalpost has well and truly shifted?
The orphans are currently on an annual and much-anticipated holiday with their carers, visiting Angkor Wat, so our usual classroom has been unavailable this week and our class of 18 diminished to six, which then diminished further as two and then three of the remaining students were also absent. We took these children on their own treat, to a riverside restaurant usually only affordable to Barang, where we ordered food and drinks from the menu. One of the girls ordered a serve of ice cream which was very tiny but when I offered her to order something else she declined. In response to this, Chom informed me that 13yo Vorn was instructing her “you have to eat everything you can because you will never come to a restaurant like this again, it’s too expensive for Khmer people”. Three meals, four desserts and eight drinks grand totalled $24, which shows how “expensive” this restaurant is!
Today Win and I visited the little amputee guy at Shackville. His baby sister had chicken pox last week and she spent the week coloured purple as Mum kept her smothered in Gentian Violet. Today her big brother is sporting some lovely little poxes on his face. Yesterday I picked him up and brought him with us to the restaurant where he sat with the English students, wondering what we were all doing, but happily sipping on a coconut milkshake and enjoying the “very nice house” that he told his Mum I took him to. As he would have been in the infectious stage of his chicken pox yesterday I am now on tenterhooks, hoping I haven’t exposed the other children to the virus, or that if I have, they are already immune, which is quite likely.
When I told Win we had taken him with us to a restaurant yesterday, Win replied without judgement “you can see how easy it is for Khmer children to disappear or end up adopted. Just because you are Barang, you can take him with you because they trust you and they are hoping for something better for him and for themselves. You are a good person, but plenty of Barang with bad intentions could do the same thing, and they do. He is very vulnerable”. My admiration for Win only increased when we took a takeaway container of fried rice to the little guy oneday, when he had proclaimed hunger as his mother worked at her labouring job off in the distance while he sat alone on the undercover platform shelf outside their shack. When we returned with the rice, Win noticed a young mother with her small child standing nearby and recognised that the little girl was hungry. He took the takeaway container, ripped it in half and dished about a third of the rice into the second container, passing it to the young mother for her child. As he did so he said to me “It’s important for all children to learn about sharing”. His values, understanding and compassion are inspiring.
This ties in with the theme of human trafficking and why people from third world countries are so much more vulnerable. According to the United Nations Interagency Project on Human Trafficking (UNIAP), there are a range of trafficking networks in Cambodia, from small and ad-hoc to large and well-organised. Reasons for Cambodia’s vulnerability to these activities include the recent turbulent history which has seen an undermining of traditional structures such as family, community, the central role of elders and Buddhism; the lack of local educational opportunities and employment which encourages people across borders; natural disasters; corruption; debt pressures; increased tourism; untenable labour supply compared with the job creation rate; and many others (refer to UNIAP at http://www.no-trafficking.org/cambodia.html). It is also a huge strain on the country that half of the population are under 20 years of age.
Meanwhile I have been roped into a fundraising bicycle ride in Sydney not long after I return and I recently registered online for the race before sending out a fundraising email to my all-too generous friends and family. I’m amazed at the sponsorship I’ve accrued with next to no effort for a very worthy cause, but I can’t help but think about how much suffering this money could alleviate had I the means to raise the same amount for a Cambodian cause instead of a perfectly deserving health-related western cause. But comparisons are not something I will allow myself to make as Australia has the means to sustain itself and that can never be considered a bad thing regardless of what is happening elsewhere.
This week I also heard from the husband of an amazing friend who I first met earlier this year in Cambodia. She wrote to me about six weeks ago asking for my opinion on the idea of going to work with the Ebola outbreak in West Africa. We exchanged thoughts and soon enough, as I predicted the moment she mentioned it, she signed up to go. I have not heard much from her since, but she’s in Liberia and today I heard her voice crack as I listened to her interviewed about her experiences in the few short weeks that she has been there, describing it as “the zenith of her career; an honour to be part of the work; the sense of what you’re doing is just palpable; Doctors Without Borders needs much more help on the frontlines of this fight”. You can hear the short interview at this link: http://www.npr.org/programs/all-things-considered/2014/09/07/346547291?showDate=2014-09-07.
