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Media Huddle: April, May, June
By
Judith King, HIVAN

Out of the muddle of media ?– a huddle of resources

One man's noise is another man's knowledge. Noise is the raw material, information is the refined substance, and knowledge is the pot of gold.

As anthropologist Edmund Leach suggests, one can apply information theory to the study of myths and messages by taking what resonates within us as individuals, bringing our own instincts to the contents, questioning what we think is being posed to us, and remaining unleashed to the prescriptive dogma of any one theory or approach. Once we line up the array and volume of messages, we can discern the structures and patterns of communication that create meaning for us, and that either assist or frustrate our progress to knowledge.

Over the last few years, HIVAN's Media Consultant has issued - for internal use by the Centre's diverse project and geographically dispersed staff - a condensed bi-monthly dossier of the local, national and global issues and developments inter-related with HIV and AIDS, gathering and bundling media reportage and resource references, and tracking specialist analysis and mainstream public opinion.

Having done the work of reaping and radiating this material within our own circles, our objective is to create a wider, deeper concourse for this ?“Media Huddle?” by sharing it in periodic website editorials.

Welcome to the first edition, which features:

• The Wrath Against Rath
• Court Short: De Lille, Smith and their publisher
• Home Testing and Treatment ?– for and against
• HIV and Children ?– orphans' schooling needs and health rights for kids
• Nota Bene: Pope Benedict XVIth and HIV/AIDS
• Guarding and guiding the global AIDS care effort: ?“3 x 5?” Update and AIDS CareWatch Campaign
• Sourcing Resources? An selection by topic focus
• Media Monitoring: the latest MMP Survey findings
• HIVAN writing and reaching out ?– published and publicised items
• Last Gasp : Cause for alarm - The epidemic in India escalates

Read on ?… and do write in with your comments. Judith King: HIVAN Media and Publications Consultant [email protected]

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Foregrounded in the news ?…

"? The Pill vs. the Potato ?– Episode Infinitum:

The Wrath around Rath

In one corner (inter alia) : The TAC, Kader Asmal, COSATU, SA Medical Association (SAMA), SA Clinicians' Society, Medicins Sans Frontieres (MSF), former Deputy-President Jacob Zuma

In the other corner

(inter alia) : Drs. Matthias Rath and Manto Tshabalala-Msimang, Traditional Healers' Forum, Tina van der Maas , Medicines Control Council (MCC), SA National Civic Organisation (SANCO), Anthony Brink, Kim & Delaine Cools

Circumspect coaches : SA Medical Research Council

Horrified reservists : NAPWA, WHO and UNAIDS (staking their claims outside the ring, but loudly nonetheless)

Confused spectators : all South African citizens, of known and unknown HIV status

Ill-advised referees : The media

This has been the focus of countless print-media reports, whether as hard news in the dailies or more in-depth narrative journalism in the weekend papers, culminating in anti-defamation interdict proceedings led by the TAC against the Rath Health Foundation. A crisis in perception and priorities is at hand, and its ontological signposts can be traced through an excavation of relevant reportage catalogued in the HIVAN Print-Media Archive.

Over the last number of years, this feud has generated an ever-intensifying civil war, so to speak, around ARVs as opposed to nutrition and/or natural remedies. The conflict has burgeoned to burst through professional and private barricades, with the scripts unfolding around quotes from the protagonists and antagonists (who vary in these roles across the dimensions of reportage), once again being played out in a court of law.

At the XVth International AIDS Conference in Bangkok last year, the risks of resistance in expectant mothers taking Nevirapine became the trigger. Dr Rath's emergence as a key catalyst for this year's round of the sparring match was showcased at the 2 nd SA AIDS Conference in Durban early in June.

It is not merely the personalities representing the perspectives that fall under the spotlight of incompatibility: the remedies themselves are pitted against one another within a circuitous debate around efficacy, toxicity, contra-indications and side-effects. It is claimed that certain natural substances militate against the active components of ARVs; in turn, the drugs are said to impede the benefits of natural products. Experts from both sides confirm that combinations of the two can fatally overload the already compromised liver function of a patient with advanced AIDS, and in a report published in SA Financial Mail (3 June), the MRC's Unit for TB Operational and Policy Research is concerned about ARVs being dangerous for patients with active, but undetected, TB.

