Heading Home

I'm heading to the airport in just about an hour. My flight leaves Lusaka at 2:30 in the morning and I'll stop first in Nairobi, then Amsterdam, and finally arrive home after the fireworks on the night of the 4th of July.

Independence Day has a particularly significant meaning for me this year. Yes, I'm proud to be an American. Yes, I'm proud of the way Americans reach into their hearts and wallets to help those less fortunate around the world. But I can't help thinking about our Pledge of Allegiance. Especially the last line that reads, "With liberty and justice for all."

I know that the Pledge is written for Americans about America. But this year, I also take it as a challenge. I think that we all have the unique responsibility to work toward the day when all people everywhere are free from tyranny, free from hunger, and free from disease.

Is this too much to hope for? I don't think so.

It is, after all, that kind of hope that made the United States of America the strongest country on Earth. With strength comes power. And with power comes responsibility. I'm taking that responsibility seriously and challenge you to do the same.

I'll write again after I get a bit of rest at home.

Karibu

Karibu means welcome in Swahili. Honestly, that is one of the few Swahili words I knew before returning to Kenya for CMMB's press conference. It was important to me, though, to at least attempt to say a few words in Swahili to the gathered media that morning.

So, a week before I left New York for Nairobi, I asked my friend John to translate several sentences for me. That way I could open the press conference with a sense of familiarity. I'll admit this was not an original idea. I know from our trips to Paris that even a few words in French will encourage warming feelings among Parisians. So I figured it couldn't hurt here.

Once everyone was settled in the conference room of the Nairobi hotel, I walked to the podium and addressed in Swahili the assembled members of the press. It was little more than welcoming them, thanking them for being there, introducing the reason for the conference, and finally, letting them know that I had exhausted my extent of their language. To my surprise, the room erupted in applause.

Sure, it was an ego boost to have journalists applaud. I'd never, ever seen that happen before. But more than that, I realized the value of what I'd done. I had bowed to those in the room, greeted them in their native language, and then acknowledged that I knew very little else that I could say in Swahili. It was, it turns out, enough.

What has this to do with public health? Quite a lot, I think. It reaffirms the fact that we Americans have to be careful in the way we approach people in other lands. Our very best intentions can serve no purpose if we don't take into consideration the customs, traditions, culture, and even language of the people with whom we are communicating. Our best efforts to fight AIDS, malaria, TB, infant mortality, even hunger, are of no use if we approach individuals as less than intelligent people.

Whether someone lives in a palace or a hut, has an apartment on New York's 5th Avenue or the slums of Haiti, it is about respecting the person. This must be the first order in making a difference.

I see Dr. Dianne from Haiti, Dr. Salvador in Kenya, and Dr. Moses in Zambia all meeting people where they are. Is it because they are doctors? I doubt it. They are humanitarians first and most importantly. And the first order of being a humanitarian and easing the suffering of other humans is to address people with empathy and respect.

So often in the US we simply don't understand this important principle. Even among our own citizens. We speak ill of those in public housing projects, don't "understand" how anyone can be hungry in the United States, and adopt the "we must take care of our own first" philosophy instead of understanding that everyone in the world is our own.

Is learning a few words in Swahili the answer? Maybe it is. It at least humbles one enough to say, "I respect you and am willing to meet you where you are." Easier said than put into practice, but practice we must.

Way Down Upon the Zambezi River

I walked alone along the bank of the Zambezi River yesterday. Walking on the Zambia side, I saw a few children tempting fate and crocodiles by splashing in the cool water, a few men hauling in lines of fish, and little more. Looking across the river to Zimbabwe I spotted several playful monkeys and a heard of something that looked like reindeer.

It was a beautiful walk. It was so easy to get caught up in the serenity of the setting that I lost track of time. Wandering back to meet my colleagues, I realized that the serenity I was sensing was mine. Many people in villages within walking distance of where I stood were not gazing upon the mighty river with a postcard sensibility. Instead, they were trying to live lives ravaged by AIDS.

This country, particularly parts of Zambia, have a horrible prevalence of AIDS cases. Part of the problem, at least now, is not that there isn't treatment available, but a lack of understanding among men. In a male dominated society, the man has the final word. It's as true for lions as it is for humans. Consider that the male lion spends his day fluffing his mane, doing is best to look manly, while his wife goes out hunting, prepares the food, and takes care of the children. Hmmm. Sounds familiar, doesn't it?

