A caffeine-infused rant about the Starbucks CEO and religion

There are five pillars of Islam (see references with my book, “The Heroine Next Door”:

1. You should bear witness that there is no God but Allah and that
Muhammad is the Messenger of Allah
2. You should keep up Salah (prayer conducted five times per day)
3. You should give Zakat (donations to the poor)
4. You should Saum (fast) during the month of Ramadan (ninth month
of the lunar, Islamic calendar)
5. You should make hajj (pilgrimage) if you are able to do so

In terms of a moral code, it seems less complicated than the Ten Commandments, but continues to be a source of conflict and condemnation around the globe. One is not the enemy of the other. We are all human and as such find it difficult to adhere to five or ten rules.

Whether one rejects the pillars, the notion of God, or the very idea of spirituality are no longer options for communities living in the middle of conflict zones. It is also very easy to get ensnared in tribal dogma, the modifications from different schools of thought within the religion, shooting the original messenger, or debating about who is most appropriate in terms of expanding or reinterpreting that message to a wider audience.

That luxury is usually reserved for well-fed and clothed experts and casual observers. Refugees crossing different boundaries in search of safety and food and water might be forgiven for thinking that academic discussions about the future of a faith is a case of “too little, too late.”

For those intent on making strategic compassion the focus of any specific intervention, perhaps condescension in any rhetoric could be modified with a Starbucks-CEO approach. No, I am not suggesting that tone-deaf, overworked barristas barrage the latté-swilling masses with the latest horrible headline or discuss the political correctness of using “Islam” and “extremism” in the same sentence.

However, Starbucks has the platform to create an “events”-type scenario, where gold – or platinum- or interested-members could be invited to special evenings with, let’s say discounted cake pops or other desserts, and their favorite activist for special meetings.

Topics could range from the latest horror story in the news to getting ordinary people to adopt “Yoga Girl’s” impossible poses on Instagram.

Just a thought.

Being poor and sick in America

This post, which first appeared in the pre-Obamacare days in the Norwalk Patch, still resonates with me today. I miss my friend and dedicate this post to her.

I will never forget the first time I heard her voice in the university hallways. “Are you from Cape Town?,” she asked. I stopped momentarily, because that familiar-sounding accent brought back a flood of memories about South Africa. When I turned around, I saw a tall, middle-aged lady with a smile, reminiscent of the African sunshine in my former homeland, beaming at me. This was the beginning of a decade-long friendship between two lost souls in the heart of Manhattan. I quickly learned that Lady M., as I will call her, had been through a lot of ups and downs in her life. She had been diagnosed with an insidious oral cancer that eventually required surgical removal of part of her tongue, rendering her sounding like a female version of Scrooge McDuck. Lady M. did not let her condition get the better of her. She became a mother figure, who dispensed advice along with recipes for how to make tarts and stews based on the produce on offer at Jack’s World and other cheap emporiums in Manhattan. Visits at Lady M’s place were filled with laughter, stories and trips to the local bodegas to search for the Hispanic equivalent of South African staples such as Marie biscuits (a cookie with a hint of vanilla, best consumed with tea) and Milo (a Nestlé chocolate and malt powder product that we liked). She showed me tokens of her youth as a South African lass born to Scottish parents. I learned about the influence of friends on her formative years and about how she had cared for her aging parents before emigrating here.

While her cancer was in remission, we could both ignore the elephant in the room. In many respects, Lady M’s story was similar to those of others in households all over New York; however, she faced the added burden of being poor and without health insurance in a country that regards this item as a benefit and not a necessity. The first sign that her cancer had returned was marked by slurred speech and pain in her jaw. After finally securing insurance and consolidating her medical records from various institutions, experts confirmed her worst fears. The cancer had spread and this time it would be fatal. It was ironic that she was the one that ended up comforting the few people that knew her. Lady M quietly started preparing for her own death. She withdrew from the few friends that still kept in contact with her. Gradually her speech became incomprehensible. People would automatically assume that she had a mental disability when she spoke to them. So she learned to get by with a pen and paper.

