Author Archives: tess

Breast milk for-profit companies are popping up around the globe – why haven’t governments stepped in?

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Over the last few decades, the demand for breast milk has grown. The message “breast is best” has driven parents and caregivers to buy breast milk. Even the unwell, bodybuilders and “clean eaters” are known to use it. Once limited to milk banks and peer-to-peer sharing, a new for-profit milk market has emerged.

This post, by Dr Sarah Steele, of Jesus College Cambridge, first appeared on The Conversation website.

Companies producing a range of breast milk products are popping up around the globe, including in India, Cambodia, the US and England. These products include formula replacements – designed to be the sole source of nutrition – and other dietary supplements that complement or are added to formula.

Breast milk products are often marketed as safer, vegan, better for the immune system and infant development. Sometimes, in the case of replacements, products are marketed as more ethical than formula. And they are not just sold to individuals and caregivers, but also to healthcare providers and hospitals.

In England, one breast-milk processing company produces and sells, according to its own sources, six 50ml bottles for £45. Breast milk sale is now a profitable endeavour.

Notably, a company in England cites my past research with colleagues on its website to support mothers donating breast milk to it rather than selling or sharing peer-to-peer or to other online sites like onlythebreast.com. The research of mine that is being cited found selling milk informally poses risks to the consumer, whether an infant or an adult, because the milk can transmit viruses and bacteria, and can be contaminated. Using safety concerns as marketing, these companies promote themselves as a better alternative to the informal market because they test and process the milk to reduce the risk of food-borne illness.

But as companies seek to grow their business, they are likely to increasingly look to more stable longer-term contracts with larger entities, such as the NHS, and this poses other issues to us all. Companies courting healthcare providers to become their suppliers, may increase costs to the healthcare system while creating ethical dilemmas. If mothers move from donating to national health services and milk banks to donating to companies, the natural effect is to drive healthcare providers to turn to such contracts to provide milk in their services and communities.

Rationing access to milk banks – which limits who can get milk on fixed medical criteria, excluding, for example, those adults looking for fitness supplementation – directs milk to those who need it most. This has sought to keep demand in closer alignment with supply, but this is not the same in the for-profit sector. For-profit companies are beholden to their shareholders who wish to see growth and profit. The imperative to growth will probably see the privatisation of a previously public service.

Milk too will be needed to meet the growing demands and mass contracts. To avert concerns about exploitation, by their own accounts, many of these companies state that those women providing the milk do so as “donors”, meaning these women expressing milk are not paid a salary or per ounce payments, nor are they employed by the company. Many company websites convey a distinctively middle-class woman as the typical “donor”, but research suggests it is not always made clear that milk could instead be coming from those in poverty, often in developing countries or marginalised communities, who are paid to provide it.

While donation regimes were designed to avoid the commercialisation of women’s bodies, there are real concerns we are now engaging in the commodification of a woman-produced substance. But also, to meet healthcare-provider contracts, donations to companies are not stable enough. Companies can’t rely on the same public and community sentiments that drive NHS and other public system donations.

Pumping for profit

While marketing their products and donation programmes may increase milk donations to companies, employing women to pump on contracts is probably needed in the longer term to create a more stable supply. The result, though, could be women pumping for profit.

This has happened around the world, leading to issues like women pumping more than they would to meet company demands, or diverting nutrition from their own children. Indeed, such concerns about payment and employment practices led to community activism in the US and led Cambodia to a total ban on sales to the US.

Few governments, however, are revisiting their frameworks to address what some commentators have labelled “a corporate takeover”. Most responses to date have focused on the public health or food safety risks of milk-sharing and mother-to-consumer sales. Indeed, many countries regulate breast milk as a food and so have failed to explore the substantial issues about the new global marketplace.

Such a discussion must respect breastfeeding and long-held customary practices concerning infant feeding in diverse cultures, but we must address the fact that multinational corporations are moving into the space. Policymakers must consider what this means for women and their infants and place these voices at the centre of responses.

Blood, cells, tissues and organs are highly regulated in most countries to stop people from being exploited. We must urgently consider an international agreement on breast milk, which would help to guide governments in drafting regulation.

This will involve confronting difficult ethical questions. Is employing women to pump for profit really where we wish to head in the future? Are we comfortable paying women to produce milk, much like we do dairy cows? Should milk continue to flow from areas of poverty to areas of affluence?

Regulators must look at milk as more than a food. The global market means we must look instead to the women, and their children, who ultimately could be the greatest losers if for-profit companies put profit before people.

“Mural + Breast Feeding” by JulianBleecker is licensed under CC BY-NC-ND 2.0

Fertility: It is now possible to store frozen eggs for 50 years

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The number of women choosing to freeze their eggs is on the rise in Europe, including in the UK. Even during the pandemic, fertility clinics have seen a sharp rise in the number of women enquiring about egg freezing. While there are many reasons why a woman may elect to freeze her eggs, regulations in the UK are extremely restrictive, stipulating that eggs frozen for social reasons can only be stored for up to ten years. Then, a person would have to decide whether to use those eggs or destroy them.

This blog, by Zeynep Gurtin, Lecturer in Women’s Health at UCL, first appeared on The Conversation website.

Freezing technology has come a long way since regulations were first made, leading many experts to argue there’s currently no medical reason to limit storage so restrictively. As a result, the UK government plans to extend the storage limit. This will allow people to be able to store frozen eggs, sperm and embryos for up to 55 years regardless of the reason for freezing – giving them more choice when it comes to their fertility.

Already, this has seen concerns that more women will delay motherhood until later in life – even into their 50s and 60s. Based on my own research and that of others, many women who freeze their eggs do not want to delay motherhood into their 50s and 60s – and instead wish to have children as soon as they are able to.

It’s also worth noting that many UK fertility clinics will not routinely provide fertility treatment of any kind to a women much beyond the age of 50, whether this is with her own eggs or that of a donor. So these practices would also have to change in order for women to delay motherhood into their 50s.

Instead, the extended limit means more women in many different situations will be able to choose to become a mother at a time that is right for them which most often will be in their late 30s or early to mid 40s.