A balanced diet of healthy foods has also fallen into the tumble - in the same kitchen-kit as herbs and vitamins - with Minister T-M vociferously vouching for the medicinal properties of garlic, spinach lemons, onions and beetroot. Unfortunately, the wrestle that this tenacious stand has caused led KZN journalist Liz Clarke to point out, nearly two years ago, that the ensuing polarisation ?“has made ?‘nutrition' a dirty word?”. Similarly, Pat Sidley, a specialist writer in consumer and health services issues, noted more recently that TAC vs. Rath court case is preventing journalists from writing about nutrition for fear of being relegated to one vilified faction or the other.

At this point, stakeholders are cast as being either pro-ARVs or anti-ARVS, a deadly division that brings with it a host of ideological presumptions that have no bearing on the scientific facts and myths relating to either ARVs or natural solutions. It seems now that arguments are developing around whether the polarisation itself is the greatest challenge, and if the agendas behind it are more disturbing that the HIV/AIDS crisis itself (while, of course, they are ALL intertwined).

Award-winning health reporter and researcher Kerry Cullinan questions Sidley's standpoint about reporters' self-censorship in this regard, and highlights instead the enduring difficulty that journalists have in countering ?“editors' perception that AIDS stories are boring?”. Could Cullinan's observation provide insight as to why the various media seem hell-bent on perpetuating these exhaustingly divisive debates and the pugilistic politicking around South Africa 's public health disaster scenario?

The subtle manipulation and over-simplification of terms such as ?“life-saving?” and ?“life-prolonging?”, which in the minds of many could equate to ?“cure?”, are becoming unsupportable ?– and indicate an unproductive and highly damaging game of brinkmanship being played by activist groups from both camps.

As the M & G reported in the third week of June, ?“tensions ran high in earlier court appearances ?… and acrimony entered the final arguments, while supporters of both sides again demonstrated outside the court under the gaze of several policemen?”. A SAPA report encased both Zackie Achmat's allegations that the Rath/THO respondents were ?“experimenting on people?” ?– which is not very different from the charge levelled by the respondents against drug companies and treatment activists.

At another ringside, the newsroom and managing editors are betting the odds on vindication every week, while they place-and-pace the articles that push one picture ahead of another and so perpetuate the game ?– which, for many of them, is way less about the public they serve and much more about their sales and profits.

There is a glaring gap in the discourse being stoked by these forces, literally at the fulcrum of the debate: these statements and press reports are not clarifying, in sufficiently compelling terms, that ARV adherence and efficacy depend upon adequate nutrition, while at the same time, nutrition alone cannot retrieve patients with OIs so severe that they are on the brink of death.

As the bell for each round rings, social e quilibrium is being flung against the ropes, while the Virus itself kneels beside the stricken, doing the final count-down, wondering why we are not learning to play as one team.

Yet, there is light beyond the Technical Knock-Out: it seems that the TAC has done some brainstorming around this, if their advertorial in the Mail & Guardian (and, no doubt, in other newspapers) is anything to go by: it's a colourful, well laid-out educational poster, stating unambiguously that NUTRITION AND ANTI-RETROVIRALS ARE BOTH IMPORTANT. Vital nutrients, whether consumed from a balanced diet or through supplements, AND ARVs, FORM A UNITED FORCE IN REGAINING AND RETAINING HEALTH WITH HIV [my paraphrase] . One fact-flash on the poster states: ?“HIV causes poor nutrition. Poor nutrition makes HIV worse. A vicious circle?”.

Actively promoting nutrition and vitamin support is a first for the TAC, and while the Campaign is not backing away from the fight against the Health Ministry, it is using its position in the spotlight to offer ordinary citizens an understanding of the balance required. Instead of perpetuating the opposition and deriding each other, if only this poster could have issued years ago, perhaps all the labelling, law-suits and many, many lives could have been saved.

Three weeks after the June court hearings, TAC activists took to the wards of the Frontier Hospital in Queenstown , Eastern Cape Province, and in the melee that ensued during police crowd-control measures, scores of protestors sustained injuries. News of this event induced spokespersons from the International AIDS Society to send out an e-forum message calling for ?“More dialogue, less violence?”.

TIME OUT!

The following is not offered to give the ?“HIV kitchen klastch?” the last word, but readers might be interested in this e-forum posting that describes clinical trials being conducted on intra-vaginal lime juice as a natural microbicide:

http://www.aids.net.au/lemons-news-29-04-05.htm

" COURT SHORT: De Lille, Smith and publisher sued over HIV status disclosure without consent of three named women:- coverage in The Witness (26 April), Business Day (28 April), City Press (15 May), to name very few. The judgement ruled that ID leader Patricia de Lille and journalist Charlene Smith are not to blame for including the names of three HIV-positive women in De Lille's biography, but the publishing house has been ordered to pay compensation to the plaintiffs.