And then she died, not registering a blip on the radar of thousands of passers-by in the busy city. In reality, dying of cancer is not as sanguine as euphemistically portrayed on television. People are not always fortunate to be surrounded by loving families or live in fancy houses. Sometimes people fight, because they want to live or they have someone waiting for them. Sometimes people are poor, they have no one and in the end the fight against bureaucracy and to improve the quality of their lives prove be overwhelming. I salute those people. May their struggles remind us of the human component of the financial equation in the search for effective, affordable healthcare for all citizens.

A Canaanite in Brooklyn (first posted in The Norwalk Patch)

Canaan or ‘The Promised Land’ seemed to be a mirage to the Palestinian patient advocate. He had arrived as a starry-eyed child in the USA shortly after 9/11 in search of peace, freedom, and prosperity. As a young adult, his life as a student/waiter living in a poor area best known for inspiring Dog Day Afternoon, left him with mixed feelings. Today the Chase Manhattan Bank branch, site of the robbery depicted in the 1975 movie, was gone, along with the hopes and dreams of many under-employed first-generation immigrants like himself. Despite the surroundings, his faith propelled the young Christian man into applying his scientific knowledge to the benefit of his neighbors and family. The Samaritan had already provided much-needed information to his neighbor, Shireen, and the African-American woman (with questions about cholesterol) who lived a few blocks away from his home.

These charitable activities provided a welcome relief from being caught between the opposite opinions of his relatives and friends in the multi-ethnic, intergenerational neighborhood he called home. Conversations with one uncle would sometimes veer from ordinary day-to-day life to the Israeli-Palestinian conflict. The patient advocate was constantly reminded by his uncle that the creation of Israel in 1948 marked the beginning of the Palestinian exodus, known in Arabic as the Nakba (catastrophe). The “sleepy Arab backwater of the Ottoman empire” had been transformed into a Jewish state at the expense of the life of the uncle’s wife, his favorite aunt. Moreover, the uncle had to flee Palestine and watch the struggles and dashed hopes of his former countrymen on several televisions across the globe as he searched for a new home. The patient advocate would quietly devour sour lentil and eggplant stew ( rumaniyya) and try to integrate his uncle’s tales with his own experiences.

Shadia Mansour, the British-born Palestinian singer also known as the “First Lady of Arabic hip hop”, echoed the patient advocate’s feelings towards Palestine with her song, Assalamu Aleikum(Peace be upon you). 5 Broken Cameras – the Emmy-award-winning 2011 documentary film co-directed by Palestinian Emad Burnat and Israeli Guy Davidi – might as well have been a Hollywood version of his conversations via Skype with relatives affected by the Israeli-West Bank barrier. In addition, he agreed with the opinions expressed by the Palestinian-American journalist, Ali Abunimah, in his book, One Country: A Bold Proposal to End the Israeli-Palestinian Impasse. However, he understood the fear that the Zionist vision of a unified sense of Jewish peoplehood, heritage, and destiny might become lost in a one-state solution for his former homeland. According to Zarah, the need for Herzl’s antidote to anti-Semitism – a Jewish homeland – was compounded by the Holocaust. The patient advocate wanted to identify with the struggles of his people and also wished to co-exist peacefully with his American neighbors. Would voices urging peace ever be heard above the din of competing narratives of two displaced populations occupying the same land?

The patient advocate was not a Palestinian Gandhi. He decided to focus on renewing the bonds of trust with Zarah, who had recently been diagnosed with triple-negative breast cancer. He emailed her an article elaborating on new therapies to treat the aggressive tumor. He was happy when she thanked him immediately and invited him to join her family for dinner. Members of her breast cancer support group would also be present, including a couple who had just returned from Israel. They brought news about the formation of the Parents Circle – Families Forum, a grassroots organization made up of more than 600 bereaved Palestinians and Israelis, all of whom had lost an immediate family member to the conflict. Zarah also mentioned that the couple wanted to discuss a new documentary, On the Side of the Road, with him. The film by Israeli journalist, Lia Tarachansky, combined the history of 1948 (as related by Israelis involved in the fighting) with Tarachansky’s personal story. He was curious to hear more details and accepted the invitation. It was the season of peace, forgiveness, and reconciliation – at least in one neighborhood.