Egg freezing

Since 2013, the number of egg-freezing cycles performed by UK clinics has more than doubled as greater numbers of women seek to have children later, even when their natural fertility may have otherwise declined. Women undergo egg freezing for many different reasons including illness or medical treatment (such as chemotherapy) that may leave them infertile, or because they lack a partner.

To freeze their eggs, a woman must undergo hormonal stimulation which helps her to produce more eggs than she would in her normal monthly cycle. Then, these eggs are surgically retrieved and frozen at -196℃ for potential future use.

When egg freezing was first legalised and regulated in the UK in 2000, there were many unknowns about who would use the technology, why, and about how long the frozen eggs would remain viable. It’s now widely accepted that once frozen, eggs do not age or decay – so may be viable indefinitely.

Before the pending change in regulations, only women who were freezing their eggs for medical reasons – such as chemotherapy – could store their eggs for up to 55 years. Women undergoing the procedure for social reasons (such as lacking a partner) were only able to freeze their eggs for up to ten years – at which point their eggs would have to be used or destroyed. But based on what we know about egg freezing, there was no medical reason for this limit – which is why myself and others argued to change it.

Freedom to choose

Currently, the typical woman who freezes her eggs for social reasons is around 37 years of age, single, and earning above average income.

The women I spoke to in my previous research said their decision to freeze their eggs was often shaped by the fear that they were running out of time to find the right partner and start a conventional family. Many also feared rushing into a relationship with the wrong partner just to have a child. Egg freezing gave these women a chance to find the right partner, and build a secure relationship.

Many of the women had also wanted a child for many years and would have preferred actively trying to conceive over freezing their eggs. Others felt they had not deliberately chosen to delay motherhood. Rather, they hadn’t become a mother for reasons outside their control.

Based on my research and other studies on the subject, egg freezing often isn’t about putting off motherhood for as long as possible. Rather, it’s about maintaining the possibility to have a child with a chosen partner in the future, or when a person feels they’re ready to have a child.

Research also shows that women who freeze their eggs don’t want to pursue motherhood for the first time in their 50s and 60s. Rather, they want the option to use their eggs in their early to mid-40s with a partner of their choosing.

Egg freezing is expensive, invasive, painful and not without risk. While some women may choose to delay motherhood until much later as a result of these storage limit changes, it’s unlikely large numbers of women will delay childbearing as a result. Instead, increased storage time limits are likely to give women the option to use their eggs to conceive when it best suits them.

Photo: “IVF Capillary Tube Insertion” by ZEISS Microscopy is licensed under CC BY-NC-ND 2.0

When plagues meet: if we can learn from the past we can change the future

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“I guess the last lesson I’ve learned as an AIDS activist and the hardest one to learn, is that fights are never won. They just go on and on. They are. And yet they must be fought. They must, must, still, continually, and forever, be fought. Over and over and over, they must be fought.”

Almost the final words from Larry Kramer’s updated and expanded Reports from the holocaust: the story of an AIDS activist, published in 1994. And then the book’s parting shot: “I’ll think of ways to continue to raise hell.”

He did too. The man who had enraged many gay men with his novel Faggots in 1978 continued to rage on our behalf, whether we liked it or not, for the next four decades. But in May this year, as the world paused, he let out his last breath and his roiling presence left us.

Kramer died of pneumonia, not COVID-19. Yet his passing could scarcely have been timelier nor his call to action more relevant. In myriad ways — from local lives to global headlines — two plagues have found themselves in an inescapable embrace.

As COVID-19 tightened its grip, Maggie O’Farrell, whose novel, Hamnet, is set against the recurrence of bubonic plague, reflected that perhaps, in coping with it, we are looking to ingrained history lessons about earlier plagues.

For me, as this crisis unfolded, the lens of HIV became irresistible. I returned to Kramer, to Randy Shilts’ earlier book, And the Band Played On, and David France’s remarkable and more recent volume, How to Survive a Plague. I did so in search of clues, not just about the present horror but as to what the future might — could — hold.

Forty years ago, the arrival of HIV framed our world, and those of others on the margins, but governments were scandalously slow to act. By contrast, the response to COVID-19, for all its manifest failings and inconsistencies, has been urgent and global. It’s hard to avoid the conclusion that the difference is, well…the economy stupid.

It is worth remembering that it took two years to even begin to identify HIV, that it was another 13 before the arrival of antiretroviral therapy, and another decade still before PrEP became available. That there is still no vaccine. That stigma is still pervasive and that misconceptions among the public still abound. The global death toll is 32 million and still rising.

No wonder then that the discourse COVID-19 has spawned is replete with painful reminders, its lexicon relentlessly familiar. Testing, antibodies, T-cells — even the name Anthony Fauci. I could go on. None of this is new.

Such resonances we have tripped over daily. But what, if anything, can 40 years of tackling HIV tell us about our way out of this present crisis and creating a better world beyond it?

I do not have all the answers to that question anymore than anyone else. And much of what I offer here is borrowed from others, wiser than me. But on World AIDS Day, here are twelve things to think about.

  1. This plague will change us. For all the inevitable yearning from some — but not all — for a pre-COVID-19 world, tomorrow has been altered. There is no going back. Neither should there be.
  2. Some of that change will be personal. As Andrew Sullivan has reflected, just as AIDS did, COVID-19 will have far-reaching consequences for how we relate to one another — and for our sense of what really matters.
  3. What governments do is paramount. But they must work with experts and citizens. If they eschew either or both, still worse allow political considerations to override them, they will fail.
  4. This is a long game. The astonishingly speedy arrival of vaccines is cause for hope but we are a long way from out of the woods. There are no magic wands, world-beating or otherwise.
  5. We cannot control the virus. We can only control our responses to it both individually and institutionally. We cannot eliminate risk, but we can mitigate and manage it. And some will choose not to.
  6. Plagues hit the poorest hardest. The economic challenge created by COVID-19 puts the financial crisis of a decade ago in the shade. But austerity is not the solution — investment is critical.
  7. If we ignore or perpetuate inequalities of access to treatment between the developed and developing worlds, we will reap the consequences. In a globalised world, there are only porous borders for the virus.
  8. Vulnerability to plagues is man-made, not God-given. Structures, systems and processes must hardwire kindness, dignity and human rights. They are the hard edge, not the soft filling.
  9. We must commemorate those who have died. As Matthew D’Ancona has urged, we must find ways to acknowledge the scale of the loss. Memorials and monuments don’t bring people back to life but remembrance matters.
  10. We must be prepared for the next pandemic. It will come. If we have not learnt the lessons of this one by the time the starting gun goes, it will be too late. And lives will be needlessly lost again.
  11. The root cause of plagues is environmental. We didn’t invent COVID-19 any more than HIV. But we did incubate them. So to quote Mary Robinson, ‘we must make climate change personal in our lives.’
  12. As David France said in After Surviving: A Great Gift, a lot of good can come from a lot of death. But sloganising and grandstanding gets us nowhere. We must talk to each other, not ourselves— especially those hardest hit. And we must act.

