IAS and Site Visit

Last week was a very busy week for the m2m office given the International AIDS Society meeting was taking place, with over 5,000 international AIDS researchers descending on the city. On top of sending people to the meeting to learn more about the latest on PMTCT research, the meeting also meant the office had a lot of networking and PR development to take advantage of while the spotlight was on Cape Town.

Wednesday morning I had the opportunity to tag along as m2m organized a site visit for around 15-20 international journalists. These particular journalists were mostly from other countries all over the African continent, and a few were from Europe and Pakistan. We took a bus out to a clinics in Khayelitsha, one of the largest townships outside of Cape Town. Townships are essentially slums where many (in this case roughly one million) black people live in informal settlements. As far as the eye can see, makeshift houses comprised of corrugated metal, boards, plastic sheeting, and cardboard are crowded against one another. In some areas there are government housing projects with real structures built, but in the backyard of almost every real house you still see makeshift shacks, as people can make some extra money by renting out their yards. Somewhere in the midst of this, we pulled up to a government run maternity clinic. It felt strange to step off a bus that was probably 4 times as big as many of the makeshift houses we drove past and parade into the clinic to “see how the other half lives,” but it at least made me feel better to realize these reporters were here to tell the important story of real women’s lives and m2m’s work.

Inside, we met with two mentor mothers and a few of their clients. One mentor mother and all of the clients spoke only Xhosa, so a few Xhosa women from the office had come along to translate. Needless to say, these women who were brave enough to stand in front of 20 intimidating outsiders and tell their stories demanded much admiration. The journalists asked numerous questions. Sometimes I felt uncomfortable with their probing nature, but I suppose that’s what they’re trained to do. I couldn’t help thinking that publicity of this nature is an incredibly fine line for an organization like m2m to walk – while they of course want to expose their work and demonstrate their success to outsiders, it’s hard not to do that without making spectacles of their clients, to some degree. Some women had been living with the virus for many years, some had just recently been diagnosed, some felt they could tell their families, some did not, some had successfully completed the program and had HIV- children, others were less fortunate.

(FYI, even if a mother follows all of the current recommendations for PMTCT there is still a 1 in 20 chance that her child will be HIV+. PMTCT involves taking ARVs (anti-retrovirals) while pregnant, taking extra ARVs during birth, continuing to take ARVs after birth and making sure the baby is on ARVs for a certain number of days after birth, and exclusively breastfeeding. While breast milk can contain the virus, studies have found that in developing countries babies are actually more at risk of becoming sick and dying when they are formula fed because many places aren’t equipped for mothers to have sterile bottles and the babies miss out on acquiring a number of important nutrients from breast milk when access to formula is pricey and inconsistent (resulting in fewer feedings). The worst scenario is when babies are mix fed because the formula is harder on their stomachs, so when they are exposed to breast milk which contains virus, the virus is more likely to gain access to the bloodstream as the stomach lining is compromised. In short, it’s often better to risk contracting the virus from breast milk than to risk getting sick from the lack of nutrients and exposure to germs that occurs with formula feeding in developing areas.)

Most of all, I just kept thinking about how hopeless I would feel in their situation, but when I saw these women standing in front of us speaking of how they wanted to live for their children, I was very moved by their strength. One of the mentor mothers told of how she participated in the m2m program a few years ago when she found out she was HIV+, and how she worked hard to follow all of the procedures to ensure her baby was HIV negative, only to come through it all with her baby testing HIV+. All that was running through my head was despair, but this mother went on to describe how her child has been on ARVs since then and is living a good life, and how with her next child she went back to m2m and he was HIV-, and then she went on to become a mentor mother herself. She was so upbeat about everything and so happy to talk to everyone about her story, it was a good reminder for me to get out of the mindset of everything involving HIV encompass absolute misery. That’s not fair to these women, I realized. At some point, you have to recognize their lives are still meaningful and focus on the positive strives that have been made instead of just writing them off. When we were back on the bus, a number of reporters commented on how the site visit had been the most interesting and inspiring part of their entire experience with the conference.

Whew, I’m actually feeling really frustrated right now as I’m really having trouble finding ways to express how I felt and describe what I saw in the townships, so I suppose these issues will have to wait for some other time…

Wednesday afternoon I was fortunate enough to be given one of the office passes to the IAS conference (registration for the meeting was 400 Euro, so the m2m didn’t have that many passes for everyone to share). It was really eye-opening to be there, even if only for an afternoon. I was amazed at how fancy and large the Cape Town Convention Center was, but I suppose it’s probably the best convention center on the entire continent. I haven’t been to that many scientific conferences for comparison, but this one felt absolutely huge. After listening to a number of talks and browsing through posters for the afternoon, I felt very grateful to have had that kind of exposure to the international AIDS research community – and it definitely made me more even more excited to be heading (eventually) into a research career. A number of pharmaceutical and biotech companies were there too, and their displays also amazed me – enormous flat screen TVs hanging from the ceiling, espresso stations, safari tents – definitely the most extravagant product show I’ve ever seen!

In the evening after the conference wrapped up, Byron, Wenli, Julia, and I found ourselves at a really nice gathering put on by Dr. van der Horst and other UNC researchers who had attended the conference. Once again, the restaurant was very fancy, the food was very delicious, and we were all very grateful for Dr. van der Horst’s kind invitation. We had a lovely time at the dinner, and I had the opportunity to meet a few UNC faculty and students. Witnessing first hand UNC’s relatively large presence at the conference and getting to talk to a few faculty members made me really happy about what I’ll be embarking on next year.

Seeing such contrast throughout the day, it made me think a lot about how money is spent – from pharmaceuticals putting on over-the-top three-day displays halfway across the world to researchers spending thousands of dollars to convene in a pristine, upscale convention center and brush shoulders at a posh restaurants – is that fair to the women I met that very same morning, the women this work is arguably for? Of course I don’t mean to imply that I don’t admire what these researchers have devoted themselves to, and I certainly have no easy answers for how the world should run. Anyway, apologies for rambling…but all in all in all, a very interesting day!