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Two of the women with HIV featured in the fashion show put on by Doctors Without Borders in the DRC.

This past March, Doctors Without Borders, in association with Médecins du Monde and the Réseau National Des Organisations d’Assise Communautaires des PVV, put on a fashion show in the Democratic Republic of Congo where a dozen DRC women living with HIV/AIDS were used as the models. All twelve women donned fashions that reflected the colors that were symbolic of the HIV/AIDS movement. Local fashion designers who were part of the organization, Amicale des Stylistes de Kinshasa (which was also a partner in the event) created the clothing that was worn by the women.

Although Doctors Without Borders’ intentions were notable: “…to fight discrimination against people living with HIV, to alert the public to the tragic lack of access to treatment in the country, and to show what is possible when treatment is made available” (DRC: A Fashion Show Featuring Women Living With HIV), there still exists an estimated 300,000 individuals in the DRC who will only have a life expectancy of three years (DRC: A Fashion Show Featuring Women Living With HIV). And the primary reason why many of these individuals are faced with this short life expectancy is because of their inability to pay for the badly needed antiretroviral drugs (ARV), as well as other vital medications and health screenings needed to enhance their life expectancies.

The reality is HIV/AIDS is not a glamorous disease. It is filled with feelings of embarrassment, misery, and mortality. And by putting on a fashion, Doctor’s Without Borders is blinding society from the harsh reality of living with HIV/AIDS. In fact, Doctor’s Without Borders is violating Article 25 of the Universal Declaration of Human Rights, which states: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care…” How so? Because Doctor’s Without Borders was not actually assisting the models with funding or supplying their medication; or even other DRC citizens living with HIV/AIDS.

Rather than put on a fashion show, I believe that Doctors Without Borders should have organized a fundraising event where other humanitarian relief organizations could donate money towards supplying the citizens of the DRC with condoms and ARVs. In addition, Doctors Without Borders could have devised a plan that would have raised awareness to the citizens of the DRC on how to prevent HIV/AIDS; like the proper method of using condoms, proper use and disposal of needles in hospital settings, and how to actually take care of oneself in the event that one contracts the disease.

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Earlier this month, I had World News with Diane Sawyer in the background as I was cleaning my apartment when a particular news report captured my attention. According to the report, Americans here in the United States are being screened too often for medical tests that they really do not need. In fact, a number of those additional medical tests are doing more harm than good. How so? Because there are a number of health risks that patients are being exposed to when these medical tests are being conducted, according to Dr. Christine Cassel, the president and chief executive officer of the American Board of Internal Medicine Foundation. Therefore, in an effort to reduce this less than beneficial trend that appears to be transpiring in the healthcare world, the ABIM Foundation and Consumer Reports have teamed up to develop the “Choosing Wisely” project. In this project, nine physician groups have compiled a list of five medical tests–in a variety of fields–that are performed on patients more often than necessary. Those five tests are as follows: the cardiac stress test, chest x-rays, imaging tests that include MRIs and CT scans, colonoscopies, bone density scans, and bone mineral density tests, which are commonly known as dual-energy x-ray absorptiometry, or a DEXA scan.

This news report honestly left me not only speechless, but a little outraged. As I speak, there is an elderly woman in a remote village in Africa whose osteoporosis has left her within the confinements of her home. She has neither the strength nor the money to afford the appropriate testing and treatment for her painful bone condition. Or, there is a gentleman in his early 60’s in southeast Asia suffering from symptoms that are evocative of colon cancer. However, he has never been properly diagnosed. He is reaching the end of his fight, for the cancer has spread. But if he had had access to a colonoscopy in his early 50’s, doctors could have not only detected his precancerous growths, but removed them as well. As a result, his death rate would have been reduced by 53%. I understand that there are a number of factors (lack of infrastructure, government funds, etc.) that influence whether or not citizens of third world countries can have access to the very same tests that Americans are being inundated with here in the U.S. But like we discussed in class a few weeks back, NGOs most not limit their focus to only  life-threatening illnesses; they must also promote the idea of “quality of life” by addressing non-communicable diseases (or NCDs) as well. To the surprise of many, there has been a shift of NCDs to developing countries, where 63% of deaths in third world countries are non-communicable in nature, and 1/3 of those deaths occur before the age of 60. If NGOs do not take the time to address and treat the occurrences of NCDs, they are in violation of the human right to a healthy life.

