Week 9 or 10 Analysis

I'm confused as to what week we're actually on. Anyway, I'll be analyzing Pierre Bourdieu et al., The Weight of the World: Social Suffering in Contemporary Society. I was actually very surprised to find that none of the pieces in the book directly dealth with HIV/AIDS. Is there another example of suffering in contemporary that is more accute that has more emotional, physical, spiritual, and societal implications? Can we not say that for at least the first decade and a half of AIDS in Western society, that the disease was truly our modern leprosy? (Attitudes and actions have improved somewhat, but there are those who are still sadly ignorant or malicious towards those with the disease.)

I want to look at two pieces in The Weight of the World. The first piece is the second half of "Inside 'The Zone'" by Loic J. D. Wacquant. Wacquant discusses various attitudes towards those living in the ghetto. The "miserabilistic" attitude leads one to mental compassion for those in the ghetto. Such a view believes that those in the ghetto are "reduced to the passive state of hapless victims." The other view is the "populist" that "celebrates thenvirtues of the dominated and portrays as a heroic strategy of 'resistance' what is often merely an economic tactic of self-preservation." Both views lead us to objectify those in the ghetto. Wacquant wants us to instead "suspend, if only temporarily, one's initialreaction of sympathy, indignation or horror, and agree to look at this world from the point of view [of]...the 'natural attitude' or everyday life." (Wacquant, in Bourdieu et al., 152)

Wacquant's words might at first feel like a slap in the face to Christians who truly want to be compassionate people and suffer with those enduring injustice. But before reacting to the fact that Wacquant is critical of only mentally compassionate responses, let us appreciate his critique first. Wacquant's view wants us to actually go into the culture or life of a person first and see their world through the eyes of the inhabitants of that society as much as we can. Christians have an amazing capacity to help, but we have also had an astounding ability to be paternalistic. The ghetto is by no means a paradise -- simply read the account from Ricky in the book -- but it is a home full of people created in God's image. Only through seeing the world through the eyes of the inhabitants are we able to truly suffer with (be compassionate) people in the ghetto. This stance does not lead to quietism, but respect for the people there.

I wonder how Wacquant's words can critique (both positively and negatively) the Church's response to HIV/AIDS. Africa is on fire and the world must respond. But do we do so only out of mental compassion? Are we apt to in fact romanticize those living with the disease? One option leads to paternalism and the other to quietism. Do we instead allow Africans to take the lead in fighting the disease in their country? This third option is one of the most difficult for our project since those groups leading in Africa are hard to find on the web. Africa as a continent is still in the process of development and the Internet is by no means a primary source of information and communication for the general population. Right now most of our resources are Western, but I think that they are doing a good job. Still, it would be great to find more African groups fighting AIDS.

The second article I want to respond to is "The Sick Person as Object" by Francois Bovin. his interview with Isabelle, a hospitalized woman seeking help with her life-long disability. Isabelle's account of meeting with doctors who performed several surgeries to give her prostheses is incredibly shocking, especially the callousness that some of the physicians and nurses showed her. While this piece is a good discussion for the reform of hospital care in the West, it does not have much to do with a societal or Church-wide response to HIV/AIDS. I do think, however, that Bonvin's article can help us as we move forward in addressing HIV/AIDS.

First, while we are rightly putting a lot of energy into prevention, we must remember that there are over 40 million people living with HIV right now. Prevention alone is not a just response to the disease -- we must also treat the ill. What we must protect ourselves from, however, is the objectification of people living with HIV/AIDS. They do have a horrible disease, but these people are not the disease. Isabelle recounts how her health care providers saw only her disability. Her emotional and physical pain were not heavily considered since the goal was to alleviate her disability. The doctors and nurses were well-meaning, I am sure, but they made a mistake and did not treat Isabelle as a whole person. They only treated the malady. We cannot make the same mistake with HIV/AIDS. We are not treating only symptoms, but trying to help whole persons. These people are no different than the rest of us. They have families and friends, they work, they live in communities, they participate in their faith traditions. A societal response to those living with and dying from HIV will have to take the whole person -- including their larger milieu -- if that response is to be just and consistent with the gospel of Jesus.

