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In 2006, WebMD Assistant Managing Editor Cherie Berkley traveled to Tanzania as part of a UN delegation to report on the plight of women with HIV/AIDS and the devastating effects of malaria. She also covered globe-trotting issues such jet lag, food & water safety, shots, and emergencies.

Friday, August 17, 2007

Tanzania Travels Honored

I am happy to report that African health issues are getting some national recognition. The National Association of Black Journalists awarded the Tanzania Travels blog a “Salute to Excellence Award” in the category of New Media-Best Commentary last weekend.

There were a number of prominent media players also being honored that night including retired CNN anchor Bernard Shaw, NBC president Steve Capus, and former Los Angeles Times editor Dean Baquet. Hopefully, the timing of this award coinciding with their honors will spark continued dialogue in the media of dire health issues in Africa and other developing countries.

Thank you for your support!

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Posted by: Cherie Berkley at 3:42 pm

Wednesday, May 31, 2006

Congo Rapes: “Unforgivable”

Today I read (and watched) with much dismay a story CNN broke about the raping of women and girls in Congo by uniformed military. The reports say the soldiers from one ethnic group were systematically raping women of another with the intent of destroying their reproductive capabilities.

Some were girls just 8 years old, raped in front of their mothers and fathers for days at a time. The raping is another indicator of how powerless and undervalued women are in some parts of Africa. These women were raped and tortured (some used knives to rape their victims) but not killed. Maybe it is because it is often worse in this culture to live with the stigma of being a rape victim and the emotional scars of surviving. Imagine raising a child born as a result of rape and hating yourself and that child as one women explained. Or feeling worthless as another woman noted.

The health toll of HIV is exacerbated by these inhumane acts as the reality is there is a high risk that these women could have contracted this fatal disease from their attackers. Women with HIV in Africa as previously noted, are often thrown out of their families and treated as outcasts.

It is hard to conceive that President Joseph Kabila, or any president, could be totally oblivious to this. He says this is “unforgivable.” But a more unforgivable act would be to continue to let the offenders go unpunished as noted by Amnesty International.

Related Topics: Global Report: AIDS at a Crossroads

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Posted by: Cherie Berkley at 5:44 pm

Monday, May 29, 2006

The Final Frontier: Jetlag

The first thing I did when I got home was take a hot shower. I called my parents but other than that wanted to be left alone to decompress. I was just too wiped out to go into conversation; too wiped out to go anywhere; and too wiped out to even eat.

I attempted to stay up to write and unpack but lost the battle after about two hours. I felt sick with sleep — a bit nauseated and drunk with fatigue. The jet lag was compounded by the serious sleep debt accumulated while in Africa. So instead of trying to adjust by staying up until bedtime in my current time zone, I didn’t fight it and slept the rest of the night.

Experts say sleep problems tend to be more common when people travel from west to east as it is more difficult to advance than to delay sleep time. However, for me, I am hardest hit traveling from east to west. I saw a story about jet lag on CNN as I was packing up in my hotel room on my last day in Tanzania.

The expert said that for every hour of time difference you travel, it takes that number of days to recover from jetlag. My track record has been the number of days I am away is the number of days it requires to recover. So I anticipate it will take me at least a week and a half to get back to a normal sleep schedule.

My first full day back, I woke up at 5:30 a.m. (early by my standards). By 7 a.m I had suited up to work out, made a light breakfast, and watched some news. By 9 a.m., I got hit again with uncontrollable sleep (before I got to the gym). I woke up around 11:30 a.m., still moving like a zombie. By this point, I was famished and mustered up enough energy to eat and get some groceries for my bare pantry — and of course take my Malarone.

I had given up on the dream of making it to the gym. By 4:30 p.m., I felt the urge to crawl back in bed where I fielded a few calls. I vaguely remember my dad calling; I think I fell asleep on him. By 6 p.m. I was out like a light and nothing could rouse me. My bed has never felt so good! I slept through a series of other calls. I felt like a brick wall was laying on my body, leaving it immobile, and the sleep mimiced the heavy, good sleep that you get while under anesthesia (this would continue for another week or so).

Some tips to help with jet lag include: Avoiding excess caffeine, alcohol, and tobacco; avoiding social isolation; practicing good sleep habits right away; taking a one-hour walk first thing in the morning; limiting sleep to no more than two hours immediately after arrival; drinking plenty of fluids to avoid dehydration; and controlling naps while in flight to your destination.

Melatonin
has worked for some people but not for me in the past. Melatonin is a hormone the body naturally produces at night and is thought to help initiate sleep. Melatonin supplements have been available in health food stores for quite awhile, but they are not FDA-approved, so their purity and safety are not known. A recent study from the University of Alberta has shown that melatonin supplements may not actually be as effective as once thought.

