The Lion King

I went to see the Lion King last night. It was fabulous. I feel, I just want to write a list of superlatives!

Have you seen it? If not, you really should if you get the opportunity!

I've been on Safari, but this had far more color, much more excitement, music, singing and dancing animals than I've ever seen from a top of a landrover.

My favorite character was the lady in the picture, the baboon witch doctor, v funny and a voice powered by twenty lungs for sure. My brother's was the grass; honestly the grass was hilarious. It was fascinating seeing all the humans manipulate the puppet extensions to make them animals, which float, spin and leap onto stage with whirling scenery and intense African drumming. There was even a to scale elephant!

The show has been hailed as The Lion King's return home - don't tell anyone, but its based in the east African savanna - in any case it's immensely popular, the audience were often clapping mid scene and the jokes in Zula or Xohsa went down well. It was wonderful!

A friend's farm

"Dad, where are we?"
"Well, the middle of nowhere really."
And that's where we spent the weekend!

Thursday: Bureaucratic tour of Jo'burg and Divas

After talking about the difficulties of negotiating South African Home Affairs department for Zimbabwean refugees 2 days ago, today, I got my own personal experience.

I discovered that Stellenbosch University, where I will be doing my elective, need my visitors permit (stuck into my passport in the airport) to have written ‘medical elective’ on it. I got it done starting at 7am and finished by lunch - a minor miracle I think. However, it did involve driving an hour north of Jo’burg to what was hopefully a quieter Home Affairs office, only to be sent back though rush hour traffic to central Jo’burg office. There, neither counters 6, 8 nor 12; nor room 102 (or did they say I should go to 101) nor 112 on the second floor could help. I was slowly starting to feel like Asterix in ‘the twelve tasks', where the chaotic bureaucracy of Athens proves more challenging for him and Obolix than defeating a ghost army (it involves Asterix running around ALOT and Obolix struggled to carry all the forms they got given). I was finally told to go to the airport?!? They insisted I must go inland! Persistence, or maybe desperation, prevailed and an immigration officer eventually agreed to meet us, laughed at me, and scribbled on my bit of paper.

This evening, I went to see Miriam Makeba in concert. The 75 year old star, famed for being the first South African to speak out against apartheid at the UN, belted out her repertoire in a tent (a very big one) erected for the occasion in downtown Jo’burg . Most of her band seemed related - it included a granddaughter, a great grandson and even a few ex husbands!

Wednesday: The battle for science

A great mystery: why is Thabo Mbeki, president of South Africa, in denial about the AIDS epidemic?

It is killing one thousand South Africans a day, infection rates are rising,it is expected to remove the most economically productive people from the population and cost effective treatment, and the money to buy it, exists. Yet, Mbeki has resisted the role out of ARVs at almost ever step, despite court cases enforcing him to do so, publicly denied the link between HIV and AIDS and put in place a health minster, Manto Tshabalala-Msimang who has promoted beetroot, african potato and quack’s herbal remedies, over ARVs. A few months ago Manto fell ill and her deputy, Nozizwe Madlala-Routledge, took over. She was a much needed relief, publicly tacking an HIV test in her first week in office and kick starting governments program to tackle the epidemic. This week Mbeki sacked her; claiming a trip to an international AIDS conference in Spain was unauthorised. The press and NGOs have been up in arms in response. So, answering why is Mbeki in denial has never been more pressing.

I went to a talk on Wednesday by someone who doesn’t know either. But she has looked closely at the rise and effects of Mbeki’s denialism. Nicoli Nattrass, a professor in economics, thinks that the most devastating effect has been over the value of science. Under Mbeki not only have alternative therapies been promoted publicly before ARVs but the institutions that should be responsible for protecting the pubic from unscientifically supported medicine have been sidelined. For example it was in 2002 the Medicines Control Council rightly impounded untested pills promoted by an American Matthias Ratth at the port when they arrived, only for the decision to be over turned by the Health Minster. There are a whole series of quacks selling treatments unregulated across the country. Many of the government broads responsible for managing the epidemic apparently lack scientific expertise. This has left patients confused about which treatments work and public health messages based on the science of the epidemic treated with ambivalence.

