Doctor Mehret

http://drmehretmandefro.com/

2008-07-10T20:01:00.000-07:00

My blog is moving!

My entries now live at: http://drmehretmandefro.com/

Lillie Jackson

2008-06-25T20:43:00.001-07:00

Lillie Jackson of the National Black Alcoholism and Addictions Council made my day today! After viewing All of Us the movie she has started using Truth Circles in her work. She took it upon herself to pay me a visit on the job in West Philadelphia. I was filming a Truth Circle with a group of young women. Lillie participated in the discussion with her words of wisdom. Lillie has been engaged in HIV work since the 1990s and has much to share. She is using the TruthAIDS Truth Circles idea in her HIV prevention work with young men. I was so happy to hear the idea is spreading. It will take a village to decrease the rate of HIV in the hardest hit communities. Lillie's visit was a reminder that many have been and are already working towards this goal. Her parting words were appropriate: "Stay strong."

Flies on Babies

2008-06-10T16:21:00.000-07:00

Just read a BBC article on yet another famine in Ethiopia and watched the video ( http://news.bbc.co.uk/2/hi/africa/7444753.stm ). Anytime Ethiopia is in the news the visual images are usually flies on babies. As a daughter of Ethiopia, living in the land of plenty, these images always leave me with mixed feelings. I either want to buy my plane ticket tomorrow and start working there, or I think about the countless Ethiopian stories of triumph that never make it to a public stage. In both scenarios there are fragments of my human identity: guilt and pride. Being a physician changes my views on both.

Guilt has no therapeutic utility in the physician-patient interaction. In fact, it gets in the way of healing because it obscures the path to the solution. The fact is, we know what to do in order to get Ethiopia fed. The same agrarian revolution that happened in India thirty years ago needs to happen in Ethiopia. What are we waiting for? Pictures of more flies on babies? Perhaps we should reverse the gaze to confront our own role in allowing this tragedy to continue despite the unprecedented wealth and knowledge of the 21st century. Perhaps the flies are clouding our own vision... not the babies'.

Pride is equally useless to me as a physician. The patient is the teacher...end of story. In order to heal, I have to listen and translate the unadulterated truth from the perspective of the patient. You ever wonder what a baby covered with flies would say? Put away your camera and feed me.

Something special...

2008-06-06T18:36:00.000-07:00

.... is happening in Philadelphia. It seems like every time I turn around I find a new partnership ready to be had. Today I was at Christ Community Baptist Church in West Philadelphia helping plan a march. Apparently, my zip code, along with the neighboring 19104 zip code has the highest cases of HIV in West Philly. I had the pleasure of meeting yet another visionary pastor, Rev White, who has made it his mission to rally his church and his zip code to do something about it. So, September 27, 2008 we are planning a march on the streets of Philly to educate, motivate, and test. I will be interviewing Rev White as part of the new Philly-based documentary.

Towards Nonviolence

2008-05-31T21:30:00.000-07:00

The last day of the Stop the Violence Conference in Philadelphia was enlightening. Many lessons were learned. Rev Dandridge Collins, author of the Trauma Zone, led the session on what it takes to create a nonviolent community. All participants, young and old, brainstormed an action plan for the next steps that would have to be taken. I shared my own thoughts about the connection between HIV prevention and violence prevention. Community members with the help of city officials and the police also bought guns off the street for cash incentives. The entire event was recorded as part of a TruthAIDS documentary. Clips from the conference will be posted on the TruthAIDS You Tube Channel (www.youtube.com/truthaids). This project begins a new series on healing that is grounded in practical steps.

Mill Creek Baptist Church

2008-05-30T20:41:00.000-07:00

I just got back from the first day of the Stop the Violence Conference at Mill Creek Baptist Church in West Philadelphia. It's a small church with a big spirit. I was filming the event and almost dropped the camera twice because I was so moved by the program. The evening started out with a group of children clapping to a beat and rhyming about changing the world. Their voices were strong and they stood tall. Soon after, Reverend Dandridge Collins, author of Trauma Zone, gave a powerful talk on truth telling.