Related Topics: Summer Travel, Tips for the International Traveler

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Posted by: Cherie Berkley at 9:16 am

Monday, May 29, 2006

America at Last

At 7:30 a.m. we arrived at JFK in on a rainy, cold, New York City day. I deboarded groggy and stiff but excited to have completed my long voyage safe and sound. Still, I had another two-hour flight to Atlanta. My flight was scheduled for 10:45 a.m. but the plane never arrived because it got struck by lightening. By now, I was quite irritable with fatigue as the flight was delayed two hours (while they tried to repair the plane) before they told us what happened. After some debate with several rather useless (groggy attitude kicking in) airline representatives, I ended up taking on the painful task of arranging to reclaim all of my baggage and catching a cab to La Guardia. The thought of waiting another three hours for a flight at JFK was unbearable in my state of hunger and fatigue. After 20 hours of flying, all you want to do is get home to your bed.

During my cab ride home once in Atlanta, I felt a familiar feeling taking hold: jet lag. It is like you are awake but know that a wave of unavoidable sleep is lurking beneath the surface. I turned my head to look out of the window and another feeling overwhelmed me: one of sadness and guilt.

I thought about the neighborhoods I passed along the expressway that people say are depressed and thought about what I had seen in Tanzania. I knew that even poverty here is eons better by comparison. I thought about all of the luxuries we have in America yet we always complain about wanting more. Here a hot shower, clean water, smooth pavement, access to medical treatment, and no malaria-infected mosquitoes are all things I never thought of as being luxuries — just basics. I guess the word basic is relative.

While Tanzania has its challenges, I never feared for my safety. There were beautiful places like Arusha and Zanzibar, like most countries, there are a few people who are very well off, and the people were kind and cheerful in spite of their hardships. Again, these people are proud and smart, they just need some help — a lot of it.

Related Topics: Top 10 Causes of Death Worldwide, AIDS Taking on a Female Face

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Posted by: Cherie Berkley at 9:07 am

Thursday, May 25, 2006

Heading Home: 20 Hours and Counting

I think it’s fair to say we are all exhausted. I couldn’t even process the idea of another 20-hour plane ride. Nobody honestly wanted to talk about it. I packed my arsenal for the ride: aspirin, decongestants, Malarone, toothbrush, and socks. I drank a lot of water to start out hydrated, polishing off the bottles I had brought with me so not to have to lug them back.

My experience in Africa, and other undeveloped nations, just makes me feel that safe drinking water should not be wasted. This thought shows me, I am already noticing the changes in my ‘charmed’ American mindset.

I sat on the plane next to my colleague, John, an editor from Miami. He is still tackling his sinus issues, so I shared my decongestants with him and emphasized the need for them while flying. John manages international coverage for the Herald and has an enviable wealth of global experiences.

Despite his intriguing tales, I realized when I embarrassed myself by falling asleep on him midconversation that the flight home was all about paying back the heavy sleep debt we all had accumulated. Sleep debt is the number of hours of sleep your body requires to function well but has not been getting. Eventually, however, one needs to make up for that lost sleep in order to get back on track. On this trip, it is fair to say, I owe a lot. When I looked back from my seat, which was in the front of the plane, I saw everyone was passed out.

The time change in flight also made me paranoid that I would forget to take my Malarone. Each way, we lost a day traveling, but I know how important it is to continue taking the malaria prophylaxis. I must still take Malarone for seven days after I get back. In my delirium, I tried to calculate the proper time to take it based on when I took it in Tanzania, but I was probably off. You are supposed to set your watch to the time zone of your destination to start the process of adjusting. Clearly, that was not an option for me since I never found a battery for my watch.

The first 5.5 hours from Tanzania to Dubai were fine. I may have slept an hour or so. But the 14.5-hour flight to New York City was a wash. As much as I tried to fight going to sleep, even to watch a movie, I kept losing the battle. I woke up to drink water and for restroom breaks (which I hoped counted for my walking requirement). John and I did manage to get in a few good conversations, but I don’t know that I’ve ever been this wiped out.

By the way, I managed not to get one mosquito bite. Night, night.

Related Topics: Bringing Home Illness From Overseas, Sleep and Travel

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Posted by: Cherie Berkley at 7:48 am

Wednesday, May 24, 2006

Funding the Fight

The question usually arises about how money for the top 3 killers of the world — HIV/AIDS, tuberculosis (TB), and malaria — gets distributed and where it comes from.

I have noticed several posts on this blog about what one can do to change things for the better. I’ve felt perplexed by the same question at times after seeing so much poverty and feeling so helpless on this trip.