South African gold miners are at greater risk of developing TB due to the heavy presence of silica dust in their working environment

This past Saturday, the Deputy President of South Africa, Kgalema Motlanthe, spoke at an event held at the Driefontein Gold Fields mine, located in the Gauteng province of South Africa. The event was being held in observance of World Tuberculosis Day–a bacterial disease that has become all too common among South African mine workers. Individuals within this particular profession have been known to have a greater risk of contracting the disease due to the heavy presence of silica dusk within their working environment. Although silica is nothing more than a mineral found in rocks and soil, repeated inhalation of the mineral can lead to serious implications. In fact, a staggering 22,000 mine workers are infected with the disease yearly. However, TB is not the only illness in which these mine workers must battle daily; there is that widespread virus that occurs outside the workplace: HIV. Between 60%-70% of mine workers who have been infected with TB have also been infected with HIV as well. But these startling statistics have not stopped South Africa from doing all that it can to combat these two life-threatening illnesses.

Standing before an audience that included Gold Fields mine workers and their mining managers, union leaders, community development agencies, health workers and government representatives, Motlanthe vowed that the South African government would continue its initiative in supplying its citizens with the programs needed to successfully thwart TB and HIV. As a matter of fact, Motlanthe states that within the last few years, South Africa has made testing for TB and HIV more of a regular initiative, as opposed to an initiative that arises only during emergency outbreaks. Nick Holland, CEO of Driefontein Gold Fields mine, has also hopped on the bandwagon in making TB testing more readily available for his own mine workers. At the event, he spoke of the necessity of Gold Fields mine being able to diagnose TB in its earlier stages, as well as being able to develop more efficient means for testing for TB.

Even so, the progress that South Africa has made in their fight to stop the spread of TB has been incredibly noteworthy thus far. Just last year, South Africa embarked on a new approach in actually traveling to the homes of individuals who have had contact with a TB infected person. Furthermore, individuals were also tested and educated about HIV. During that mission, roughly 160,000 people were screened, where 3,000 individuals tested positive for TB. What is more, another 3,200 individuals actually tested positive for HIV. In addition to home screenings, since last year, South Africa has also been utilizing the GeneXpert machine, enabling the successful diagnosis of drug-resistant and drug-sensitive TB patients. At the moment, South Africa is number one in the manufacture of GeneXpert tests, having completed roughly 300,000 tests.

I think that it is important to acknowledge here that although South Africa is still in some aspects a developing nation, the initiatives, however, that the Country appears to be taking in the prevention of TB and HIV, in my opinion, would illustrate its advancement into a developed nation. When a nation’s own government makes it their endeavor to provide the utmost care to their citizens, a sense of unity transpires between all. As we saw in class during our attempts to revise TRIPS, it was difficult for us to come to an agreement on how high-income and middle-income countries could not only efficiently provide foreign aid to low-income countries, but also continue to recognize some of their own personal goals as well. In my opinion, South Africa sets a wonderful example of the potential that developing and also underdeveloped nations have in terms of the combat of life-threatening epidemics.

An MSF physiotherapist providing medical assistance to a Libyan detainee in a detention center in Misrata.

Last month, Doctors Without Borders/Médecins Sans Frontières or MSF for short, decided to put an end to all efforts designed to provide medical care to Libyan detainees, according to MSF’s general director Christopher Stokes. The organization, which is globally recognized for its humanitarian relief in both war and natural disaster swept countries, believed that their services were not being employed for the common good.

Since August of 2011, MSF had been stationed in Misrata–Libya’s third largest city–providing medical relief to detainees who had been injured in the war. However, MSF soon began noticing a disturbing trend. A large majority of the wounds in which MSF was treating the Libyan detainees for were being obtained during torturous interrogation sessions by the National Army Security Service. And what was more disturbing was the fact that many of these same detainees that had been previously treated by MSF for torture wounds were being sent back to the organization for the treatment of additional torture wounds–which were being acquired during further interrogation sessions. In fact, on one occasion, MSF had been asked to actually provide medical aid to detainees after interrogation sessions. MSF, of course, did not carry out the request.

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