After the sermon he opened it up to the crowd and led a massive truth circle on violence, healing, and why being a truth teller will get you killed. The footage will speak for itself but suffice it to say it was deep. We ended the night with Pastor McCabe reading a letter she received from an inmate in prison who had read that the conference was happening. He wrote the letter to the audience to let us know that everyone behind the bars was hoping the conference would go well. Tomorrow is the "homework" task of the TruthCircle on violence where we come up with an action plan for how to create a nonviolent community.

Stay tuned to the TruthAIDS You Tube channel for the footage (www.youtube.com/truthaids).

Rainbow Tribe

2008-05-26T20:15:00.000-07:00

I spent memorial day weekend with two moms, eight kids, five dogs, and five cats. The kids were all shades and mostly adopted. The two women at the head of the household had a habit of bringing kids home. Their stated reason was simple: there's always more love to give. I watched in amazement. It was the fullest household I had ever seen and it was the home of David's niece. The kids were his "flowers" (ages 6 to 20) and he insisted I meet them with the camera.

The discussion was lively and real. Race and ethnicity was the subject of the day. I sat and listened as the rainbow tribe recounted the ridiculous situations they had confronted as a family that defies conventional classifications. I was hooked. The siblings represented every stereotype, personality, and disability but the love was authentically blood. The motley crew was a perfect complement to David's personality. He was in his element surrounded by his flowers. We finished off the evening with David on the piano and everyone singing. It was a memorable day.

Art and Change

2008-05-24T10:41:00.001-07:00

I got my first grant as an artist this week. I applied for the grant to make a film about 12 young men I met in West Philadelphia. These boys are part of a Fatherhood group in West Philadelphia at the E3 center that is spearheaded by a diligent community center director, David Johnson. We meet on Wednesdays to figure out how to take the group higher. Telling the story of a group of people versus an individual story is a new genre worth exploring. The story of a group is rooted in its collective identity and power to transform those inside the group as well as those outside it. Telling the story of a group is different than individual storytelling and frees you of the trappings inherent to the visual medium. More on that later.

The reception ceremony was moving. Every recipient was using her art to change the world. The disciplines ranged from film, photography, clown (yup...and I mean the "master clown" form), dance, theater, and poetry. In fact, one of my favorite poets, Ursula Rucker, was a co-recipient. I couldn't believe it. She has been a truth teller for the last 15 years that has consistently challenged audiences. True to form, she is using the grant to write an epic poem of New Orleans and pay tribute to a disaster that should never be forgotten.

We all sat around a room and shared the experiences that had brought us all to our various projects. Everyone in that room had connected their personal stories to a larger shared vision of humanity. The take home point was " change " is going to take unprecedented solidarity and support from each other and "un-learning" about how to NOT work together. This latter point is something I have been deeply reflecting on. In this country, we learn how to exploit each other, not how to lift. It is going to take massive de-programming to achieve solidarity. I am hopeful but the road ahead is long.

Strong is OK

2008-05-21T08:25:00.000-07:00

My first HIV positive patient got married this past weekend. Her journey was the one that put me on the path to creating TruthAIDS. I just got an email message from her that reminded me what this is all about... being comfortable in your own skin unapologetically. Her email was short and sweet. All women need to learn "strong is ok". My clinic sessions with her were largely about getting to this point. It's a tough lesson to learn for us all. But there is nothing like watching each other grow and become stronger. That is true power. Her wedding brought a group of women inspired by these lessons and she is now going to spearhead the first Bronx-based TruthCircles. How ya like us now!

What's promiscuity got to do with it?

2008-05-20T19:22:00.000-07:00

If there was one word I would erase from the English language I think it would have to be "promiscuity." It does nothing but obscure a sexual double standard that blames women worldwide. Morever, in an environment that uses sex to sell everything (not to mention the Viagra commercials) it's society that is promiscuous, not the people! We got it so twisted.