So ?– in a landmark case about individual rights and the ethics of HIV and AIDS, High Court Judge Ivor Schwartzman found no liability attached to the defendants, but awarded damages in the amount of R15 000 to each of the named women for emotional distress. According to the Judge, the authors had the right to print the names, because the plaintiffs had signed a written consent form to this effect, but despite this, ethically, their rights to privacy had been infringed by the publisher, whose duty it was to ensure that the book took into account all of these considerations before publication. This is important for all of us involved in media, publications and communications , whether of specialist research, artistic applications and interventions, or mainstream reportage. Let's always look at everything before we leap!

3. HOME TESTING AND TREATMENT ?– FOR AND AGAINST

a) The sale of HIV test kits at supermarkets: Business Day (23 May), The Citizen (25 May), The Witness (26 May). Although home-testing could provide more options for privacy, the Pharmaceutical Society of SA has joined SAMA in criticising this practice, pointing out that the home setting does not ensure the appropriate, extensive counselling and support so needed to bolster the individual, whether he or she tests negative or positive. In some cases, tests might be conducted in the home under threat or force. Doctors regard the kits as technically reliable, but not in untrained hands.

"? ARVs distributed by post and courier: In a letter to The Mercury (20/5), a Melmoth pharmacy owner warned that ARVs funded by the Bonitas Medical Scheme's ?“Aid For AIDS?” programme were no longer being dispensed at community pharmacies, but mailed to patients. This measure is seen as a potential threat to their health, as it precludes monitoring of adherence and side-effects, late delivery risks delays in taking the dosages, and the counselling relationship between patients and pharmacists is undermined.

4.

a) ?“Orphans Lag Behind in School?” - Mail & Guardian (13 ?– 19 May) ?– article written by researchers Anne Case and Cally Ardington (both attached to the Africa Centre for Health and Population Studies in northern KZN). In investigating the questions around the fairness of providing special services and grants to orphans when many households with parents are as poor, the study reveals that orphans are indeed uniquely disadvantaged on a number of levels. Deficits in their education are the focus of this research.

b) ?“Health Rights of Children Not Being Met?” ?– The Witness (1 June 2005) ?– release of a discussion paper based on a study done at UCT's Children's Institute entitled ?“ARV roll-out in South Africa : Where do the children feature??”. The CI analysis of the national ARV plan notes that it lacks measures to meet the specific counselling needs of children with HIV, and that age- and development-appropriate guidelines for disclosure and confidentiality are missing from the plan.

Quick-stats: Health MEC Peggy Nkonyeni told the provincial legislature on 30 May 2004 that at least 900 HIV-positive children are on ARV treatment in KZN.

5. NOTA BENE - Pope Benedict XVIth's election - implications for HIV/AIDS and sexual health education: evolving media analysis generated outspoken concern that the anticipated conservative stance of the new Pontiff on issues such as sexual abstinence, condom usage and abortion ?– as well as the patriarchal norms still prevalent in the Catholic Church ?– would act as a polarising force amongst its followers across the globe. These fears seem to have been realised, as the Pope's earliest addresses on these issues have raised the ire of HIV/AIDS interventionists, (many of whom are Catholic).

In a speech to African bishops on 10 th June, the Pope said that abstinence and fidelity are the only fail-safe ways of preventing the spread of HIV, while the ?“mentality of contraception, abortion, prostitution and human trafficking?” was threatening the source of hope and stability in African life [ GENDER-AIDS, 16 June]. Ugandan President Yoweri Museveni has called on the Catholic Church to drop its opposition to the use of condoms, ?“not to support immorality ?… but if the Church is really interested in having its followers live?”. [ IRIN PlusNews, 16 June ]

An activist from SAfAIDS in Zimbabwe points out that fidelity only works where all partners are negative, and questions that the Pope has not yet pronounced on pre-marital HIV testing. [ GENDER-AIDS, 20 June ]. There is also a call for the Pope to lead an RC response that would understand condom usage as being protective of human life, and therefore congruent with the Church's teachings.

Follow more of these opinions in the e-forum debate on ?“Abstinence-only Fails to Respond to HIV/AIDS Prevention?” via:

[email protected]

6. Guarding and guiding the global AIDS care effort :

3 X 5 WHO/UNAIDS Report on access to ARV treatment <> AIDS Care-Watch Campaign

While the WHO Director-General Dr Lee Jong-Wook announced on 29 June that ?“the movement to expand HIV treatment access is making substantial progress?” ( note that movement to expand is not the same as access in actuality ), the AIDS Care-Watch Campaign challenges the two UN agencies to

"? clearly acknowledge the failure of the ?“3x5?” target, and

"? accelerate policies and programmes for access to alternatives

for those who are ill and dying while waiting for ARV treatment.

