Essay: Written October 31, 1999
convened by Resources Unlimited Foundation, and prepared in early observance of World AIDS Day (December 1)
LISTENING, LEARNING, LIVING
World AIDS Day, December 1, is a reminder of the impact that HIV disease is having on individuals, families, friends, colleagues, neighbors, and on people in communities around the world. Continuing education on ways of preventing the disease—by listening, learning, and living—will help end this pandemic globally and locally.
A recent educational conference/dinner conversation addressed AIDS and related barriers to good public health. Called the isms, the barriers discussed at Good Shepherd Lutheran Church included ageism, classism, heterosexism, homophobia, racism, sexism, others.
The dialogue took the form of 12 formal presentations from among 40 people at one table. Each presentation was on one or more of the isms, followed by informal reflections. Convened by the local municipal board of health committee on AIDS, this third conference happens within an annual late-October series of conferences that offer multiple and pluralistic perspectives on a complex subject.
Perspectives ranged from students to senior citizens, from consumers of HIV services to health and medical practitioners, and from recent college graduates to university professors and HIV research specialists. Dr. Helen Bishop, an organizational specialist and Midwest director of congregational services for the Unitarian Universalist Association, was facilitator.
Offering numerous ways of understanding and preventing HIV—the virus that causes AIDS—the evening discourse explored barriers to good public health, those six isms. In all, the question of how the community can work together to fight AIDS by overcoming the barriers was answered through a combination of broad and specific perspectives—a mix of the global and local.
Dr. Rafael Campo, a specialist in HIV disease and an award-winning author of several pioneering medical studies in public health, is professor of internal medicine at Harvard Medical School. There he convened a summit recently to address how barriers to good public health are major obstacles in prevention efforts. Said Dr. Campo:
The World Health Organization estimates that over 33 million people are living with HIV/AIDS worldwide. The Centers for Disease Control reports that at least three-quarters of a million, perhaps one million, Americans are living with the disease. Oak Park health department statistics show, as one local example of this tragedy, that since 1983 some 145 residents have been diagnosed with AIDS.
There is still no cure on the horizon. Expensive anti-retroviral drug therapy is still way beyond the means of many. Well-targeted and low-cost prevention and care strategies, however, have had a major impact on saving countless lives and stopping the spread of the disease.
These strategies include effective health initiatives in promoting sex education, sexuality education, good nutrition, hygiene, immunization against other diseases, and ensuring that parents know what to do when a child is sick.
Yet these strategies alone cannot succeed without continued work toward (1) a stronger political commitment at the highest levels to a better health care system able to deliver services to all Americans and (2) a greater public demand for action on these and related fronts, particularly finding a cure or vaccine.
A glance back at the fight against polio more than 50 years ago shows that polio is now controllable nearly everywhere around the globe. Strong public/private partnerships overcame natural and human-made obstacles to freeing the world from the disease. In addition to creating a polio-free world, eradication activities strengthened the capacity to tackle other preventable diseases, including such infectious ones as HIV/AIDS and other STDs.
Similarly with the AIDS epidemic, there is need for increased collaboration between the different public sectors which impact on health. Building partnerships with the private sector is also essential. Efforts to eradicate or eliminate diseases are a collaborative effort by partnerships that are global in philosophy and local in process and product. In the past two decades, the epidemic has made obvious this interdependence of word and deed.
It is equally clear that the barriers to good public health prevent an increase in collaborative partnerships. Ageism, classism, heterosexism, homophobia, racism, sexism and other forms of discrimination are barriers to good public health because, by definition, they play off superior-inferior relationships. Clearly discrimination is a social justice concern. As such, it is a public health barrier to the development of programs in care, prevention, education.
Over the course of 35 years of community development education in the nonprofit and faith-based sectors, a central goal of our professional work has been to influence and create environments where individuals can achieve awareness of their authentic power in the delivery of—and the receiving of—appropriate services.
The success of any program or service is directly connected to the self-actualization capacities of both participants and providers. Thus the community is challenged to an ongoing role in understanding and preventing HIV. It is critical, as well, to continue advocating for that medically decisive blow, that once-and-for-all knockout punch to end AIDS, as America did with polio a half-century ago.
P. Promoting ongoing dialogue through educational and prevention messages and strategies to fight the disease at all levels.
U. Understanding better ways to advocate for and support improved program services—their availability, their accessibility, their acceptability.
N. Noting the differing yet similar ways the community responds uniquely to the disease as a major public health responsibility and challenge.
C. Celebrating a sense of shared hope that increased dialogue and knowledge shall overcome the darkness of lives lost and shall be transformed into the light of lives saved.
H. Heeding the dual call for sensitivity to persons with HIV disease and for its eradication once and for all by working in partnership to overcome the obstacles--to keep on keeping on.
Through significant activities—whether past, present, or planned—World AIDS Day is an opportunity today and tomorrow for citizens to continue adding their goodwill voices and efforts to those accumulated worldwide.
Locally annual efforts at home, including the mid-autumn dinner conversation and dialogue which addressed AIDS and the barriers to good public health, are a means of building needed coalitions and partnerships. Together consumers, youth, adults, medical practitioners, health specialists, local networks of service providers, schools, churches, and other organizations can work in partnership to show HIV and AIDS as a public health responsibility and concern.
Rickey Sain and Jim Boushay ___________________________________________
Sain is chair of the Oak Park Board of Health Committee on AIDS. Boushay, collaborator, is a community leadership development specialist at Resources Unlimited Foundation, an education institute in social justice and civic engagement. They are currently working to build a consortium of public/private partnerships that address barriers to well-being and public health. ___________________________________________ |