As with many things in life much of the solution to getting a grip on malaria and AIDS boils down to sufficient resources. The financial piece has a big impact on why malaria and the other ‘big 2′ have yet to be eradicated in Africa. In my discussions with Louis, I asked him to explain to me what the Global Fund is that he speaks about so often. Louis, who is with Global Health Advocates, is also board member for the malaria section of the Global Fund and has first-hand experience with it.

The Global Fund is probably a little-known entity to many Americans. It is a war chest of money that was established by Kofi Annan and the United Nations to increase the resources to fight AIDS, TB, and malaria — the world’s most devastating diseases — and to direct those resources to areas of greatest need.

In a nutshell, the fund consists of donor countries and recipient countries. The U.S., naturally, is one of the donor countries. The fund supplements money already in place for these causes in recipient countries. Recipient countries write grants to apply for funds, then the proposals are reviewed through an independent review process. Once granted, the recipient country is given the freedom to use the money to implement/supplement programs according to its needs.

While most people I’ve spoken to seem to think the Global Fund is a great vehicle to help, clearly there is much still to be done in terms of fighting malaria, HIV/AIDS, and TB, and more money needed to get control of these diseases. That is apparent by the number of people who are still dying.

Louis has expressed numerous times that it would take a mere $3 billion a year, each year, for 10 years to wipe out malaria worldwide. For the average person that may seem like an exorbitant amount of money. But in reality it is quite small compared with other governmental expenditures. Currently, the U.S. national debt clock shows the country is at $8 trillion. The war in Iraq will soon exceed $300 billion, according to recent news reports. That is the U.S.’ share alone.

The dispersement of Global Fund money is broken down into ’rounds.’ The current funding round is No. 5. The total amount of money approved for all five rounds so far is U.S. $ 4.3 billion over two years to support programs for the ‘big 3′ in 128 countries. The shortfall of funding to eradicate these diseases is glaring when looking at the need (Louis’ estimate) vs. what is available. Between round 4 and 5, the funding has been cut dramatically for both HIV and malaria.

From my viewpoint, the heart of the problem with funding the fight does not seem to stem from a lack of financial ability, but more from a lack of it being a priority in the eyes of empowered nations.

The issues with funding form a complex web compounded by politics, race, gender, and economic empowerment. Africa has long been overlooked, partially, from what the experts on our travels have said, because it does not bear the economic fruit other continents do and sadly because of race.

Louis echoes a sentiment that I have heard from experts — black and nonblack — both in America and Africa, “Nobody cares about poor, black babies in Africa,” he says. “Every time a child dies here [from malaria], it is because we could not get $2.40 to the mother.”

I and the other journalists on the trip have discussed the reality that malaria’s devastation in Africa is often a hard sell to newsroom managers in the States, and HIV across the board is going under the radar, too, with more advancements in treatment. I think that maybe it isn’t that citizens of the developed world (who can make a difference) don’t care about these topics, I think it is more likely that they don’t know to.

More to come on funding…

Related Topics: The Global Fund: Fighting Malaria in Niger, World Health Organization: Global Malaria Programme

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Posted by: Cherie Berkley at 3:26 pm

Monday, May 22, 2006

Bono Speaks Out on African Health

Today I was happy to see that Bono is spreading the word on malaria and the two other major killers in Africa, TB and HIV. Read more about his journey through Africa here

Related Sites

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Posted by: Cherie Berkley at 5:05 pm

Thursday, May 18, 2006

Ignorance Is Not Always Bliss: Mollelian’s Story

One of the most glaring examples of ignorance and the need for education, came to light while at a village where Artemisia, the plant used for Artemisinin-based Combination Therapies (ACT) for malaria drugs, is being farmed. This is where I, and my colleague, Bob, a CBS news radio reporter, interviewed, Mollelian, a young woman living in the village.

We asked Mollelian about malaria to obtain a general sense about her knowledge. Women are the first line of defense so if the woman in the house is lost, then the children’s health is in serious jeopardy.

She says that even now she is sick with a headache and a temperature. She says she has no money to buy nets and doesn’t know where to get them. We ask her how she gets treatment. She says that she gets treatment at a clinic. But we find that she buys most of her drugs at a local ducha (neighborhood corner store) and it may just be aspirin. The translator explains to us that when people get prescriptions, most are written in English so many people in rural parts don’t understand what the prescription is for. Mollelian can’t read or write any language. In addition to Swahili, educated Tanzanians learn English at a young age.