Marcel van Soest, Executive Director of the World AIDS Campaign, says: ?“What about the people dying now? Why are we talking about universal access by 2010 when we could not even reach the goal of 3by5? There are many simple, concrete care and treatment options available to keep people alive now; we need to provide them with a comprehensive health programme. Focusing only on ARVs is too narrow.?” Dr N M Samuel of the Department of Experimental Medicine and AIDS Research in Chennai , India , lists among these measures the provision of regular prophylaxis and treatment for opportunistic infections, and of nutritional supplements.

The threads of this debate can be interwoven with our national scenario, once again drawing one into the TAC/Manto/Rath/THF wrangle over nutrition, natural remedies and ARVs. The TAC's sub-campaign slogan in this localised context is ?“Treat 200 000 by 2006?” .

For the full debate around the WHO/UNAIDS press release, as well as the most recent global treatment enrolment stats, link up to:

[email protected] ; for more information about the AIDS-Care-Watch Campaign, go to www.aidscarewatch.org .

Sourcing resources? Try these ?…

www.empow.co.za : Empowerment Concepts ?– multilayered training and facilitation modules that cover aims, ethics, methods of empowerment for any individual, group or community with general or specific needs in relation to health and HIV/AIDS. Models developed by David Patient and Neil Orr.

New MRC Report: Estimates of Provincial Mortality Find the report at:

http://www.mrc.ac.za/bod/estimates.htm

Rob Pattman (Sociology, UKZN) gave a Gender Studies Seminar during May on: ?“ Resources for Promoting Gender Equality through Education in the Context of HIV ?”, the focus of which was a learner-centred approach , building on the idea that the very lives and identities of learners themselves provide the resource-base for strategy development. Rob kindly provided me with a copy of his paper, as well as a LifeSkills Training Manual and Module for Educators he co-authored with Fatuma Chege for UNICEF.

Download these materials from the HIVAN website here: https://hivan.org.za/arttemp.asp?id=4328

Asiphile (Let us Live) = a landmark board-game designed to enable children, parents and teachers to talk about the disease and other sex-related topics. Launched at the start of KZN MEC for Education's HIV/AIDS Roadshow, Ina Cronje described the game as a ?“positive form of entertainment, for learning and having fun, educational but not boring, helping children and adults to respect each other and themselves.?”

For more information, contact the reporter at The Witness : Kavith Harrilall on [email protected]

Amnesty International urges a stronger movement towards human rights for nurses and midwives , and in advance of the Congress of the International Council of Nurses in Taipei, issued a Public Statement (19 May 2005) to this effect, linking the global problem of violence against women with HIV and AIDS to the challenges and opportunities they bring into daily work and lives of these caregivers. AI believes that nurses and midwives themselves not only need special care and protection from abuse, but can be strengthened to protect the rights and interests of patients, and so contribute to a more just society.

www.amnesty.org/health

HIVAN's Media and Publications Project (MAPP) is also archiving Nursing Update , published on behalf of DENOSA, the Democratic Nursing Organisation of South Africa, which covers numerous topics relating to caregivers' experiences of the pandemic and its consequences for their professional and personal lives.

?“CD4 ?– Levi's Originals?” - Songs for AIDS = Levi's and Music (Sony BMG) have joined to produce a compilation album featuring some of SA's best artists performing 15 unplugged tracks. Proceeds of the CD sales go to the TAC. [ Note ?– the Media Office does not have this CD in stock ?– this is a referral only ]

Migrant Group Attitudes Towards Sex: Hosted by the AF-AIDS e-forum with assistance from the European Union, a very interesting structured discussion on how migration and population mobility leads to increased HIV/AIDS vulnerability in southern Africa [with comparative views from other regions such as Asia], and in turn, how HIV/AIDS influences migration and mobility patterns in Africa. Among other issues raised, there is input on different attitudes among men and women who are on the move, how they view the need for sex and for each other, the ABC prevention approach, transactional and coerced sex, limited options, cross-border trading of sex for services and many other topical ideas.

e.g. from Daniel Kanyembe = Researcher [email protected]

?“THE CORE FACTOR IS HOW AN INDIVIDUAL PERSON VIEWS SEX, WHETHER AS INDISPENSABLE OR AS ONE OF THOSE NEEDS THAT CAN EASILY BE SUBSTITUTED?”

eforums.healthdev.org

Representation of women and men in the media

Media @ SAfm ?– 22 May 2005?