This list is just that. It’s not exhaustive. It’s probably not in the right order. And there’s almost certainly a glaring omission or two. The collective trauma the virus will beget springs to mind. Whatever light exists at the end of the tunnel, plague shadows are unending. We must face that head-on.

On World AIDS Day, it seems fitting to end where I began — with Kramer. In his speech, Some Thoughts About Evil, delivered at Yale University on December 2nd, 1993, he looked back at his activism through that first brutal decade.

“I’d always hoped my words would make a difference, that anybody who was telling the truth would and could make a difference. I’ve learned otherwise. I’ve learned that people can be left to die, quite intentionally, in this country of ours. Many different kinds of people. I’ve learnt that democracy does not protect one and all. I have learned that democracy is a sham. I have learnt that democracy protects only the straight white man with the money and the power to demand that he be protected. I have learned that everybody else is pretty much left to die.”

These words are seared with Kramer’s trademark anger. They are words from another time, about another plague, in another place. But in truth, I know that anger. I have felt it, and I’m lucky enough to count the personal losses of those years in 10s, not 100s.

You might flinch at my citation. Kramer’s style was not everyone’s cup of tea. As Andrew Sullivan remarked in his obituary, he preferred reasoned dialogue to Kramer’s aggressive provocations, but both approaches were necessary.

You can argue that here, we did a lot better back then. I’m not so sure. You can argue that here, we did a lot better this time around too. But not everyone will feel that way.

Sullivan again: “Plagues destroy but through the devastation, they can rebuild and renew.” Whether this one will — well that’s up to us. And if we really want to change the future, we could do worse than channel a bit of Larry.

How coronavirus affects the brain

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With COVID-19, the severity of lung illness doesn’t always correlate with severity of neurological illness. Having only minor lung illness doesn’t protect against potentially severe complications.

This post by consultant neurologist Michael Zandi first appeared on The Conversation.

Six months into the COVID-19 pandemic, we’re still learning what the disease can do. There are now detailed reports of brain illness emerging in people with relatively mild lung illness, in those who are critically ill and also in those in recovery.

One key thing we’re seeing is that severity of lung illness doesn’t always correlate with severity of neurological illness. Having only minor lung illness doesn’t protect against potentially severe complications.

When it comes to the brain and nerves, the virus appears to have four main sets of effects:

  1. A confused state (known as delirium or encephalopathy), sometimes with psychosis and memory disturbance.
  2. Inflammation of the brain (known as encephalitis). This includes a form showing inflammatory lesions – acute disseminated encephalomyelitis (ADEM) – together with the effects of low oxygen in the brain.
  3. Blood clots, leading to stroke (including in younger patients).
  4. Potential damage to the nerves in the body, causing pain and numbness (for example in the form of post-infectious Guillain-Barré syndrome, in which your body’s immune system attacks your nerves).

To date, the patterns of these effects seem similar across the world. Some of these illnesses are fatal and, for those who survive, many will bear long-term consequences.

This raises an important question: will COVID-19 be associated with a large epidemic of brain illness, in the same manner that the 1918 influenza pandemic was linked (admittedly somewhat uncertainly) to the epidemic of encephalitis lethargica (sleeping sickness) that took hold until the 1930s? At this stage, it’s hard to say – but here’s what we know about the virus’s effects on the brain so far.

What’s happening inside people’s heads?

Firstly, some people with COVID-19 experience confused thoughts and disorientation. Thankfully, in many cases it’s short-lived. But we still don’t know the long-term effects of delirium caused by COVID-19 and whether long-term memory problems or even dementia in some people could arise. Delirium has been mostly studied in the elderly and, in this group, it’s associated with accelerated cognitive decline beyond what’s expected if patients already suffer dementia.

The virus also has the potential to infect the brain directly. However, most of the physical effects we’ve seen in survivors look like secondary impacts of the virus being present in the brain rather than the effects of direct infection. For example, our immune system can appropriately fight the virus, but may start to attack our own cells – including our brain cells and nerves. This may be through the actions of immune cells and antibodies via an inflammatory mechanism known as a cytokine storm, or through mechanisms we don’t yet understand.

There are also COVID-19 patients having ischaemic strokes, where a blood clot blocks the flow of blood and oxygen to the brain. Some of these patients have stroke risk factors (for example high blood pressure, diabetes or obesity), though their strokes have been particularly severe. It seems that this is because the blood rapidly becomes thickened in COVID-19 and, in these patients, there have been multiple blood clots in the arteries feeding blood to the brain, even in patients already receiving blood thinners. In others, there is brain bleeding due to weakened blood vessels, perhaps inflamed by the effects of the virus.

Where infection with the coronavirus is associated with inflammation or damage to the nerve endings themselves, individuals may develop burning and numbness and also weakness and paralysis. Often it’s difficult to know if these are the effects of a critical illness on the nerves themselves or if there’s brain and spine involvement.

Only a select group of COVID-19 patients have made it into an MRI scanner so far. NIH Image Gallery/Flickr

All of these effects on the brain and nervous system have the potential for long-term damage and can stack up in an individual. But we need to know more about what’s going on in people’s nervous systems before we can accurately predict any long-term effects.

