HIV Epidemic Emerging in Middle East and North Africa
Recently published on National Public Radio is a study showing that governments are quietly gathering statistics on the rising tide of HIV infections in the Middle East and North Africa, but they don’t want those statistics published:
HIV epidemics are emerging among men who have sex with men in the Middle East and North Africa, researchers say. It’s a region where HIV/AIDS isn’t well understood, or studied.
More than 5 percent of men who have sex with men are infected by HIV in countries including Egypt, Iran, Lebanon, Morocco, Sudan and Tunisia, according to a recent study in PLoS Medicine. In one group of men in Pakistan, the rate of infection was about 28 percent. (For reference, in 2008, rates of HIV infection among men who have sex with men in the U.S. ranged from 16 percent among white men up to 28 percent of black men, according to the CDC.)
Risky behavior, low condom use, injectable drug use and male sex workers are some of the factors that could cause HIV rates to rise in the region, the researchers say. On average, the men who have sex with men group had between four and 14 sexual partners within the past six months, with consistent condom use falling below 25 percent.
Lack of HIV surveillance and low access to treatment and prevention are a concern for researchers, who believe the window of opportunity to prevent the epidemic from spreading across the region is growing smaller.
Shots had a chance to speak with one of the study’s authors, Dr. Laith Abu-Raddad, assistant professor of public health at the Weill Cornell Medical College in Qatar, to discuss the challenges of researching such a taboo topic.
What made you decide to pursue this study?
There are some political and community leaders who believe that our region is not affected by the epidemic. While others, such as HIV activists, believe that men having sex with men behavior is hidden, so HIV data must be hidden. They have called it the “HIV epidemic behind the veil.” It occurred to me that these are very contrasting views, and the truth must be out there somewhere.
I started this work eight years ago, to get every piece of evidence that we have on HIV. Turns out that there are more data than we think. The regions are not hiding the data, it’s just a sensitive issue. These issues aren’t discussed like in the western media. But it doesn’t mean that the government isn’t dealing with it. Governments do have programs such as active non-government organizations, NGOs, working with groups that are infected.
What surprised you about the findings?
Certain countries did surprise us with the work they’ve done. In Iran, they target the population of drug users. When Iran discovered HIV among drug users, they created programs that offered drug users access to treatment, and gave them free clean needles and syringes.
Many governments don’t want to provide HIV treatment or counseling directly. They support NGOs financially and logistically to help treat communities affected. It’s a way for them to protect people without raising sensitive issues of sexual and drug use behaviors that are often controversial.
What challenges did you face while gathering evidence?
There were some governments that gave us their data on the condition that we didn’t publish it. They want to deal with this issue, but they see no reason to raise it to the public. There were governments who did not want to release data. I can’t tell you which countries, since we have long-standing relationships with them. But we managed to convince some of them that the data would be used purely for scientific research and not used against them by the media.
What do you hope to accomplish from this study?
To raise awareness among policy makers. Hopefully, governments will make changes to policy. Surprisingly, the No. 1 barrier is poor research capacity in this region. If we don’t have the scientific data, we can’t have effective policy. We need to have an effective surveillance program, so we can help prevent further HIV transmission.
This part of the world is seen as not addressing the epidemic. Countries like Iran, Morocco and Egypt are developing programs and working with NGOs. But other countries haven’t yet improved their services to the public. But we hope they will.
Major Pettigrew’s Last Stand
Major Pettigrew’s Last Stand by Helen Simonson
My rating: 5 of 5 stars
I loved this book. It follows all the themes I love – how convention blinds us, how our cultural assumptions make us unconsciously snobbish and leads us to hideous behavior, it is very cultural and also very cross-cultural. Major Pettrigrew is widowed, and his grief has made him old. At the beginning of the book, his life seems very dull and grey. It lightens as his friendship sparks with Mrs. Ali, a widow who runs a small convenience market in his small English village. They both love reading (of course I love that part!) and they talk books, and sparks of warmth kindle.
This book is also very uncomfortable for me, as Roger has a grown son who bullies his father. The book isn’t just cross-cultural, it’s cross-generational, and I see glimpses of myself in the boorish behavior of his son toward his father.
