Have a Coke and an Anti-Retroviral
Fighting AIDS in Tanzania
Slate Magazine. June 8, 2011.
HAI DISTRICT, Tanzania—A Coca-Cola truck rumbled down the road, ferrying its bubbly, sugary cargo to shops and kiosks in the northern part of the country around the edge of Kilimanjaro National Park. The one thing you can be sure of finding in any far-flung corner of Tanzania is a bottle of Coke. A new pilot program—the first of its kind—aims to make anti-retroviral drugs as easily accessible as a bottle of soda by tapping into Coca-Cola’s established delivery network throughout Tanzania.
Tanzania’s government supply-chain agency, the Medical Stores Department, currently distributes anti-retrovirals, malaria medication, and other drugs to 500 points around Tanzania, but President Jakaya Kikwete wants medicine taken to the doorsteps of all of the country’s 5,000 health facilities. Widening the distribution net so broadly could prove a daunting task, since Tanzania’s current distribution system is already overtaxed, and even the best health facilities have trouble keeping all the necessary medicines in stock.
Enter Coca-Cola. The beverage giant, which opened its first bottling plant in Tanzania in 1952, has spent decades finding the most efficient way to reach distant villages and adapting to changing roadway conditions. Through three local bottling franchises, the company is sharing its distribution routes with the government supply-chain agency. The program, a public-private partnership that is now being tried in nine of the country’s regions, lets MSD use Coca-Cola’s delivery maps and distribution partners to create a new delivery model, with the aim of moving drugs around the country more efficiently. “If anyone is sure how to get stuff the last mile, it’s Coke,” says Shaaban Husein, director of finance and administration at MSD.
Can Traditional Medicine and Modern Science Coexist?
Fighting AIDS in Tanzania.
Slate Magazine. June 9, 2011.
SIHA DISTRICT, Tanzania—Maria Paulo sat on a bench in the middle of the playground outside the children’s tuberculosis ward at the Kibong’oto National TB Hospital, adjusting her red shúkà wrap and bobbing her 3-year-old grandson, Musa, on her knee. She had brought Musa to the TB hospital from their Maasai village, after both traditional medicine and a two-month stint in the Monduli District Hospital had failed to cure him. Musa’s advanced TB, which Maria said he probably contracted from his father, was diagnosed with an X-ray. “His lungs were black,” she said. Treating the Maasai has been a particular challenge, since many believe that AIDS, TB, and other ailments are “not for the Maasai,” and so they do not seek treatment until they are very sick, if ever, doctors told me.
The nomadic lifestyle of the Maasai and their trust in traditional medicine hinder attempts to provide them with modern medical treatment. “The situation at the hospital is not like home, but Musa is getting better, so I forget about all my other problems,” Maria told me. At home, Maria lives in a polygamist household, but at the hospital she is her grandson’s sole caretaker, sleeping on a bed next to him in the pediatric TB ward. The room was airy and bright, with knotted mosquito nets dangling over the bed. Kibong’oto is surprisingly cheery: The lush, well-manicured grounds are bisected by swept red paths and dotted with tidy cinder-block buildings with green metal roofs. The hospital, which has 340 beds, opened as a tuberculosis sanitarium in 1926, when it was thought that the fresh air at the base of Mount Kilimanjaro would heal the patients, who came to the hospital from around British East Africa. “There were no TB meds then,” said Dr. Liberate John, the hospital’s administrator. “They thought that sunlight would kill the bacilla.”
Today, the TB epidemic looks very different. HIV and tuberculosis often march in tandem, with the former fueling the spread of the latter. In 1983, before HIV really took hold in Tanzania, 11,750 people were diagnosed with TB, according to government statistics. Today there are 64,267 diagnosed cases. Together, HIV and TB kill around 91,000 people in Tanzania each year, according to UNAIDS and WHO statistics. In Tanzania, 30 percent of AIDS-related deaths are caused by TB, and some 20,000 TB patients are HIV-positive.
Biting the Hand That Doesn’t Feed Me
Internships for college credit are a scam.
Slate Magazine. June 8. 2006.
On your next summer trip to Disneyland, take another look at the person in the mouse costume: He or she might be a college student. Disneyland now offers amusement park “summer internships,” the Los Angeles Times reported last month. Interns play “front-line roles”—operating the Pirates of the Caribbean ride, dispensing colorful slush drinks, and hawking Disney schlock. A similar program has been operating at Orlando’s Walt Disney World since 2000.
While you ponder the academic merits of spending a summer dressed up like Minnie, give Disney credit for compensating the students for their labor, at more than the minimum wage, as well as asking them to get course credit. In other fields, by contrast, college credit without pay is becoming the norm. According to an April 2006 survey from Vault.com, 84 percent of college students complete an internship before graduation and 64 percent of those students reported being paid. However, the majority of internships in the fields of politics and journalism are typically unpaid. Using the listings in the 2005 edition of The Internship Bible, I calculated that 52 percent of magazine internships, 54 percent of politics and public-policy internships, 62 percent of TV internships, and 71 percent of radio internships are unpaid. (Newspapers are the exception to the media rule, with only 19 percent of the listed positions going unpaid.) Washington, D.C., where I have lived and studied for the last four years, is ground zero for unpaid summer interns, but they also dot the country.