One way of finding out more is to take a look inside patients’ heads using brain-imaging techniques, such as MRI. So far, brain imaging has revealed a pattern of previously unseen findings, but its still very early days for using it in this pandemic.

In one study, patterns found included signs of inflammation and a shower of small spots of bleeding, often in the deepest parts of the brain. Some of these findings are similar to those seen in divers or in altitude sickness. They might represent the profound lack of oxygen being delivered to the brain in some patients with COVID-19 – but we are only starting to understand the full scope of the brain’s involvement in the disease. Brain-imaging and postmortem studies for those killed by COVID-19 have been limited to date.

Parallels with the past

The 1918 influenza pandemic may have killed 50-100 million people – one in 50 of those infected, and three to six times the number killed in the first world war. Yet it has faded from our collective memory. It’s not often mentioned that this pandemic was linked to an outbreak of brain disease – the “sleeping sickness” encephalitis lethargica.

Encephalitis and sleeping sickness had been linked to previous influenza outbreaks between the 1580s to 1890s. But the 20th-century epidemic of encephalitis lethargica started in 1915, before the influenza pandemic, and continued into the 1930s, so a direct link between the two has remained difficult to prove.

In those who died, postmortems revealed a pattern of inflammation in the seat of the brain (known as the brainstem). Some patients who had damage to areas of the brain involved in movement were locked in their bodies, unable to move for decades (post-encephalitic Parkinsonism), and were only “awakened” by treatment with L-Dopa (a chemical that naturally occurs in the body) by Oliver Sacks in the 1960s. It is too early to tell if we will see a similar outbreak associated with the COVID-19 pandemic, though early reports of encephalitis in COVID-19 have shown features similar to those in encephalitis lethargica.

The aftermath of this global event has many lessons for us now in the time of COVID-19. One, of course, is that we may see widespread brain damage following this viral pandemic.

But importantly, it’s also a reminder to consider the political and societal impact of pandemics, and the need to help vulnerable people who have illness afterwards. COVID-19 has already exposed disparities in access to healthcare. Societies will remain judged on how they protect and treat those most at risk from – and sustain the health consequences of – this virus. This will include people with neurological disease arising from COVID-19.

Michael Zandi MA MB BChir PhD FRCP is a consultant neurologist at the National Hospital for Neurology and Neurosurgery, in London. He co-chairs the Queen Square COVID-19 neurology and encephalitis multi-disciplinary team meeting, and sees and studies patients with autoimmune and infectious diseases of the nervous system.

Main photo:  NIAID – https://www.flickr.com/photos/niaid/49534865371/

Coronavirus: How behaviour can help control the spread of COVID-19

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If you’ve been wondering why we are all being asked to wash our hands and sneeze into our sleeves to slow the spread of the COVID-19 virus, here is the answer:  it is all about herd immunity.
This post by Professor Peter Hall from the School of Public Health and Health Systems, University of Waterloo, Canada first appeared on The Conversation website.

 

Amid the carnage of the First World War, a flu epidemic took hold in the front-line trenches and subsequently spread around the world, infecting one-quarter of the world’s total population and ultimately killing more people than the war itself.

Before it was over, somewhere between 50 million and 100 million people died from what became known as “the Spanish flu.” The currently accepted mortality rate for the Spanish flu is between one and three per cent, and its total mortality numbers are shocking in part because of its widespread reach, proliferating throughout country after country around the globe.

A familiar name

The Spanish flu pandemic was triggered by a virus that is now a household name: H1N1. H1N1 resurfaced in 2009, again spreading to the far reaches of the planet, but with only a small fraction of the death toll of its first emergence.

Although it was not an identical virus, it could have been equally deadly in theory, in part because of its potential to kill people who were younger in age and not otherwise considered vulnerable to flu-related mortality. The absolute mortality rate of the 2009 H1N1 pandemic was 0.001-0.007 per cent. The total number of dead in this case was in the hundreds of thousands around the globe, with a disproportionate number believed to be affected in southeast Asia and Africa.

Walter Reed Hospital flu ward during the Spanish Flu epidemic of 1918-19, in Washington D.C. (Shutterstock)

Why the vast differences in mortality? These two versions of H1N1 did not have the same origin, and there is also an evolutionary push for subsequent versions of the same virus to be less deadly. So the two versions of H1N1 would have been different in these respects.

But, importantly, the world was different too. The conditions under which the Spanish flu overtook the world were abhorrent. The First World War had been raging for several years, and the front lines where the illness emerged were places where young soldiers lived among corpses, rats and contaminated water, and had limited opportunities for personal hygiene.

In 2009, even the most poor nations of the world had better living conditions than those experienced by the average soldier in the trenches of First World War. Despite this, the nations that had the least ability to provide clean environments for their populations were hit the hardest by the H1N1 infections, with large numbers infected and many fatalities.

The spread of COVID-19 in China — and recent cases appearing closer to home — has people worried about another Spanish flu scenario. This will not be another Spanish flu, but we have an important opportunity to control the proliferation of the virus within our own populations.

Behaviour and herd immunity

Herd immunity is a concept that comes from the field of zoology. It refers to the ability of a population of animals to resist infection by a pathogen — such as a virus — because a sufficiently large number of individuals within the population have humoural immunity on an individual level. Humoural immunity is the ability of the immune system to form antibodies against a specific infectious agent.

With herd immunity, transmissibility in a population is dramatically reduced via immunological mechanisms. This is the theory behind vaccines, which boost specific immunity within (ideally) a very large proportion of the population, such that a transmissible disease never gains a foothold.

Notice the term “immunological mechanism,” and consider whether the same principle could apply on a behavioural level.

An electron microscope image issued by U.S. National Institutes of Health in February 2020 showing the novel coronavirus 2019-nCoV, the virus that causes COVID-19. (NIAID-RML via AP)

As the body’s humoural immune responses deflect infection, so do behaviours that block routes into the body for an infectious agent. With a very large proportion of the population consistently implementing behaviours that reduce transmissibility, epidemics can be prevented or vastly limited, without the reactionary measure of quarantine.