There are some amusing scenes, some wickedly insightful village-interaction scenes, some painfully introspective moments, and some truly grand moments when everything becomes clear and a person acts. For me, there was an added bonus in that as I read Mrs. Ali’s words, I could hear them so clearly, and she spoke in the voice of a dear friend. I could picture her, because I could see the sweet smiling face of a dear friend. It was like having a great visit.
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“We Have Lost Our Moral Compass”
There is something I need to confess, as I print my friend Amer’s most recent editorial from the Arab Times in Kuwait.
Amer is writing about the great loss of civility in Kuwait, a country where trade routes crossed, merchants ruled and differences were tolerated. While I lived in Kuwait, I was horrified at the flaunting of traffic rules and the reckless endangerment of the population because some people believed the laws did not apply to them.
Amer, with a few differences specific to Islam, your editorial, sadly, could be equally well applied many places in the United States today, where some people believe they should not have to patiently stand in line, or obey the traffic rules, or protect the quality of the food supplies or water sources that provide for the communities.
When we fail to restrain ourselves and our selfish greediness, we harm others – but we also harm ourselves. We damage the fabric of society that protects us from the chaos of anarchy. Well said, Amer.
We Have Lost Our Moral Compass
EVERY Ramadan we are inundated by articles and features highlighting the proper means of fasting, alms-giving, praying and other essential pillars of Islam. I am not going to do that.
Most citizens are decent, God-fearing individuals trying to improve their lot and the lives of their loved ones. I believe the Kuwaiti character in essence is one of integrity and generosity — we are a charitable people, evident by the Ramadan dinners we sponsor and the alms we pay (Zakat) — indeed we are almost always the first to rush in aid of others, local or internationally. We should be proud of this trait.
We are, however, far from perfect. Praying, fasting and spending alms on the needful are not enough to qualify us or other societies as superior Muslims.
Our Prophet (Peace Be Upon Him) stated, ‘The best amongst you are those who have the best manners and character.’
Recently, we have all been witness to a drastic deterioration in the way people treat one another and conduct their lives — a certain segment lack the proper traits, either due to absence of decent rearing, non-implementation of laws (which they view as ‘toothless’) or the gradual radicalism in society which encourages gender segregation, intolerance of foreigners and non-Islamic ideals and views.
Our society seems to have lost its moral compass; gaze around you, materialism and power is valued over integrity and honesty; harshness in tone is embraced, over humility and etiquette. An individual’s caliber is immaterial; what matters is how one can ‘benefit’ another, the extent of personal influence and how many laws one can break with impunity.
On the behavioral level, this is evident all around us, nothing is respected; people don’t wait their turn, they drive erratically, they walk into elevators without waiting for others to exit, they are rude to foreign workers, they disturb women in malls and public places, they cause a ruckus in movie theatres, road and traffic signs are ignored, municipality laws are ignored, smoking signs are ignored. The list goes on…
This personal methodology is poisoning society — we are all victims of and responsible for this collective, ethical Achilles’ heel.
Follow the law, pay your bills on time, stand in a queue, follow road signs and you’re regarded as a dimwit.
These days you get a taste of good manners when you travel to countries like the United States and the European Union where parents educate their children ‘not to point at others’, ‘scream’ and wait patiently for their turn in a queue, saying ‘please’ and ‘thank you.’
Even progressive GCC states such as the UAE — eager to attract foreigners and investment — do not tolerate any law breaking: speeding tickets affect the validity of your car license and insurance premiums; if unruly youths disturb or sexually harass women in public, security arrests them, shaves their heads, splashes their mugs in the papers, for example. People think twice before embarking on any moves which might offend the personal space or respect of others.
It’s the atmosphere of tolerance, openness and the implementation of laws that truly make an Islamic society, not the number of mosques built or how many foreigners converted to Islam. Where is Islam if society deems Expired Food Merchants and MPs and their ‘state benefactors’ — who dabble in tens of millions of corrupt money — for example, as ‘untouchables’?