Reach a Hand

Reach a Hand ─a non-profit, HIV-prevention-and-empowerment group targeted specifically towards youths and started by Humphrey Nabimanya ─embodies a can-do spirit in terms of providing practical education to a vulnerable group that might not have access/knowledge to cope with the ongoing HIV/AIDS crisis in Sub-Saharan Africa. Humphrey lost close family members, including a sister and her partner, to the disease.

Together with his team, they have recently launched a music project, involving some of Uganda’s leading music celebrities, to drive home the point that empowerment through peer-to-peer education is one of the powerful tools that sexually active young people have against HIV. One of their songs ,“If Its Not On Its Not Safe”, features East Africa’s top artists in the music industry, GNL Zamba, Ray Signature, Lydia Jasmine, Big Trill (singers are from Uganda), and Jody Phibi (Rwanda).

People wishing to engage in similar programs can apply for funding at http://goo.gl/gRSL1P.

The Two Faces of Rwanda

(This article first appeared in a newsletter and then in the Patch).

Gorillas

Rwanda, a central African republic no bigger than Belgium, piques the interest of avid travelers for many reasons. Perhaps they are interested in the lakes surrounded by mostly tilled hills ranging from 2,952 feet to more than 13,000 feet above sea level. Others may come with binoculars and tripod cameras in hand to view the diverse flora and fauna, paying special attention to the gorillas in the northern part of Rwanda. Some people may think that they know this country based on news of the genocide or after having viewed the movie, Hotel Rwanda. The movie showed how Paul Rusesabagina, played by Don Cheadle, saved more than a thousand people during the genocide by sheltering them in a hotel in the capital, Kigali.

For this traveler, the mountain gorillas native to the  National Volcano Park provided one impetus for a visit. A combination of studying the American naturalist, Dian Fossey’s work as described in the movie,Gorillas in the Mist, and reading about successful efforts to teach gorillas sign language fueled my fascination with these primates.

The chain of extinct volcanoes known as Birunga–or Virunga as it is referred to in the Democratic Republic of Congo (DRC)–forms a natural barrier between Rwanda, Uganda and the DRC. It also serves as one of the few remaining habitats for mountain gorillas. Here, on the slopes of  Mounts Gahinga (11,397 feet), Sabyinyo (11,922 feet), Bushokoro/Bisoke (12,175 feet) and Mount Karisimbe (14,786 feet), gorillas can live freely thanks to conservation programs. Rwandan authorities, international aid, and involvement of the locals have buffered the negative effects of poachers.

Gorillas live in groups led by a dominant male, which is a silverback with signature gray hair, and the remaining gorillas are typically blackbacks (younger males), females, and newborns The 400 plus-pound silverback leader of the Sabyinyo group provided me with the thrill of a lifetime upon first sighting. Our guides had prepared us on gorilla etiquette and with stories about this group that had been habituated to humans; however, nothing could quite prepare us for the thrill of seeing these gentle creatures supplementing their largely vegetarian diet with insects and going about their daily business. Crouched just beyond the twenty-two feet gorilla “personal boundary” line, we watched in awe and amusement as the  silverback “womanizer” interacted with his seven wives. His offspring, playing with raucous abandon near their mothers, had our cameras working overtime.

I learned first hand the value of interspecies communication, when grunts exchanged between the guides and the silverback kept him at bay. The human group agreed that seeing their non-human brethren made the arduous trek up the rain-drenched mountain slopes worthwhile. Subsequent fireside chats included tales of one human group being charged by a blackback, while another person related a more positive form of communication in the form of a gorilla tapping him on the shoulder. Viewing golden monkeys, other wildlife, and raptors such as ogre buzzards performing an aerial mating ritual provided an added bonus.