We ask Mollelian if she had any kids. “Yes, 2,” she tells the translator. We asked if she had any that died from malaria. She said no. After some time passed and more questioning it turns out she had two children die “at child birth.” Louis comments that it is likely that the kids died from malaria. We have found during our travels that many people in the villages don’t know that ‘fever’ is malaria and mistake symptoms of malaria for other things. Then we ask her if she knows how you get malaria. “You get it from close contact from people who are sick.” For the record, malaria is only transmitted by mosquitoes, not human-to-human contact.

I thought about asking Mollelian about HIV, but I sensed from our conversation that she wouldn’t know much – if anything – about that either. However, she did get one thing right, she knows what the Artemisia plants being grown in her backyard are for. Ironic that it is a cure that is right outside her door and one she may never be able to afford.

Related Topics: Spotlight on HIV/AIDS in Females, HIV and AIDS in the 21st Century

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Posted by: Cherie Berkley at 8:28 am

Thursday, May 18, 2006

Gender Inequality: Striking a Balance

I could not leave Africa without addressing the important role women play in society. The topic of the impact of gender inequality and health care is a topic I could write about all day. Women are the care takers, the home base, the back bone of family life, much like in the U.S. — and they are responsible for getting health care for the kids.

Unfortunately, the gender inequality that persists in the culture in Tanzania and other African countries still reflects a devaluation of women that is far greater than in the U.S. I had heard about how women are the last to get medicine in the household since the man is the breadwinner; that they can be thrown out of their homes if they admit they have HIV because stigma is so strong both in Tanzania and Zanzibar; have fewer sexual rights within a relationship; and are often overlooked in terms of getting an education — a decision made by a man, their father. While here, I thought it was important to find out first hand from the women who live this life.

I asked Ritha, a WHO malaria professional and part of our team, about her experience as a woman growing up in Tanzania. We talked while in transit to a village in Arusha. She says her tribe was more progressive than some others. Her father always thought it was important for her to get an education and saw to that happening. She adds that she and her husband share decision making in her home as well. While there are a number of women like Ritha, particularly in the city, sadly, I would guess she’s the exception. Again, most Tanzanians live in the rural parts of the country, where access to everything is just scarcer and mindsets less progressive. Ritha does say that the government is trying intervene and things are slowly changing regarding elevating the girl child more and emphasizing giving her more rights.

After our visit to the clinic, where we saw the malaria ward in Arusha, the female NABJ fellows discussed a situation that baffled us. One of the women explained to us through our translator that she had to beg and beg her husband for the money to go get treatment. Finally the woman said she won him over with her ‘womanly’ ways.

Men control the money and make the final decisions generally. Gender inequality plays a major role as to why women are so left behind in terms of health care. Much of it boils down to lack of education and therefore lack of empowerment and control over their destinies. When I’ve asked women here if they feel oppressed (by American standards), I don’t think many of them have the knowledge or exposure to even understand what that means. They don’t realize what is out there in the greater world. I’ve asked the question in many ways and have received the same responses.

Louis weighs in on this issue, saying tackling ignorance is a way of empowering people. “The only way we’re going to see a massive change is through education. And formalizing education and perhaps making it required for families to send their girls to school,” he explains. Then we discuss some girls we met in Arusha. They explained that they didn’t have $.50 USD to get to school (what they needed for one year) because their father didn’t think it was a priority or didn’t have the money.

“I think the problem is finding financial resources to make this happen and making this a high priority,” Louis adds. Compound this with throughout Africa, most of the decisions made within countries are made by men. Women rarely a part of the political process at high levels.

This lack of empowerment is also one reason that women are the highest risk group for HIV in Africa, just as black women are in America. Louis explains that some of the customs and practices culturally completely “victimize” women so empowerment is important dealing with the HIV crisis in Africa.

As noted in my entry Reconciling With Reality, women are the last to get antiretroviral drugs, carry the strongest stigma and have the most to lose if they are diagnosed with AIDS and reveal their status, and have fewer means to be self-sufficient. Women often contract the disease from their husbands who are frequently away for months at a time working. During this time they may have affairs with prostitutes without condoms and then transmit HIV to their wives. In rural areas, often times access to condoms is scarce even if a man or woman knows to use them, Louis says.

Stigma is a very big issue with women. Particularly in Muslim countries, such as Zanzibar, it is even more difficult for women to come forward. In addition to more funding, access, and education, cultural attitudes play a major part in combating HIV. It seems the same systematic problems that need fixing for AIDS will also be needed to bring malaria to its knees. As Americans, we are no stranger to the impact of stigma.

Related Topics: AIDS Taking On a Female Face, WebMD Women’s Health Center

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Posted by: Cherie Berkley at 8:20 am

Wednesday, May 17, 2006

Arusha: The People


Ursa River Village Children


Maasai woman standing outside her home in small village in Arusha.

Posted by: Cherie Berkley at 10:07 am