The problem with humans in Zambia, as opposed to the lions, is that men also decide how and if women receive medical care. A lack of understanding, combined with cultural norms, can produce lethal results for individuals and families. And, in the case of rural villages, those results can wipe out most of a village.

That's why I'm so interested in, and excited by, Men Taking Action (MTA), a program designed by CMMB (Catholic Medical Mission Board) to work with men, educate them, and empower them to be true leaders in their families and in their villages.

When my friend, Dr. Moses Sincala, CMMB's Zambia Country Director, explained it to me a year ago, I'll admit that I had my doubts. He told me that they were working with tribal chiefs and community leaders to gather men together for education about HIV and AIDS. "Sounds good," I thought. "But how do you possibly hope to change entire communities' thinking about a disease that is both feared and reviled?

Well, he showed me. This week I had the chance to witness the power of MTA. I saw dozens of men coming together to learn about HIV and AIDS, and more importantly, how to take care of their families and themselves. Instead of relying on loads of printed material and lectures, MTA utilizes the African traditions of storytelling to educate, empower, and move men to action.

Standing 100 feet away from the gathered group, I saw "scenarios" or skits that would, to most Americans, seem more appropriate for a Boy Scout gathering than presented to a group of grown men. But the laughter, applause, and subsequent questions let me know that this seemingly simple technique is producing pretty powerful results.

The men learn the importance of learning their HIV status, and of helping their wives to get and maintain treatment for themselves and their soon-to-be-delivered babies. Another component of the MTA program involves men who are not imminent fathers. In both cases, I was struck by the lighbulbs I saw going off over their heads. The were absorbing the information in a way that would not have been possible if the program relied on slick printed material, cute slogans, or other time-tested techniques used in the United States.

The most telling sign of all was when the session was wrapping up. The community leader who had been moderating the session rallied the men to say together, "Men taking action!" Given that their native language is Tongo, it was impressive to hear these men proclaim their commitment in English. "Men taking action! Men taking action! Men taking action!" The sound rose above that of the rolling Zambezi River. It out shined the native birds singing loudly in the trees. These men were fired up and ready to be true leaders.

The most poignant moment of all came at the very end. The leader asked who would be the first to be tested for HIV. Hands started shooting up, men jumped up from their wooden benches, and soon there was a near stampede to the clinic where they would be tested. I counted 24+ men ready to be tested. This is amazing by any standards.

This illustrates how the attack on AIDS must not rely on those measures employed in the United States. We must take into account cultural norms, traditions, and experiences to reach people where they are. The beautiful thing about Men Taking Action is that it can be modified to address men in many parts of the world. Today my colleagues from Haiti and Kenya are meeting with Dr. Moses to learn from his experiences and to begin tailoring MTA for work in their own countries.

Seeing the resolve in these men to truly take action makes me proud to be a man. It also makes me proud to be a part of CMMB. I'm convinced more and more completely that I work with some mighty smart people. I'm honored to stand in their company.

Awww, Look at the Baby Lion

In David Sadaris' latest book he has a piece about how American are suckers for baby animals. I can't argue the point.

Look at this adorable lion cub. She's 3 months old and was orphaned when her mother was attacked. She is all alone in the world and is living in an animal orphanage.

This little lioness is named Lucy and she is a powerful little girl. She has a fierce growl, but it subsides when you rub under her chin. She's as soft as a fleece blanket. When you look into Lucy's eyes you don't see a vicious lion. You see a scared little baby. It costs a lot to take care of Lucy, because even as a cub she has a great appetite.

It probably wouldn't take much more writing before people would start sending in checks to support Lucy. And why not? She's sweet, adorable, and all alone in the world. Who could resist that beautiful face?

I wonder, though, If I posted a picture of a 33-year-old man or 21-year-old woman suffering from AIDS if it would result in the same response. Lucy is being well cared fore. But that man or woman, particularly in a developing nation, is probably left to fend for him/herself.

