Helen Epstein is a writer specializing in public health and an adjunct professor at Bard College. She has advised numerous organizations, including the United States Agency for International Development, the World Bank, Human Rights Watch, and UNICEF. She is the author of The Invisible Cure: Why We Are Losing the Fight Against AIDS in Africa and has contributed articles to many publications, including The New York Review of Books and The New York Times Magazine. Her research for the article in the November 5, 2015 issue was supported by the Open Society Foundations.

The Cost of Fake Democracy

Police chasing a supporter of Ugandan opposition leader Kizza Besigye, Kampala, Uganda, February 19, 2016

It’s become fashionable lately to disparage democracy. From the failure of “nation building” attempts in Iraq, to the rise of Donald Trump, some see government of the people as a liability in a violent and polarized world. Readers who find such arguments appealing might want to consider moving to impoverished, corruption-ridden Uganda, ruled by President Yoweri Museveni for thirty years through a combination of bribery, blackmail, and brute force.

Uganda: When Democracy Doesn’t Count

Riot police dispersing a gathering of opposition supporters in Jinja, eastern Uganda, September 10, 2015

In exchange for putting Ugandan troops at America’s disposal, Uganda has received some $15 billion in foreign aid from the West since 1990 and a virtual free pass from the US when it comes to human rights violations. Its presidential election on February 18 may be decided outside the voting both.

The Strange Politics of Saving the Children

UNICEF’s executive director Jim Grant at the São Martinho children’s shelter, Rio de Janeiro, Brazil, 1992
The United Nations Children’s Fund, or UNICEF, was established shortly after World War II to improve the lives of children worldwide, but it was facing hard times when Jim Grant took over as executive director in 1980. In the poor countries where the agency did most of its work, 15 …

Who’s Afraid of African Democracy?

Security forces facing off with protesters in Bujumbura, Burundi, May 20, 2015

As the events in Burundi suggest, US support of ugly regimes may ultimately undermine the very stability we are supposedly seeking. In many cases, austerity programs, intended to lead to more efficient government, instead encourage unprecedented corruption.

Ebola in Liberia: An Epidemic of Rumors

Liberian President Ellen Johnson Sirleaf; portrait by former President George W. Bush from his exhibition ‘The Art of Leadership: A President’s Personal Diplomacy,’ at the George W. Bush Center in Dallas last spring
Eventually Ebola will be contained in Liberia, and next time people should be ready for it so fewer will die. Maybe none will die if new medicines are developed by then. But the virus has shed light on a far tougher problem. Many Liberians don’t trust their president or her government.

Colossal Corruption in Africa

Zambia's former president Kenneth Kaunda, 2000
There’s a lot of money to be made in Africa, with its vast reserves of oil and gas, its abundant gold, diamonds, uranium, and other minerals, its timber, ivory, and fish. The ongoing Ebola epidemic in West Africa obscures the fact that the continent’s fast-growing population includes hundreds of millions …

Liberia: The Hidden Truth About Ebola

Three people with possible Ebola symptoms awaiting treatment near Monrovia, Liberia, October 24, 2014

Even as Ebola hysteria rages in the US, the epidemic here in Liberia, which is supposed to be its epicenter, seems to be subsiding. According to official counts, this impoverished country of 4 million people is currently home to fewer than four hundred Ebola patients and the number of new cases is declining. The paranoid US response could make the disease far more dangerous than it currently is.

Uganda: The General Challenges the Dictator

Uganda’s President Yoweri Museveni has long been an important US ally in the war on terror—his troops have been deployed on America’s side in Somalia, Sudan, Afghanistan, and Iraq. In fact, Museveni has made Africa even more dangerous. And even as US officials made lofty pledges to support African democracy, Museveni used looted development funds to close off nearly every peaceful means of loosening his grip on power.

