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Joanna Stephens '08: When the Health Minister Advises Beetroot and Garlic for AIDS

stephensJoanna Stephens '08 has firsthand experience with South Africa's myriad social and governmental problems, with its longstanding racial divides and the devastating effects of AIDS on its population.

Throughout her adolescence she often traveled to South Africa, where she still has family. When she decided to pursue a {{http://www.wm.edu/as/charlescenter/?svr=web, Monroe scholarship}} thesis in International Relations, Joanna knew that she could use the opportunity to do some much-needed research in South Africa.

This past summer, Joanna spent three months in Johannesburg, examining the effects of the government's policies regarding HIV/AIDS. She had particular interest in which treatment programs the government was advocating, which she summarizes in an introduction to her essay: "Health Minister Tshabalala-Msimang has been condemned at home and abroad for her controversial policy of recommending traditional remedies for AIDS. She has spent years stating that anti-retrovirals (ARVs) are toxic, while telling AIDS patients to take beetroot and garlic for their symptoms. No clinical studies have shown garlic and beetroot to be effective against AIDS."

Through her family contacts, Joanna began studying a non-government-affiliated clinic for patients in various stages of HIV/AIDS treatment. Sometimes she would shadow the doctors as they treated patients and ran blood work; on other days, she would survey those in the waiting room in hopes of learning whether the Health Minister's dubious recommendations are being followed by AIDS patients.

"Several times a week for three months, I went to the clinic," Joanna explained. "I asked all the patients in the waiting room if they wanted to be interviewed. Some days I'd be there for 7 hours, and I would get only 1 interview. Other days I'd get 6 people within the first 20 minutes." In total, she was able to survey 46 patients - an estimated 37.5 of those asked refused to participate.

Of those interviewed, 30 said they had tried garlic, beetroot, or both as a remedy. 8 of those 30 said they had tried the herbal remedies in direct response to the health minister's recommendations. The work that Joanna has done on this topic could be extended to help people working to combat AIDS. It's crucial to understand how public information can affect the population of a country like South Africa, where approximately 900 people die from AIDS every day.

"According to clinical studies, those who use traditional remedies are more likely to skip pills in their anti-retroviral regimen, which is why it is important to understand the effect of government health statements on patients' behavior." Further complicating matters is "the potential for drug interactions between anti-retrovirals and traditional remedies. Studies have shown that large amounts of garlic lower the concentration of anti-retrovirals in the blood."

The prevalence of traditional remedies, moreover, has led to the spread of false information. "For instance, the prevailing 'knowledge' is that garlic is an antibiotic and beetroot strengthens your blood. There's no iron in beetroot, but because of its deep purple color, people believe that it's effective. They'll also crush garlic cloves and eat or drink them."

Joanna and children at the Johannesburg orphanage: 'Spending time with them was a really incredible experience.'In 2000, President Thabo Mbeki made headlines when he publicly denied the viral origins of AIDS. Since 2004, the government has made some anti-retroviral drugs available to the public. It's an important concession, but Joanna emphasized that the government is still far from exonerated.

"They do have a national strategic plan for AIDS. They do have a government rollout program to provide anti-retroviral drugs. But that's from international and domestic pressure - they kind of gave in. There are still many more people who need anti-retrovirals. If the government stopped spending money on huge parties and limousines, they would be doing much more good. A lot of money is being earmarked for the wrong things. For example, on a recent visit to a rural hospital, the Health Minister traveled by helicopter, and brought with her a ridiculous number of security guards. It's completely unnecessary. The money spent on that helicopter trip could be providing anti-retrovirals to AIDS patients or improving the infrastructure of hospitals."

The problem isn't limited to drug accessibility, however. "Sometimes I would try to interview patients and they would ask, 'Do you have food? I can't take my retrovirals because I'll throw up. I haven't eaten enough.'" The poverty in South Africa is a major factor affecting the success of anti-retroviral therapy for AIDS patients.

In addition to her work at the clinic, Joanna volunteered at a Johannesburg orphanage. "I felt helpless at the clinic because I was just a researcher. I couldn't really help these people." In the midst of observing such harsh political realities, spending time at the orphanage allowed her to make a difference on a more individual level. "They were just the most amazing children, and spending time with them was a really incredible experience."

Joanna's paper will be published in the Monitor, an undergraduate journal for International Studies. After graduating from the College, she plans to do graduate work for a master's degree in public health. "I'd like a career in public health, focusing on infectious diseases," she said. "Shadowing at the clinic this summer really clinched the deal for me."