Just as humoural immunity does not convey perfect protection to the individual, the same is true for behavioural immunity; it is simply important that a very high proportion of the population is performing precautionary behaviours consistently. Protection is on the level of the herd, more so than on the level of the individual.

Are we talking about the wrong things?

In the context of this concept of “behavioural herd immunity,” current discussions about COVID-19 in conventional and social media may be focused on the wrong things. Rather than talking about fear-inducing counterfactual scenarios (what ifs), we need to focus on crowdsourcing strategies that limit the ability of the infection to get a foothold in our population.

Read more: Coronavirus fears: Should we take a deep breath?

A vaccine would be nice and will eventually arrive. But in the meantime, epidemics like COVID-19 can be prevented by increasing the prevalence of precautionary behaviours in the general population that impede its spread.

These measures include a few familiar maxims, none of which are implemented consistently enough, and a few unfamiliar ones, which very much need to be taken up individually en masse. And soon.

The familiar ones:

  • wash your hands frequently and properly;
  • cover your mouth (with your arm) when coughing or sneezing;
  • avoid close contact with those who are already infected.

Before brushing off the above as obvious, we should ask ourselves: do we do these with complete consistency? Can we do better? Consider also the following less obvious but equally important behaviours:

Your device screen is a portable petri dish. (Shutterstock)

1. Disinfect your mobile device screen twice per day — it is a portable petri dish, accumulating bacteria and, yes, viruses. Antibacterial wipes are necessary here, as they generally kill viruses as well. Clean your device at least twice daily, once at lunch and once at dinner time (or linked to another daily routine). A recently published study estimates that viruses like COVID-19 may be able to persist for up to nine days on smooth glass and plastic surfaces, like a mobile phone screen.

2. Avoid touching your face. Your mouth, nose, eyes and ears are all routes into your body for viruses, and your fingers are constantly in touch with surfaces that may contain viruses. This simple measure is very hard to maintain consistently, but is essential for infection control.

3. Use masks only if you are yourself ill and give social kudos to people who are responsible enough to use them when sick.

4. Self-quarantine if you are ill and have a fever.

5. Engage your social network to brainstorm other simple behavioural changes.

Preventing spread

Strengthening herd immunity through behaviour is critical to preventing COVID-19 spread. We need to be talking about it more, and doing it more. In the sea of fear-provoking uncertainties, this is something that we are in control of individually and en masse.

Let’s do better about implementing the above precautionary behaviours with high consistency, and over the long-term.

And here’s a side benefit: we will be preventing many other infectious illnesses from spreading, including seasonal influenza, which kills more people in an average month than COVID-19 did last month.

Adventures in Abyssinia – Introducing James Bruce of Kinneard

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Take a look at The Tribuna of the Uffizi by Johan Zoffany. What do you see?
A group of Georgian Grand Tourist poseurs.  But one figure, towers above the rest, stands apart, on the far right of the painting. It is James Bruce of Kinneard, the real Indiana Jones.

James Bruce is introduced in this blog, and in the accompanying short podcast  by our producer, Antonia Dalivalle.  Antonia explores the story of Bruce’s travels in Abyssinia/Ethiopia in her  longer podcast The Real Indiana Jones – coming soon. 

In the left-hand corner of the painting, a jumble of valuable artefacts – including a distressed looking lion sculpture – are strewn across the floor. The connoisseurs are crowded into a chapel-like space, the Tribuna in Florence’s Uffizi Gallery. This was a ‘Holy of Holies’ – a ‘Hollywood Walk of Fame’ – of treasured European antiquities and artworks.

They were on an eighteenth-century equivalent of the ‘Gap Year’. They weren’t finding
themselves – but rather, the roots of European culture, through art, literature and archaeology.

Between coffee breaks at Rome’s Caffè degli Inglesi, the go-to-place for Brits abroad,
members of the landed gentry would draw classical antiquities and attempt to elevate their minds.Zoffany’s painting was designed to be a ‘conversation piece’. And it achieved its aim. In November 1779, Horace Walpole sent a letter to Sir Horace Mann, sneering that the piece is ‘crowded with a flock of travelling boys, and one does not know or care whom’. Bit awkward, considering Horace Mann himself is in the painting.
The son of Robert Walpole (the first Prime Minister of Britain) Horace himself had sashayed through Europe on a Grand – or rather, Grandiloquent – Tour. Instead of following the pack of milordi around the to-do list of Florentine sights, Horace enjoyed balmy evenings on the Ponte Vecchio bridge in his wide-brimmed straw hat and linen nightie, recounting a list of all the sights he couldn’t be bothered to go and see.

Back to the Tribuna. On the right, a small gathering of Grand Tourists admire the Johan_Zoffany_-_Tribuna_of_the_Uffizi_-James Bruce cropvoluptuous posterior of the Venus de’ Medici. One of them goes in for a closer look with his magnifying glass. One figure, towering above the rest, stands apart. In the midst of the swaggering, sniggering gaggle of Grand Tourists, he almost escapes our notice. He’s at the margin of the painting, and seemingly an outsider, but he’s an essential compositional device. He’s one of only three participants in this painting who meet our gaze directly. The ruddy face of Zoffany peeps at us from behind the Niccolini Madonna and Titian’s sassy Venus of Urbino gives us the eye. Is Zoffany trying to tell us something, trying to mark this person out from the others? Who was he? Zoffany thought he was a ‘great man – the wonder of his age’.2 He had
presence. A six-foot four, red-headed Scottish laird, with a loud, booming voice. Despite his raging tempers, he was empathetic and charismatic. His name was James Bruce of Kinnaird.

 

JamesBruceIn 1774, he was in Florence, having just been on a diversion in his Grand Tour. It was a very long and unusual diversion. He went to ‘Abyssiniah’ on his Gap Year.
James Bruce of Kinnaird was the real Indiana Jones. On his black horse Mizra, Persian for ‘scholar’, he visited the ancient city believed to be the Queen of Sheba’s hometown and dwelling-place of the Ark of the Covenant, the Holy of Holies. But Bruce was no interloper. He stayed in Abyssinia, today known as Ethiopia, for three years, from 1769 to 1772.  He would become a familiar of the Abyssinian royal court. Appointed Lord of the Bedchamber to the Emperor, he would gain unique insights into the country’s royal and political history.

