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The HIV/AIDS epidemic in South Africa

UBUNTU – Human Solidarity

A Personal JourneyDr. Barbara Zeller, August, 2003

In July and August, 2003, I traveled to Durban, South Africa, with the support of Project Samaritan Aids Services, friends, and family, to the epicenter of the AIDS pandemic – to be of use.  I accompanied my husband, Dr. Alan Berkman, and a longtime friend and midwife, Jennifer Dohrn.  All of us embarked, hoping that our experience in caring for people with HIV/AIDS over the years in New York City could be helpful to those taking on the Sisyphian task of developing HIV treatment and prevention programs in Durban.

Many emotional ties drew me to Durban.  For many years, along with millions of people around the world, I was involved in supporting South African’s long struggle against apartheid and for democracy.  Nelson R. Mandela, “Mandiba”, long time political prisoner of the apartheid era and the first President of the new South Africa, celebrated his 85th  birthday on July 18, 2003, while I was in South Africa.  His words, spoken at the end of his trial in 1964, have been providential, “I have cherished the ideal of a democratic and free society in which all persons can live together in harmony and with equal opportunities.  It is an ideal for which I hope to live for and achieve.  But if need be, it is an ideal for which I am prepared to die.”   The country’s transition to democracy and the process of national reconciliation after civil war embodied in the Truth and Reconciliation Commission have been beacons to the world of a new vision of conflict resolution and human decency.  But the most devastating epidemic that the world has ever known accompanied the birth of this new nation and is threatening its progress along its path to forging a free and just society.

Another emotional tie to Durban was forged when, in 2000, I traveled there to participate in the 13th International AIDS Conference.  This meeting of 15,000 representatives of the global movement to fights HIV/AIDS was momentous.  Up until then the prevailing opinion amongst all sectors dealing with the global epidemic was that resource poor countries could not possibly use antiretrovirals (ARVs) to treat HIV —  they were too poor, too lacking in healthcare infrastructure, and were comprised of people too ignorant to comprehend medication adherence.  This position was not only discriminatory, but gave the message to the 40 million people already HIV infected that their lives were not worth fighting for; that the only efforts that could be made would be towards preventing new infections.  By the end of this Conference this position was resoundingly defeated.  There was a resounding call for access to HIV treatments as a human right, and the demand for the political will to force a change in global AIDS policy.  Years of advocacy from people living with HIV/AIDS and human rights activists had finally begun to bear fruit.   The heartbreak of that moment was that the President of South Africa, Thabo Mbeki, was refusing to recognize that HIV caused AIDS. “A virus cannot cause a syndrome.  A virus can cause a disease, and AIDS is not a disease, it is a syndrome.”  In the subsequent months the costs of antiretrovirals began to plummet in response to international pressure and the United Nations formed the Global Health Fund to Fight AIDS, TB and Malaria.  Many African leaders welcomed the ability to begin to use antiretrovirals to treat their people.  But the Government of South Africa, to the disbelief and heartbreak of the international community, blocked their use through their public health system and blocked the Global Fund money from reaching South African sites.

It was during that Conference in 2000 that we heard first hand the alarming statistics of the pandemic in Africa and began to see its human face. Since the Conference, the sheer scope of the epidemic and the newly steeled will of the global AIDS movement for treatment access have compelled a global response.  In the United States, governmental and private sectors have begun to provide help.  My husband has been in the forefront of these issues since 1998, and in January, changed his job to concentrate on the global AIDS pandemic through Columbia University’s School of Public Health.  He came to Durban as part of his work. He then was able to facilitate my ability to come along.

Why Durban?  Durban is the coastal hub of Kwazulu-Natal (KZN), the province that was the former seat of the great Zulu Kingdom, a nation that was defeated in the 19th century by the Afrikaaner and British colonists.  It is a lovely province, comprised of 8.5 million people, about 21 % of the total population of about 35 million.  About 80% are isiZulu-speaking Black Africans.  There is a large Indian population descended from the indentured servants brought by the British in the mid-19th century.  And the white population comprises the remainder.  KZN is bearing the highest burden of HIV in South Africa which estimates it has 5-6 million people infected.   Therefore, KZN, has a total population about the same of New York City, and has about 700,000 people HIV+.  In comparison, New York City, at the height of the AIDS epidemic had 15,000 cases. The vast majority of those infected are Black Africans.  KZN leaders have also been the most outspoken in challenging the terrible position of the South African Government, which to date has not provided antiretrovirals through the public health system, except for the use of neviripine, to help prevent HIV transmission from mother to child during birth.  Durban has the University of Natal and the Nelson Mandela School of Medicine, both progressive institutions who have produced brilliant leaders in the fields of research and advocacy about HIV.  And Durban has some small clinical projects and non-governmental health care institutions, many faith-based, who have begun just recently to use ARVs.  It, therefore, seemed hopeful that my long experience in the use of ARVs to treat HIV would be arriving at a crucial time.