Genocide

When one winds one’s way back down roads and is occasionally mobbed by smiling children shouting “muzungu” (white/light-skinned person), one might imagine having stumbled upon a hidden paradise. However, the grinding poverty, lack of potable water and sanitation, sacks of USAID food donations being sold at markets, and Kanyarwandan (national language) signs describing the genocide point to the harsher realities of living in Rwanda.

The Kigali Genocide Memorial Center, built on a site where more than 250,000 people are buried and guarded by armed soldiers, drove home the impact of this recent tragedy. Manicured gardens encircled these mass graves and exhibits outlined the genocide story.  Briefly, physical features/changing personal circumstances among the Hutu, Tutsi, and Twa peoples of Rwanda were legally codified by colonial powers in the form of identity documents (reminiscent of apartheid) in 1932. The Tutsi-Hutu distinction differed from the prior system where differences among them were viewed as more akin to livestock versus agricultural farmers. The positive development and practical benefits of European occupation were therefore counterbalanced by the negative influence of socially enforcing a distinction between the Tutsi and Hutu peoples. Simmering tensions finally boiled over on April 6, 1994, when the jet carrying Presidents Habyarimana (Rwanda) and Ntaryamira (Burundi) was shot down over Kigali by unknown assailants.

Today, ten million Rwandans struggle to cope with the knowledge of almost a million deaths, displacement of two million people and the consequences of tending to rape victims and countless orphans. Stories about thousands of bodies washing down from the Kagera River into Lake Victoria in Uganda highlighted the horrors of the genocide to this traveler. A growing body of literature, art, medicine and the involvement of the justice system on local and international fronts have begun to address the genocide. Recently, the Canadian Supreme Curt sentenced a genocide fugitive, Desire Munyaneza, under its “Crimes against Humanity and War Crimes Act.”

Although political leadership, international aid, and economic growth have revitalized post-genocide Rwanda, much remains to be done. Destabilizing influences in neighboring countries are warning signals that the current peace should not be taken for granted.

As we departed, I was left with the scent of eucalyptus trees and the juxtaposition of magnificent natural beauty against a backdrop of sadness still etched in my memory.

Sources

1. Dian Fossey Foundation: http://www.gorillafund.org/

2. The Gorilla Foundation: http://www.koko.org/index.php

3. Lorch D.: Thousands of Rwanda Dead Wash Down to Lake Victoria

http://partners.nytimes.com/library/world/africa/052194rwanda-genocide.html

4. Kigali Memorial Centre: http://www.kigalimemorialcentre.org/old/index.html

5. Desire Munyaneza:

http://en.wikipedia.org/wiki/D%C3%A9sir%C3%A9_Munyaneza

6. J.C., Klotchkoff. and F., Letourneaux.: Rwanda Today, Jaguar, June 30,

2003

Addressing a need by printing prosthetics (First appeared in The Norwalk Patch)

Losing a hand, digits, or limbs can sometimes be viewed as unfortunate accidents or the traumatic consequences of life in war-torn regions. However, estimates suggest that major (amputation above the elbow, below the elbow, above the knee, below the knee, or the foot) or minor (amputation of the hand, fingers, or toes) limb loss occurs more often than we realize in the general population. According to separatereports, almost 2 million people lived with limb loss in the USA and hospital expenses associated with amputations totaled $8.3 billion in 2009. A small fraction of the cost could possibly be attributed to treatment of 1,715 US soldiers (as of December 2012) who lost limbs in Iraq or Afghanistan or congenital limb deficiencies. Based on a 2008 report, the remaining amputationswere mostly caused by vascular disease (54%) – including diabetes and peripheral arterial disease – trauma (45%) and cancer (less than 2%). Thepercentage of non-traumatic lower limb amputations in diabetics increased to more than 60%, according to data from the 2011 National Diabetes Fact Sheet. Moreover, it is estimated that up to 55%of diabetic amputees will require amputation of the second leg within 2‐3 years.

