Wednesday, February 27, 2013

Witness to PEPFAR

A young Guyanese patient navigates life's challenges with humor.

A Guayanese pediatrician who passionately guards her patients' health.
            As a phototographer, I am witness, on the outside looking in. I can only judge by what I see. 

            To me it seemed like things were going well, programs made a difference in the lives of people. 

In Rwanda, a young patient becomes the first to
use a new testing card for those too small for
the standard syringe-based blood draw.

            Yesterday, I noticed an item in the Washington Post that talked about a recent glowing report issued by the Institute of Medicine and Academy of Sciences on the 10th anniversary of the inception of President’s Emergency Plan for AIDS Relief, known commonly as PEPFAR.
Testing for HIV in a small hostpital
lab in Gonaives, Haiti.


            It's great news to confirm what I thought I was seeing on the ground as I photographed assignments for Catholic Relief Services' AIDSRelief programs, funded by PEPFAR in Uganda, Rwanda, Haiti, Guyana and Brazil. 

            According to the Post, the report says "PEPFAR has been “globally transformative,” a “lifeline” and credited around the world for “restoring hope” in the long, difficult struggle against HIV/AIDS. (PEPFAR) has saved and improved the lives of millions.' It set big goals 'and has met or surpassed many of them.'"

A Homecare nurse examines her ill patient
in a Kampala, Uganda neighborhood
A Rwandan lab tech prepares to test
for HIV in the Bungwe clinic.

             Truly awesome.  

            The projects have been working. 

            As I worked in rural places, meeting people who had once been on death's door, now the picture of health, I could see at least a microcosm of the programs' successes.

With half the family testing positive with HIV,
Rwanda program has kept a little boy's family healthy
            As I photographed, I learned that in addition to providing medication, HIV programs necessarily include counseling patients who live in mud homes without power or running water, on how to get into the habit of taking their medication daily at the same time and continuously and correctly. 

A counselor checks in with a patient ensuring she is taking
her medication correctly. When the counselor first met her,
she was on death's door. 
           Taking their medication correctly means everything. It means staying healthy to provide for their families, it means making the disease a condition rather than a death sentence and it means their children getting an education rather than skipping school to care for their sick parent. 

            I learned that this counseling not only helps people learn to live with their condition, but also helps to roll back at least some of the attitude of ostracism that is prevalent in some societies. 
A Rwandan doctor confers with his patient
and nurse in a rural health center

           I photographed healthcare professionals of local descent, trained to draw blood and run tests in local labs. The labs were constructed to bring testing closer to the population, making it easier to get as many people tested and treated as possible.

           Healthcare, healthcare training,  AND job creation. 

           In front of my lens this all has meant documenting the faces of the adults and children who are healthier as a result of this massive program. It is the doctors, nurses, pharmacists, counselors, and lab techs who serve those who have HIV/AIDS. Fewer children are orphaned, fewer people are contracting the disease.

A Rwandan doctor checks on his patients
in rural Bungwe, Rwanda.
          I felt honored to be, in some small way,  a part of something pretty important, by bringing the images home of how PEPFAR and the partner organizations are really and truly making a difference for so many people, and by extension making a difference for all of us. 

A young Rwandan couple learns their tests are clear of HIV.

In Brazil the government provides testing and medication, while NGOs provide wellness, counseling and job training programs. One family has navigated struggles to find a healthy life which includes a mom whose job is to share her personal experiences and encourage other HIV-positive people to return to the government hospitals to begin their treatment programs. 
A Haitian woman maintains her health through monthly visits to the doctor at Albert Schweitzer Hospital in Haiti.

Friday, February 15, 2013

The Blue Guns, Sheriff's Posse trains in school scenarios

Sheriff's armed Posse members enter a school during a training exercise.
      Men in uniform enter a hallway, weapons drawn as children rush toward them.

The Blue Guns: Possemen approach a "shooter" in front of the school. 
      "He's got a gun, he's got a gun," they shout in a terrified voice at the men as they rush past toward daylight.

      The two uniformed men pause at the intersection of hallways just as two more children rush at them followed by a man in a t-shirt, with his hands up in surrender.

      "Get down, get down" they shout as they move closer to the man who doesn't immediately comply. They force him to his knees and then face down and handcuff him as another man moves toward them in the dim hallway.

      "Don't shoot, don't shoot, I'm the principal, don't shoot." Not sure if it's true, they repeat the handcuffing exercise on the second man."he's in there, along, he's got a gun!"

Posseman checks "shooter" after a take-down.
      The two move toward the door, checking the rooms before the room indicated, to be sure no other threat is lurking.

      As they disappear into the room, "clack, clack, clack," the sound of training weapons shooting in rapid succession, neutralizing the attacking "gunman."

"End of Excercise!"  a supervisor calls down the hallway.

Actor Seagal observes training exercise.
      The children and gunmen are actors,  the men in uniform, members of the Maricopa County armed Sheriff's Posse. The weapons are designed for training, firing various forms of non-lethal projectiles.