An excellent opinion piece appeared last week in the Washington Post by Dr Paul Farmer and his colleague and good friend Jim Yong Kim, which I will post below in full (it’s not very long). The main point of their discourse is that “The Ebola crisis today is a reflection of long-standing and growing inequalities of access to basic health care”. These inequalities do not have to exist and with any luck, given the work of people such as Farmer and Kim, they will follow the path of other outdated views, such as that which was once popular about the AIDS epidemic being “hopeless”. It’s revolutionaries like these men who make the seemingly impossible, possible. In a world filled with apparent hopelessness, champions such as Paul Farmer, Jim Yong Kim, Ophelia Dahl, Dan Murphy, Scott Neeson and so many others who work to make a difference rather than settling for the status quo, give our world hope and a future that doesn’t have to settle for the cynicism of despondency. To quote Neeson who I am sure is quoting someone else, “while we can’t save everyone, if you save just one then you have made a huge accomplishment”.
As I listened to the interview with my American friend another friend in Australia messaged me asking how I can ever return home after the experiences I’ve reported from afar in the past year? I guess that’s a question to be answered in 14 months’ time when I am due back at my much-loved, but well-worn job. This past year has certainly challenged my perceptions of where I belong and what I should be doing with my life.
What’s Missing in the Ebola fight in West Africa
Jim Yong Kim is president of the World Bank. Paul Farmer is the Kolokotrones University professor at Harvard University. Farmer and Kim, who are infectious disease physicians, co-founded the nonprofit organization Partners in Health.
If the Ebola epidemic devastating the countries of Guinea, Liberia and Sierra Leone had instead struck Washington, New York or Boston, there is no doubt that the health systems in place could contain and then eliminate the disease.
Hospitals would isolate suspected cases. Health workers would be outfitted with proper protective clothing and equipment. Doctors and nurses would administer effective supportive care, including comprehensive management of dehydration, impaired kidney and liver function, bleeding disorders and electrolyte disturbance. Labs would dispose of hazardous materials properly. And a public health command center would both direct the response and communicate clearly to the public about the outbreak.
Ebola is spread by direct physical contact with infected bodily fluids, making it less transmissible than an airborne disease such as tuberculosis. A functioning health system can stop Ebola transmission and, we believe, save the lives of a majority of those who are afflicted.
So why isn’t this happening in West Africa, where more than 1,500 people have already died?
As international groups pull staff from the three countries, airlines suspend commercial flights and neighboring countries close their borders, some have argued that it will be next to impossible to contain the outbreak — that public health systems are too weak, the cost of providing effective care too high and health workers too scarce.
But Ebola has been stopped in every other outbreak to date, and it can be stopped in West Africa, too. The crisis we are watching unfold derives less from the virus itself and more from deadly and misinformed biases that have led to a disastrously inadequate response to the outbreak.
These biases, tragically, live on, despite evidence that disproves them again and again.
Just 15 years ago, Western experts said confidently that there was little that rich countries could do to stop the global AIDS crisis, which was killing millions of people in Africa and elsewhere.
Today, thanks to leadership and advocacy from President George W. Bush, a bipartisan coalition of members in Congress, courageous faith-based organizations and U.S. government researchers such as Tony Fauci and Mark Dybul, more than 10 million Africans are getting life-saving treatment.
The take-no-action argument has been used over the years as an excuse not to mount an effort to control drug-resistant tuberculosis, malaria and many other diseases that afflict primarily the poor.
But the reality is this: The Ebola crisis today is a reflection of long-standing and growing inequalities of access to basic health care. Guinea, Liberia and Sierra Leone do not have the staff, stuff and systems required to halt the outbreak on their own. According to its ministry of health, before the outbreak Liberia had just 50 doctors working in public health facilities serving a population of 4.3 million.
To halt this epidemic, we need an emergency response that is equal to the challenge. We need international organizations and wealthy countries that possess the required resources and knowledge to step forward and partner with West African governments to mount a serious, coordinated response as laid out in the World Health Organization’s Ebola response roadmap.