So I invited myself to two clinics – and with the warmth and welcome of the people at these clinics, I was able to help.

SINIKITHEMBA, “We give HOPE”, was the first site.  This is the HIV/AIDS Care Program of McCord Hospital.  McCord’s is a hospital, founded by a Christian missionary, that has made a commitment to build a comprehensive program for people with HIV.  The program is housed in a lovely building near the hospital that used to be a private home.  This new building was officially dedicated with a ribbon-cutting ceremony on July 31th, which I was fortunate enough to attend.  Besides the medical services provided, they have an energetic support group, a committed team of peer counselors, HIV educational groups and adherence training, and social and psychological services.  They also have formed the Sinikithemba Development Program, which includes a choir, a beading project, a sewing project and a baking project.  The profits are put into a foundation that provides the costs of ARVs for the members.   The choir, which sings in Zulu and is comprised of HIV positive members, has toured the United States two times in 2003 and will be performing in New York on December 1st for World’s AIDS Day.

For the first two weeks I shadowed Dr. Jane Hampton, who is their full time “anchor” physician.  It was wonderful working as a team seeing each patient.  She, clearly, was relieved to have someone to whom to ask all of her questions about ARV management.  Dr. Hampton is motivated by her devout Christian ethos and belief in service.  During my first day there I was touched by her warmth and concern for each patient, yet I was completely taken aback as each encounter had to be mediated by what each person could afford.  The hospital operates with great subsidies, but they cannot keep afloat without charging minimal fees and charging for the cost of ARVs.  Later, when I was seeing patients on my own, the words would stick in my throat as I spoke to a suffering soul, who would be able to heal with ARVs and had to say, “ There are medications that could help you.  But they are very expensive.  Could you afford 700 Rand (about $100) each month?”  And as I watched their eyes lower from my gaze and their shoulders droop, I would quickly retreat and add, “I see, well let’s talk about what else might help you today.”   

The Sinikithemba Clinic is where I gained my understanding of the human face of the epidemic.  The medical term “high prevalence, generalized pandemic” took on its human face.  Now twenty years after the epidemic was recognized the HIV epidemic is now an AIDS epidemic.  Huge numbers of people are coming for medical care because they are now desperately sick with opportunisitc infections and dying. I also saw firsthand how Tuberculosis and HIV have formed a deadly partnership – the sheer numbers of coinfected patients was astounding.

The people coming to the clinic were 98% Black African, generally the working poor – domestics, service and industrial workers, some teachers, nursing assistants, and students.  Very few had health insurance.  Most paid 110 rand ($15)to walk in the door for the consultation.  Zulu is their first language.  The 110 rand pays for the medical consultation and up to six formulary medicines for each visit.  Blood work, X-rays, procedures, PAP tests,and hospitalizations are all cost extra.

Here is how my first day, July 1st, went.  Like the blind man comprehending the elephant,  I felt my way along day after day with patients such as these, and by the end of  eight weeks comprehended the shape and enormity and the heartbreak of the epidemic.

Phumbili, a 34 year old mother of a 13 year old daughter and a daughter who died in 1999 of AIDS at the age of 8, came in very short of breath with a temperature of 103.  She was on ARVs.  She was asked if she could afford a chest X-ray for 40 rand.  Yes.  Her X-ray showed severe pneumonia.  She was asked if she could afford hospitalization – 350 rand per night.  No.  She was sent home on oral antibiotics.  She had TB 2 years ago.

Goodness Mkeni, a teacher, 30 years old, came for a follow up visit.  She had been taking Zerit, Videx and Sustiva (the cheapest available regimen at that time at 850 rand (about $100) for several months.  She explained that she had stopped her ARVs on May 31st because she needed to pay for her grandfather’s funeral.  She had a huge lymph node that was draining pus on the side of her neck – TB.  Just then, the pharmacist came in and said that Combivir and Sustiva was just available for 700 rand (instead of 1400 However, she couldn’t afford a PAP test for 20 rand.  But she would get her TB treatment, Rifafour, for free at the public health clinic.

