Wednesday, July 28, 2010

A 12 month death sentence, for a 12 year old girl

Xoli (pronounced Koli) is just a girl. 12 years old and full of life. She laughs contagiously at Raven Symone on the Disney Channel, has posters of Miley Cyrus decorating her bedroom wall, herds stuffed animals on her twin-sized top bunk bed, and wears bright yellow sneakers and orange t-shirts. If she lived in one of South Africa's bordering countries, however, she would be none of this. She would have rather not made it to her 12th birthday.

Underneath Xoli's fuzzy corn rows and subtle smiles is a disease that 285 million live with throughout the world: diabetes. Unlike the rest of the world, however, this disease is most often fatal in the developing world. In neighboring Mozambique, a child who develops diabetes is likely to die within one year… A 12 month death sentence.

As unimaginable as this is to process, it's tragically the reality for millions. Unlike the more commonly known infectious diseases (HIV/AIDs, tuberculosis, malaria) diabetes is a noncommunicable disease (NCD) that has slowly snuck into the continent. Its prevalence is hovering around 3-5% in most African countries and is expected to grow to nearly 20% by 2030, as diets (read: more sugar) and lifestyles (read: less physical activity) of the poor continue to evolve. Ironically, this is one of the unpredicted consequences of the increased income and development that countries have enjoyed.

And to complicate things, health systems throughout the continent are completely unequipped to manage diabetes. Medical professionals aren't trained to diagnose the disease, let alone treat it. Equipment (e.g., meters, syringes, etc.) is scarcely available. And without government policies, diabetic drugs are beyond unaffordable  for example, a year's supply of unsubsidized insulin can cost almost $200, while the majority of the bottom of the pyramid makes less than $2 a day.

Fortunately, it appears as if progress is being made, as evidenced by the project that I supported during my two month assignment in South Africa: a pan African leadership forum focusing on diabetes and other NCDs. In collaboration with a major international pharmaceutical company, the South African Ministry of Health, and the International Diabetes Federation, Dalberg (my employer) is designing this first-of-its-kind conference with the aim of creating policy, raising donor funding, and stimulating general awareness for diabetes. If successful, a number of new diabetes/NCD programs will be catalyzed and funded throughout the continent, and governments will develop and implement national diabetes policies.

As for Xoli, she can continue to worry about her upcoming mathematics exam and spelling quiz  as she was when I first met her  instead of how she will make it to the hospital for treatment or afford insulin. She's found a home at Marang House, a nonprofit organisation that provides a stable home-environment to disadvantaged children suffering from diseases such as chronic renal failure and diabetes. Here, she is given the treatment she needs and makes daily trips to the hospital, while living in a comfortable and loving environment that is void of the traumatic culture faced in traditional hospitals.

Run by a friend of mine after his dad (and the founder) passed away, this home is truly providing "a ray of the sun that gives hope," as its Tswana name would suggest. The hope is that this same ray will begin to shine on the rest of Southern Africa and throughout the Continent. 

Sunday, July 18, 2010

Mandela's 92nd birthday and the first annual Nelson Mandela International Day

Thinking about this celebration, I remember two days before my own (26th) birthday, when I stepped on to a ferry to tour Robben Island, the prison facility in Cape Town where Mandela spent over 17 years of his life (before spending another 10 at two other facilities). Over 27 years in total: The realization that he had spent my entire life time  plus another year  was enough to feel as if the weight of Table Mountains was crushing my head!

After a wavy 20 minute ferry ride, I quickly realized that the surrealism was only just beginning.
Standing in front of the prison yard, our tour guide introduced himself as Mandezi Mncedisis, an ex-political prisoner who was on the Island the same time as Mandela. As he pointed out various sites  the lime quarry, Mandela's cell, the prison yard, the kitchen and dining hall  his humble voice, subtle smile and cautious tone resurrected stories from Mandela's autobiography, Long Walk to Freedom. Discussions regarding the apartheid struggle while digging in the lime quarries; hunger strikes to protest beatings and detestable living conditions; smugglings of newspapers and notes between prisoners; letters that Madiba wrote to his wife Winnie; solidarity confinement when caught smuggling; and early manuscripts of Long Walk to Freedom that were buried/hidden in the dirt of the prison yard.
As these stories came to life, the sacrifice, perseverance, courage, humility, forgiveness, and love of Madiba became even more incomprehensible. Sitting back in Nairobi – thinking about the magic, country-wide unification created by the World Cup and the challenges (or opportunities?) that still lay ahead  words from Madiba's autobiography have developed a new and profound significance, and I wanted to share a few of them here...
Perhaps it requires such depth of oppression to create such heights of character… I learned that courage was not the absence of fear, but the triumph over it. I felt fear myself more times than I can remember, but I hid it behind a mask of boldness. The brave man is not he who does not feel afraid, but he who conquers that fear...

I am no more virtuous or self-sacrificing than the next man, but I found that I could not even enjoy the poor and limited freedoms I was allowed when I knew my people were not free. Freedom is indivisible; the chains on any one of my people were the chains on all of them, the chains on all of my people were the chains on me...

No one is born hating another person because of the color of his skin, or his background, or his religion. People must learn to hate, and if they can learn to hate, they can be taught to love, for loves comes more naturally to the human heart than its opposite...

I knew as well as I knew anything that the oppressor must be liberated just as surely as the oppressed. A man who takes away another man's freedom is a prisoner of hatred, he is locked behind the bars of prejudice and narrow-mindedness. I am not truly free if I am taking away someone else's freedom, just as surely as I am not free when my freedom is taken from me. The oppressed and the oppressor alike are robbed of their humanity.

When I walked out of prison, that was my mission, to liberate the oppressed and the oppressor both. Some say that has now been achieved. But I know that that is not the case. The truth is that we are not yet free; we have merely achieved the freedom to be free, the right not to be oppressed. We have not taken the final step of our journey, but the first step on a longer and even more difficult road. For to be free is not merely to cast off one's chains, but to live in a way that respects and enhances the freedom of others. The true test of our devotion to freedom is just beginning.

Happy Nelson Mandela Day. 

Madiba's cell

Saturday, July 10, 2010

World Cup highlight pt.2: A photo montage from South Africa

The 2010 World Cup officially ends tomorrow, and I'm still in shock (slash slightly depressed) that the tournament has gone by so quickly (and that Brasil is not in the finals?)! 

So much has happened over the past 30 days, that I quickly realized it's impossible to recap everything in one blog post. So, I'm hoping that my pixelated camera phone and this resulting photo montage can do much better!