People’s behavior forces one to ditch the law because the law is not really on one’s side, it’s not really being enforced — it’s an illusion. Additionally, we need to start embarking on ‘naming and shaming’ lawbreakers and criminals instead of shielding their identities from the public, who have a right to know.
The state apparatus — traditionally infatuated with forming committees, hosting seminars and running bloated campaigns — needs to execute them properly, namely by implementing a two-track initiative: On the one hand formulating an awareness campaign on ‘Islamic Moderation And Tolerance’ by highlighting the work of groundbreaking pioneers and world-renowned Moderate Islamic voices such as our very own Dr Naif Al-Mutawa (creator of the comic book series ‘The 99’) and Dr Reza Aslan, author of ‘No God But God,’ among other accomplished intellectual luminaries — so that younger generations may be able to benefit from their stimulating, refreshing views. Simultaneously, on the other track enforcing Civic and Constitutional Laws preaching freedom of speech, equality and appropriate justice — so individuals may learn to respect state laws and tolerate differing views – they need to realize grave repercussions are incoming, leading to imprisonment or worse, if they indulge in any lawbreaking or negative antisocial behavior. Ultimately, the State needs to step up to the plate and protect society, lest individuals take the law into their own hands and mob rule surfaces.
Islam without proper laws, justice for all and proper education is abridged, toothless — as a society we need to instill the values amongst ourselves and future generations, not just censure ‘external influences,’ the media or the West for our ills (many which are self created). Moreover, we need as a community to re-examine the way we conduct ourselves and treat others — to realize that no good can come from a society that obliquely persuades fraud, dishonesty and ill-treatment of others.
By: Amer Al-Hilal
The Value of the Trivial
“Be sure to use your full name, First, maiden and married, on your quilt labels,” our presenter instructed us.
Oh-oh. I’ve been lucky just to get labels on my quilts, and I haven’t used my maiden name at all.
“Years from now, if someone is trying to track you as a quilter, it will help to have your maiden name to distinguish you from other quilters who may have similar names,” she continued.
OK. So now I will include my maiden name. (For my Moslem friends, it is our custom to take our husband’s names when we marry. Some women don’t, but even now, the majority do. I know, I know, it seems backward to you, it is irrational, it is just the way it is. We also don’t have marriage contracts.)
At lunch with a long-time friend this week, she mentioned she still has her mother’s diaries. I suggested she offer them to a major university near where my friend grew up, to their historical collection, and my friend said “oh, it’s just daily weather, who’s sick, stuff like that.”
Stuff like that is just exactly what historians treasure. When I was at university, I worked for a time in the copying department of the library, and I specialized in the historical collections, many of which were from people who came west. The papers were fascinating – letters home, lists of supplies they asked to have sent West, to-do lists, old photos. The scraps of paper you and I throw away – there in the Northwest collection.
They become valuable, at least for historical research, for writing period fiction, for medical research – because we do throw them away, and so few survive.
Keeping up with this blog has become more problematic. I just don’t have the time in my life I used to have. My life is interesting to me, but now that I am no longer living in exotic locations, I don’t believe I am so interesting to others. My internal debate is whether or not to continue. I would let it go in a heartbeat and not miss the time, but . . . I think I would miss your feedback.
I’m not writing this for you. I’m sort of writing more for my own record-keeping, it’s why I include news articles and scraps of daily life (not my own) and all the oddities and irrationalities that catch my eye. I love having a place to store it all (this blog) and I love your comments, which can sometimes completely turn me around in point of view; you give me perspectives I hadn’t considered.
The point of all this is the ephemeral nature of our daily lives, and the records of our lives. There are things worth keeping.
I wish someone in Kuwait were doing oral histories on the older people who were living there ‘before oil’.
Culture of Honor Shortens Lives
As I read this article, I thought about life growing up in a small town in Alaska, and how similar it was to life in Qatar and Kuwait, where you live all your life in one community and reputations, once ruined, are never lived down.
HealthDay News
For Men, ‘Culture of Honor’ Can Be Deadly
Mindset spurs risky behaviors and is most prevalent in U.S. South and West, study shows.
