Disease Detective

One Step Forward, Two Steps Back: Court Decision in China Upholds HIV Employment Discrimination

November 18, 2010August 13, 2015 by Disease Detective, posted in HIV/AIDS, Human Rights

China always seems to find its way into human rights headlines these days. Now that the sound and fury of Liu Xiaobo’s Nobel Peace Prize has died down, the People’s Republic is in the news again: this time for a landmark court decision in which a man lost a discrimination case for being denied a teaching job based on his HIV status. Wu Xiao (an alias that means “Little Wu”), a 22-year-old college grad, passed a series of written tests and an interview for the position, so he should have been perfectly qualified for the post. However, when his mandatory blood test revealed his HIV status, the local education bureau in Anqing rejected his application. The court ruled that the criteria for hiring civil servants (which disqualifies HIV-positive individuals from being hired) overrules a 2006 law that prohibits discrimination against persons with HIV and their families. The verdict is highly discouraging to Chinese AIDS advocates.

Discrimination against persons with HIV is nothing new. The history of the disease is littered with horror stories of stigma, persecution, and invasion of privacy, and discrimination continues all over the world in various forms, including cultural norms and, in some cases, even laws. In Chile, HIV-positive women are frequently pressured to get sterilized, and some are even sterilized without consent. Twenty-two countries, including Russia, Egypt, and South Korea, will deport foreign nationals based solely on HIV status, and other countries (such as Malaysia and Syria) will not allow students with HIV to apply for study. Gugu Dlamini, a SouthAfrican woman, was beaten to death after speaking openly about her HIV status at an AIDS awareness gathering on World AIDS Day in 1998.

China is certainly no stranger to HIV/AIDS discrimination. From the government’s frantic cover-up of the “Bloodhead Scandal” (in which 30,000-50,000 people were infected through blood transfusion programs in the 90s) to present-day violations of patient privacy laws, Chinese HIV patients face harsh stigma from healthcare providers, government officials, and their friends and neighbors. On the surface, the country has been somewhat proactive in mitigating this: it passed its first laws regarding HIV patient privacy in 1988, and it is illegal to disclose personal information of HIV-positive individuals. Chinese President Hu Jintao and Prime Minister Wen Jiabao make visible appearances with people with AIDS every year on World AIDS Day, and ARVs are available to AIDS patients for free. However, privacy laws are routinely violated, and people with HIV are ostracized from their families and communities. The government routinely harasses and often imprisons AIDS activists (Hu Jia, for example, was held under house in 2006 and has been in jail since 2008). Fear, ignorance and the threat of discrimination discourage individuals from getting tested and deter many who already know their status from seeking treatment. Chinese AIDS patients are encouraged by their providers to use fake names and IDs when seeking treatment and picking up medicines.

Wu’s lawyers plan to appeal the decision, but advocates are frustrated. “The entire H.I.V. community had high hopes, but now the door appears to be shutting for people who want to use the courts to fight against discrimination,” said Yu Fangqiang, whose organization represented Wu in his case. Others, however, urge patience, and point out that the fact that the case was even heard demonstrates progress. Either way, it is crucial to end the institutionalization of discrimination against HIV. Cultural norms will not change until the official government position changes, and, along with it, its laws. People will not seek treatment until they are no longer afraid to come out of hiding.

Post-Annual Meeting Reflections

November 11, 2010August 13, 2015 by Disease Detective, posted in APHA IH Section

As I scrolled down the #apha10 hashtag feed on Twitter, it seemed like everyone was singing (or tweeting, I suppose) the same tune – it was great to (re)connect with colleagues and friends at the conference, but there’s no place like home (particularly when your spouse picks you up from the airport with a bouquet of flowers and a dinner reservation).

Unfortunately, I was unable to attend either the global health luncheon or the closing general session this year, but I still had a great experience. As I unwind after a bustling and productive four days, I thought I would post some post-conference reflections.

Take the bus: I would challenge all public health professionals to at least try to work with the public transportation for these annual meetings. Public transport is a major issue for so many of our domestically-focused colleagues, so even just taking it from the airport to the hotel would provide a lot of much-needed perspective. Plus, I had a lovely conversation with a researcher from Milwaukee about environmental health and the built environment on the way downtown – you never know who you will meet on the bus.
Bring a smart phone: Okay, so this is really more of a personal note for myself. While the Mix and Mingle Lounge was great, I rarely got any signal inside the meeting rooms and so I could only tweet between sessions. And when I have the choice between Twitter and coffee, the latte is the clear winner (despite being shamefully over-priced).
Learn: Go to a session that focuses on an area that you do not know much about. I went to just one child health and survival session, but I learned quite a bit and added a lot of detail to my own “mental map” of the global health field.
Bring a pen: If you are looking for opportunities to break into the field, go to as many sessions as you can and as wide a variety of sessions as you can. While the expo is worth exploring and there are opportunities there, you can learn about opportunities by paying attention to the programs that presenters worked with and their sources of funding. Both years that I have attended the annual meeting, I have picked up the names of multiple fellowship and research programs.
Clone yourself: Both Dr. Gonzalo Bacigalupe and I lamented at not being able to attend the mHealth Summit that took place in DC this year – because it happened at the same time as the APHA Annual Meeting, and I am sure we are not the only ones. Luckily for everyone, next year’s mHealth Summit is taking place during the first week in December, which does not conflict with APHA (which happens during the first week of November). Plus, they will both be in DC – so all of your DCites will have everything right in your backyard.
Network: Get involved in your section! Attend the business meetings and social events, and don’t be shy. More than half the time, getting a job is all about who you know, so networking is absolutely crucial – your section are a perfect way to do it. I jumped right into the IH section at last year’s meeting and was welcomed with open arms; my friend experienced the same kind of welcome in the Cancer Caucus. Established section members love to take on mentees and will be more than happy to help you.
Write for us: During the “Careers in Global Health” session, I offered to provide my list of fellowships and global health resources to anyone who would write an entry for this blog. That offer still stands, whether you were there or not. I have a “Practical Resources for Students and Green Professionals” sheet, which includes paid entry-level fellowships in the field (for both US citizens and foreign nationals), domestic opportunities, and valuable sources of knowledge tailored specifically to those wanting to break into international health and development. If you are interested, pitch me your idea (to make sure we do not post duplicates) via e-mail: jmkeralis [at] gmail [dot] com.