The actual reasons for Mbeki denial continue to rage. Is it two fingers up to western ideas, part of his African renaissance, accepting only “ Africa solutions to Africa problems”? Is accepting the scale of the epidemic untenable to Mbkei because answering why the epidemic has been so severe in Africa is so difficult and prone to value judgments? Has AIDS hit his personal life? Is he too proud to admit he was wrong in the past? Or does he truly disbelieve contemporary science? What ever the reason is, the way forward is not only to speak out against Mbeki’s denialism and government inaction but also to promote the understanding of science and the institutions which uphold it. For example alternative remedies need to go undergo randomised control trials, and there needs to be much more public education about the epidemic and the reasons for its scientific basis. The professor drew parallels to the Republican war on science in the US and the situation echos the campaign led by Ernest Hart, editor of the BMJ, against quacks at the turn of the 19th century in the UK. Complacency, it seems, about the founding principle of science cannot be assumed at the early part of this century either.

I'm here!

I don't know quite what I expected in my first 48hrs in the country, but possibly not stepping off the plane and into an epicentre of one of southern Africa's most pressing political crisis: the effects of Roberts Mugabe's Zimbabwe!

On Tuesday, I visited Johannesburg's central methodist church. It has become home to over one thousand asylum seekers and economic migrants - the majority from Zimbabwe. During the day the many floors of the church are bustling but apparently at night, almost every floor space and stair well of the 4 floor building is filled wall to wall. This week the UN indicated that the exdous from Zimbabwe is set expected to increase, building on the 3 million people who have already fled the country (about a quarter of Zimbabwe's population). They indicated much more will be need to be done in response - quite!

I was at the church to attend the clinic which runs once a week. My Mum, being a nurse, has recently started helping run the clinic. The church's population have a range of health problems. Many came complaining of colds but some attended with suspected AIDS illnesses and TB, often in the last stages of their disease and having never having seen a doctor before.

Treatment and referral is complex and involves a combination of identifying other friendly clinics, ringing other doctors for favors and negotiating the South African home affairs department to obtain refugee status. Refugee status is important for patients to secure easier access to treatment and increase a chance of finding income and food. For example, one man we saw came in was severely underweight, panting for breath just sitting in the clinic chair and complaining of a cough and night sweats.... TB was highly likely and HIV probable. He was drawn a map to a local clinic that does not charge user fees for HIV and TB testing. Then told to come back with the results to be able to visit a clinic run by the 'Sisters of Nazareth', a Catholic church funded clinic, on the other side of town who could start him on ARVs. Meanwhile he was advised to go 55 Km to Pretoria to start the process of seeking aslyum. There are many personal stories in the South African press.

Politically, it is hard to assess what the impact of the church has been or will be. Locally, there are apparently rumors of discontent about the church being used the way it is, and the bishop is quick to upturn myths about refugees - indicating for example there are enough teachers living in the church to run a small school. Nationally, it has been used, unsurprisingly as an example of a growing humanitarian crisis. In fact, Paul Verryn, the bishop of the church was part a protest about the South Africa government's lack of support for this vulnerable population, earlier this month. But definitions such as refugee are difficult. Legally, many in the church are there often because they simply could not find food in Zimbabwe and so be classed as "economic migrants" as apposed to "well founded fear of persecution" needed to be proved for refugee status. Politically, the South Africa government defining them as refugees and starting "refuge camps" may upset its current attempts to conduct "quiet diplomacy" with Zimbabwe. You can read about the unfolding of the debate here. Meanwhile, the church will continue to be a de facto refugee camp in the heart of the city.

If you're interested in visiting the church too....

.....watch this video, it gives a good insight into life in the church. (yes, no prizes for recognizing the jorno may be related)