Week 8 Analysis

Once again, the readings do not pertain directly to our topic, but some things did stand out. In Global Transformations, Held, et al show strong evidence for the quick rise of multinational corporations (MNCs) since 1945. The MNCs did exist and they were growing in number prior to World War II, but since the end of that conflict, their influence and magnitude have skyrocketed. How does this affect the issues of HIV/AIDS? For one thing, if MNCs "account for around two-thirds of world trade," (Held, et al, 236) and if many of these MNCs have larger GDPs than many nations, we cannot discount their role in the global ecnonomy as well as global politics. Nations will want to have these MNCs within their borders so that the nations can earn some revenue from them. It is imperative that these MNCs are just as accountable as world governments since they directly affect the people of various nations. As consumers of and investors in these MNCs, we must demand just treatment of workers and care for the environment no matter where the production facility of the MNC is. Safe working facilities, clean water, etc. are necessary to combat the spread of HIV and fair wages for workers help those living with the disease earn enough money to supply for their health care costs. Because of the influence of the MNCs -- both on governments and the citizens of various nations -- they must be paragons of good business. The checks and balances for MNCs are difficult to maintain since different nations will have different business standards. As we discussed in class this week, corruption is a real problem in many nations. Several of these nations, I would assume, have MNCs in them or looking to enter into them. If the MNCs are expected to play the corruption game themselves, where is there transformation? Where are the beneficial effects of capitalism -- e.g., the bolstering of the middle class -- if the largest capitalistic entities are corrupt themselves?

Held, et al write:

multinational production is much more common in the pharmaceutical industry, in large measure because of segmentation between markets arising from heavy demand from localized health services, which is best met locally. Accordingly, production is highly internationalized; overseas affiliates account for up to half of all pharmaceuticals sales and the majority of production in developing countries. (Ibid., 266)

If this is the case, then why is it so difficult for developing nations to receive the ARTs they need? Why is it so difficult to get the triple drug therapies to Africa and South East Asia? On our Wiki, we quote Avert.org, stating, "There are 6.5 million people in developing nations who need life-saving AIDS drugs, but fewer than 1 million receive them." Can we not encourage these pharmaceutical companies to shift some production of ARTs to the regions who most desparately need them? I understand the research and development (R&D) carry heavy costs for these companies, but I wonder if that is the entire reason why the drugs are so expensive or why patents for ARTs have not opened up. What is the role of the investor in keeping ARTs from Africa? Would we as shareholders have to take hits in our portfolios in order to help those most in need? (I do not ask these questions in an entirely hypothetical manner since I have a mutual fund with holdings in Pfizer and Merck.)

Jan Nederveen Pieterse's Globalization and Culture is an interesting book, but it is difficult to relate it to our topic. If nothing else, seeing the hybridization or post-hybridization of cultures (Pieterse, 77-81) should make us realize that the issue of HIV/AIDS is not a localized or an ethnic specific problem -- of course we should have realized that with the fact that the disease is in virtually every nation in the world at this time. One of the interesting points Pieterse raises is that the idea of societies being equated with nations is dwindling. Instead, "A global sociology is taking shape around notions such as social networks (rather than 'societies'), border zones, boundary crossing, diaspora, and global society." (Ibid., 81) As I reflect on that statement, I do believe that Pieterse is correct, but in terms of transformations to meet global health crises, it seems that the task has become that much more difficult. Changing nations is one thing, but changing all different tribes and various social networks seems to be much more difficult and specialized. Of course, I could be taking a top-down approach when thinking about macro-transformations, while the social network understanding is much more grassroots.

Much of our discussion in class about transformation makes me think of H. Richard Niebuhr's Christ and culture typologies. I am somewhat familiar with the arguments -- who could not be after three years at Fuller? -- though I have never read Niebuhr's book. Regardless, I thought that the paper, "Soft Difference: Theological Reflections on the Relation Between Church and Culture in 1 Peter" by Miroslav Volf would benefit our class discussion. In the paper, Volf argues that all five of Niebuhr's typologies can be found in 1 Peter and that we do not have to adopt only one method of interacting with our surrounding milieu.