Certainly, there are many people who are passionate about caring for those whose lives are threatened by HIV and AIDS. But because it isn't an instant "feel good" cause, we find it easier to support baby lions than we do adults whose only hope lies in the hands of strangers.

I hope Lucy lives a long and happy life. And I'm sure that generous strangers will see to it that she does. Now if we could only make AIDS patients in developing countries look cute and cuddly.

A Reason to Dance

Even a couple of years ago it would have been virtually impossible to find a group of HIV-positive women gather together singing and dancing. Today I witnessed how things really can change for an individual, a family, and an entire community.

I went with some of my Kenya- and New York-based colleagues to be a part of a graduation ceremony for a powerful CMMB program called mothers2mothers-kenya. It was about an hour and a half outside Nairobi. When we arrived and walked into the room, 23 women stood up from their seats and began clapping and singing a song. I don't remember all of the words, but the refrain of the song was, "Thank you, CMMB."

As the morning progressed, I would learn what the women had learned over the past three weeks. And, from some of them, what they've endured over the past few years.

mothers2mothers-kenya is a CMMB program that educates HIV-positive women about every aspect of the disease. They learn what it is, what it can do, how to prevent transmission from one person to another, and from mother to baby. They learned about medications and how to live a normal, productive, active, and healthy life. They learned about balancing the responsibilities of their families and taking care of themselves. They also identified positive and negative things in life, and how to focus on the positive side of the equation.

Through this educational process, the women learn not only about HIV and AIDS, but about themselves. As a result of the multi-faceted education, these powerful women also become empowered. And as empowered women, they stand ready to mentor other HIV positive mothers and mothers-to-be.

But this is more than just community work. It is life changing, lifesaving work that these amazing women will carry back to their homes. They will counsel women and their spouses to explain that AIDS is no longer a death sentence, provided treatment is maintained by the women they are counseling. They will show--by personal example--that women can be HIV-positive and live very positive lives.

They have their newly acquired knowledge, of course, but they also have their own experiences to share. A part of the program encourages the women to be bold, proclaim their HIV status, and lead by example so that others might live.

Can you imagine a group of women who are prepared to battle the stigma associated with HIV in this country standing up and saying, "Look at me!"? They actually did more than that. They didn't shy away from the camera and, in fact, many wanted to tell their stories on camera. The more people who know the facts, they believe, the more families that will stay together.

These newly-minted mentor mothers will become invaluable in the fight against HIV and AIDS in Kenya. The fact is, the true extent of their work will not be known for years. In fact, their positive influence will be so strong that future generations of Kenyans will grow up in a community where HIV is no longer an issue.

Do these women have reason to sing and dance? You bet they do. And the rest of us have reason to rejoice with them. I tried to uploac a video in this post, but had no luck. You would have seen not only the new mentor mothers, but also a Mexican and several white Americans. We are all singing and dancing together because we recognize the commitment that these women have made and the impact that they will have. We also recognize that it takes all of us to make a real difference in preventing, treating, and eliminating HIV and AIDS.

"News" vs. "Information"

I've been in Kenya for the past couple of weeks with colleagues to announce a pretty impressive expansion of CMMB's work here. We held a press conference on Thursday, and the media response was very gratifying.

After the conference had ended, I spoke with a television journalist and asked if he had everything he needed for his story. He mumbled a bit as he began packing his equipment, and then said, "We have everything. This really isn't news, it's just information. We'll do something with it."

I couldn't let that comment go. I wanted to know what he thought to be the difference between news and information. Although I had a good idea, I wanted to hear it from him.

"News," the journalist told me, "is a taxi driver getting shot for a few shillings or a politician getting caught in a sick affair. Helping sick people is information, it's not news. People really don't care."

Hmmm.

My immediate thought was, "Well, buddy, those sick people whose lives are being saved would probably disagree with you. If your kid is dying with no hope, and then some organization offers the opportunity of life-saving drugs and treatment, that's news." But I didn't say that.

I was too busy thinking about the way I read the papers and the things that attract my attention.

I read those stories about politicians and taxi drivers. But the stories of the Boy Scout troop cleaning up a park, a firefighter saving a dog from a hot car, or the children's program at the sr. citizens' center are often the stories I skip.