As a HIV doctor who will soon be seeing patients at the Children's Hospital of Philadelphia, I am deeply worried about the implications of this extreme environment. We are heading no where good fast! My work the past 6 months with an HIV prevention project in a youth development center only confirms this fact as does the recent report confirming the rise of HIV in NYC teens. The kids are saturated with messages about sex and there are no limits to the incessant messaging. It's really starting to piss me off because it's making my job harder. The youth need protection from a toxic environment and as adults we need to step up and say "enough".

Geography: Towards a unified front

2008-05-19T06:46:00.000-07:00

I have had to start studying a new topic to better understand David's story, namely geography. Like most things in life, when you give it your all, the lines start connecting.

This past weekend, my father asked me to attend The Ethiopian Forum for Peace, Democracy and Development's 5th symposium and I was blown away by a presentation given by an Ethiopian Professor of Geography. Professor Assefa Mehretu teaches at Michigan State University and gave a talk entitled: "Toward Compatible Narratives in Dealing with Difference and Identity in Ethiopia."

Professor Mehretu was gently brilliant and asking for an Ethiopian cultural renaissance rooted in a collective emancipation that would allow Ethiopia to change the path of her future. His presentation reviewed the blessing and curse of post-modernism, the importance of challenging dominant discourses, and the creation of a new 21st century identity rooted in the strength of the past while blazing a benevolent course for the future. Professor Mehretu encouraged the audience to think about collective emancipation and solidarity in rewriting the current geographically divisive narratives. He reminded us of pre-1970s vignettes of Ethiopian identity and culture that embraced the multiplicity of identities with love instead of using them to divide and rule.

I drank every word. The ideas were so relevant to TruthAIDS and I was bursting to ask a question. So I did. My father was moderating the discussion and chuckled when he saw my hand go up. I asked Professor Mehretu about the "old" story of power... namely that it always divides to rule. His response was " that is why it is up to your generation to commit to the truth and follow it." I took his response as a cosmic sign to stay committed to the long haul road TruthAIDS was trying to blaze. So there you have it... David's story put me on a path that was connected to Ethiopia's. Go figure... life is a trip!

Free?

2008-05-11T17:08:00.000-07:00

I spent my Sunday catching up on editorials and newspaper articles. The election coverage leaves much to think about regarding gender and race in America. The paternalism of some of the comments is remarkable and makes me wonder if progressive people are truly free. David often says to me: "...people may be saved, but they are not free" and I think I know what he means. People have strings attached to the wrong things, even when their heart is in the right place. David recently expanded on this point with a song, a Labelle song, "People Say They're Changing".

People say they're changing I know they're still the same... they are just rearranging, making the rules to fit their game... (CHORUS)
They tell me Uncle Tom has passed away
Overheard he's resting for another day
People come and they pulled him from his grave
because deep down in every heart there is a master and a slave
and as I turned I said, where are you off to now (Nona Hendrix)

David: The Piano Player

2008-05-05T13:48:00.000-07:00

David finally got a chance to sing in his home church yesterday. It was a special day. His family members and old friends were in attendance. I was not allowed to bring my camera in but I did manage to record audio of his performance and take some stills. He gave it his all, and by the end of the performance I was holding my breath. His breathing pattern had recently changed and I was worried. But watching him belt, you would have never known it. Music is everything to David. It will always be.

Surprises

2008-05-03T19:45:00.000-07:00

There's not much that surprises me. But I just had a phone conversation that made me pause. I was on the phone with a woman who could not say the word AIDS. She literally kept saying... you know, "that word." I had to finally come out and say it to believe it. It's so easy to forget that we all live in self-selected pockets. Occasionally you get a reminder of how far we have to go to break common ground. In those moments, the importance of connections could not be clearer. By the end of the phone conversation, she still could not say the word but her tone had changed. Though her moral judgements about AIDS were set in stone, her heart was willing to listen. I hung up the phone feeling slightly sad and thinking about an MLK quote: "And I guess one of the great agonies of life is that we are constantly trying to finish that which is unfinishable." Process, process, process...

Sisterhood is Power

2008-04-28T20:05:00.001-07:00

That was the chant of the night. I just spent the last four hours with the women of Sister Act in Washington, D.C. It was their graduation. Sister Act is an intergenerational sexual health program run by the Women's Collective. I was filming their oral histories for their graduation as a memory to the HIV positive and negative women that came together to find strength, knowledge and power.