Week 7 Analysis: Economics

This week's readings in Global Transformations: Politics, Economics and Culture (1999) on economics and globalism (chs. 3 and 4) were especially interesting. Like in our readings on politics and violence (chs. 1 and 2, respectively), the topics relate to the global HIV/AIDS crisis, but not in a direct manner. One can say, however, given the intensity and extensity of globalization in the areas of trade and finance and the relation between those topics and health care, that this week's chapters do address HIV/AIDS. Not only are we dealing with the issues of poverty that exacerbate HIV/AIDS' and the concurrent affect of HIV/AIDS on poverty (see: "Putting it All Together" [PDF]), but these chapters give us an insight into the forces that create our economic milieu, for good or evil -- though it should be said that Held, et al generally refrain from making value judgments on the phenomena they observe.

Being raised in a world where trade, specifically international trade, is a dominant force and a given, I found it very interesting that trade has not always been a significant factor in most nations' economies. It has only been since the end of the Second World War that international trade has become so prevalent (Held, et al, 168-170). Through trade, national economies are becoming more and more enmeshed, especially as a new division of labor emerges. If countries that engage in trade more freely show economic growth and stability -- thanks in large part to the overall removal of tariffs and other protectionist measures -- as well as technological development, it seems imperative that we support developing nations so that they can become greater trading partners in the world. A large problem with HIV/AIDS in developing nations is that they do not have the infrastructure nor the technology needed to fight the disease. While virtually every nation does engage in international trade, Held et al show that there is also an emerging trade stratification. Richer nations tend to export manufactures while poorer nations export primary commodities (ibid., 173). There has been a shift as poorer nations have entered into manufacture exports with their cheaper labor costs, but that simply translated into richer nations continuing to export products requiring greater skills to manufacture (ibid., 186).

The authors of Global Transformations argue that trade has increased the wages of workers and GDP of nations overall and that economic growth also seems to lead to welfare growth.

[S]ince trade in principle produces a net welfare gain for a country, the gainers could compensate the losers adn still be better off. In this light it is not surprising that more open economies generally have more extensive welfare states... Neverthelesss, the growth of trace and changes in the structure of trade have placed increasing strains on the welfare roles of SIACS [states in advanced capitalist societies]. Although there is no systematic evidence that welfare provision harms trade performance...employers, in the tradabel industries particularly, resist increases in their social security contributions, pressing for reductions on grounds of global competetiveness. But erosion of the employment prospects of low-skilled worders as a result of trade...places a significantly higher burden on the welfare system. (Ibid., 183-184)

If our goal in helping developing countries is development rather than charity, then it seems imperitive that those of us in developed countries encourage just, equitible, and sustainable trade with other nations. If increased international trade does assist in the development of welfare within a nation's borders, then it seems that trade is a means of helping poorer nations achieving self-sufficiency, especially in the area of health care. (I know that the concept self-sufficiency is something of a phantom -- especially since international trade creates interdependent relationships -- but I use the term for its ease.) It is the beneficial aspects of just trade that leads groups like DATA to emphasize the role of trade in combatting HIV/AIDS.

It is important, however, to not see international trade and open markets easy saviors to world problems. Held et al remind us that banks are still an important structure within capitalist societies and "banks and other financial institutions still rely on national and international regulatory authorities for their effective operation" (ibid., 214). The authors also give us sobering reminders about the affects of emerging global markets on the existing welfare states.

Global financial markets are conceived as central to inducing a convergence of political and social agendas among governments of varied ideological persuasions to 'market friendly' policies: a general commitment to price stability; low public deficits and indeed expenditure, especially on social goods; low direct taxation; privatization and labour market deregulatoin.