Annual Meeting, Final Day: Between Malaria and TB with no Coffee is not a Good Place to Be

November 10, 2010November 11, 2010 by Disease Detective, posted in APHA IH Section

I usually get restless on the last day of a given conference. It is really a shame, too: the presentations on the last day are just as interesting and important as those on the first, but by then I am already thinking of getting home, following up with connections made, and going through the business cards I picked up (and trying to find them on Linked In). Fortunately for me, two of the three global health hot topics were featured this morning: malaria and tuberculosis.

The session on malaria and vector-borne diseases featured several presentations on distributing insecticide-treated bed nets and their impact, as well as one that highlighted the importance of accurate diagnosis. I have been interested in malaria ever since I was an undergraduate student at Texas A&M, so I always attend sessions on malaria if they happen at a given conference, and it is always encouraging to see how much energy there is to fight it. (I took part in a student debate at the 2007 Entomological Society of America’s annual meeting, and I went to every vector-borne disease session they had.)

Up until that point, I’d had no coffee, so I gave in to my need for caffeine and bought an over-priced latte.

The TB session was also interesting, particularly because it is another area in which I have a lot to learn (though USAID’s Global Health eLearning Center has helped a lot with that). Despite being one of the top three global diseases, it has always seemed to be the red-headed stepchild of the three big killers – since HIV/AIDS and malaria always seem to dominate the news and be a whole lot sexier in general. The presentation on latent TB in a colonia in Baja California in particular stood out to me. During my work as a Pesticide Poisoning Surveillance Fellow at NIOSH last year, I drafted an article on pesticide poisoning in farm workers and learned quite a bit about their unique burdens. With all of the attention on our ongoing border “crisis” (or however it should be phrased), I think this will remain in the spotlight.

Unfortunately, I was unable to attend the Global Health Luncheon, as I had to catch the Sky Rail to the airport for my flight. If I find any coverage of it, I will be sure to post it here. (If you would like to cover it, dear reader, be sure to let me know!)

Annual Meeting, Day 3: NTDs, Kids, and Careers

November 10, 2010August 13, 2015 by Disease Detective, posted in Aid Effectiveness, APHA IH Section, Maternal and Child Health

I started off my morning with two unpleasant experiences: a burnt cup of coffee from my hotel’s breakfast buffet and a session on neglected tropical diseases (NTDs). Please don’t misunderstand me – the session, hosted by Dr. Hélène Carabin, was very interesting, but pictures of the clinical manifestations of those worms will make even the sturdiest of young professionals’ skin crawl. I learned more than I ever wanted to know about onchocerciasis, or river blindness (did you know that those worms can live for 14 years in the body?); helminthes; baglisascariasis, or raccoon roundworm (in Brooklyn, of all places); neurocysticercosis, and trachoma. These diseases have rightly earned their designation as NTDs – they are inexpensive and easy to treat and prevent, yet most people have never heard of most of them. (Alanna Shaikh has a theory that giving them more descriptive and graphic names will attract attention to them – you can read her proposed naming scheme here.)

Next up was a session hosted by Dr. Elvira Beracochea on aid accountability and effectiveness. There were several very insightful talks and an interesting discussion (Dr. Beracochea always likes to involve the audience, which can be fun). After a lunch of Vietnamese fast food, I attended a session on child survival and child health, to which I was invited by Ms. Beth Charpentier (Ms. Katherine Robsky’s colleague from Global Health Access Program). While I believe that maternal and child health is very important (and I am thrilled that it is enjoying so much attention from Secretary Clinton and other development advocates), I am not very familiar with that area, so I learned a lot.

Finally, I attended the “Careers in Global Health” panel that is organized by Dr. Carabin every year. There was a very useful presentation on the key knowledge areas and skills that currently global health leaders identified as crucial to the incoming workforce. Ms. Carol Dabbs provided some practical information on the different points of entry with USAID, and then Dr. Eckhard Kleinau told his incredible story of breaking into global health after finishing his residency (he and his wife sold everything they owned and drove to Burkina Faso – from Germany! – in a VW van). If you would like any of this information, please contact me by e-mail at jmkeralis [at] gmail [dot] com.

Finally, the section held its closing business meeting at 6. After committee updates, Dr. Miriam Labbok was recognized for her hard work as section chair for the past two years. I personally will always remember her as a very welcoming face when I attended the annual meeting for the first time last year as a CDC fellow – she encouraged us “newbies” to jump right in.

Tomorrow’s Global Health Luncheon promises to be a real treat (though I probably will not be able to attend – I will have to navigate public transportation back to the airport). The malaria session is always well-attended, however, and it is in the morning – so hopefully I will see you there!

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