Gemma Harries and William Bird of the Media Monitoring Project were interviewed about the latest MMP report, which assesses media coverage of the 16 Days of No Violence Against Women and Children Campaign 2004 .

The key findings of this quantitative and qualitative study show that, through the duration of the Campaign (ending on World AIDS Day, 1 December 2004):

* An unprecedented number of female sources in relation to males:

Female = 46% Male = 54%

* A dramatic increase in the number of stories about gender-based violence, and women / child abuse stories, as compared with MMP research conducted in 1998. Also, in contrast to the picture painted in the media then, women are no longer presented as voiceless, helpless creatures needing support from their male abusers, but as independent human beings narrating their own lives and experiences, with hope for a better future and progressing in solidarity with others.

* 55% of all stories were written by female journalists.

* 20% of all topics focused on child abuse.

* 6% of topics focused on positive advocacy efforts.

* An overwhelming majority (35%) of items on violence against women centred on sexual assault, femicide, domestic violence, murder, sexual harassment and gender-based violence.

* A number of media outdid themselves in support of the Campaign, while other ignored it completely. Interestingly, the Sunday Times , Sunday Independent and Mail & Guardian were assessed as having marginalised the Campaign.

* A greater diversity of roles for women was messaged in the items = women were more often portrayed as survivors rather than victims of abuse, with men as perpetrators. The voices of women telling their own stories served as inspiration to others to speak out. In terms of sources, women featured (in descending order) as victims, parents, government figures, activists, and perpetrators, while men were described as perpetrators, government figures, victims, SAPS and legal representatives.

* There was a clear effort by the media to include men in the Campaign. This is a heartening move to an intelligent rendering of the benevolent power of men to restore and uphold human rights and responsibilities, through responsible fatherhood and caring partnership with women.

* A discernibly positive trend towards partnership between media, government and civil society emerged as a critical success factor for the 2004 Campaign.

Other monitoring exercises conducted by the MMP have confirmed HIVAN's Media Office perceptions (reported in earlier Monthly Media Round-ups) that there were vastly more articles and focused media programmes on the aims and effects of the 2004 Campaign than ever before.

For useful stats and analysis of the technical and ethical issues involved in media coverage pertaining to women, men and children, go to:

http://www.mediamonitoring.org.za/news_news.php

HIVAN writing and reaching out ?– published and publicised items

* In the latest MRC AIDS Bulletin (Vol. 14, No. 2, June 2005), Judith King's article ?‘ ?“Listen Darling?” ?– An Afternoon with Paul Farmer' , is featured (pp. 14?–18). For those who could not attend the event, it is a comprehensive record of the dialogue, beautifully presented by the Bulletin editors, using the set of useful links to Dr Farmer's life and work.

* The on-line Agenda publication [Agenda-News] , edited by Christine Davis, republished Judith King's article entitled ?“Empowerment for a Gentler World ?– Charlene Smith's Antidote to Sexual Violence?” . Click here for the full article, if you missed it on the HIVAN home-page:

www.agenda.org.za

* Two articles featuring Dudu Zondi's co-ordination of Community Outreach volunteers attached to HIVAN's Campus HIV/AIDS Support Unit at the University of KwaZulu-Natal in Durban have been published:

= ?“A Circle of Giving?” ?– UKZNDaba, Vol 2 #5, May 2005

= ?“Students Lend a Hand for AIDS?” ?– The Mercury, 6 June 2005, p.10

Last gasp

GLOBAL FUND TO FIGHT AIDS, MALARIA AND TB - EXECUTIVE DIRECTOR, RICHARD FEACHEM ?– has confirmed that India (not South Africa ) is now the country with the highest count of people living with HIV/AIDS. In a Daily News article (20 April 2005), the estimated incidence as at the end of 2003 - according to UNAIDS official figures -reflected SA with 5,3 million infected adults, and children in a range of 4,5 to 6,2 million. India's total was 5,1 million at that time, but the range estimate was far wider: 2,5 to 8,5 million ?– reflecting the many unquantifiable prevalence factors present there. Said Feachem: ?“The epidemic in India is growing very rapidly out of control. There is nothing happening there today that is big or serious enough to prevent it; without action, millions and millions and millions of Indians are going to die.?”

Last year, some were describing this prediction as ?“alarmist?”.

Now the global alarm bells are ringing, but too late?…

Judith King
Media and Publications Consultant
HIVAN Communications, Arts and Advocacy Unit
30 June 2005