These developments are argued to be particularly unfavourable to organized labour, public sector employees, welfare state beneficiaries, and other traditional interest groups of the left. In this context financial globalization shifts the balance of economic advantage further towards capital and away from labour. But global financial markets do not, as many hyperglobalists imply, simply spell the end of the welfare state... [E]xpansionary economic policies and strong welfare programmes are not precluded by financial globalization, but rather markets impose on governments higher costs of international borrowing or falling exchange rates. (Ibid., 232)

It is an interesting point that welfare structures do not do away with the gains from open markets and open markets do not spell the end of the benefits received via the welfare state. This is a helpful point as we look at how publicly traded pharmaceutical companies affect the fight of HIV/AIDS. Some want to villify them as merely being slaves to the market, whereas others defend their capitalistic structures and high profits as necessary for research and development. Perhaps there is some middle ground. But then again, I'm not an economist, but a theologian/minister in training.

And for good measure, here is a new link for the Pacto de Esperanza, an HIV/AIDS awareness campaign targeting Hispanic churches in the US. Note the links on the sidebar to the left, which give more discussion on HIV and Latinos.

Week 6 Discussion

The chapters we read in Global Transformations: Politics Economics and Culture did not directly deal with HIV/AIDS or health crises per se, but I did find the discussion in chapter one about regimes (see pg. 51 for a definition of the term) to be pertinent to our research. Held, et al. describe the purpose of international regimes as "an expression of the necessity to find new modes of cooperation and regulation for collective problems." (51) It would appear that the creation of these international regimes, along with the explosion of the number of international non-governmental organizations (INGO) have assisted the and in fact led the fight against HIV/AIDS internationally. Groups like the World Health Organization or UNAIDS have become the primary resources and hubs of information concerning the global AIDS crisis.

Nations around the world have understood that a Westphalian approach to the problem will do nothing, as HIV crosses political and territorial borders with ease. (In fact, I would argue that it has been the globalization of international travel primarily via airlines that has made the global spread of AIDS possible.) A more creative, concerted, and multilateral approach to addressing the problem must be taken. Thus nations and INGOs have adopted a certain set of international regimes to combat HIV/AIDS. The Millennium Development Goals (MDGs) that we have discussed at length are a great example of an international regime. All the member states of the UN, many INGOs, and other international regimes such as the World Bank and the International Monetary Fund (IMF) have agreed to implement the goals together. This is not a case of international laws governing specific states, but an example of soveriegn nations and organizations agreeing to work together in a global village.

I was most impressed with the discussion about the human rights regime (65-70), especially the discussion of how certain INGOs like Amnesty International have taken international leadership for education, advocacy, and implementation of international human rights standards. I believe it is the ability of these INGOs to stand outside governments and apart from any conflict of interests that allow them to voice their prophetic statements. Governments are too intricately tied to various systems to be able to voice protest. This is not a general critique, rather an observation. Governments have to concern themselves with maintaining relationships for various reasons: be it to maintain trade, help in security, etc. The INGOs, however, are not tied to these other systems and thus can use their detached nature to call out areas of injustice where they see it. (In many ways, I believe these groups act as a great example from which churches can learn.) The story of Las Madres de Plazo de Mayo, "The Mothers of the Disappeared," (68) is a terrific example of an INGO exercising both authority and pressure on governments to institute justice in certain nations.

As we continue to look at HIV/AIDS, I believe that it will be imperative for churches to partner with these INGOs and other international regimes to affect change and to defeat the disease. Churches trying to work on their own will not be affective. I do not think it is necessary to start something from scratch since many groups such as World Vision or OXFAM have been working hard to network with governments and other INGOs to fight AIDS. The choice is not so much to start something altogether new, but to add numbers to the forces already in the battle.

Analysis of Week 5 Links

Hideyo and I spoke about how to get churches mobilized in fighting HIV/AIDS. I was especially inspired by the stories of the conservative campus group working with the atheist and gay and lesbian groups to build homes for Habitat for Humanity. We wondered how churches could do something similar with HIV/AIDS. That is, how can we work with other groups whose philosophies and theologies are different than ours to fight HIV/AIDS and be the city on the hill Jesus calls us to be? So many churches are worried that if we reach out together, we must approve of everything others do. But that is not the case of Jesus in the Gospels, and as I learned in my pastoral counseling class, acceptance does not mean approval. Anyway, Hideyo believed that our Wiki would need some theological and biblical materials to support HIV/AIDS outreach. I found this page, which is a study on the concept of hospitality in the Bible and how it relates to the current HIV/AIDS crisis. Nancy A. Carter writes,

Hospitality and justice are...linked in the Bible. When some individuals or groups lack these necessities, justice is not fully present in society.