He became friends with the Machiavellian Governor of Tigray and fell in love with his wife,Ozoro Esther, a beautiful and brutal princess. When he left Abyssinia, she threw a lavish party for him. They dined on honey and hunted buffalo.

No wonder weedy Walpole was a bit of a hater.   “Africa”, he said, “is indeed coming into fashion. There is just returned a Mr Bruce, who had lived three
years in the Court of Abyssinia and breakfasted every morning with the maids of honour on live oxen”.

Bruce had returned to London excited with the thought of regaling polite society with tales of dining under shimmering African skies with Abyssinian Princesses.
He had gone to Abyssinia to learn about the nation’s people, culture, history – music. He had even brought along a telescope so large it required six men to carry it. When you’re as committed to the pursuit of knowledge as Bruce, you don’t pack light!

Bruce might reasonably have expected a favourable reaction to his antiquarian interests. One of them being ethnomusicology. In 1776, the English music historian Charles Burney had published a letter from Bruce in his book, the General History of Music, where Bruce spoke about the musical instruments he found in Abyssinia. One of them was the Abyssinian lyre. Charles’s daughter – the famous novelist Fanny Burney – was infatuated with the imposing Scot, calling Bruce ‘His Abyssinian Majesty’.

To Bruce’s dismay, however, the London dinner party circuit was less enthusiastic. Instead of the hoped-for adulation, his Abyssinian anecdotes made Bruce a laughing stock.  Horace Walpole even said, “Last spring Mr Bruce dined at Mr Crawford’s. George Selwyn was one of the company. After relating the story of the bramble and several other curious particulars, somebody asked Mr Bruce, if the Abyssinians had any musical instruments. ‘Musical instruments’, said he,  and paused -‘Yes I think I remember one lyre’. George Selwyn whispered to his neighbour, ‘I
am sure there is one less since he came out of the country’. There are now six instruments there.”

Bruce now found himself bearing the punning nickname – the Abyssinian Liar. Worse still, he had to watch as his contemporary, Samuel Johnson, was crowned the leading expert on Ethiopia.To add insult to injury, Bruce was accused of never even setting foot in the country.

Ostracized from the chattering classes of London, he beat a retreat to his castle in the Scottish Highlands. He had returned to Britain with the aim of introducing Abyssinia to Europe, bearing gifts from the Abyssinian royal family. Now he built a museum in Kinnaird to showoff his ‘curiosities’.  But it was a bit of an anticlimax.  One visitor thought it was “just a whole lot of fish pictures”. The English clergyman John Lettice remembered his visit to Bruce’s museum thus, “Before we departed Mr Bruce obligingly accompanied us to an enclosure in his park, to show us his Abyssinian sheep. They are entirely white, except their heads which are black. They are extremely tame, and often very frolicksome. The three or four remaining in thepossession of Mr Bruce are unfortunately all males. One of them bred with a she-goat but the offspring died.”

Bruce might have been teasing his visitor. These sheep sound suspiciously similar to Suffolk Blacks. Bruce’s charisma, and his love of female company, opened doors to the Abyssinian royal court. Back at home they were his undoing. In a characteristic act of chivalry, in April 1794, Bruce rushed to accompany a woman to her carriage after a dinner party. But it would be his last. Having survived shipwrecks, rampant
warlords and Machiavellian rulers, he was felled – by a flight of stairs in his own house in Stirlingshire, Scotland.

Bruce was misrepresented in his own day, and although some of his stories were later proved correct, he is still largely misunderstood. The truth was a moral imperative for Bruce. As he said himself:

“To represent as a truth a thing I know to be a falsehood, not to avow to a truth I ought to declare… the one is fraud, the other cowardice. I hope I am equally distant from them both; and I pledge myself never to retract the fact here advanced”.

And right now, it’s more important than ever to revisit his story.

Notes

Researched, written, and presented by Antonia Dalivalle

Edited by Ian Cozier at The Hall, Chipping Norton
Recorded at The Hall, Chipping Norton
With contributions by Steve Hay, Richard Worland, Michael Levy and Nick Vest

Music:

Intro Music —- ‘Mela Mela’ by Seyfu Yohannes

Musical Interlude  —- Yekermo Sew’ by Mulatu Astatke

End music: ‘Romance Anonimo’ (Romance by Anonymous) for guitar

 

 

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THE PEDAGOGY OF PODCASTS

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Kristi Kaeppel & Emma Björngard-Basayne consider how podcasts can point the way to better teaching and learning:

At various points in the last few years, a captivating, slightly unnerving, and we suspect not unique thought has gripped us: a great deal of our learning happens via podcasts. We say unnerving considering the effort, time, and money spent on formal education, only to realize that this considerably less costly way of informal learning ranks right up there alongside our years of formal schooling (although no, podcasts have not helped us with the tedious, taxing task of improving our writing or research skills. There are limits to what they can do, alas!).

One of the reasons we suspect that podcasts have been so effective in our learning is because of the way they simultaneously inform and delight in ways that instructors often aspire to. That got us thinking about the ways that podcasts can inform our pedagogy. What is it about podcasts that draw the audience in to make meaning and retain the information presented within, that get us excitedly sharing their insights with our friends, and how might we borrow some of their lessons in our own teaching?

Storytelling:

Humans are storytelling creatures who long for narratives that explain events and discrete bits of information. Research has shown that stories facilitate better understanding and retention of a speaker’s points (Zak, 2014). Many podcasts effectively use storytelling to hook a reader, as in the podcast Hidden Brain, which discusses the mental processes that shape our behavior. Before getting into the research that is the spine of the show, the podcast opens with a story of real person, as in the case of the episode “Rap on Trial” that looks at how public perception shapes our judgments. It begins with the story of a rapper arrested on terrorist charges.

This got us thinking about how we can draw our students in with a quick anecdote or story that relates to the topic. One of Kristi’s most powerful classes happened when her students were studying the fourth amendment. On its own, this topic didn’t awaken curiosity and engagement. When a student chimed in and told the story of how the police came to her house searching for her father, a heated, emotional discussion ensued about whether this was a violation of the 4th amendment. Her students won’t be forgetting that amendment any time soon!