Princess Xulu, a 51 year old woman arrived with a cough.  Her partner had died last year.  “Do you want to check your CD4 count?  Did you bring your money for the test (100 rand)?”  No.  “Have you got 20 rand for a chest X-ray.”  Yes.

Innocence Mbondi, a 27 year old man came with his mother, a nursing assistant.  He had had TB and cryptococcal meningitis in September, 2002.  The he had a seizure in April.  At this visit he was suffering from a large genital ulcer, most likely herpes or syphilis.  His mother said they couldn’t afford ARVs.  She knew that without them he had little hope.  She paid 20 rand for a syphilis test.  We could give him acyclovir for 5 days and Pfizer was donating fluconazole after the proper forms were filled out – so at least his immediate infections could be treated.  I saw him with his parents on August 1st – now seeing patients on my own.  He was unable to walk, demented, and dying.  His dignified patents listened as I explained how the Dream Center, the affiliated hospice, might help them now that he needed total care.  They nodded yes, theirs eyes brimming with tears.

Thembo, a 27 year old man, now with his second bout of TB, sick and losing weight, lost his job.  Dr. Hamptom discussed ARVs.  No.  He couldn’t afford them.  Now she discussed “how we all were on earth only for a little time and if he stayed close to Jesus, he would be in His arms for eternity.”

Pretty Parker – 31 years old with a CD4 count of 14 had been on ARVs for two months.  Her husband is positive, and so is one of her two little girls.  They were all there with her in the clinic.  They could afford to treat only one of them, and mom was the one who was the most ill. 

The stories unfolded.  I learned that CD4 counts and viral loads cost 490 rand ($70), but if people were on ARVs, the tests were free from a lab with a research protocol.  I learned that one or two people each day might be able to have ARVs, and one or two people might never had had TB – yet!

Several weeks later, one of the doctors talked to me in a quiet moment, saying that he had a practice in the township ( the informal Black settlement).  50% of his practice was gone over the past three years.  That day, I sunk into despair.  How does a community, a nation, usher in the next generation?  The human act of sex and procreation is bringing death.  The birthing is bringing death. (My friend Jennifer was working at the public hospital in the antenatal clinic where over 50% of the women were testing HIV positive). And the bonding of mother and child through breastfeeding is bringing death.  The parents are dying.  The work force is dying.  And the people are disarmed by government’s denial and disinformation about AIDS.  After defeating apartheid, the great nation of South Africa is not mobilized to fight perhaps their most dangerous enemy ever.

At that point I needed to focus on what was doable – to just take a few steps with all those people I was meeting who were trying to do something rather than nothing.  I needed to find some peace with being a drop in a torrent.

I was comforted by a small accomplishment during my stay.  Marlene, who owned our lovely bed and breakfast, had come one might to tell us of her concerns about her gardener, Zwehihle, whose wife had died last year, and who himself was losing weight and strength.  She was terribly worried about him and thought he most likely was suffering from HIV.  I was able to provide information and support for her.  I could tell her that the cost of the ARVs had gone down to 700 rand and how McCord’s system was organized for HIVcounselling and testing, medical consultation, the amount for CD4 counts and staging of the disease, and so forth.  She told me later that she and her husband had decided to pay for his treatment.  She mustered the courage to ask him if he was worried about HIV.  He said yes immediately.  She was able to help him through each step of the process.  Yes, he was HIV positive.  Yes, his CD4 count was 115.  Yes, he needed treatment. And on August 11, Zwehihle took his first dose of Combivir and Sustiva!  Everyday at Sinikithemba, I saw one or two white African women, with their domestic workers, bringing them for care and ARVs if necessary.  These small acts of decency and compassion are also harbingers of hope.

The other site where I volunteered was “Ikhaya Lempilo” – The Healthy Household.  Located in Cato Manor, the large Durban township and shantytown, this clinic is a site for Columbia University’s School of Public Health’s MTCT+  program (Mother to Child Transmission Plus).  Here the grant provides a treatment model that includes treatment with ARVs.  It hopes to be a model for scale-up of treatment for the future in resource poor settings.  Here, HIV positive mothers from the Cato Manor community are identified in the antenatal clinic where counselling and HIV is provided in order to give mothers neveripine to help prevent mother to infant transmission during birth.  After birthing, the mother and new baby are monitored and given treatment, including ARVs if needed.  Treatment can be extended to other positive children in the family and another adult.  Partners are encouraged to test for HIV.  They had only started enrolling patients since March, 2003.  But 160 patients are so far enrolled.  Only ten or so are on ARV’s to date.  The project operates with a wonderful team – two doctors, one nurse practitioner, another nurse, a social worker and many counselors.  It brims with enthusiasm and hope.  The terrible financial dilemmas of the private non-for profit sector do not exist here.  This project encourages “exclusive” breastfeeding – some scientific data suggests that its necessary for women in this community to breastfeed rather than formula feed because of cultural and economic reasons even though breastfeeding is a known risk for HIV transmission to the baby.  But there is some evidence that if the mother needs to breastfeed, exclusive breastfeeding is safer than intermittent breastfeeding with occasional bottles.  