While I wanted to be angry with the journalist, I actually became frustrated with myself. I'm in the business of conveying information about a superb nonprofit whose only goal is to provide quality healthcare. I want people to understand, appreciate, and support this work. What could be better than saving the life of someone? But how do you help people understand the needs of people in a remote village of Kenya or Swaziland or anywhere else when you have to compete with crooked elected officials and "celebrities" whose biggest accomplishment is staying sober for a few hours?

I don't really have the answer, but I do know I'm not going to quit trying. I think it's time for all of us to start rethinking our definition of what news really is.

Seat of Power (and Hope)

I'd love to tell you about the magnificent animals I saw yesterday here in Kenya. It would be a pleasure to describe in flowing detail the spectacular Kenyan flowers that are visible from my hotel room window. It would be a fun diversion to describe in words the sounds of the amazing birds that I can hear beginning just as the first shards of sunlight pierce the night sky. But these things will have to wait for another day.

Today I want to share with you a concern focused not on Kenya but on the US Congress. It seems that a few senators are blocking action on a new bill that would increase significantly funding to address AIDS, malaria, and tuberculosis around the world.

Many people are alive today because of the people of the United States. The first five years of President Bush's President's Emergency Plan for AIDS Relief (PEPFAR) allowed for US$19 billion to be spent in some of the world's most in-need locations. The new funding initiative would increase funding over the next five years to US$50 billion.

The US House of Representatives passed its version of the bill in April. Sadly, the Senate's efforts are being dogged by procedural uncertainties. Seven Senators--yes, just seven people--have placed a stop on the bill unless and until their concerns. This blockade group, helmed by Senator Tom Coburn of my home state of Oklahoma, contend that the spending level is irresponsible.

Irresponsible? Even if the $50 billion were to be matched or exceeded by other developed nations, it would still not properly finance the treatment and prevention programs required to halt the AIDS epidemic. But we can't throw up our hands and simply walk away.

In a couple of recent conversations with friends, the phrase "charity begins at home" has presented itself. "We have people suffering right here at home," they say. True enough. But we also have effective programs in place to deal with that suffering. I would never suggest that the suffering of one person, or group of people, is any less or more than another. But one need travel less than two miles from my hotel in Nairobi to get a clear picture of what widespread suffering entails.

From the slums of the capitol city here to the remote villages, families are torn apart by AIDS. Certainly CMMB programs, and those of other NGOs, are making a vast difference here and around the world. But it would be a violation of everything this is good and right and moral to allow seven people to block critical funding to continue these efforts.

True, the $50 billion is significantly more than the Bush administration has requested. But it will take that and even more to meet the needs of the world's poorest people infected with and affected by HIV and AIDS.

I'll be back in the US in a couple of weeks. And once I'm back I will make this offer to any of the seven Senators blocking movement of this funding initiative: I will personally accompany you to Kenya or Zambia or Haiti to introduce you to children, women, and men who are alive today because of the generosity of the American people. And while we are there, I'll show you the millions of reasons to move swiftly on this funding. Each one of those reasons has a name and a face.

Please, let me show you first hand why we must do everything in our power as the most prosperous nation on Earth to help those most in need. US dollars translate into hope. Hope translates into health. Health translates into self sufficiency.

Charity may begin at home, but it cannot stop there.

I Want Access & I Want it Now

I arrived in Nairobi last night and checked into my hotel. The first thing I did was unpack my computer and plug in my headset. I'm here in Kenya to conduct a press conference announcing some major, positive developments for CMMB here. So, naturally, I was excited about setting up my "mobile office" in my hotel room. That's where I'll conduct the majority of my business while in Kenya.


After I booted up my laptop, I learned that I could get an Internet connection, albeit a very weak one. So weak, in fact, that I could not access email, could not access my Skype account, could not access much of anything except Tetris and blackjack. While the latter two are certainly worthwhile to have while traveling, they do little to help me communicate with media representatives around the world, my office, and my home.


So at just before midnight, I requested a change to a room where I could have a stronger access to the Internet, and to the programs and files I need. The front desk clerk was most gracious and agreed to move me to another room. Within a few minutes, though, she called back to tell me that the signal would be no stronger in another room; that I should just stay in my room and "try it again tomorrow."


