Friday, December 21, 2007

Shouting fire? - Botswana Guardian

Do we have a right to unrestricted free speech? Well, most of us would instinctively say that yes, of course we do, we live in a democracy and we can say what we like. Or can we?

Oliver Wendell Holmes, the famed American Supreme Court judge once said in a ruling that “The most stringent protection of free speech would not protect a man falsely shouting fire in a theatre and causing a panic”. In other words there are certain things you can’t say. You can’t shout fire in a theatre if there isn’t actually a fire. We’re simply not allowed to say things that will cause panic or that may cause death, injury or civil disturbance.

So what are we going to do about Pastor Tshifhiwa Irene who visited Francistown recently and who told the crowds that God has decided to end HIV/AIDS in a few days?

According to the Midweek Sun Pastor Irene, who had presumably forgotten to take her medication that day, reported that HIV was caused by a committee of demonic principals, chaired by Lucifer himself, who took blood from a crocodile, a snake, a tortoise and a hyena, mixed it with demonic saliva and blood which then somehow produced AIDS to destroy humanity. There’s no point in trying to understand this deranged claptrap because it’s, well, deranged claptrap.

However I suppose we’re all entitled to our ludicrous opinions. Botswana is a free country where the state isn’t allowed to forbid ideas, no matter how weird they might be.

What I DO object to is when people like Pastor Irene shout fire when there isn’t one. She apparently went on to report that on 20th November God started to roll out his big plan for ending HIV and AIDS and predicted that very soon “All children born of HIV positive mothers will be free of HIV”.

Let’s get our facts straight. There genuinely HAS been a reduction in the proportion of children of HIV positive mothers who were born with HIV and that’s tremendous news. But it wasn’t religion that did that, it was our Prevention of Mother to Child Transmission program. It was PMTCT that took the proportion of HIV positive children born to HIV positive mothers down from 40% to less than 4%. It was PMTCT backed up by rationalism, logic and medical science that did it.

Luckily also present at the so-called prayer crusade in Francistown was the local MP and Government Minister, Phandu Skelemani, who is reported to have said afterwards “She must be out of her mind” and proceeded to ask local politicians “How can any self-respecting leader attend such a misleading service?”

Coincidentally another recent story from Francistown reported that the police were investigating piles of anti-retroviral drugs and hospital cards that were found near makeshift community churches. It seems that encouraged by religious fanatics patients are throwing away their hugely expensive drugs in the hope of promised miracle cures. Cures that of course miraculously don’t ever happen.

I believe very strongly that if only one HIV positive person is persuaded to leave the PMTCT program or to discard their ARVs as a result of what Pastor Irene and her colleagues say then she and her fellow preachers will have blood on their hands. She has gone further than we should accept. Her speech may end up not being free but in fact very expensive indeed.

Tuesday, November 27, 2007

Barry Eustice – a personal tribute

Barry Eustice died last week and Botswana is a slightly poorer country because of it.

Barry was well-known throughout Botswana for his charitable walks, walks that covered Botswana but also other countries, raising many millions for the disabled wherever he went. I’m not going to repeat all the dates, distances and achievements, many others are better placed to report on those. Yes, he got an MBE for his achievements but that wasn’t what impressed people.

Barry was a role model, a demonstration of the spirit that can overcome the greatest of disabilities and was living proof that whatever fate throws at you there is always room for a smile. Well, in Barry’s case a load of smiles and a few beers as well.

I first grew to know him a decade ago as a regular in the bar at the President Hotel in Gaborone. He seemed to be forever there, sitting on a bar stool, surrounded by friends of every background, often with the Weekly Telegraph crossword half-completed (but not for long). One of the first things he ever said to me was “Who directed Dirty Harry?” “Don Siegel”, I said. We knew then that we had each met someone with the same level of passion for the sort of knowledge that is completely useless but that comes in very useful in pub quizzes and long conversations in bars after you’ve had a few.

A few years ago my wife Kate and I were part of a large team of people that was helping Nomsa Mbere and her followers prepare for her walk across the Makgadikgadi Pans. In order to launch the walk publicly there was a gathering at the Maharaja and I persuaded Barry, as a famous walker, to come along and give everyone an uplifting talk. After a series of, I have to say, rather unexciting lectures up sprang Barry. Within minutes he had the audience eating out of his hand. There were stories of mishaps, accidents, women ending up topless and the occasional President who would come along to wish him well. It ended with Barry doing one of his party tricks. After a comedian’s warm-up he showed us how he could balance one of his crutches vertically on the palm of his hand. “See”, he said, “just because I’m disabled, it doesn’t mean I’m incapable!”