      They return to the hallway intersection to meet up with Posse instructor and actor Steven Seagal and two other trainers in police tactics for critique.

     Although critics suggest that the exercise is another publicity stunt by the notorious Sheriff Joe Arpaio, the training is nonetheless real and, according to deputies involved in the training, nothing new.  Police have been training for such scenarios since the Columbine attack in 1999.

"Students" rush from the building as Possemen prepare to deal with the threat.
Arresting a surrendering suspect as principal exits classroom down hall.
      Perhaps inviting Seagal to join the Posse last year was designed to gain more notoriety for Arpaio, well-known for seeking publicity throughout his tenure.

      But while that may draw the extra publicity, perhaps the training session actually serves two purposes, as Seagal  has  experience to provide training and to render important critiques to those who might one day be faced with the real thing.

One of four scenarios, a "shooter"
takes over a cafeteria.
     "Don't get into a shouting match, if they don't comply right away, make them comply," he instructs after a scenario is run.

      "You took too long to get down the hallway, you have to move faster," he instructs another team.
      For a photojournalist, it doesn't matter.  Under the pall of school shootings and other violence that has risen to the top of the news of late, it was valuable to cover. It helps address an important question, how are police reacting across the country? How are people reacting in general?

      As a photojournalist I want to be able to see and cover at least some of the important stories. The access was quite good, presenting opportunities to document Posse handling of three scenarios.

      The school presented numerous challenging situations, poorly lit hallways, with rapidly unfolding activity, but with numerous Posse members in training, the repetition of various scenarios, rate of successful and strong images improves.

Possemen enter cafeteria to try and stop "active shooter"  as "students flee"
      It's a photography lesson as well as anything, be patient, do not get discouraged, pay attention, make adjustments to improve even when you think you have it, keep trying. 

      The fact that the Sheriff likes publicity simply plays into my Master Plan, gain good access to such things, when possible, in order to make good pictures that tell a piece of the story.

The whole set of Photographs are available via Corbis Images.

Seagal critiques a sheriff's posseman on his handling of situation.

Tuesday, February 12, 2013

Of Mud and Trenches, back in the Field, NGO style

A farm worker cleans a head of lettuce.
           My quads were already screaming.

          In front of me, they deftly separated the crop from the ground, slicing away the waste leaves and tossing the Romaine lettuce onto stainless steel trays to be rinsed and packed into a box for the trip to the cooler warehouse for further prep for market. Within days this fresh vegetable would be on its way to a supermarket or restaurant somewhere in the US.

Workers head for their crew buses to begin the work day

          The accumulating mud threatened to suck my boots off my feet as I stepped backwards in front of the advancing farmworkers as they harvested.
Workers wait for their bus departure at Circle K near the border.
 I stood in the only place I could, the water-carrying troughs between the vast rows of salad.

          Always trying to see into my subjects' faces,  I get as low as possible to witness the work, literally in the trenches. If I didn't have to keep moving, I probably would have sacrificed my clothes to get low enough to find the very best and interesting view of my subjects.

A cutter tosses lettuce onto the packing table to be boxed.
          As the sunlight changed from ideal early day warmth to that unflattering midday quality, it was time to head back to the car. My coworker Robyn, one of CRS' regional information officers, could only laugh at me as I stumbled from muddy field trying to keep my gear out of harm's way.

         We'd already been out "in the field" for six hours, beginning at 5 a.m. at a convenience store, two blocks from the San Luis border crossing where several hundred workers daily cross the border to meet their crew buses and travel to their place of work. We wanted to get a sense of what the workers went through to earn a day's pay. It's a long day for them.

Howard G. Buffet meets with CITA personel.
           It was only the second time I've had the opportunity to shoot domestically for one of my biggest non-governmental organization clients, Catholic Relief Services, documenting the work of Mexican farm workers who benefit from a program that helps them navigate the bureaucratically tangled process of obtaining a farmworker's H-2a visa to care for, and harvest a large portion of America's lettuce.

          The visa process, set up by the U.S. government, requires farmers to search for domestic employees before granting visas allowing farms to hire foreign workers.
Workers entertain each other while cutting red lettuce
Hot breakfast at Farmworkers Day celebration

Taking off the worst of the bottom leaves.
          The cumbersome nature of the process discourages many farmers and workers from attempting the process on their own. The Howard G. Buffet Foundation partnered with CRS to work with CITA, a farmworkers organization in Yuma, to match farmers and farmworkers to navigate the process. 

          In Yuma, most of the crews are an even mix of Arizona residents and Mexican citizens doing this back-breaking work.

          As the CRS information officer/writer and I crossed the hotel lobby, after a day literally in the field, I'm sure I was followed with disapproving looks at the several pounds of mud that still clung to my boots in spite of my best effort to lighten their weight.

          It didn't matter, I was tickled to be back at it, teaming up again with a great colleague and for one my NGO clients whose assignments I always enjoy. 

Waiting for breakfast at Farmworkers day on San Luis morning