I like to think of myself as a pretty patient guy (although I'm not sure those closest to me would always agree with that), but after 23 hours on planes and in airports, I was less than a patient guy last midnight. To my credit, I didn't say the things I was thinking: "Lady, I respect that it's late. I also respect that Kenya is a developing nation and that I can't expect lightening Internet speeds. But I am paying good money to stay in a hotel that promises good quality Internet connections in every room. I want my access and I want it now!"


Instead, I thanked her and agreed to stay in my room. There had to be some way around this and I was determined to find that way. The first order of business was to pry the dried out contact lenses from my eyes. They'd been in for two straight days and I could barely see through them. I then put on my glasses and set about getting my Internet access.


I should explain that my contact lenses are bi-focal. I don't know how they work, but they do. My glasses, though, are only single vision. I'm too vain to have the line in my glasses and too cheap to spring for the line less bi-focals. So I have to constantly move the glasses from the tip of my nose, back to the bridge, take them off, put them back on, back to the tip of my nose, and so on. This is just to dial a telephone number. So you can imagine what it was like wandering about my hotel room trying to find a sweet spot with a stronger wireless signal.


I moved from the desk with my laptop in hand. I stood up on the bed and tried the connection from there. No luck. Next I went into the bathroom. Standing in the shower offered one signal bar strength better, but I've never been too comfortable with electronic things around water. Standing in the corner and holding the computer high above my head proved even better. Although the signal was still very low, the indicator moved a tiny bit toward green. At least I think it did. Trying to adjust my glasses with one hand and rock the computer back and forth with the other to optimize the signal strength made me dizzy and I couldn't really see the signal indicator very well.


Next I opened the window and held the computer outside. This is not the rainy season in Nairobi, so I figured this was worth a shot. Bingo. Now I had a "fair" signal. That means I can at least send and receive email, but it's still not strong enough to make telephone calls or access my files from New York. But here I am, hanging out the window of my hotel room at 1:30 in the morning and I realize that I can't hold the computer and type at the same time. So this probably wasn't a viable option.


I then repeated my route: Standing on the bed, climbing in the shower, reaching above the sink, risking life (and computer) by leaning out the window. All to no avail. This is 2008. Is it so unreasonable to expect and get Internet access when you want it? Cost wasn't an issue because access is free with the room. But if it is not accessible, it's no help.


I finally gave up and went to bed. After a few hours of sleep, I tried it again and still had no adequate access.


A little later in the morning I was speaking with my friend Doris Odera. Doris is the CMMB interim country director in Kenya and a lovely person. I figured she would have great sympathy when I told her of my hotel room gymnastics to get a decent Internet connection.


Before our conversation could turn to my woes, we talked a bit about the people of Kenya and what their healthcare needs are. Beyond statistics and the kinds of diseases affecting Kenyans, Doris said that the big issue here is access to medical care. Cost is not a problem, but gaining access to to treatment is a big challenge in rural areas. That, of course, is why CMMB's work is so critical to the people of this beautiful country.


I'm sure the rest of the conversation was interesting, but for a few moments my mind left the room. I was seeing myself, half asleep, trying without success to gain Internet access last night. I was looking at this goofy American stand on his toes in the shower holding a computer, risking life and limb by stretching out the window with a white laptop. How urgent was my quest for an Internet connection that I would do just about anything.


The ah-ha moment, of course, was seeing the foolishness of my quest. I was half crazy trying to connect to the Internet while people here struggle to gain access to even basic medical care. Suddenly, this is not about the Internet or laptops or a press conference. Instead, it's about the children, women, and men who deserve to live in good health. They are why I'm in Kenya. They are why CMMB is here.


Somehow, having immediate access to my email or my voicemail just doesn't seem so important. I'm sure this moment of reflection will be fleeting and soon enough I'll be doing handstands in my hotel room trying to increase the wireless signal to my computer. But at least my focus will be on access that is far more important than the kind I'm looking for.


In case I forget that, I put a photo at the top of this post. These are children that I saw the last time I was here in Kenya. And their needs far outweigh me having access to my email.

Attack of the Killer Tomatoes

There are few things as special in life as plucking a ripe tomato from the vine, sprinkling its sun-warmed flesh with a little salt, and chomping into the juicy fruit. It sings summertime with each drop of juice, each tiny seed.