This project, like Sinikithemba, begins each morning staff meeting  with Christian songs,  “Oh Jesus I surrender, I surrender all.”  And prayers.  The day I arrived, they were discussing their surprise that the team doing home visits to the new moms had found several families with very ill grandmothers.  Upon evaluation, these grandmoms had AIDS.  Another terribly “Sophis’s choice” was presenting itself.  The protocol for the project’s grant allowed for only one other adult to be treated, usually the partner.  But thankfully, these grandmothers could be included because their daughters were not living with their baby’s fathers.

My role at Cato Manor was consulting on ARV treatment issues, training staff, and providing medical coverage when staff went on vacation.

By late July, I had earned my South African name.  I was helping the Treatment Action Campaign (TAC) find doctors for their five members in KZN who had been chosen for ARV treatment.  TAC is an activist organization, with many HIV+ positive members, that since 1998 has been pressuring the government to provide treatment access.  Until this date, the government had not changed its position, and TAC felt they needed to begin to find a way to provide help to some of their own people.  They had raised some money and set up a system to start treating some of their own members with ARVs.  During the first meeting with them, the young organizer Sindi, stumbled over her words as she tried to introduce me and my husband to the group.  She explained that young people could not use the first names of elders.  So after I had heard an elder to my left introduced as MamRita, I suggested I be called, MamZell.  So MamZell it was.  The following week, MamZell was able to provide a training session for these first five people in  basic HIV education and ARV readiness, so that they all could start their treatment.

When I was in Durban, the last week of July, the South African Medical Controls Council, the MCC, comparable to our FDA, queried the safety and efficacy of neverapine for the prevention of mother to child transmission.  It threatened to withdraw its permission for its use unless the manufacturer could provide more proof.  To the horror of the clinical and scientific community and the HIV advocates, this small beacon of hope that had been provided by the government’s public health system (and is used worldwide) could be withdrawn.  Why?  It seemed so irrational and terrifying.

Health Minister, Mantu Tshabalala-Msimany, defended the decision on August 1, appealing to the media to assist with the promotion of health and nutrition and to encourage people to “grow vegetables” to deal with the AIDS epidemic.  She sang the praises of garlic, lemons, olive oil and the African potato as key elements in the fight against HIV/AIDS.

Because of positions like this, last April, the TAC filed charges of manslaughter against Mantu and the President, Thaba Mbeki.  Even Nelson Mandela entered the fray. In February, he said,” This is a war.  It has killed more people than has been the case in all the previous wars and in all the previous natural disasters.  We must not continue to be debating, to be arguing, when people are dying.”

In the first week of August, events unfolded with astonishing speed and Durban was the site of the drama.  The TAC held its national meeting beginning on August 1st.  Passionately, they called for a resumption of the civil disobedience campaign they had ended last March after they thought they had won concessions from the Government.  Since they ended the civil disobedience and took the Government at its word that they would provide treatment, the Government had done nothing.  In those four months, 90,000 people in South Africa died of AIDS.  600 per day.  Now it is 1000 per day.  100 people from the TAC had died as they were desperately trying to develop their own treatment project and raise money to buy ARVs. 

Then the first South African AIDS Conference convened at the Durban Convention Center on Monday, August 3rd, bringing together scientists, clinicians, activists and Government officials.  With consummate diplomacy, the Conference organizers kept the pressure exerted on the Government without causing an irreparable rift in the debate.  In a plenary address, the epidemiologist, Quarraisha Abdool Kareem, said that the country was now entering a new phase of the HIV/AIDS epidemic – where mortality is starting to exceed the incidence of new infection. She also said that among those aged 25-29 in South Africa, the prevalence of HIV is now 51%.

Remarkably on Thursday, August 7th, the Government put an end to its eighteen-month delay by signing an agreement with the Global Fund to Fight AIDS, TB and Malaria, giving South Africa access to $41 million dollars for the fight against the pandemic. 