By Kathleen Doheny, HealthDay News
MONDAY, Aug. 15 (HealthDay News) — Psychologists call it the “culture of honor,” a mostly male mindset that places a high value on defending one’s reputation at any cost. But new research confirms that it’s linked with high rates of accidental deaths.
“People who embrace these values also report more risk-taking,” explained study author Dr. Ryan Brown, an associate professor of psychology at the University of Oklahoma, in Norman.
This dangerous male mindset is also more prevalent among those living in the South and West, in such states as South Carolina, Texas and Wyoming, he added.
In two studies published in the current issue of the journal Social Psychological and Personality Science, Brown looked at the consequences of such thinking.
First, he compared rates of accidental deaths (car accidents, drowning, over-exertion and so on) in all U.S. states. He found the so-called “honor states” had higher rates than non-honor states (such as New York, Ohio, Wisconsin).
More than 7,000 deaths a year can be blamed on risk-taking linked with the “culture of honor,” he said.
The behavior was most common in more rural areas of the honor states, he found. In the cities of honor states, he found a 14 percent higher accidental death rate than in the cities of non-honor states. He found a 19 percent higher rate in the smaller towns of honor states compared to non-honor states.
“In a smaller town, your reputation is much more important,” he said. It’s likely that everyone knows your business, and that could be good or bad for your reputation, he explained.
In a second study, Brown surveyed 103 college students from his university, including 79 women.
The participants completed tests measuring how much they subscribed to the culture of honor, finished a self-esteem test and answered questions about their tendencies toward risk-taking behavior. A sample statement to which they agreed or not was: “A real man doesn’t let other people push him around.”
The more the person subscribed to a culture of honor, the more likely they were to engage in risky behaviors, the findings showed.
The effect was there for women, too, Brown said.
He and others have previously noted that this culture of honor originated with the Ulster Scots (mistakenly sometimes called the Scotch-Irish) who came to the United States during the 18th century.
In their homeland, he said, they were herders and were always being invaded by someone. They learned to protect and defend themselves, not always in ideal ways. A typical statement, Brown noted: “You take one of our cows, we will take your whole herd.”
The culture of honor behavior persists, he said, despite the disappearance of the herds.
It has staying power, Brown added, and is fostered through norms and values about masculinity and femininity. It’s the stuff of country songs, he explained.
That makes sense to Richard Nisbett, the Theodore M. Newcomb Distinguished Professor of Psychology at the University of Michigan. He is the author of Culture of Honor: The Psychology of Violence in the South.
In the past, Nisbett explained, “if you kept animals for a living, you ran the risk of having your entire livelihood taken away [if someone opens the pasture gate, for instance].”
In modern times, “if you stand the risk of losing your livelihood easily and the state is not around to protect you, you are going to develop this kind of culture of honor,” Nisbett said.
There’s more to it than showing off for women, although that is part of it, he added. It is also, for a man, showing other guys your toughness.
While Brown’s research and that of others clearly shows that some states aren’t honor states, Nisbett said that the behavior is kept going partly by the false belief that everyone else subscribes to the same mindset.
“We tend to think of the culture of honor as historical,” said Joe Vandello, an associate professor of psychology at the University of South Florida. But, “elements of this culture of honor still exist today.”
Simply becoming aware of the phenomenon might help reduce the behavior, Brown noted. Even though it can become “part of your programming,” he said, “we have a will, we have a choice.”
Learn more in the Everyday Health Emotional Health Center.
Surprising Secrets to Happiness
Received this in an e-mail this morning from Bottom Line, a service we have subscribed to for many years because they report some of the newest findings in concise and readable articles:
Surprising Secrets from the World’s Happiest People
Dan Buettner
We’ve all heard that “wealth doesn’t buy happiness.” Neither, it turns out, does social status, youth or beauty.
Social scientists have collected tens of millions of data points that help identify what truly makes people happy. Genetics and life circumstances can influence happiness, but personal choices account for about 55% of it. That means we all have more control over our happiness than we may realize.
National Geographic author and explorer Dan Buettner spent five years talking to people in areas identified by researchers as the world leaders in happiness—Denmark’s Jutland Peninsula… Singapore…Nuevo León, Mexico … and the town of San Luis Obispo in California.