To address lack of justice in biblical times, Israel created laws to help strangers, widows, and orphans, some of the most vulnerable people in society-- people whom Jesus would have called "the least of these." For example, Exodus records this command: "You shall not wrong or oppress a resident alien, for you were aliens in the land of Egypt. You shall not abuse any widow or orphan. If you do abuse them, when they cry out to me, I will surely heed their cry" (22:21-23)....

For Jesus, hospitality meant not only welcoming strangers, but also doing justice.

The study is primarily focused on reaching out to those with HIV/AIDS in our local communities. Many of us Christians in the US agree that there is a heartbreaking crisis on other continents, but we are hesitant to reach out to those living with HIV/AIDS in our neighborhoods. And while I appreciate the transition of groups from primarily didactic teaching to practices, in order to make that change, some communities will need the didactic information before even considering a transformation. This exegesis of hospitality also reminded me of the discussion of different churches in the US who consider hospitality one of the main ministries of their congregations. Certainly Carter's study would resonate with those communities.

Secondly, I focused much of my attention this week on microfinance. According to FINCA International, microfinance involves offering "loans, not grants, to low-income microentrepreneurs, because at the root of their poverty is lack of opportunity, not lack of desire to work." Wikipedia's definition of microfinance (of which microloans are a part) says, "Microcredit is the extension of very small loans to unemployed, poor entrepreneurs and others living in poverty who are not bankable. These individuals lack collateral, steady employment and a verifiable credit history and therefore cannot meet even the most minimum qualifications to gain access to traditional credit."

The UNAIDS background paper, "The Role of Microfinance in the Fight Against AIDS (.pdf)," offers a larger discussion of how microfinance can help combat AIDS. It says that the majority of the work occurs before HIV enters into the family by helping families save money so that if the disease does come, they have capital to help take care of themselves. Also, and perhaps this is more important in terms of justice, microfinance has been directed mostly at women. If women can establish sustainable work for themselves and their faimlies via microfinance, they may not have to resort to high-risk behaviors such as prostitution for economic necessity. (1) The article lists other ways that microfinance helps, as does the article, "Microcredit Helps Ease the Burden of AIDS in Africa." Let us not look at microfinance as a savior, but as a necessary part of the solution. The International Labour Organization just released a report entitled, "Microfinance - Not a Gold Mine, but Saving Livelihoods." The following quote comes from that report:

The research team found that many MFIs are technically efficient, but fail to be fully financially self-sufficient due to adverse local market conditions, like low population densities, insufficient diversification of economic activities and limited acceptance of certain cost-reducing techniques such as group lending. Yet, these MFIs generate substantial social benefits by stabilising livelihoods and incomes, helping the working poor to protect themselves against risks and empowering women.

It would behove us as we develop our resources for churches to look into these microfinance organizations. They seem to be a great developmental tool so that we help people create just and sustainable economic systems, rather than focusing on immediate (and necessary) relief.

Week 5 Links

This is the last batch of new links for the quarter:

1. Reuters: China warns HIV cases could exceed 10 mln by 2010
2. African Microenterprise AIDS Initiative: Preventing the spread of HIV/AIDS by empowering women in Africa
3. Chicken & Biscuits and More: AIDS Ministry and Christian Hospitality Bible Study by Nancy A. Carter
4. The Body: Spiritual Support and HIV
5. Field Notes for Considering Microfinance Services in the Context of AIDS Orphans
6. FINCA International. FINCA is a microfinance organization. This site is helpful for an overview of what microfinance is and how it helps developing nations.
7. Microcredit Helps Ease the Burden of AIDS in Africa
8. Microfinance Gateway. Lots of articles on microfinance and what it is doing around the world.
9. The Role of Microfinance in the Fight against HIV/AIDS (.pdf). Report published in 2000 by UNAIDS United Nations Joint Programme on HIV/AIDS.
10. Decade Development Goals by John Gardner. An alternative suggestion to the UN's MGDs.
    