My mother insisted I bring her which was an extra special treat. She sat and listened as the women told me their stories. At the end of the evening, she turned around and said... "you know... women's lives are heavy." The translation in Amharic is more potent, but I think you get the point. My mother witnessed the singing, dancing, sharing and crying with a bit of awe and intrigue. She has always wanted to understand what I do better. I think she finally got it. Sisterhood is powerful.

Finally!

2008-04-17T09:52:00.001-07:00

After working with women for the last 12 years, I have finally turned my attention towards men. This week TruthAIDS kicked off it's second Philadelphia community partnership with the E3 center targeting young African American men as part of a Fatherhood mentorship program. The program was a direct result of an HIV prevention outreach session conducted in February where a group of young men asked us to help them mobilize about the health problems facing them, namely violence. The Fatherhood program will run weekly and has 22 participants. The first session was discussing violence and the young men had plenty to say.

Listening quietly, I heard a voice I rarely see in the clinic. Due to biology, women start health screenings early with PAP smears, contraception and pregnancy. But young men, rarely, if ever, come in to see the doctor. This makes them a hard group to reach. Yet, the work that TruthAIDS has done with gender equity and HIV prevention makes it clear that their voice has a formative role to play. So, I have been waiting to find male TruthAIDS allies to help carry this work forward and am thrilled to have found David Johnson at the E3 center. His commitment, enthusiasm, and principles insure that this new partnership is a match made for success. I have a lot to learn, but am hopeful with time the lessons will lay out a path to follow.

Young Black Men

2008-04-08T11:34:00.000-07:00

After years of working with women, my attention has recently turned towards men. I came to Philadelphia with this wish but wasn't sure how it was going to materialize. Well... they found me. I was developing a TruthAIDS community-based partnership with a local HIV prevention project called PALMS when it happened. I strongly believe HIV prevention programs should run through or be partnered with community development organizations. PALMS operates with this model.

The PALMS acronym stands for the Prevention of AIDS through Live Movement and Sound and is a project run out of the Philadelphia Health Management Corporation. This project uses actors to perform role plays to at-risk youth as a method of delivering HIV prevention education. The actors are amazing and the community health educators are wonderfully charismatic but the program has recently gotten some of its funding cut. That's when I came along. After witnessing their work first hand, I was so impressed with the effect they had on the youth they were teaching and believed in the potential of this small community-based programs.

One of the frustrating realities about HIV prevention is that there are so many great programs that stay small. We need to find ways to help scale these existing projects up so they can begin to build a movement of change. I have been working with PALMS to see how a physician partnering up alongside an existing community-based program can begin to address this issue of scale-up. I have been recently incorporated into their interventions as an official collaborator, offering my knowledge as a physician during their interventions with the youth and helping out with testing and counseling if needed. I have also brought a film crew to tape them to see how media can serve to bolster the scale up efforts.

The partnership is working lovely and is serving as a stepping stone for how the different silos of HIV prevention can be brought together. Fortuitously, PALMS runs their interventions in single gender groups because of the tricky topics of love, sex, violence, and power that the role plays reflect. This has provided me with the chance to work with young black men. As I listen to their stories, I can't help but reflect on my own brother's who lives in Washington D.C. The violence in communities like Philadelphia and Washington D.C. leave a lot for a sister to worry about. The families are under attack.

Sundays with David

2008-04-06T21:43:00.001-07:00

Thank you for my problems. That was the lesson today with David. He took me to the church where he was raised so I could understand his sense of home. He introduced me to everybody as his documentarian but I felt like he should be introducing me as his student. I am learning volumes about how to live with light despite darkness. I knew when I met him that he was going to help me in ways that I didn't quite understand and I was right. Telling his story is changing me. That's where healing lies I think- in the exchange.