In his new book, Thrive, he identified the main characteristics of what he calls thrivers, people who consistently report the highest levels of well-being. Here, secrets from the world’s happiest people…
Own one TV, no more. Americans spend more than four hours a day, on average, in front of the television. This is time that they’re not spending with other people, including their families. (Family time in front of the television is not the same as real interaction.)
In the places where happiness is highest, people spend the least time watching television. It’s not that they never watch—they just watch less than most people.
I advise people to own no more than one television—and to keep it in an out-of-the-way place, such as the basement. You still can watch your favorite programs, but watching will become a deliberate activity, not something you just do automatically.
Create a “flow room.” In Danish society, most families have an area in the house where everyone naturally congregates. I call these rooms “flow rooms” because they’re places where time seems to flow away when people are engaged and enjoying one another’s company. Flow rooms have no screens (TVs or computers) and no clocks. They are quiet environments where it’s easy to engage in meaningful activities with family.
In our house, I chose a room with good lighting and the best views—it’s comfortable, and everyone in the family wants to be there. I keep it stocked with good books, musical instruments and the best family games.
There’s nothing formal about our gatherings. People wander in and out. Because it’s so pleasant, we spend a lot more time there than in front of the TV or separated in different parts of the house.
Experience the “sun bonus.” By most standard measures, people in Mexico should be less happy than those in other countries. About 60% of the population is poor. Education and health care are less than optimal. Yet on the happiness scale, Mexico ranks high.
This is partly due to the “sun bonus.” People in sunnier climates are consistently happier than those who live in northern countries.
Those of us who live in colder, less sunny climates still can take advantage of the sunny days we do have by getting out and enjoying the sun. The vitamin D that is produced in the body from sun exposure is sometimes called the “happiness vitamin” because it increases brain levels of serotonin, the same neurotransmitter that is increased by some anti-depressant medications.
Stop shopping. The satisfaction that we get from buying things—an expensive watch, a new suit, a fancy car—wears off within 14 months. Yet in the US, we’re pressured by the media and social expectations to always want more. In order to get it, we have to work longer hours and take fewer vacations, which generally reduces happiness.
In Denmark, regulations limit the number of hours that shops can be open. In Mexico, most of the inhabitants are not running a status race with their neighbors.
For more happiness, take the money that you could spend on nonessential items and spend it on something that lasts. For example, take a vacation with your family or sign up for a painting class. The experiences and good memories will continue to give satisfaction for the rest of your life.
Employ yourself. Self-employed workers and business owners report some of the highest levels of well-being. It may be because they are more likely to pursue work that they love or simply because they feel more in control.
The happiness zone of San Luis Obispo, California, has far more self-employed people per capita than the average community in the US. These self-employed workers are shop owners, graphic designers, artists, wine-makers and the like. The more autonomy and control you have over your job, the more likely you will be satisfied with your work.
Make new friends. People around the world report higher levels of satisfaction when they spend time with family and friends. Every additional friend that you make (assuming that these friends are upbeat) increases your chances of being happy by 9%.
People who get together with others for at least seven hours a day have the highest levels of happiness. That sounds like a lot, but the time quickly adds up.
For example, everyone eats lunch. Ask a coworker to join you, or sit with a group in a cafeteria. Talk with friends during coffee breaks. After work, encourage the family to eat and socialize together, rather than dispersing to separate rooms. Take classes or join a club.
The Danes don’t identify themselves as being particularly outgoing, yet 19 out of 20 Danish adults belong to clubs dedicated to arts, exercise and hobbies.
Get addicted to this. The happiest people almost always volunteer in some fashion—at their church, with environmental groups, for social-service organizations and the like. Volunteering means spending time with others, and it also takes your mind off your own problems and increases self-worth and pride in your community.
Studies have shown that altruism has an effect on the brain that is similar to that of sugar and cocaine. It creates feelings of well-being, along with an addictive feedback loop that encourages people to keep doing it.
Also, volunteers are healthier. They tend to weigh less than those who don’t volunteer, and they’re even less likely to suffer a heart attack.
Commit to volunteering for a set period of time—say, once a week for four weeks. People are more likely to keep doing it when they make this initial commitment—and then get “hooked” on the rewards.