The last time I saw Barry I was sitting in a restaurant with a visitor from South Africa when Barry slowly walked by. He joined us and then I watched as my guest sat open-mouthed as I made Barry share some of his stories. He seemed to have that effect on people. Here was a rather diminutive, elderly-looking, disabled man who would stun his guests with his achievements.

Barry raised the profile of the disabled in Botswana. He raised enormous amounts of money. He bothered government and businesses into donating to charity. He started the Botswana branch of the Cheshire Foundation. Like Leonard Cheshire, Barry achieved what very few of us can hope to do with our lives. He made a real difference to the society he lived in.

In an age of mortals, he was a hero.

Friday, September 07, 2007

A change of career? - Botswana Guardian

I think I’m going to train to be a lawyer. I know 43 might be a little old for a career change but I’ve spent some time recently reading our laws. Some of them like the Collective Investment Undertakings Act are incredibly dull but many of them are fascinating.

One of my favourites is the Penal Code. Discrimination is illegal. Anyone who treats another “less favourably” on the grounds of colour, race, nationality or creed can be fined up to P500 or go to prison for up to 6 months. It’s illegal to deliberately wound anybody’s religious feelings. It’s obviously not illegal to say you don’t believe something someone else believes or even to point out flaws in their belief systems but going out of your way to offend them is punishable by up to a year in jail. So don’t do it OK?

Then there’s witchcraft. Not acceptable. The Witchcraft Act makes it illegal to tell fortunes or to find stolen or lost things using any claim to supernatural power. The thing I like best about the Act is that it refers to “so-called witchcraft”. The authors of the law knew it was all unbelievable hocus-pocus and, quite rightly, outlawed it.

However, every so often the laws take a small step sideways and have, in my slightly humble opinion, erred. For instance the Botswana Health Professions Act, 2001 demands that any health professionals must be registered. All very sensible so far. Doctors, dentists, pharmacists and other recognised professionals like opticians, occupational therapists and physiotherapists all have to prove their legitimacy before they can practice. However the Act then mentions what are called “Associated Health Professionals”. This includes chiropodists who are a logical bunch but then goes on to include homeopaths and acupuncturists. This is a mistake. Those last two professions are based on pseudoscience. There is no real, scientific, rational evidence for either homeopathy or acupuncture. They are both based on rubbish. No clinical trials into their effectiveness have ever shown any real effect. I think it’s an insult to chiropodists to lump them in with charlatans.

Back to the Penal Code. The wonderful clause 92 makes it an offence punishable by a fine of up to P500 to say or write anything that expresses hatred, ridicule or contempt for any person or group based on their “race, tribe, place of origin, colour or creed”. It’s simply illegal to make sweeping, offensive generalisations about people because they’re black or white, born here or elsewhere. We are all given the same protection from being insulted.

Of course none of us have any protection against logical argument and reasoned criticism. None of us deserve any such protection. All of us, every day, are open to criticism of our beliefs, our values and our allegiances. That’s the way of a democracy and we are all VERY fortunate to live in a genuine democracy. Millions of people around the world are dying to have the rights of free speech and the protections we have. The people of Burma, led by Aung Sang Suu Kyi, are struggling to have just a fraction of what we have.

So I’m just very happy to be in a country where free speech is not only respected, it is also protected and encouraged. If anyone thinks I’m talking nonsense I would be delighted to see reasoned arguments saying why. If, however, all people can come up with is that I’m wrong because I’m white then not only are your arguments silly, they may even be illegal!

Friday, August 03, 2007

Alternative medicine can cause alternative illness - Botswana Guardian

It goes on and on. The parade of rubbish, nonsense and drivel masquerading as “alternative medicine”. In the Advertiser last week two advertisements offered something rather special.

Promises. Just promises. Nothing else.

The first was from Lam-Med Health Care. It asked whether we suffer from “Arthritis, Cramps, Cellulite, Muscular Pains, Back problems, Cancer, Poor circulation, Stress, High Blood Pressure, Diabetes, Asthma, Eczema etc”. The solution to all of these problems? “Health through the power of Oxygen Ozone”.

The second, from “Siloam”, asked if we’re suffering from problems including “Insomnia and Headache”, “Sciatic nerve, rheumatism, arthritis” and yet again “High blood pressure”. The solution? “Reflexology and muscle and bone adjustment”. This lot go one stage further and promise that “you will be free from the suffering”. They say that Siloam “is the solution to your problems”.

Where to begin.