The Left Forum

2008-04-04T22:47:00.001-07:00

Presenting with Dr. Bob Fullilove and Dr. Rodrick Wallace on HIV prevention was the highlight of the month. Dr. Wallace broke down the history of the epidemic as told through the lense of marginalized communities world wide and Dr. Fullilove made a call for community action. I presented the TruthAIDS work from Philadelphia and Los Angeles collaborators using video. The multimedia format was tricky as I have never be technologically literate but I think the visual medium continues to be a powerful way to teach about HIV. The panel attendees got a chance to meet the wonderful young men I am working with in Philadelphia as well as the talents of Shea Scott in L.A. It's wondrous when life allows you to bring all your circles together as one.

Brava

2008-03-30T19:52:00.000-07:00

I went to the Frida Kahlo exhibit at the Philadelphia Museum of Art this weekend. It was heavy. Frida is a woman whose intensity transcends time and space. Her subjectivity was the center of her art. Walking through the exhibit made me think of the countless stories I have been trying to translate that sit at the crossroads of HIV, gender, race, and love. Frida had been through it but she had staying power.

In the audio portion of the exhibit, the Chicana artist and cultural critic Amalia Mesa-Bains made the point of distinguishing what Frida represented to Chicanas versus women at large. To the Chicanas, Frida represented the spirit of resilience and "brava". Whereas the perceptions in the broader women's community was Frida as an icon of suffering. It's interesting how audience defines the narrative. What is the lesson to teach?

For stories of HIV, race, gender and love... brava is the only way forward.

Later with love

2008-03-28T18:38:00.000-07:00

One of my favorite patients from the South Bronx tracked me down in Philadelphia. She was a young girl with a story to tell. Not sure why she thought her doctor would be a good person to try to tell her story. But I have signed up for the challenge.

Since I don't see her in my clinic office anymore, we mostly stay in touch over the phone. She calls to check in at the oddest times and usually with an update about her love life. During one of my visits back to NYC I met up with her and tried to schedule her to see a colleague of mine at an adolescent health clinic. But she wasn't interested. All she wanted to do was talk. Sometimes talking is the way we heal, especially if no one is listening.

So, that is what I do for her now. I listen and try to give advice. Every phone call has to end with "later" and not "good-bye," because good-bye means forever in her words. She called today and I was feeling particularly annoyed that she wouldn't and hadn't gone to see a doctor for a check-up. She told me she already had a doctor in me. I told her, "you need more than just talk." She said, "it's not talk, it's love."

I smiled... Later D.

Philadelphia to Ethiopia

2008-03-25T11:12:00.000-07:00

TruthAIDS has a community partnership in Philadelphia with the Prevention of AIDS through Live Movement and Sound (PALMS) project. PALMS uses actors to teach about HIV prevention via role plays of very sticky life situations to at-risk youth. I accompany them on all their interventions and help out with answering questions from the youth regarding HIV. I also help out with testing and counseling after the interventions if needed and am working on strategies to help scale-up their efforts.

The intervention consists of 3 consecutive mornings of education with single-gender groups. The last round took place last week. The second day ends in a keep-it-real session which is similar to a TruthAIDS exercise called a TruthCircle. The session was extra real. Abuse, addiction, and difficult discussions with mothers and daughters were the themes of discussion. One of the participants didn’t say a word throughout the three days. She was extra quiet, I thought she had tuned us out and didn’t really care.

Fast forward, one week later. I receive a call today. “Miss… I don’t know if you remember me but I am one of the girls from the E3 center.” It was her, the quiet girl. “I’ve been thinking about you a lot and how much you care.” I listened. “Well you kinda look different and I only know one other person who looks like you and it’s my manager at the job. Anyhow, I got to talking about all the things you said about how stuff here and where you was born is actually worse. My manager be sayin the same thing and she really wants to meet you. I figure you guys are from the same part of town and all and she really cares too…” Well how did you get my number I asked? “I called the E3 center and asked the directors who had the number of the doctor who was around talking to us. I am at the job now and I just wanted to put my manager on the phone so you could connect.” I chuckled realizing she had not tuned me out at all. She was just listening really hard and making her own connections because she cared.