On Friday, a special session of the Cabinet said it asked the Health Department to prepare a plan for the provision of AIDS drugs by next month!

Clearly, there is no time to waste.  This represents a new phase for the people of South Africa.  There is a glimmer of hope.  There is some easing of despair.

In my last days before departure, I traveled to the South Coast Hospice and accompanied two community women into the rural homes as they made their homecare rounds.  Here, the suffering was terrible.  Here, a 5 year old boy just recovering from AIDS related diarrhea and dehydration tells the worker about his “memory box” – the small box containing small items and pictures that his mother left him to remember her by before she died a few months back.  His granny looked on.  This is a disease of predominantly women now.  That means it is a disease of mothers and children, more even than the men.  The workers lead me to the next small mud house, with a sick baby with AIDS drinking black tea in utter squalor.  For them, the new possibility of going into the community with treatment rather than only comfort was truly a miracle.  And the resolve of the people we met who have accepted the challenge of defeated this scourge will defy all odds.

Enter your content here!

Three revolutionary white male US political leaders gone b4 their usefulness was exhausted

I cannot understand what I am still doing here when three of my heroes and models – all better, younger, braver and more useful men have perished. Please meet Tim Carpenter, Alan Berkman, and Steven Brion-Miesel.

Bernie Sanders – 2023

This speech was disappointing – Bernie in NH  telling it as he sees it in a 40+ minute video in which he sounds like a socialist with a class based analysis but acts like a liberal Democrat who sees corporate greed and the concentration of wealth in the hands of a few as the cause of the problems the US should “take on.”  Buthe offers nothing “strategic,” other than that “we” must “demand” fairer taxes, a raised min wage, breakup monopolies, “fight” for medicare for all, “take on” the greed of insurance and pharm, “transfer away” from fossil fuels, “overturn” CU, etc. Nothing on the war economy/mentality. Nothing on racism or indigeneity. and nothing on strategy. All Bernie can say in essence is “let the masses know that the Dems are on their side.” 

BERNIE SANDERS

Bernie Sanders at the podium

Bernie Sanders

I’ve got a lot of respect for this politician, and I’ve enjoyed being involved in his movement over the years.

BERNIE SANDERS

Bernie Sanders at the podium

Report from the Front Lines

Report from the Front Lines I


June 3, 2016

Report from the Front Lines – embedded in the Sanders Campaign HQ in LA
5500 Hollywood Blvd. Friday June 3. Less than 100 hours until the polls close.
Berneste!

It is, of course, immensely hard to convey the energy, and the spirit of the campaign as text. I’ve been in three Campaign “offices” in 24 hours …

At the Diner, https://www.youtube.com/watch?v=7pCh_-grdGc.
At the sad 1 person office on MLK Blvd/South Central LA in the middle of the all Black and Hispanic world – where nothing was going on and the decision not to devote resources there was a rational acknowledgement of voter interest and density.
And at the epicenter of Bernie LA– the true Center of Centers … a field HQ operations center, with canvas captains and Susan Sarandon. Where if you complete a 3 hour canvassing shift you get a wrist band letting you into the show.
The time is now.
We’re gonna change the world.
Sign up for three three hour canvassing shifts over the next three days.
This moment in history will not happen again.
We did it without big money.
Overturn CU.
Bernie may be here at noon tomorrow.
It makes you feel vulnerable to believe again.
IT will be a story with a much better ending if we all do three shifts.
We need to push.
We need to pray.
Don’t get this wrong, but it’s “as if God put him here.”
We are being given an opportunity to change the world.
There is an emergence of imagination, of art, of thinking outside the box.
Hamilton is a yuge hit show. Link to the Hamilton Bernie ad.https://www.youtube.com/watch?v=PoNV7IuM_S8
Some guy who says he’s in LA from Cape Cod (and alleges he is a delegate from the 9th MA CD and is out here to help win the primary on Tuesday) wants a minute to share a message from the east about gratitude, breadth, the ancestors, and Mother Earth. He approaches the HQ Leader and asks to convene for a collective moment, for one collective breath, for the literal infusion of energy that accompanies acknowledging our common mother and common ancestors. The leader says not now.
The visitor from the east creates a much smaller moment in which to receive greetings from the great spirit. To preach the gospel. The choir knows the gospel. The apostles take one breath together … They hold hands and say their names and where they were born and where they are now from and even perhaps a word about themselves. The beads are strung. Every voice is heard. The choir takes a breath together. If you are not in Cali make phone calls. Winning here is important.