Firstly everything offered is known to be utterly useless. In case you don’t know reflexology is based on the idea that the soles of your feet somehow map the structure of your body. They say that if you apply pressure to various spots on your feet it will affect your organs. Squeeze here and your liver will be affected, tickle here and your spleen will be in top-notch shape.

This is nonsense. Every time there has been serious scientific research into reflexology it has been shown to have no more of an effect that having your feet massaged. Of course some of us might like having our feet massaged. It’s not my thing but people say it’s wonderfully relaxing and feels terrific. But that doesn’t make it medicine. It doesn’t make it true.

As for ozone that’s rubbish as well. Not only is there absolutely no evidence that ozone helps with any health problems, there IS evidence that ozone can actually be harmful to our health.

Then there’s the danger of relying on this rubbish rather than things that do work. Like medicine. Medicine based on science. Science that is rational, logical and enlightened. My fear is that some poor soul, suffering from one or other of the nasty conditions mentioned will go to these charlatans and take their nonsensical treatments rather than something that actually works. The risk is terrifying. Instead of taking real medication for potentially dangerous disorders like high blood pressure, asthma and diabetes they’ll take some ludicrous herb or the useless reflexology approach. Who knows what might happen. Someone’s going to die, if they haven’t already.

I’m not going to say that traditional or herbal remedies have no effect. We all know how many conventional medicines come from natural origins. Penicillin was discovered when samples in a laboratory were infected by an air-born mould. Warfarin, commonly used to treat heart conditions, is found in many plants such as sweet clover and even in liqorice.

But the trouble is how unpredictable herbal remedies can be. If I go to my local pharmacy and buy paracetamol I know for sure that each tablet contains exactly 500mg of paracetamol. With herbal remedies, who knows? The only certainly I have is if I use a homeopathic “remedy”. At least with those I know they contain nothing at all!

I think it’s about time that we did something to fix this problem. Luckily we have the tools to act. These nonsensical therapies cost money. That makes us consumers. The Consumer Protection Regulations make it really unwise to offer products where “the supplier promises outcomes where those outcomes have no safe scientific, medical or performance basis”. Reflexology and ozone have no scientific or medical basis. The fantastic news is that they are illegal!

Friday, March 23, 2007

We’re being invaded - Botswana Guardian

No, I’m not talking about Zimbabweans, I think we’re under threat from something much more dangerous than illegal aliens, health charlatans and international consultants telling us we’re doing everything wrong.

We’re being invaded by nonsense.

In the last couple of weeks I’ve encountered several ludicrous ideas. The Scientologists will probably say this is because of alien ghosts in my brain but I blame something much more harmful: the internet.

Several times in the last few weeks I’ve received emails announcing the release of a DVD called The Secret. This DVD, which you’ll not be surprised to learn costs money, tells us that our thoughts can “create reality”. Just thinking that you’ll become a millionaire will make you a millionaire. If you just think that your marriage is going to be wonderful then it will be wonderful. Just thinking that it will rain, will, yes, you guessed it, make it rain. The trouble is it’s not all positive, there’s a negative side as well. We become ill apparently because we think bad thoughts. Presumably we get robbed, raped and murdered because we made it happen with our bad thoughts?

Apart from the cruelty of the message that The Secret delivers, there is of course, the utter nonsense that it comprises. Did we have a drought because we made it happen by being negative? Did the tsunami kill all those people because they weren’t thinking happy thoughts? Did tens of millions of people die during the Second World War because they hadn’t bought a DVD from a bunch of New Agers? Can you make HIV leave your body just by thinking?

Of course not.

I’m a big believer in positive thought but I do recognise it’s limitations. Positive thought alone doesn’t do anything. It’s what results from positive thought that matters. We’ve all known people who have managed to survive illness and adversity and whose positive outlook has made them a great role model but their outlook was just helpful, it didn’t itself cure anything. There is almost always a third factor behind such obvious associations.

Someone who retains a positive outlook when faced with illness is surely the one who is also more likely to improve their diet, cut down on the booze and start exercising? Surely it’s those things that help them live longer, recover more quickly and become healthier?

We get the same thing from all the other purveyors of the “thought makes reality” message. Whether it’s The Journey talking about cell memory, churches telling the congregation that prayer alone will make us rich or the Scientologists saying that we just need to clear out all those pesky aliens from our minds, it’s all the same.

As Oscar Wilde said, the truth is never pure and rarely simple. Our health and wealth are, in fact, heavily influenced by things beyond our control. Of course we can modify our destiny hugely by taking personal responsibility for it. We can work harder, learn something new every day, and listen to genuine, qualified experts when they give us health advice but we can’t avoid the fact that much of what happens in life is beyond the control of positive thinking.