Globally, one amputation occurs every 30 seconds. In addition, The International Society for Prosthetics and Orthotics and the World Health Organization (WHO) estimated that at least 0.5% of populations in developing countries and other regions are in need ofprostheses or orthoticsand related services. Prosthetic devices can range from basic walking support for lower-limb amputees to state-of-the-art devices mimicking human movement, enabling amputees to navigate rough terrain, climb stairs, or perform athletic feats. Physical and societal obstacles, leadership and governance, service delivery, human resources, production, and affordability are key barriers to assisting amputees.

While the WHO made suggestions to overcome these barriers, it means that in practice considerable time would have elapsed before people like Richard Van As in South Africa and limbless children in the Sudan obtained access to affordable prostheses. Van As, a master carpenter, lost four of his fingers in a work accident and collaborated with others to make mechanical fingers (using a 3D printer). Richard has since expanded theRobohand project to making mechanical fingers for people with congenital deformities or who have lost their digits. Similarly, Not Impossible’s Mick Ebeling gave hope to Sudanese child amputees (through Project Daniel) by setting up a 3D-printing prosthetics lab and facility in that country.

State-of-the-art prosthetics may simply be beyond the pocket books of many amputees. Could Project Daniel and the efforts of the Open Prosthetics Project be replicated in other low- or middle-income countries where disabled people may have inadequate health insurance? In those cases, low-cost 3D-printers (such as a prototype currently in development in Togo or the printrbotPLUS) could conceivably be used to print replacement digits while awaiting evaluation by a medical professional. While amputees in poor countries and elsewhere await government support, ordinary folks will likely continue to fill an important need and inspire others through their actions.

American immigrants – The New Wave

A warm welcome to all my new subscribers. I would be grateful for your feedback about ordinary people you might know  who inspire you and who are new immigrants. I hope to expand those ideas with appropriate acknowledgments.

Thanks ! Enjoy.

Immigrant stories

Irish-Americans. Italian-Americans. Mexican-Americans. Chinese-Americans. Each generation or catastrophe seems to bring a flock of immigrants to these shores, either fleeing persecution or hoping for a better life. That hope is personified by success stories of great immigrants building a better life for themselves and society such as Andrew Carnegie and others. One might well say that these days a hyphenated designation of nationality is meaningless, because everyone is automatically anointed with a “can-do-and-will-succeed” spirit once they reach a land vested in the principles of freedom and justice. For the silent majority of people, this is indeed the case. They follow tried-and-true traditions of forming small communities, often toiling away in positions sidestepped by those who have lived here for more than a generation. Each immigrant also brings with him or her a unique heritage to integrate and expand the great melting pot known as the United States of America. Sometimes those stories are larger than life and become part of global discourse e.g., some Quakers dissatisfied with the teachings of the Church of England settled in North America and brought with them a view of non-violence that resonated across real-world boundaries with the likes of Tolstoy and Gandhi. Others reached these shores as slaves and imbued future generations with a legacy of standing tall in the face of suffering and contributing to the heart and soul of a society.

However, in a digital age where sound-bites can obscure the changing dynamics of immigration, it is worthwhile to share a cup-of-java with a new immigrant on a cyber-porch and find out how they are adjusting to life in the USA.

Female scientists

International Women's Day

Happy International Women’s Day, everyone. I wrote a series of posts about female scientists that appeared – you guessed it – in the Norwalk Patch. I am reposting the links here for your reading enjoyment.

1. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-1-0

2. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-2-0

3. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-3-0

4. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-4-0

Co-infection of HIV patients with the silent killer, hepatitis C (first appeared in The Norwalk Patch)

Hepatitis C (HCV), a liver condition amenable to appropriate treatment depending on disease status, is caused by different blood-borne HCV genotypes. Approximately 130–150 million people across the globe have chronic HCV infections.  In addition, millions of baby boomers— people born between 1945 and 1965 — may be unaware that they are infected with HCV. Antiviral treatment is successful in 50–90% of diagnosed cases, depending on the treatment used, but access to these resources are limited, according to the World Health Organization.