In Bernie
where I’m at “politically” …
November 10, 2012

After years and years of a saying I wanted to change the world and see it freed of unjust power relations, imperialism, greed, environmental denial and lack of respect – I now view a focus on “how we change the world as a whole” to be (a) presumptuous, and (b) a ‘practice” error Changing societies and human and interspecies interrelationships and structures takes time, the right conditions, the sharp and blunt forces of evolution, and immense amounts of “doing”/changing behavior and perception. So now I’m just a single issue guy.

In this regard I still consider pda – www.pdamerica.org – to offer the finest practical strategy for changing the American political landscape. Yet even there I believe that “activists” must focus on one or two areas they choose to give attention to, rather than saying they are replacing capitalism with socialism, or ending war per se, as examples. Rather we have to target very specific campaigns, i.e., reforming the tax code, protecting fair elections, working for a specific candidate, single payer health care … think globally, act locally. Besides, while positive transformation is obviously about “politics” it is also about spirituality and the evolution of consciousness..

The political areas I give my “doing” attention to these days are

  • transforming the mechanisms for democratically electing our representatives,
  • ending the Israeli Occupation of Palestine,
  • the environment, particularly nuclear energy, particularly the evil Pilgrim Nuclear Disease Factory in Plymouth, MA.

I am a very active member of the Cape Cod affiliate of Move to Amend – www.movetoamend.com. An article worth reading in regard to big money and the electoral process is – http://www.southernstudies.org/2012/11/did-big-money-really-lose-this-election-hardly.html. And this redrawing of maps reflecting real red/blue distribution in the USA – http://www-personal.umich.edu/~mejn/election/2012/ – is also useful and revealing. Evolving to a ranked voting system would be ideal. Google it.

Regarding matters in Israel/Palestine I am an active member of the U.S. Campaign to end the Occupation, http://www.endtheoccupation.org/, and Jewish Voice for Peace, http://jewishvoiceforpeace.org/. The issue of one state/two states in I/P has long been a problem for me. The popular position of those peace and justice organizations i align myself with has traditionally been “agnostic” on the question of one state/two states, believing, and rightly so, that resolution of the conflict in I/P can only be arrived at by the Palestinians and the Israelis themselves, and that we American opponents of the Occupation are limited in our efforts to only the derailing of the Occupation. Even when we believed that the “facts on the ground” precluded a just two state solution it was considered politically correct to say we were agnostic, that it was not ours to decide, and that the only legitimate posture we could take was to work for and demand an end to the occ. That has now changed for me for a number of reasons and I believe that the one state solution is the inevitable outcome in I/P, and given that outcome i find it hard to imagine that israel can long remain an apartheid nation. Thus i live with the hope that the remarkable israeli people and the remarkable palestinian people – given each people’s common ancestry and often shared history of suffering, compassion, and courage – will in fact find a way to establish a meaningful joint state, protective of the interests of both people in honoring their humane traditions, in an atmosphere of mutual respect, and the understanding that what is good for one is good for all and that israelis will acknowledge the nakba – much as Palestinians have come to acknowledge the holocaust – and will allow the right of return, and the sharing of Jerusalem as the nations capital. The Jewish-dominant state must fall … as well it should. Palestinians and Israelis – united in their search for security and social and economic justiuce and prosperity – will become a beacon to the world and the middle east for modernity, equality, women’s liberation, environmental sharing and respect, economic power not rooted in oil. i look forward to the future and it will be good. .

Finally, I am of the view that the intended and unintended genocide of the indigenous populations in the western hemisphere has failed and that the wisdom and perspective of native peoples lives on. Needless to say, this is a good thing, because we humans must remember that we belong to mother Earth and not the other way around.

For an interesting comparison of the Palestinian problem and the Indigenous Peoples of the U.S. problem see …

Report From the Front Lines – II
Embedded with the Sanders Campaign in LA

June 5, 2016

Embedded with the Sanders Campaign in LA – Saturday June 4th – 72 hours until the polls close.
Bernaste!

The reality of the unreality, the reality of the potential for genuine global, planetary, environmental, social, economic transformation is almost too much to bear, like being high, like being excited, like Christmas morning… only better.