At a more profound level my objection is that so much of this is simply untrue. Cells don’t have memory any more than rocks do. Wealth comes from good fortune for a few lottery winners and the grandchildren of millionaires but mostly it comes from hard work, imagination and talent. As for Scientology aliens in my brain, well, I think they gave up and went home years ago.

Friday, February 16, 2007

Colour blindness

It occurred to me that HIV, wickedness and ignorance all have something in common.

They are all colour-blind.

HIV can’t see in colour. It doesn’t check someone’s colour before it infects them. It doesn’t take a quick peek to see whether it’s about to infect someone black or white. It doesn’t even check to see if someone is male or female. In fact it’s very liberal and totally unbiased. If it didn’t cause such suffering and distress we’d probably admire it for being so unprejudiced.

Wickedness also doesn’t discriminate. It doesn’t decide who to corrupt by looking at their skin colour first. You don’t need to be an academic to see the appalling history of human wickedness.

Adolf Hitler was wicked and white, Idi Amin was wicked and black. Joseph Stalin was wicked and white, Haile Mengistu was wicked and black and Pol Pot was wicked and oriental. Like most serial killers each of them slaughtered largely within their own ethnic group. In none of those cases did skin colour play even a tiny role. They were all just plain wicked. No ethnic group has a monopoly, or even a majority share, in wickedness. In fact it’s fairly evenly distributed. It’s a thoroughly human failing, not an ethnic one.

And finally ignorance. Ignorance knows absolutely no boundaries and unfortunately seems to be present in epidemic proportions. Just take a look at the enormous spread of ludicrous superstitions and crazy pseudo-religions spreading through the world. Whether it follows the decline of regular religion I’m not sure but you can’t avoid the latest nutritional, self-help or other “New Age” lunacy everywhere you go.

I don’t think it’s pushing a point too far to state that willful ignorance has even played a huge role in the disastrous situation the US government got themselves into in Iraq. Pretty much everyone else in the world was saying they shouldn’t try it but their minds were closed and a determined ignorance won the day.

However, it’s not just in the west that ignorance raises it’s ugly head. Just across our border in South Africa their esteemed leaders have regularly fallen into disastrous and (verging on criminal) flirtations with AIDS denialism and the awful German Matthis Rath and his horrible vitamin concoctions that “allow the prevention, treatment and eventually the eradication of today's most common diseases”. Well, they do after you’ve made him rich of course.

It’s not just Rath though. We’ve had the misguided here in Botswana saying they can cure AIDS with apple juice and prayer and others who say that walnuts are better than ARVS. Is it improper of me to call that last one the “Nuts theory”?

It’s not been widely covered here but we had an even more remarkable case of either willful madness or possibly just badness a month ago in Gambia. Their president, Yahya Jammeh, has announced that with his own combination of the Quran and some herbs he found in the forest he can cure people of AIDS within three days. According to the Gambian State House web site (http://www.statehouse.gm) his claims have left medical experts in Gambia “mesmerised and stunned”. Presumably because they knew he’d have them shot if they didn’t look suitably impressed.

My point is simple, if a little long-winded. There IS a strange parallel between HIV on the one hand and wickedness and ignorance on the other, but to assume that any particular group has a monopoly on either wickedness or ignorance is, in my view, wicked and ignorant.

Wednesday, January 24, 2007

Medical malpractice?

Last week Gilbert Sesinyi wrote a response to a letter I wrote. I had objected to his idea that doctors and medicine were the source of our ill-health problems. According to Gilbert all we need is to do is avoid processed food and the “whiteman” and things will be OK.

For instance one of Gilbert’s central ideas seems to be that all organic chemicals are good for us and inorganic ones are all poisons. This is a huge simplification. Oxygen, baking soda and water are all inorganic along with an enormous range of minerals without which we’ll die. On the other hand nicotine, monosodium glutamate and most nerve gasses are all organic compounds. The terms organic and inorganic don’t mean the same as good and bad.

He says that people aren’t living as long as they used to and that this is medicine’s fault. I wanted evidence for this. All we got from Gilbert was an observation that his grandparents lived longer than his parents. Sorry Gilbert but that’s not evidence, that’s an anecdote. It’s a bit like saying that Uncle Albert smoked 20 cigarettes a day, lived to be 90 and therefore smoking isn’t dangerous.

The facts are actually simple. If you exclude the people dying because of AIDS, we are living longer than ever before. It’s our average life expectancy that has decreased and it’s AIDS that did this. Simple as that.

