Issue X – July 2009

• Introduction
• Announcements
• Opinion – Tour de Force for a Better Healthcare System, by Ariel Rojas
• In the News
• In Other Words

INTRODUCTION

While the summer weather has gotten off to a bit of a cool, slow start, Transdiaspora Network is hot, hot, hot! We are proudly expanding our reach, and the community is beginning to take notice. Hop on over to our community blog to check out a new post by Joshua Cohen about HIV prevention efforts in other parts of the globe.  Keep reading to learn more about our latest grant awards and other accolades. We are excited to announce that our second annual End of Summer Caribbean Dance Party will be on August 27 at Boucarou Lounge. Stay tuned for details!

Everyone at TDN extends their heartfelt congratulations to Carib Youth Society members Brandon, Shanhai, Gena, Christal, and Liza who graduated from Paul Robeson High School on June 25.  Shanhai had the honor of sharing some inspiring words with her graduating class. “Everyone always says enjoy your high school years, as they will be the best years of your life. I am not sure this is true, but one thing I have learned over the past four years is that we determine our own future. If you choose to, you can make every year your best. And this is one thing our graduation from high school will certainly offer us: the opportunity to make more choices.” As though echoing Shanhai’s sentiments, Brandon is well on his way to fulfilling his dream of becoming an actor, thanks to his recent admission to the prestigious New York Film Academy. We wish them the best of luck and look forward to hearing about their future endeavors. See the photos here.

Our work doesn’t slow down, even in recession. While we’re all trying to figure out how to do more with less, TDN would be grateful for your tax-deductible support to help us fund our fall youth programming. Click here to donate.

Susan Wile Schwarz, MPH
Communications & Research Director

ANNOUNCEMENTS

Rojas Honored at YouthBridge Banquet

On Monday, June 15, Transdiaspora Network’s Founder and President Ariel Rojas spoke at the YouthBridge-NY End-of-Year Banquet at the CUNY Graduation Center. On behalf of TDN, recipient of last year’s Shared Resources for a Shared Future grant, Rojas thanked YouthBridge for the many accomplishments the grant helped TDN to achieve, including the Carib Youth Society trip to Vassar and production of an educational video to engage their peers in the program. Rojas explained, “the grant was instrumental in helping us build out the uniqueness of our programs, which represent a fundamental shift in youth empowerment and HIV prevention.” But according to Rojas, the true value of the grant is not just the money. “It is about staying ahead of future challenges and obstacles and learning by doing.”

Call to Action: HIV is Not in Recession
While President Obama’s 2010 budget showed a real, positive change from the previous administration, there are critical areas regarding AIDS policy where the budget did not go far enough.  Advocates for Youth joined with organizational partners to ask Congress to improve the federal HIV/AIDS budget in three additional ways: remove the ban on syringe exchange funding, provide full funding for AIDS housing programs, and pay its fair share to fight global AIDS.  For more information on each of the issues, click here.

Because budget decisions are being made now, call Senate Majority Leader Harry Reid (D-NV) and Speaker Nancy Pelosi (D-CA) today and tell them HIV is not in recession. Click here for detailed call-in instructions.

TDN Awarded Leading by Giving Grant
Transdiaspora Network has been named the recipient of the 2009 We Are All Brooklyn Fellowship’s Leading by Giving Grant. The grant was presented in a formal ceremony at the Brooklyn College Conference Center on July 16.

In selecting TDN as grant recipient, the committee cited our tremendous impact on youth in Brooklyn. The grant committee expressed their belief that TDN has accomplished a tremendous amount and are thrilled to join us in our efforts to strengthen Brooklyn. To see the pictures, click here.

CYS Members Mix It Up at Summer Youth Party

On June 26, members of our Carib Youth Society attended a “School’s Out Summer Party” sponsored by the HEAT Program and the Young Women of Color HIV/AIDS Coalition (YWCHAC). The event was open and free of charge for all NYC youth ages 13-24. The party, which took place at The Lab in Brooklyn, featured music, DJs, food, safer sex educational resources, giveaways, free and confidential HIV rapid testing, and a spontaneous tribute to Michael Jackson’s musical legacy.

KFF Initiative to Mobilize African Americans Against HIV/AIDS
On June 27, the Kaiser Family Foundation launched a national effort to mobilize African Americans to prevent and reduce the further spread of HIV/AIDS. Organized by the Black AIDS Media Partnership, a coalition of leading media companies, in collaboration with the CDC’s Act Against AIDS campaign, the Greater Than AIDS initiative broadcasts public service ads to help strengthen a sense of community response by African Americans to the HIV/AIDS epidemic. Launched to coincide with National HIV Testing Day, the initiative focuses on six actions: being informed, using condoms, speaking openly, acting with respect, getting involved, and seeking testing and treatment. The first wave of Greater Than AIDS content will include radio, outdoor, print, and online messages. Television content is scheduled for release in the fall.