Alas, the US Food and Drug Administration has issued dire warnings about eating fresh tomatoes. The warnings come as a result of about 140 people who have become sick with salmonella poisoning since April. Not one of these people have died from eating a tomato, but the FDA is taking no chances.

I read this morning that Burger King, McDonalds, Taco Bell, and other fast food joints have taken tomatoes off of their burgers, out of their tacos, etc. They all indicate they are just trying to protect their customers. How considerate of them.

Too bad that the tomato on a Whopper is probably about the only healthy thing on that sandwich. The same could be said for the other fast food offerings. But I'm really glad that I'm being protected by Burger King, Ronald McDonald, and their friends. I mean, I just never imagined that they were so concerned about my health. Why, this could actually make me feel good about ordering a super deluxe extra value meal. Well, maybe not.

If the King, Ronald, and the FDA were really concerned about my health, they might want to take a look at the ingredients they've left on their sandwiches. Have you ever thought about the health benefits of "secret sauce?" Or corn syrup-sweetened catsup? Or full fat processed American cheese slices? How about the oil used to fry the potatoes and the "chicken" snacks?

In the same time period that 140 people got sick from eating tomatoes that are assumed to be the cause of salmonella poisoning, I wonder how many people developed diabetes, high blood pressure, had a stroke or heart attack, all because of everything except the tomatoes in fast food.

When I walk into a McDonalds at breakfast time (not often, mind you, but Ronald and I are on a first name basis), I see bags overflowing with fat and carbs. The McDonalds near my office sometimes has lines so long at lunchtime I imagine that the customers must have 2-hour lunch hours. From morning until late night (or 24-hours in some cases), person after person is eating variations of the same fat and carbs and the occasional slice of tomato. And now that there are no tomatoes around, well, it's an awful lot of fat and carbs.

If the fast food chains--and the FDA--really care about you and me, you'd think that they'd be concerned about the millions of people around the world who are suffering from fast-food-related obesity. That's an awful lot more than the 140 people who got food poisoning from a few tomatoes.

Test Time

My mother, a two-time cancer survivor, had a routine appointment with her urologist last week. He did a routine test and indicated there was blood in the urine. That was about all he said. A few minutes later the nurse came into the examination room and handed my mother a lab form and said to her, "You need to go have an ultrasound done. It's for cancer." She then turned and walked out of the room.

The doctor had said nothing about cancer. In fact, he didn't make it seem like a big deal at all. And the nurse's matter-of-fact attitude really shocked my mother. My mom is not the shy type. She's in her 70s, very active, has a great personality and sense of humor. She is a very outgoing person and is quick to share her opinion. But this left her without comment.

My first instinct when hearing this account was to call the doctor and yank a knot in his backside. "What kind of doctor are you?" I could hear myself asking. "And if your staff has no more compassion than this nurse displayed, then you need to start over," I was ready to tell him. The fact is, though, that the news left me without comment, too.

I'm a grown man. I've been grown a long time. But this is my Mom we're talking about. More appropriately in times like this, this is my Mama we're talking about. Even in a time when so many cancers are curable, or at least treatable, the very word conjures up the darkest images.

The day after I heard about this incident--my mother still does not have the results from the ultrasound--I was still worried about her and thinking about the possibility of another cancer diagnosis. How would she handle that? How would my dad? How would I, for that matter?

As these thoughts were bouncing around in the back of my mind, I had a conversation with my friend Dr. Moses Sincala. He's CMMB's country director in Zambia. It's always a pleasure to visit with him. Dr. Moses is smart and funny, and just an all-around good guy. In this particular conversation, Dr. Moses indicated that there is a shifting concern in healthcare in Africa. He said that new incidents of cervical cancer are shocking everyone. There are more new diagnoses than ever before. Cancer, it seems, is an increasingly major concern in Zambia, Kenya, and other African nations.

We went on to talk about other things, most of them unrelated to healthcare. But I couldn't help but think about my mother and her careless nurse. Somehow I started to be rather hopeful about my mom's situation. Even if her doctor does not communicate well, and even if the nurse seems cold as a slab of marble in February, at least my mother is receiving medical care. She has insurance. And if one doctor doesn't meet her expectations, she can always change to another doctor. These are all advantages we have in the United States.