I am at HQ for the 9AM canvas. There are at least 100 other people there ready to walk the early Saturday morning LA streets. The first photo is of the crowd getting their assignments. Look at the demographic! As Bernie says … we are doing very well among those under 40.
The canvass itself is very hard for this senior. It is hot. No one is home. I walk for hours in a middle class/working class LA neighborhood in Hollywood just on the other side of a freeway. The photo of the Hollywood sign in the distance is my view walking back to HQ. The few people I do talk with seem genuinely supportive, if not also somewhat disinterested. The enthusiasm of the campaign and the campaign workers and the volunteers is quickly dissipated in the reality of the lives being lived in the villages.

Back at HQ you see another pic of a typical cross section of volunteers – mostly young, many not “white,” an equal presence of women and men. Many openly gay people. Some gray hairs … but not Cape Cod!!

Bernie arrives to gives a very short, real, personal presentation. (That’s him, way in the rear of that last photo.) Even if you’ve heard it before it is worth repeating. This is not about percentages. This is the candidate, the man, talking directly to the troops. His family is with him. Grown sons. Grandchildren. This is the campaign leadership reminding his loyal foot soldiers that we are doing this work not just to elect a progressive, compassionate, visionary Jewish son of immigrants to lead the nation, but a movement, a political rEvolution, that we are doing this work in an effort to help one another live fuller, richer, more satisfying lives. That we are doing this work so that the planet we leave our children will be healthy and habitable, that the water from that comes through the faucet will be safe and drinkable, that we won’t be the nation with more people in jail per capita than any other nation on earth. We are being given an opportunity to change the world Bernie tells us. He asks that we do all we can. That we not despair. He reminds us that the battle to win the nomination will continue to the Convention. Bernie says if we have a YUGE voter turnout on Tuesday we shall win and if we do not … and he actually says these words … we shall lose. He thanks the troops. The troops cheer back “Thank you.” The next team of over 100 canvassers heads out the door.

There is talk in the air that the rules of the Dem National Committee itself will be turned upon the Party and used to invalidate the delegate standing of certain super Ds who – it will be alleged breached the DNC’s own Delegate Selection Rules. I talk with Jeff Weaver about this. (Well “talk” may not exactly be accurate as it implies a back and forth dialog. I talk. Jeff listens.) Maybe I’m not saying anything new. The fight over super delegates WILL be the next battleground … all the way from the last primary on June 14 until a nominee is chosen in Philly.
Indeed, at the Massachusetts Dem Convention held this same day in Lowell, MA Senator Elizabeth Warren, no slouch of a political luminary and one of the Party’s most prominent figures speaks critically of her Party’s ‘super-delegate’ process, going so far as to say super delegates shouldn’t “sway the election.” I want to believe that these words mean Elizabeth thinks the supers ought not vote on the first ballot. Wouldn’t that be nice?

Bernie’s last words before leaving to his next venue … after saying “thank you” again … are “onward to victory.” He doesn’t yell the words. He says the words softly, almost under his breath, almost as if to himself. But he is oh so clearly talking to all of us as well. “Onward to victory,” he says. You gotta believe. You also have to call into California.

Report From the Front Lines – III
Embedded in the Official Campaign Rally

June 6, 2016

Embedded in the Official Sanders Campaign Rally at the San Diego Qualcomm Stadium Parking Lot, Sunday … as well as reports and speculation from other real and virtual realms.

Everyone and their mother knows that the California Democratic Presidential Primary election is too close to call and totally dependent on voter turnout (duh), which is really unpredictable, although Sanders does have a good field teams. Plus we will use the lines and the time waiting to vote for good things to happen, i.e., petitions to be signed.
Re the rally, my sense is that the Campaign hoped for 40 thousand people and only 10,000 showed up. Mostly young. All Berniacs. With surprisingly really good musical choices from the stage. Honoring the ancestors. Remembering the Braceros who – in the early 40’s when many young men were engaged in the war effort – were Mexican workers we advertised to come to Cali to work in the fields. Cesar Chavez’ grandson also spoke. He said his papa would be happy and proud to stand w Bernie and would say, “Si, se puede”
The guy from the Cape showed up at the rally and gave away the last few 100 of the 4,000 buttons he brought from MA in a suitcase he had to check in at the airport … that weighed just under fifty pounds … of buttons!! Kudos to Michael Tafe, the productive super canvasser and Bernie Delegate from MA, the man of myth, the outstanding Boston Button Fairie himself. I left after 3 hours … before Berne spoke.

