Idealism Notwithstanding, an Introduction:
"I have fought the long defeat and brought other people on to fight the long defeat, and I'm not going to stop because we keep losing. Now I actually think sometimes we may win... [People] from our background -- like you,... like me -- we're used to being on a victory team, and actually what we're really trying to do... is to make common cause with the losers. Those are two very different things. We want to be on the winning team, but at the risk of turning our backs on the losers, no, it's not worth it. So you fight the long defeat."
"I have fought the long defeat and brought other people on to fight the long defeat, and I'm not going to stop because we keep losing. Now I actually think sometimes we may win... [People] from our background -- like you,... like me -- we're used to being on a victory team, and actually what we're really trying to do... is to make common cause with the losers. Those are two very different things. We want to be on the winning team, but at the risk of turning our backs on the losers, no, it's not worth it. So you fight the long defeat."
-Paul Farmer in "Mountains Beyond Mountains" by Tracy Kidder
Hello. Welcome. How's it going?
My name is Dan.
Nice to meet you.
This blog will be the chronicle of my adventures as I spend the next ten and a half months as a Fulbright Community Service Fellow in Russia. It will also be a place in which I scribble down my musings on politics, economics, philosophy and social justice, so bear with me. With hope, you will be entertained.
I have derived its title from two sources very central to what I will be trying to accomplish with my time there. The first source, as is quite clear from the epigraph above, is a quote by one of my greatest personal heroes, Dr. Paul Farmer, founder of Partners in Health (PIH), a non-governmental organization which partners with highly oppressed communities to develop community health programs with the same standards of care that one would expect from a medical center in the developed world. I find his work and his ethics quite inspiring.
The second source is an essay I recently wrote for medical school applications explaining my reasons for applying. Eventually, I will figure out how I can put a link to it here. For now, I will simply say that it is about the difficulty I had, working as a case manager for people living with HIV/AIDS in the south Bronx. In the essay, I describe a client with whom I worked whose circumstances were tragic and entrenched. I describe my futile and draining (and, hence, foolhardy) efforts to change them. Ultimately (as it is a personal statement and a capstone lesson is required), I learned that "idealism notwithstanding, I am only as useful as the skills I possess and the energy I can harness to them." Knowing about and being inspired by the work of Paul Farmer, PIH and other social justice heroes does not allow me to effectively partner with those for whom the political and economic systems in which we live mostly provide misfortune. I must become skilled in an area or areas needed the misfortunate, and I must overcome my own psychological and social barriers to doing this work.
In this blog, I will describe my adventures (and misadventures) in trying to simultaneously apply the skills I have and develop those skills further in a context abound with potential misfortunate partners. As I have it planned, I will be helping to develop a case management program for people living with HIV/AIDS (PLWHA) in Samara, Russia. PLWHA in Russia face extraordinary stigma. Most people in Russia do not realize there is an epidemic there, though it is the fastest spreading AIDS epidemic in the world. The average Russian does not understand the transmission of HIV or the difference between HIV and AIDS. Furthermore, since the epidemic has been driven mostly by intravenous drug use, many PLWHA face the combined stigma of being HIV-positive and being a drug user. A well-researched Human Rights Watch report (I need to figure out this linking thing) has documented that many doctors and nurses in Russia are verbally abusive to HIV-positive patients and refuse to treat them.
My hope is that the case management program with which I will work will be tool to help PLWHA overcome this stigma and get the medical care they deserve. I also hope to use this program to empower PLWHA to become involved in the decisions made by politicians that affect their lives.
While in Russia, I will also be doing some research. I will be taking a close look (through literature review, interviews, surveys and, of course, participant observation) at the interactions both local and international non-governmental organizations have with other sectors of society. I would like to see how they are viewed by and what influence they have on government, the healthcare establishment and members of the communities targeted by their programs. In particular, I am interested in seeing how they may be facilitating "community consultation," a role prescribed for them by the UN General Assembly during their "Special Session" on AIDS in 2002.
As a foreigner, my social capital will be skewed. To some, I will be an unwanted outsider, trying to intrude with my imperialist Western ways. As an American this will be amplified not only by the recent global upturn in anti-Americanism, but also by the recent tensions between the U.S. and Russia over the Orange Revolution in Ukraine and various subsequent events. To others, I will be a powerful asset, with a working knowledge of how things are done in a community that has been facing the virus for 25 years (and the backing of the U.S. State Department).