According to KFF, AIDS has disproportionately affected African Americans, who today account for nearly half of new HIV infections in the United States despite being only 12% of the population.

“The central idea behind the campaign is to remind us as Black Americans that we are greater than any challenge we have ever faced, and that we are Greater Than AIDS as well,” said Black AIDS Institute founder and CEO Phill Wilson. “It is about a shared responsibility in the face of AIDS — and hope for the possibility of an HIV-free future.”

HIV-Positive Woman Jailed Then Freed Because of Pregnancy
An HIV-positive pregnant woman has been embroiled in a legal battle in an effort to stay out of prison in Maine. The 28 year old, who is originally from Cameroon, was sentenced to 238 days in prison by a judge trying to protect her unborn child from being born with HIV. In a confusing turn of events, a coalition of mobilized AIDS activists, including the National Advocates for Pregnant Women and the Center for HIV Law and Policy, secured the young woman’s release on the very same grounds as her original imprisonment: to protect the unborn child. An amicus brief filed prior to a bail hearing on June 15 outlined the hurdles to meeting necessary care for HIV-positive pregnant women in even the best of prison health care systems. Because of concerns around the continuity and quality of health care, the presiding judge released the woman on bail. At the time of her release, the young woman had been imprisoned for nearly six months.

Crown Heights Leadership Training Institute Graduates New Crop of Leaders
By Mollie Spevack, Crown Heights Community Mediation Center’s Special Project Coordinator

On Tuesday, June 30, 19 community members graduated the Leadership Training Institute of the Crown Heights
Community Mediation Center. The event was attended by over 60 community leaders, friends, and family members. The graduates were recognized with citations, and certificates.

Graduates represented a diverse subsection of the community, varying in age, race, and religion. According to new graduate Janelle Welch, “[the Institute] honed our skills in networking, coalition building, grant writing, media strategies and event planning to name a few…even more importantly we learned how to work together despite our racial, religious, and social backgrounds to help a community in need.”

Throughout the Institute, members participated in community projects, including attending Shabbat dinners at the Wasser household, keeping their oral history alive through help of Transdiaspora Network, community partner of StoryCorps, and learning about diversity with the Anti-Defamation League.

Another graduate, Ari Kievman, described “the remarkable way” that the program “fostered cohesion in the group, cohesion both in formulating the end-goal and the process of attaining it. [He] saw how [graduates'] very differences can be used to the advantage of having more perspectives and out-of-the-box thinking.”

Volunteers Needed for Gender Identity Study
The New York State Psychiatric Institute at Columbia University is recruiting research volunteers to participate in an MRI-based study on the origins of gender identity and the brain. Volunteers ages 6-20 years who show variation in gender identity, who have been diagnosed with Gender Identity Disorder, and people with typical gender identity are invited to participate.

Children age 11 and younger who participate will receive a gift certificate to Toys ‘R’ US, and children age 12 and older will receive a check, worth $120, as a thank-you for participating in the MRI study.

Call (212) 543-6072 or (212) 543-5299 or email mristudy@childpsych.columbia.edu for more information.

Sunday Retreat at the River
On July 12, Ariel Rojas, new Youth Affairs Coordinator/Community Liaison Carlton Gomez, and CYS member Niambi went down to Red Hook’s Louis Valentino Jr. Pier to enjoy Brooklyn’s natural environment by kayaking along the river and to connect with one of the most quintessential elements of the Caribbean: the sea. Following her first kayaking experience ever, Niambi expressed her amazement that “Brooklyn even had that kind of stuff.” The team also walked around this eclectic neighborhood to discover the very local taste of Steve’s Authentic Key Lime Pies, industrial warehouses, and the community of artists living in the area. Click here for the photos.

OPINION: Tour de Force for a Better Healthcare System

By Ariel Rojas, TDN Founder and President

Health policy reform is making headlines these days while President Obama pushes for new healthcare legislation that moves away from terms like “rationing” and “managed care.” The president proposed instead that the best way to drive down healthcare costs is to persuade doctors and hospitals to emphasize quality of care over the quantity of procedures. However, it will be difficult for him to start from scratch and put away the foundations of the system, which conceptualize health from a “revenue and profit” framework rather than as a social investment.

One could ask why the American public is battling still to afford the kind of healthcare system other developed nations put in place long ago.

According to Daniel M. Fox, who served in two state governments, U.S. health policy has been influenced not only by the politics of economic productivity, social justice, and demographic change, it has been guided also by perceptions of how to control disease and the development of medical interventions to mitigate diseases’ effects. In Fox’s view, policymakers have stopped analyzing organizational and financial arrangements in epidemiological terms due to the increase in life expectancy. The major task now is managing the long-term disabling consequences of chronic disease.