Co-infection of HIV patients with HCV (~4—5 million people worldwide), causes substantial morbidity and is associated with higher rates of all-cause, liver-related and AIDS-related deaths (1). The onset of treatments tailored to HCV and other known opportunistic infections in HIV patients has been outlined by the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America (2). For patients with an acute HCV co-infection and no spontaneous clearance, treatment should be offered using a genotype-specific regimen as for chronic HCV infection for 24 to 48 weeks. Factors favoring initiation or deferral should be taken into account before initiating HCV-genotype-specific regimens in chronically infected patients according to dosage guidelines based on concomitant anti-retroviral regimens. The national organizations also describe further considerations that should guide HCV therapy in a HIV-infected patient e.g., “HCV treatment is generally not recommended in patients with a CD4+ cell count <200 cells/μL (2).”

A complete summary of guidelines for the prevention and treatment of opportunistic infections in HIV patients can be found here.

References

1.   von Schoen-Angerer T, Cohn J, Swan T, Piot P. UNITAID can address HCV/HIV co-infection. The Lancet. 2013;381(9867):628.

2.   National Guideline Clearinghouse. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. http://www.guideline.gov/content.aspx?id=45359&search=hiv+and+opportunistic+infections. Accessed 4/23/2014.

The caregiver (First appeared in The Norwalk Patch)

Physical strength is measured by what we can carry; spiritual by what we can bear.

— Unknown

The caregiver pulled his car into the nursing home parking lot. Rhinestone Cowboy, the country song made famous by Glen Campbell, faded with the sound of the car engine. His reprieve from the day-to-day worries over an ailing father, an Alzheimer’s disease-sufferer, was at an end. His brother had suggested the road trip. The weekend admiring fall foliage and reminiscing over the family had been a bittersweet event. The highlight of the trip had been a joint viewing of embroidered narratives by Holocaust survivor,Esther Krinitz, at a local museum. Her stitch-by-stitch tale of horrors encountered during World War II provided evidence of a sharp memory, unlike the jumbled thoughts of his father.

He had seen the warning physical signs marking the onset of his father’s disease and watching the progressive deterioration had taken a toll on his own well-being. He had needed coping tips and the support of a sibling. He felt rejuvenated, knowing that hiscry for help after succumbing to caregiver burnout, had not fallen on deaf ears. He signed his name in the nursing home guest book, punched the door code for the Alzheimer’s wing and knocked on his father’s door.

The massage therapist let him into the room. His sister-in-law had suggested the therapist’s services as a birthday treat for his mute father. When he saw the light in the old man’s eyes, he knew that she had been right. His father had responded to the warmth of the therapist’s caring touch. His own gruff expression softened as he held his father’s hand. The meeting was brief, because there was nothing left to say anymore. However, he felt strangely at peace as he returned to his car and switched on the radio. Someone was interviewing former Supreme Court Justice, Sandra Day O’ Connor, on one of the stations. The interviewer gingerly enquired about her late husband, who had died of the disease in 2009, before shifting back to the more comfortable terrain of her illustrious career.

He reached his home and sorted through the pile of papers and magazines on the kitchen table. A Time magazine article about new biomarkers for detecting the memory-robbing illness in its earliest stages, caught his eye. Another piece of paper about Glen Campbell’s brave fight with Alzheimer’s disease fell to the floor. He would have to read that article another time. He first needed to figure out where to come up with the next month’s payment for his father’s nursing home stay. He balanced his checkbook and marked the calendar. Next week he would attend a caregivers’ support group meeting. The topic would be art and music therapy for Alzheimer’s disease. The purpose that an early-Alzheimer’s-disease sufferer found in Poetry, would also strengthen each member of the group. His courage returned because he could now rely on the support and understanding of other people.