We then had to read Gilbert’s opinion that HIV doesn’t cause AIDS. Instead he says that AIDS is due to poor nutrition, cellphone usage and “the whiteman’s culture”. This is similar to the evil nonsense South Africa has been forced to endure from the revolting Matthias Rath. All you need to do, says Rath, is buy vitamins and AIDS will go away. Oh and if you can buy them from him things will be even better. Well for him they will.

I really do object to this reckless, often paranoid denial about HIV and AIDS. I know people living with HIV and they have achieved amazing feats in coping with their infection, modifying their lifestyle, taking ARVs when required and continuing to be valuable members of the community. The denial movement slaps them in the face.

We should count ourselves lucky that we live in a country that is relatively free of AIDS denialism. Countless numbers of our South Africans cousins have died as a result of it and it’s a tribute to us as a country that our government, our health sector and most of our people have avoided the temptation to blame someone else for our situation and instead have taken some level of responsibility for it ourselves.

While all this got me a little hot under the collar Gilbert’s other assertions just made me laugh. Apparently I’m “a member of the oppressor’s nation, the white people”. Furthermore white people are all “either evil or the beneficiaries of evil”. Why can’t we shed these out-dated notions that categorise people “by the colour of their skin rather than the contents of their character”?

A much wiser man than me once said “Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity”. He also said that “we must learn to live together as brothers or perish together as fools”. He was black by the way, although he did have a very “white” name: Martin Luther King.

Oh, did I mention that my grandmother is 87 and is fighting fit?

Richard Harri-whiteman
A reply from Gilbert Sesinyi in the Botswana Guardian
"Doctors do as they’re taught".
Rest assured a response has been submitted already from this "
member of the oppressor’s nation, the white people".

Friday, January 12, 2007

Be wary of doctors?

I read with surprise and some degree of outrage the column by Gilbert Sesinyi last week in the Botswana Guardian. His piece entitled “Be wary of the doctors” was a startling piece of scaremongering and I think potentially dangerous.

In his column Gilbert suggests, amongst other things, that “the whiteman… is motivated by profit over excellence” and “His ways are surely the ways of death”.

It’s probably best if I gloss over who exactly this “whiteman” might be. I know it’s not me, because I happen to think profit and excellence are equally good things and that they can’t be divorced. Also, with the exception of that snake in my back yard a few months ago I don’t think I’ve killed anything recently.

The worrying thing about what Gilbert wrote was to do with health and the medical profession. Unfortunately much of what he wrote is clearly mistaken. For instance he states that “there is evidence that ancient man lived much longer than modern man”. What evidence? My understanding is that worldwide people are living longer than ever before. It is reckless to suggest that because the average lifespan here in Botswana has dropped into the 30s that this is because of medicine. It’s down to AIDS. It’s because of the medical and pharmaceutical professions that we have ARVs. The ARVs that are helping to increase lifespans despite the effect of HIV, not reduce them.

It’s also mistaken to suggest that doctors know nothing about nutrition. Gilbert asks why doctors don’t tell us to avoid processed food, refined flour and sugar and food laden with pesticides and fungicides. Well, as someone who spent the first half of his career surrounded by doctors I can’t remember ever meeting a doctor who didn’t go on and on about healthy eating. Also, without at least some of those chemicals we wouldn’t actually have any food to eat.

There is nothing inherently wrong with chemicals. Salt is a chemical. Baking powder is a chemical. Monosodium glutamate, otherwise known as MSG, which Gilbert suggests is a poison and “the root of chronic diseases”, is a naturally occurring substance found in tomatoes, peas and in soy sauce.

I firmly believe that we should be skeptical about all things and I certainly don’t exclude medicine and doctors from my skepticism. However we must be reasonable and accept that despite some failures, despite some scandals and despite some people seeing medicine as the solution to all of life’s problems, medicine is why most of us are alive today. Without medicine I probably wouldn’t have lived to an age when I would be grumpy enough to write irritated (and probably irritating) articles for newspapers. My wife would be dead, my eldest son would never have been born and my parents wouldn’t have lived long enough to know their grandchildren.

The solution is, as always to use our brains. If a doctor says that HIV was developed by the CIA in conjunction with aliens that doesn’t make it true. History is littered with the aftermath of charlatan doctors and healers who have brought about suffering and death, but that doesn’t undermine medicine as a body of knowledge and doctors as people who help us live to a ripe old age.

I often think it’s amusing, in a savage sort of way, to wonder who those who oppose medicine would call for if they, or heaven forbid, their children were injured in an accident? A nutritionist or a qualified doctor? I know who I’d want to see in a white coat.