Stories can also help facilitate discussion of difficult topics. For instance, Emma usually assigns her students podcast episodes for her Gender & Philosophy course not only to add more context to some of the topics being discussed during lecture, but also to provide the students with opportunities to speak more freely on sensitive topics. For instance, when discussing topics such as Gender Essentialism and Double Standards, Abortion, and Vulnerability by Marriage, it is beneficial to be able to have students engage with other individuals’ stories and experiences rather than feeling forced to draw from their own lives. When students can use stories that they received through podcasts, it decreases their nervousness about potentially being judged by their classmates or feeling attacked by someone’s response to what they shared.

Authenticity and Vulnerability:

Discussing Marc Maron’s WTF podcast, Brian Casel writes, “Marc Maron’s WTF podcast is one of the most successful out there. Why? Because his brand of comedy is all about his raw, introspective honesty. Listening to WTF, I get to hear about all the insecurities, failures, triumphs, and emotions that a professional comic goes through.” Call it sadistic, but we like to hear stories of other people’s failures and mishaps. We happen to see it not as schadenfreude, but as a way to relate and feel connected with others who can so often seem better adjusted and more successful than us. This is particularly true in the way our students view us–experts in our fields who couldn’t possibly relate to struggling with the subject material. By sharing our own doubts and fears, we allow others to do the same and relax in class, relieving anxiety that interferes with learning.

Experiments:

Ira Glass, the renowned host of This American Life, said: “We view the show as an experiment. We try things. There was the show where we taped for 24 hours in an all-night restaurant. And the show where we put a band together from musicians’ classified ads. And the show where every story had been pitched by our own parents, who — wonderful as they are — are not very talented at spotting good radio stories.”

Despite the wacky experiments, the show is one of the most popular, longstanding podcasts out there. Without experimentation, there is no chance of innovation and improvement, and just like Glass and crew, instructors have to be willing to let go of some control and try something new. It may work and it may not. But that’s okay. Be transparent with your students and let me them know you’re trying a new approach. Even failed experiments give us valuable knowledge.

Simplicity:
Podcasts do a great job of breaking down concepts in a simple way, a skill that the best professors have mastered. As an example, when Emma was working on her dissertation she was tasked with making sense of Neuroscientist and Psychologist Lisa Feldman Barrett’s constructed theory of emotions, something which she struggled with greatly. However, one day as she was listening to one of her favorite podcasts, NPR’s Invisibilia, an interview with Feldman Barrett on her emotion work was published. Hearing Feldman Barrett herself explaining her theory, together with the hosts’ reflection on what she was saying, gave Emma a different perspective to approach the text from and suddenly it made more sense. Although an anecdotal experience, we have come to think of podcast episodes like this one as a way to provide students with alternative ways to take in and understand complex ideas.

Relevance:

In reviewing the best podcasts of 2017, The Atlantic writers Laura Jade Standley and Eric McQuade wrote that the podcast world, like any other sphere, is about what have you done for me lately.” Whether we are listening to stories of heartbreak on Modern Love, taking in an interview on Ezra Klein’s show about what Buddhism got right about the brain, or listening to life questions asked on Slate’s Dear Prudence podcast, we are doing so because we want to relate the concepts to our life or those around us. Stories of heartbreak might reveal something about the way we navigate relationships and how to avoid pitfalls. Buddhism and the brain might help us to learn ways to quiet the incessant anxiety that accompanies modern life through meditation practices. Answers to others individuals’ questions regarding how to respond to inappropriate comments from colleagues or friends, such as “what do I do when so-and-so refuses to use my preferred pronouns?” might teach us something about respecting others’ identities.

How can you frame your lessons and material to be relevant to students’ lives? We believe that with a little creativity, most of the concepts we cover can have relevance. It is a matter of connecting the ideas. Even when the relevance may seem obvious to us, it may not be to students.

Not every part of our classes can be as engaging and enthralling as a podcast. Skill-building, in particular, takes time and effort that is not always glorious or fun. Podcasts also aren’t typically made multiple times a week with limited time and a crew of one, as our classes are. Nevertheless, their popularity (a recent joke on Twitter goes that friends starting a podcast is the millennial version of “wanna start a band?”) and their ability to teach their audience shows they are doing something right and worth emulating.

This post was originally published on the UConn teaching blog website (University of Connecticut)

Emma and KristiEmma Björngard-Basayne, PhD recently received her doctoral degree in Philosophy at UConn, while Kristi Kaeppel is a current PhD student in Adult Learning. They’ve worked as instructors and advisors in HE, and they share a dedication to inclusive educational environments. Recent work focuses on the role of women’s friendships in navigating male-dominated work environments.

 

 

Picture at top of this post :  “Podcast listen” by Terry Freedman. It is licensed under CC BY-NC-ND 2.0 

Gathering Storm – can video games make us more aware of the challenges of climate change?

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A new expansion has added environmental challenges to Sid Meier’s Civilization VI, the latest in a popular series of strategy video games that has been running since the 1990s. The expansion – called Gathering Storm – adds new features to the game, most notably anthropogenic climate change and natural disasters.

This blog by academics Noam Obermeister of Cambridge University and Elliot Honeybun-Arnolda of University of East Anglia first appeared on The Conversation website

The game involves developing a civilisation from its humble beginnings in the Stone Age to nowadays and beyond, while choosing from a vast array of technologies and cultural policies. As the game and the ages progress, your energy choices become increasingly important. Indeed, Gathering Storm is based on a simple model of global warming wherein CO₂ emissions from energy sources induce sea level rise, as well as more frequent and intense extreme weather events such as droughts and storms. In turn, these can have potentially devastating effects on your cities and units, pushing the player to think about different adaptation strategies such as flood barriers for coastal cities.

The game even progresses into a “future era”, where players are offered options like carbon capture and storage technologies or “seasteads” to house segments of the population. From early on, this new expansion compels players to think about some of the potential long-term consequences of actions that may offer short-term benefits. One example would be chopping down forests to accelerate production or convert land for other uses which, in the long run, renders a city more vulnerable to flooding and reduces the carbon sink capacity of your civilisation.