According to Fox, by the 1920s, health policy priorities had shifted to maintaining the supply of services to treat and prevent disease and subsidizing the demand for these services. Optimism about medical science spurred leaders of government, business, and philanthropy to allocate funds to increase the supply of medical services. The education of physicians and surgeons became more extensive and expensive.

By the 1960s, hospitals and specialized services had absorbed much of the health budget’s money because the spending priorities were focused on the prestige of medical specialists and professional compensation. By the 1990s, the unrelenting growth of healthcare costs persuaded policymakers to begin taking the political risks required to challenge special interest groups. According to Fox, much of the inflation in health budgets was a result of the perpetuation of hierarchical organization for acute care.

The weakness of Fox’s argument lays in his belief that the American healthcare reform is driven only by collective buyers (private employers and government) who force physicians and hospitals to discount their prices and who demand greater accountability from them.

Uwe E. Reinhardt, Professor of Economics and Public Affairs at Princeton University, argues that there is no reason for the U.S. to devote a huge percentage of its GDP on health spending because the country is considered to be among the youngest nations in the industrialized world, along with Australia and Canada. In spite of such spending, a substantially higher proportion of Americans express extreme dissatisfaction with their health system than do those in other nations.

Reinhardt questions how other countries (i.e. France, Germany) with much older populations manage to spend so much less on healthcare than the U.S. For him, the problem lies in the lack of interest in exploring healthcare system innovations that may be imported from other nations. He believes that our healthcare system remains so expensive and resistant to change from the bottom up because executives do not have to compete with lower-cost foreign rivals in the healthcare market. In addition, sound health policymaking is hampered because of the power of special interest groups.

He asserts that even though we have applied an “evidence-based approach to clinical practice and research, healthcare reform won’t be possible without comparable research on evidence-based administrative practice – a big challenge in economic terms that has not been taken seriously by Congress.

Reinhardt suggests a turning-point solution: encouraging policymakers to induce healthcare providers from high-cost areas to adopt more modest and effective practices modeled after best practices in lower-cost regions. He makes an excellent observation by putting the allocation of real resources at the center of the actual debate, so we should focus on the transfers that are actually needed to render adequate care to the elderly. Reinhardt criticizes the fee-for-services system because it prevents the population from being able to access better quality services. As he says, it seems odd that the medical system uses the taxes paid by some members of the working population to increase payments to other members of the working population (i.e. doctors).

Most of the healthcare spending is actually quite valuable (i.e. Medicare); however, its shortcomings are due to substantial misallocation of resources. Many services that are provided are not worth their cost, and many services that are valuable are not provided.

Some experts, like David A. Cutler, see three classes of reform proposals: financial reform, control cost reform and choice-based insurance reform. At the end, none of them is as effective as they should be. In Cutler’s view, in the world of healthcare where problems of making second-best choices are endemic, this is no surprise. Nevertheless, the healthcare puzzle is particularly challenging because of multiple, conflicting goals. The ability of America’s political leaders to balance divergent interests will have a major impact on the American healthcare system for decades to come.

IN THE NEWS

Economic Crisis Hurts HIV Fight: World Bank, UN

The economic crisis has disrupted HIV prevention and treatment programmes, including causing shortages of anti-retroviral drugs, a report by UNAIDS and the World Bank said Monday.

“In 22 countries in Africa, the Caribbean, Europe and Central Asia, and Asia and Pacific, disruption of HIV prevention and treatment programmes is expected over the course of this year as a result of the global economic crisis,” said the report.

Eight countries were already facing shortages of anti-retroviral drugs or other disruptions, added the report, which compiled responses from 71 countries where 3.4 million people receive treatment. It added that in 34 countries, respondents said there is already an impact on prevention programmes. Besides concern over external funding for treatment programmes, job losses and falling incomes are making health care more difficult to afford.

“This is a wake-up call which shows that many of our gains in HIV prevention and treatment could unravel because of the impact of the economic crisis,” said Michel Sidibe, executive director of the Joint UN Programme on HIV/AIDS (UNAIDS).

“Any interruption or slowing down in funding would be a disaster for the four million people on treatment and the millions more currently being reached by HIV prevention programmes.”

[Copyright 2009 AFP]

IN OTHER WORDS…

“Health is not a luxury, nor should it be the sole possession of a privileged few. We are all created b’tzelem elohim — in the image of God — and this makes each human life as precious as the next. By ‘pricing out’ a portion of this country’s population from health care coverage, we mock the image of God and destroy the vessels of God’s work.”

Transdiaspora Network^TM is a New York-based human capacity building non-profit organization conducting HIV prevention awareness and community-based, culturally aware preventive mentoring for a population of youth at high risk. In addition, it facilitates identification of community resources, empowerment based interventions, and educational approaches to increase health literacy. Our Afro-Caribbean Dance Mediation, Storytelling Dynamics and The Carib Youth Society provide solutions that increase self-awareness and assertiveness. For more information about our organization, please visit www.transdiasporanetwork.org.

©Transdiaspora Network, July 2009