Keep the faith. Religious people tend to be happier than those without faith. It’s not clear whether religion makes people happy or if happy people tend to be drawn to religious practices. Either way, those who are religious have less disease, live longer and are less likely to engage in dangerous behavior (such as smoking and heavy drinking).
In Mexico, for example, more than 80% of people who were asked, “How important is God in your life?” responded with a 10 on a scale of one to 10, compared with only 58% in the US. This helps explain why people in some parts of Mexico, despite the hardships of daily life, tend to thrive emotionally.
Even if you’re not religious, you can achieve similar benefits by cultivating a sense of spirituality—and a belief in giving back to your community and making the world a better place.
Bottom Line/Personal interviewed Dan Buettner, founder of Blue Zones, an organization that studies the regions of the world where people commonly live active lives past the age of 100. Based in Minneapolis, he is a writer for National Geographic and author of Thrive: Finding Happiness the Blue Zones Way (National Geographic). http://www.BlueZones.com
Jerry’s Drive-In, Pensacola
We pass it all the time. Jerry’s BBQ Drive-In. People kept telling us we had to go there, everyone goes there. When we were asking about the best hamburger in Pensacola, the word came back: Jerry’s.


When people tell you about Jerry’s it’s like in Qatar when people tell you “it’s near where Parachute Roundabout used to be,” because it isn’t a drive-in anymore, and they also don’t seem to have a lot of BBQ. Jerry’s IS like a time capsule, you walk in, you wait about 15 minutes for a table at lunch, or you try to find a seat at the counter, and it’s like you’ve walked back into the 1950’s. But it isn’t a theme restaurant, it’s just that nothing has changed. When we looked at the menu, we got a big shock – we don’t even remember prices like these. It would be hard to spend $20 on a lunch for two, unless you toss back a beer or two, and we saw a few people doing that.
It seems like a place where people are known – like people eat there all the time. We heard a many greeted by name. AdventureMan said if he were a widower, he would probably eat there all the time. It looked like the kind of place where you could get a good meal and a kind and friendly greeting.
Service was prompt, efficient, courteous and friendly.
AdventureMan said it was one of the best hamburgers he has ever eaten. He compared it to Red Robin and said it isn’t so big, and it doesn’t look so fancy, but it is the perfect size, perfectly cooked and he thinks it is hand packed, it had a great texture. He ordered it with ‘the works’ and was surprised that ‘the works’ doesn’t include a slice of onion, but it did include lettuce, tomato and pickle.
I had the BLT, which came on toast, with lettuce and tomato, nothing fancy, just a BLT, but a good BLT, generous on the bacon:
We ordered sides of hush puppies, baked beans and cole slaw, so we could see how they compare. Hush puppies were like AdventureMan used to eat when he was a kid, the kind people make at home, no surprises, no corn, no jalepenos, no sugar, just plain hush puppies, exactly in character with this slice-out-of-time. The cole slaw was wonderful. I am not a fan of mayonnaise-y cole slaw, and this one was a little vinegary, just what I love. The baked beans were divine. Not a lot of chunks of anything, just plain beans, baked to melting in a sweet tangy sauce. The best of the ’50’s.
They are undergoing renovations to add more seating room and waiting room – business is good, and they need more space to handle their many loyal customers. At the corner of Perry and Cervantes, in East Pensacola Heights, right at the stoplight. AdventureMan says this is the kind of restaurant they feature in Southern Living magazine, or Garden and Guns, one of the hidden gems of Pensacola.
Sign of the Times in Pensacola
Pensacola, with its mild climate, attracts a lot of the nation’s homeless. In an area with high unemployment and where the housing crisis has wreaked havok with the economy, people still find it in their hearts to be generous and compassionate.
There are united efforts to clothe and feed the homeless, and efforts to help them get off the street – if they want to get off the streets, and a lot of them don’t.
I wonder what funds Krispy Kreme gives – bus tickets home? A donut and a cup of coffee? Help with a mortgage payment? I thought it might give a glimmer of hope to someone down and out.