Turns out her manager was Ethiopian too and worked in human services organizations in Philadelphia. We talked about servicing unmet needs and laughed at the odd ways connections get made. I gave her my website info and told her she had a sweet employee. And just like that, the TruthAIDS family grows. Thanks quiet girl.

Young Women of Color HIV Collective Health Summit

2008-03-24T09:35:00.000-07:00

A woman's will must always be respected. This was the walk away lesson from an amazing event that I had the good fortune of speaking at in Brooklyn, NY this past weekend. The YWCHC is my favorite NYC community coalition and one that my own non-profit TruthAIDS has been supporting and collaborating with for over a year. I spoke at their first annual health summit last year and was blown away at the dialogue and exchange. Issues of domestic violence were bubbling from the girls so TruthAIDS jointly sponsored an event that was a follow-up to the obvious need to heal and speak about these issues. One of the TruthAIDS Directors, Sarah Lewis, who is spearheading the Expressive Rights programming for TruthAIDS, led the follow-up conversation with the girls. The girls loved Sarah and she loved them. It was a memorable evening for all.

This summit was no different, just bigger. There were over 150 young women in attendance and 54 of them got HIV tested. Go YWCHC. At the end of the summit, a peer education hip-hop theater group called THEO gave an amazing performance about the complicated realities of child sexual abuse in the family. There is nothing like art to communicate about the difficult situations in life that take you beyond words.

I interviewed many of the girls and took some pictures that I will soon post. However, I walked away from the event thinking deeply about a young women's will. It's amazing how often young women find themselves in situations where no does not mean no. Beyond the atrocities of physical assault and rape that cannot be talked about enough, there is the land of emotional abuse which insidiously and deeply penetrates all spheres of a young women's life. No means no here too. Yet, the world is often hell bent on convincing a young women why someone else's desires/will is best for her and her visions for her life. As one of the girls I interviewed put it..." sometimes being nice enough to listen to somebody is all it takes for them to think they can do whatever they want." Therein lies the tragedy. Being nice enough to listen is what we should all do for each other. Being nice is not the problem. It's not listening and being selfish enough to do it your way anyway. Keep your heads up ladies... where there is a will, there is a way.

David Jenkins

2008-03-24T09:27:00.000-07:00

I spent yesterday with a remarkable man by the name of David Jenkins. He invited me to Easter Sunday services and I admit, if it wasn't for him, I likely would not have been in church - much to the chagrin of my mother. David is a piano player in two different churches in Philadelphia and has the spirit of an angel. It is appropriate that he sets the mood for spiritual services. He's a gentle giant with joyful wisdom that is constantly erupting. David has a lot to teach the world and is a walking testimony. His medical ailments are life-threatening but not to his spirit. I am lucky he has given me the permission to document his life and share it with the world.

I found him unexpectedly. I was helping a dear friend/mentor move out of a long-established office space when he walked in the room to help out with the moving party. I liked him instantly. He was all smiles and lightened the mood to an otherwise drab atmosphere. There is nothing more stressful than moving. Ever since then, talking with David or spending time with him means all smiles from an eternal place. He has seen more than his share of pain and illness and reminds me of a patient I lost two years ago who exemplified the same depth of peace and joy despite it all. I think telling his story is going to finally allow me to heal from trying to tell hers. Life is cyclical like that. If your heart is open... just the right people walk in at just the right time. David thinks he needs me to tell his story and leave a legacy. But truth of the matter is I think I need him to begin telling mine.

Alas...

2008-03-24T09:04:00.000-07:00

I have been meaning to start writing this for awhile... I guess it took Easter Sunday and new beginnings to finally put my words out. I have been listening to stories as a public health practitioner for a long time and as a physician for the past four years. In medicine, there is a true moral compass that points north. These stories are meant only to serve the patient. However, I have learned introducing them into a public discourse means feeding the public imagination in ways you never intended and often cannot control. This blog is my attempt at documenting the stories I am catching everyday in my work and translating these stories in a manner that is consistent with my professional obligations as a physician, to heal. I think doing the work also has an emotional cost that can benefit from processing regularly my own thoughts about the journey. I hope in sharing these truths, I can help steer the public imagination towards having a moral compass that points north.