Meanwhile, on the East coast, here’s what Elizabeth said about super D’s … http://thehill.com/…/282232-warren-i-dont-believe-in-superd….
And here’s what Democrats in Wisconsin did – http://fox11online.com/…/wisconsin-democrats-eliminate-supe…
I believe that any delegate who pledged for Hillary b4 a certain date … surely b4 Bernie officially declared … or within a month of his declaration … or within some yet to be determined point in time … that delegate is disqualified.
Here’s what I think are a few “predicate understandings” –
The popular vote and the elected delegate vote are for all intents and purposes tied at 50%.
Each of these highly EXPERIENCED and perhaps qualified candidates can run on their records, but not their records alone … And their records are each unique.
A president’s highest duty is to country, not person.
A delegate’s highest duty is to country … to assuring the candidate who will be nominated is likely guided by the desire to provide the greatest good for the greatest number of people.
Some believe there is a potentially solid legal challenge to some super D’s. We can’t give up on Bernie being the nominee until he isn’t.
And!!! if she who shall not be named is not willing to debate Bernie and discuss openly (again and again if need be), in forum after forum … 3 times a week every week for an hour … then she is incapable of leading or representing us.
Country before self.

Finally, only Bernie beats trump. Only Bernie can win his own midterm Congress. Only Bernie can break the gridlock. Only Bernie is really a man of the people.
The name of the overall movement/coalition is We the People.
In Bernie!

Report from the Front Lines – IV
Embedded in Hollywood

June 7, 2016

Campaign HQ – L.A. Monday When you read this news it will be old, but given the obviously well planned, immense, oppressive, and deftly coordinated all out carpet bombing assault that is being inflicted by the Clinton camp and the Democratic Party establishment on the Sanders Campaign it certain warrants a note. I drive back from S.D. and arrive at the Hollywood Sanders World Campaign HQ in LA on Monday in time for my canvass. It’s all business at HQ, mixed with a sense of desperation. For a long while everyone has been incensed and fearful that the networks would declare Hill the winning nominee after the Jersey polls closed at 8P EST, thus depressing voter turnout for Bernie in California during the 5-8 Pacific coast time slot when Bernie voters getting off from work would consider whether their vote mattered. How civilized and naïve of us! Because by Monday 5PM, well before the polls have even opened on election day Tuesday, Hillary has been declared the winner by the AP, CNN, and the NY Times ALL in bold multicolored celebratory headlines ignoring even the Democratic National Committee’s statement – perhaps made sotto voce just to cover their asses – that it is wrong to count the votes of super delegates before they actually vote at the convention. And without super D’s Hillary is not close … although before Cali is tallied she is 200+ vote closer to the magic 50% +1 than Sir Bernie is. Of course, one of three possible paths that lead to the nomination of Senator Sanders (at least as I perceive it) is changing the inclinations of super delegates who do not officially vote until July 25 – including the more than 400 super delegates who endorsed Secretary Clinton 10 months before the first caucuses and primaries and long before any other candidate was in the race, something I hope may actually disqualify them from voting. The urgent, shrilled, fixed drum beat to declare Secretary Clinton the nominee reaches a peak on MSNBC which reports Senator Sanders will be heading to Burlington on Wednesday to re-evaluate his campaign… as if evaluating one’s strategy after the Cali results are in is the equivalent of a concession. There is even a report alleging Bernie received a call from Obama who – it is said – is ready to endorse Hillary and wants Bernie to step aside as Hill did in 2008. Naturally. what would throw a wrench into all these plans would be that Californians come out in large numbers, because the more people who vote, the bigger will be Bernie’s margin of victory. And a BIG Bernie victory in California keeps hope alive. Besides, everyone knows we can’t win if we play by their rules … so here’s to thinking outside the box and, dare I say it, to revolution.

A reflection on the absence of agreed upon priorities and leadership on the Left

My focus is on organizing ourselves … the Rainbow Left … at this writing … specifically in the lands and with the blessings of the Massachusett and Wampanoag and many more Indigenous people who we owe a debt to and who lead us still.

Who speaks for and to the Rainbow Left nationally? Brother West? Rev Barber? The Abolish Prison and Prison Slavery movement? Bernie? Rise Up? The Squad? Bill Fletcher?

Who speaks to or for the Rainbow Left in MA? Jamie? Jo? Nika, Ayanna? Mahtowin Monroe? Big Mike, Jim McGovern?

We MUST be able to decide on our priorities, on where we can best direct our forces/resources at this critical moment.

There is no single organization on the left that doesn’t want more active volunteers. We all think about recruitment.

My focus is on organizing ourselves. Land back!