It is hard to predict how discrepant my experiences will be from what I now expect. I am sure that many of the things I expect to see both from what I've read and what I experienced in my previous two months in Russia will be confirmed. But, then, one cannot travel without encountering as many surprises as fulfilled expectations. I do suspect it should be interesting.
So read on, stay tuned, etc.
Hello. Welcome. How's it going?
My name is Dan.
Nice to meet you.
This blog will be the chronicle of my adventures as I spend the next ten and a half months as a Fulbright Community Service Fellow in Russia. It will also be a place in which I scribble down my musings on politics, economics, philosophy and social justice, so bear with me. With hope, you will be entertained.
I have derived its title from two sources very central to what I will be trying to accomplish with my time there. The first source, as is quite clear from the epigraph above, is a quote by one of my greatest personal heroes, Dr. Paul Farmer, founder of Partners in Health (PIH), a non-governmental organization which partners with highly oppressed communities to develop community health programs with the same standards of care that one would expect from a medical center in the developed world. I find his work and his ethics quite inspiring.
The second source is an essay I recently wrote for medical school applications explaining my reasons for applying. Eventually, I will figure out how I can put a link to it here. For now, I will simply say that it is about the difficulty I had, working as a case manager for people living with HIV/AIDS in the south Bronx. In the essay, I describe a client with whom I worked whose circumstances were tragic and entrenched. I describe my futile and draining (and, hence, foolhardy) efforts to change them. Ultimately (as it is a personal statement and a capstone lesson is required), I learned that "idealism notwithstanding, I am only as useful as the skills I possess and the energy I can harness to them." Knowing about and being inspired by the work of Paul Farmer, PIH and other social justice heroes does not allow me to effectively partner with those for whom the political and economic systems in which we live mostly provide misfortune. I must become skilled in an area or areas needed the misfortunate, and I must overcome my own psychological and social barriers to doing this work.
In this blog, I will describe my adventures (and misadventures) in trying to simultaneously apply the skills I have and develop those skills further in a context abound with potential misfortunate partners. As I have it planned, I will be helping to develop a case management program for people living with HIV/AIDS (PLWHA) in Samara, Russia. PLWHA in Russia face extraordinary stigma. Most people in Russia do not realize there is an epidemic there, though it is the fastest spreading AIDS epidemic in the world. The average Russian does not understand the transmission of HIV or the difference between HIV and AIDS. Furthermore, since the epidemic has been driven mostly by intravenous drug use, many PLWHA face the combined stigma of being HIV-positive and being a drug user. A well-researched Human Rights Watch report (I need to figure out this linking thing) has documented that many doctors and nurses in Russia are verbally abusive to HIV-positive patients and refuse to treat them.
My hope is that the case management program with which I will work will be tool to help PLWHA overcome this stigma and get the medical care they deserve. I also hope to use this program to empower PLWHA to become involved in the decisions made by politicians that affect their lives.
While in Russia, I will also be doing some research. I will be taking a close look (through literature review, interviews, surveys and, of course, participant observation) at the interactions both local and international non-governmental organizations have with other sectors of society. I would like to see how they are viewed by and what influence they have on government, the healthcare establishment and members of the communities targeted by their programs. In particular, I am interested in seeing how they may be facilitating "community consultation," a role prescribed for them by the UN General Assembly during their "Special Session" on AIDS in 2002.
As a foreigner, my social capital will be skewed. To some, I will be an unwanted outsider, trying to intrude with my imperialist Western ways. As an American this will be amplified not only by the recent global upturn in anti-Americanism, but also by the recent tensions between the U.S. and Russia over the Orange Revolution in Ukraine and various subsequent events. To others, I will be a powerful asset, with a working knowledge of how things are done in a community that has been facing the virus for 25 years (and the backing of the U.S. State Department).
It is hard to predict how discrepant my experiences will be from what I now expect. I am sure that many of the things I expect to see both from what I've read and what I experienced in my previous two months in Russia will be confirmed. But, then, one cannot travel without encountering as many surprises as fulfilled expectations. I do suspect it should be interesting.
So read on, stay tuned, etc.
posted by Dan at 2:08 PM
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