Suppose my mother lived in Zambia or Kenya or South Africa or Haiti. What if she had to walk all day just to get to a clinic, only to find when she arrived that there were no doctors who could diagnose her...much less treat her. What options would she have?

Don't get me wrong. I'm grateful that my mom is being cared for. I'm very hopeful for a report from the doctor saying everything is okay, maybe she needs just a few days of an antibiotic. And, even if the news is bad, I'm hopeful for things like early detection and various treatment options. But I'm also sad for all of the other mothers in all of countries around the world who don't have such options. The disparity seems to be so vast.

But I also find hope because there are a lot of people working every single day to decrease the disparity in healthcare around the world. People like Dr. Moses in Zambia, Dr. Salvador in CMMB's Kenya office, and Dr. Dianne serving the people of Haiti. There are doctors and nurses from all over the United States and Canada who come to CMMB and say, "I want to volunteer. I want to make a difference." And they do.

These folks leave the comfort of their homes, the prestige of their practices, their friends and loved ones and go to work with some of the most in-need people in the world. They do things like diagnose cancer and provide effective remedies for childhood illnesses that would be otherwise death sentences. When I think about the people who volunteer for CMMB or any healthcare organization, I start to think about how the concerns of another son for another mother somewhere else in the world. Maybe because some people care enough to really give of themselves, the concerns of that son can be alleviated because he knows that his mom will be okay.

I'm praying for my mom today. And I'm praying for the moms I'll never meet. Because they are worthy of my prayers and the sacrifice of healthcare professionals who are traveling even today to see them in a rural clinic in some remote corner of the world. I have hope for my mom. And hope for the other moms, too.

What Are Parents Thinking?

Sure, I read the New York Times and the Wall Street Journal every day. I also visit a number of online newspapers from the Washington Post to the Haitian Time to Kenya's Daily Nation. But my one guilty pleasure remains the New York Post.

Politically, the Post is about a million miles to the right of where I am. And it's true that the paper's ink rubs off on your fingers as quickly as the "gold" from a dime store engagement ring. But the one thing the Post has that the others don't is Liz Smith. With everything that's happening in our world today, why in the world would someone buy a paper (that just doubled its price, by the way, to half a buck) just to read a gossip columnist?

Well, she hails from my neck of the woods, for starters. Her Texas twang isn't so different from my Oklahoma twang. She's also a great writer. And she supports some very worthy causes. And, because I just like her.

One day this week I picked up Post and, after reading Liz' column, I spotted a little article I'd not seen in any of the other papers. This article, buried near the sports section, indicated a steep rise in measles cases in New York. In fact, the city Department of Health reports that by May 1 there were five times more cases of measles reported than were found in all of 2007.

While measles might not be the threat it once was, it's still a serious disease. How is it spreading? Why are the number of cases increasing? Seems there is a growing sentiment among parents against vaccinating their children.

Since I have only a pit bull as a "daughter," I won't pretend to understand why parents would opt to not vaccinate their kids against preventable diseases.

In my relatively short tenure with CMMB I have seen children in Kenya, Zambia, and Haiti who are dying from preventable diseases. The numbers of such deaths worldwide are staggering. According to Jean-Pierre Habicht, a professor of epidemiology and nutritional sciences at Cornell University, 11 million children die every year from diseases that are preventable.

In developing nations, where medicines and healthcare workers are scarce, I can understand how this might happen. It is horrifying to me, but I can at least get my head around it. But in the United States? How is this possible? Don't schools require children to be immunized before they are enrolled? Cost can't be an issue because virtually every insurance plan including Medicaid pays for immunizations.

Organizations like CMMB work day in and day out to lower the death rate of children around the world. Why, then, would a parent in the U.S. choose not to protect a child? I have no answer to that question, but I sure hope someone else will offer one that will help me understand.

Spring Awakening

I walked through Union Square Park on my way to work this morning. This patch of green smack in the middle of New York City is a nice respite even in winter, so you can imagine how beautiful it is in the spring. Despite the blare of police sirens, the squeal of brakes on the cross-town #14 bus, and the ceaseless hawking of free morning newspapers, I could still hear the birds in the trees overhead. The sun, vibrant after several cloudy days, warmed gently the early morning breeze. I couldn’t help but think of those May mornings when I was very young, bare feet running through dewy grass and the promise of a summer free of school floating lazily in the puffy spring clouds.