Reflections on New Perspectives on Judaism Luncheon

The discussion at the luncheon was interesting in terms of evangelism and interaction with contemporary Jews worldwide, but very little was said that pertained to the topic of global health concerns. The majority of the discussion focused on relating as Christians to people of the Jewish faith or Jewish ethnicity. What was helpful, was the emphasis on research and contextualization. We have to know where HIV/AIDS is most affecting people and the means by which it is affecting them. For example, as we have seen in our research, the spread of HIV in rural Thailand primarily occurs via sexual intercourse. If a group wants to devote the majority of their HIV-fighting resources to supplying that region with clean needles would be an example of missing the point. Just as the speakers emphasized going where Jews are, we have to go where HIV is spreading and focus our efforts to combatting its effects on the specific regions. And just as the gospel message must be contextualized between different groups -- e.g., Eastern European Jews vs. North American Jews -- we must contextualize the educational efforts to different groups.

Week 4 Discussion

One need only to read the Millennium Development Goals (MGDs) to be both inspired and overwhelmed by the size and extent of their aims. The sixth goal, which pertains most directly to our group seeks to stop the spread of HIV/AIDS by 2015 and actually begin to decrease the disease's prevalence. A wonderful goal, but one that seems so daunting when looking at the statistics of those living with HIV. In the US alone there are about 40,000 new cases a year (according to Increase in HIV Among Gays [July 29, 2003]). The US is not the worst country by any means. The devastation AIDS has wrought to sub-Saharan Africa is well documented, but how are we to stop or even slow the disease in countries like Botswana, where the prevalence rate among 15-49 year olds is 38.8% of the population? How are nations to address the issue, let alone churches?

The links I provided below are an attempt to see how different organizations and churches are mobilizing themselves to help reach the MGDs. My recommendation to churches is to choose one MGD and devote prayer, time, energy, and resources in participating with that goal. As the global health concerns group, we will look at the sixth goal. But let us remember that issues of health, education, poverty, etc. are inextricably linked. The International AIDS Vaccine Initiative recently created a helpful report, "Putting it All Together" (.pdf) that outlines the connections between the different MGDs and the AIDS goals, specifically how the disease affects or impedes the implimentation of the other MGDs. We can see how AIDS affects poverty in the following quote from the report:

An analysis across 80 developing countries predicts that in a “typical” African country with 20% HIV prevalence, the rate of GDP growth would be 2.6% lower each year than in the absence of AIDS, due to a reduction in growth per capita (1.2%) and a shortfall in population growth (1.4%). (3)

We should be careful, however, to simply tie all the goals together. That is, just because one goal moves forward does not necessarily mean that other goals are also progressing. The World Bank issued a report in 2004 that stated many countries were falling behind in reaching the health MGDs though they may be making progress on other MGDs. This reminded me of a quote in Global Transformations: "[Globalization] cannot be conceived as a singular condition but insteqad refers to patterns of growing global interconnectedness within all the key domains of society." (Held, et al., 27) While, therefore, there is interconnectedness between economics and healthcare, we cannot assume that just by improving one of those components, both will necessarily improve.

What then can we do? The UN Millennium Project has laid out some opportunities for people to become involved. One of their suggestions is for people to write letters to political representatives, newspapers, and to organize letter writing campaigns. An example of this can be seen in Bread for the World who acknowleded the interconnection between world hunger and disease, and focused their 2004 Congressional letter writing campaign on foreign aid to African nations affected by AIDS.

As churches we must seek to equip all our members to engage in addressing the powers and work towards kingdom ideals. We cannot compartmentalize our communal worship times from our activity in the world. The Micah Project sponsored a worldwide prayer day for the MGDs and published a small work (.pdf) that had suggestions for corporate and individual prayer times. These concerns for the health of the world must enter into our liturgy or we will simply be another social group rather than heralds of God's reign.

On a personal note, I am encouraged reading these works, but I also feel a weight on me. It is heartbreaking reading stories of massive death due to diseases that have been shown to be at least treatable if they are not cureable. May our tears lead us to prayer and action. As Bono said, the situation in Africa is, "not a cause...an emergency."