Players can build wind turbines, nuclear plants, flood defences and more. Sid Meir’s Civilization / youtube

When asked about whether Gathering Storm was somewhat of a political statement, the lead developer, Dennis Shirk, remained largely agnostic: “No, I don’t think that’s about making a political statement. We just like to have our gameplay reflect current science.” It is certainly true that the game does not coerce players into taking any particular pathway, yet it does include a “World Congress” in which climate or deforestation treaties and humanitarian aid can be ratified. We would also argue that the very inclusion of anthropogenic climate change and an associated system of incentives and punishments is inherently a political act. Moreover, in the social studies of science, what one considers to be “current science” has political ramifications.

In the case of Gathering Storm, for example, in most scenarios a player could probably continue to be a “free rider” and rely solely on technological solutions. That is only possible because those technologies are known in advance and players are given virtually perfect information on the different stages of climate change and its effects. One of the consequences is that the game essentially eliminates the very uncertainty which is inherent to the “current science” on climate change and conveys a sense of technological optimism whereby innovations alone can sustain human prosperity.

We are not suggesting that the developers are necessarily liable or even responsible for promoting these views. Rather we wish to illustrate how different depictions of the future can restrict or encourage certain courses of action. The developers could have chosen to make the effects of climate change and access to mitigating technologies more random (although we do not know how difficult that would be to implement in practice nor its effects on gameplay).

Frostpunk, and surviving the ‘volcanic winter’

In contrast to this incidentally optimistic outlook, there is an interesting Polish video game by the name of Frostpunk. Frostpunk is set in a dystopian alternate reality in which a volcanic event has triggered a colossal global ice age. The game’s primary scenario consists of surviving the winter – which gets incrementally colder as time progresses – in “New London”: a settlement of survivors clustered around a large coal-powered generator. The player must choose between a number of difficult policies and options to ensure the survival of the population. These include 24 hour shifts, child labour, corpse disposal strategies and, more drastically, whether to welcome refugees or refuse them entry.

Frostpunk is a city-survival game in a world where ‘heat means life’. 11 bit studios

While Frostpunk does not directly address the issue of anthropogenic climate change, it evokes extreme scientific scenarios (from the 1970s and 1980s) of global cooling and nuclear winters. The game also takes place in what we understand is Victorian Britain, epitomising the industrial revolution and the onset of the new geological era we now live in: the Anthropocene.

Both these games go a long way in engaging and educating their players on climate change, forcing them to deal with the kinds of . We highly encourage these innovations, not just in video games but more broadly in bridging the gap between science and the digital arts.

In the academic journal Environmental Communication, we argue that science and the humanities (including the arts) need to work together in the case of complex issues such as climate change, so as to better communicate scientific thinking and its political ramifications. Video games – as interactive and playful products – offer truly exceptional opportunities to do just that. We welcome these initiatives with open arms, so long as they remain responsible and stimulate critical thinking.

Main photo: Climate Change, time to act is now by Mario Piperni

13th Cinema Human Rights and Advocacy – Summer School. Apply now!

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The 13th edition of the Summer School in Cinema Human Rights and Advocacy is a training initiative jointly developed by EIUC and CHRA. The 10-day intense training is aimed at young professionals wishing to broaden their understanding on the connections between human rights, films, digital media and video advocacy, to share ideas and foster participatory and critical thinking on urgent human rights issues, debate with experts and filmmakers from all over the world during the 75th Venice international Film Festival and learn how to use films as a tool for social and cultural change.

The Programme

The Summer School offers an exciting programme of lectures, film screenings, discussions and working groups that combine human rights expertise, media studies and video advocacy strategies. The eight sessions develop issues relating to the Universal Declaration of Human Rights illustrated in Films, a History of Human Rights Cinema, Freedom of Expression and Censorship, the Role of the Media in Advancing Human Rights Causes, the Use of Video in Human Rights Documentation and Advocacy, Production and Distribution of Human Rights Films and Social Documentaries, The Role of the New Media during Conflict, Documentary Film Project Development. Each module is illustrated by film or documentary screenings.

The storytelling workshop introduces storytelling and storyboarding key concepts, techniques and exercises that provide participants with the basic skills to develop a short film project to be pitched on the school’s final session.  For the purpose of this workshop, participants will work and be tutored in small groups.

As part of the programme participants are required to watch and analyse a selection of human rights related screenings at the 75th Venice International Film Festival. Whenever possible, filmmakers, jury members and critics from the cinema world are invited to participate to discussions with the summer school participants. Participants will be given a Cinema category Accreditation pass to the Film Festival giving access to a selection of festival screenings.

The school programme may be subject to changes during the film festival period in order to accommodate festival screenings and meetings with festival’s personalities with teaching sessions.

The programme doesn’t include technical aspects of filmmaking and film production.

The Faculty

The faculty is composed by internationally acclaimed experts in film, television, photography and human rights such as: Nick Danziger, photographer and filmmaker; Claudia Modonesi, human rights expert and media trainer with a background in Film studies and an MA in human rights studies; Charlotte Lindsey – Curtet, director of Communication And Information Management at International Committee Of The Red Cross (ICRC); Koen de Feyter, professor of International Law at the University of Antwerp and part-time Professor at PILC and the University of Maastricht; Christopher Hird, Dartmouth Films Founder and Managing Director; Kelly Matheson human rights attorney and award-winning filmmaker who leads WITNESS’ Video as Evidence program; Manfred Nowak, professor of International Law and Human Rights and EIUC – Global Campus Secretary General; Emma Sandon, Senior Lecturer in Film and Television, Birkbeck University of London; and William Schabas, professor of International Law, Middlesex University London.

Registration deadline: 31 July 2018

Course dates: 27 August – 5 September

Target: Graduates, professionals of the human rights, media, NGO and advocacy sector and anyone who uses or is interested in using audio-visual media as a tool for promoting social change are encouraged to apply to the Summer School.

The School selects a maximum of 30 participants.

For more information, contact us at chra@eiuc.org or visit https://eiuc.org/chra