As I wandered from the park’s lush greenery into the farmer’s market, I took note of the incoming bounty of the season: Asparagus as thick as your thumb but tender as can be; an avalanche of lettuces, most of whose names I don’t know, waiting to be tossed with good olive oil and a little aged vinegar; tiny red potatoes begging for a quick bath of butter and a shower of chunky salt; and herbs of every variety destined to lend their goodness to the creative efforts of many New Yorkers tonight.

The combination of a beautiful spring morning and the just-picked offerings of the farmer’s market must have mingled together to create some sort of organic time machine. It’s not uncommon for my childhood reflections to center on food—crusty fried chicken, Sunday roast with carrots and potatoes, meatloaf with edges burnt just enough to add extraordinary character—but the memory that surrounded me this morning was of a “food” equally interesting, if not nearly as mouthwatering.

When I was about 8 or so, I walked into the backyard to see my brother and sister, Clay and Lisa, making a meal for the neighbor boys. No doubt using a secret recipe handed down by their older brother, my younger siblings were hard at work making mud pies. With the garden hose at their feet, they were stirring and mashing the mud into old tins, explaining how they had to bake them in the sun. The neighbor kids were in awe as they eagerly awaited the pies that were baking in the sun.

The smile brought on by this memory lasted for a couple of blocks until I reached my office. I sat my bag down next to my desk and switched on my computer. While I waited for it to boot, I picked up a pile of photographs that had arrived late yesterday afternoon. They were from Jeffrey Austin, a photographer who traveled with me to Haiti a few weeks ago to document CMMB’s programs. I was taken by how well he had captured life in what is arguably the poorest country in the world.

One group within the stack of pictures made me pause. The photos were of a large roadside market that we’d come upon as we traveled from Port-au-Prince to the northern part of the country. I remembered it well because I bought an enormous bag of sea salt there. (It’s enough salt to last me for the next five years and it cost about 40 cents.) Amid the mountains of used clothes, dented pots, and some fresh vegetables, I spotted the pies. Some not much bigger than a hockey puck, others half the size of a Frisbee, these pies were presented as if they were in a bakery window or in the Union Square Farmer’s Market in Manhattan. The difference, though, was the pies in Haiti are not bursting with apples or plums, they aren’t filled with chocolate mousse or coconut custard. They are made of mud.

Literally, the pies contain dirt, water, a precious bit of oil or lard, and maybe some salt. And they are eaten as food by people who cannot afford even the cheapest vegetables in the market. They cost only a few pennies, but even pennies are scarce in much of Haiti. With armed guards standing watch over mangoes ripening in private orchards, only the most desperate Haitian would try to snatch the fruit from a tree. So the choices for sustenance remain slim.

I didn’t eat a mud pie when I was in Haiti. And, truth be told, I’m not sure I sampled those offered to me by my sister and brother when we were children. Even if I had, though, it would have been by choice instead of necessity.

At the farmer’s market this morning I could have bought some fresh asparagus for $6. Enough new potatoes for two of us for dinner would have cost me about $4. A cage-free chicken could have been mine for $15. The only reason I didn’t spend the twenty-five bucks is because we already had plans for dinner. I had the money in my pocket, after all, and will almost certainly buy an armload of fresh food at the market in a couple of days.

But one thing is certain: when I pop that chicken in the oven or slather butter over just-cut asparagus, or bite into the season’s first local strawberries, I’ll consider what my sisters and brothers in Haiti are eating for dinner. Or, rather, what they are not eating.

I take a lot for granted when it comes to food. A quick look at my belly will tell you that I’ve never been hungry a day in my life. Oh, you’ll hear me say something like, “I’m starving,” as I head out of the office to buy a $6 egg salad sandwich for lunch. But I realize what a poor choice of words that really is. When other folks are forced to eat dirt to survive, I have no right to ever say I’m hungry, much less starving. If you should ever hear me say that again, please put a mud pie in my mouth and send me on my way.