Murder in Uganda

Ugandan MP Cerinah Nebanda and President Yoweri Museveni, from the cover of a Ugandan news magazine published shortly after Nebanda’s death in December 2012. The headline read ‘Nebanda’s Death, Museveni’s Reaction: Will Uganda Become an Open Dictatorship in 2013?’
Politics in Uganda is not for the faint-hearted. For years, opposition supporters have been beaten, robbed, murdered, imprisoned in secret police cells, tortured, and charged with treason. Ruling party supporters have shut down the generators of radio stations and even destroyed bridges to prevent opposition candidates from campaigning in some areas. The supposedly impartial Electoral Commission has used donor-funded “civic education” programs to campaign for the ruling party. Cell phone companies and radio stations had been intimidated into refusing to carry opposition advertisements and even text messages.

Uganda’s Anti-Gay Law: The Missing Science

People reading a list of alleged gays in Red Pepper, Kampala, Uganda, February 25, 2014

Ugandan President Yoweri Museveni claims he signed an anti-gay bill into law because there is no scientific evidence that homosexuality is determined by a person’s genes, and is therefore “deviant” behavior. But my own research suggests homosexuality, and all sexual preference for that matter, is probably at least partly genetic.

The Doctor Who Made a Revolution

Dr. Sara Josephine Baker of the New York City Health Department, circa 1912
By the time Dr. Sara Josephine Baker retired from the New York City Health Department in 1923, she was famous across the nation for saving the lives of 90,000 inner-city children. The public health measures she implemented, many still in use today, have saved the lives of millions more worldwide. She was also a charming, funny storyteller, and her remarkable memoir, Fighting for Life, is an honest, unsentimental, and deeply compassionate account of how one American woman helped launch a public health revolution.

Why Are We Funding Abuse in Ethiopia?

Workers at a Saudi-owned rice farm in Gambella, Ethiopia, March 22, 2012

In 2010, the Ethiopian government began moving thousands of people out of the rural villages where they had lived for centuries to other areas several hours’ walk away. The Ethiopian government calls this program the “Commune Center Development Plan and Livelihood Strategy” and claims it is designed to bring scattered rural populations closer to schools, health clinics, roads, and other public services. But the Commune Center program has been marked by a string of human rights abuses linked to government attempts to clear huge tracts of land for foreign investors. According to testimony collected by Human Rights Watch and other groups over the past two years, the relocations have involved beatings, imprisonment, torture, rape, and even murder.

Lead Poisoning: The Ignored Scandal

A child with high levels of lead in her blood walking past a wall of peeling lead paint in her family’s apartment, Brooklyn, July 2003
Millions of children have had their growth and intelligence stunted by lead-contaminated consumer products—and some five million preschool children are still at risk today. One expert even estimated that America’s failure to address the lead paint problem early on may well have cost the American population, on average, five IQ points—enough to double the number of retarded children and halve the number of gifted children in the country.

Obama: Failing the African Spring?

President Barack Obama preparing to address Ghana's parliament, Accra, Ghana, July 11, 2009

For years, observers have wondered what the US administration’s policy toward Africa really is. Then, three years into Obama’s first term, the White House finally released its first Africa strategy document. It states that the US will “promote strong democratic norms” and “support civil society actors who are creating vibrant democratic models….” But as the situations in Ethiopia, Rwanda, and Uganda make clear, little has been done to further these aims. While continuing most of the development and public health initiatives of the Bush Administration, the Obama administration has given priority to US military aims.

The Wrong Way to Fight Polio

A child suffering from Polio outside his house near Islamabad, Pakistan, July 6, 2011

The killings in Pakistan this week of nine members of a Polio vaccination team were heinous. But they also point to some serious problems with a UN-led campaign to eradicate Polio. For one thing, in conflict areas where the US is trying to route out insurgents with drone strikes, the UN is often not seen as neutral. But more fundamentally, the lavishly funded, multiple immunizations that the program requires don’t always make sense to ordinary poor people who are struggling just to keep their children alive. In order to avoid further tragedies, donors should work more closely with local people to improve the health of children in general, rather than strive for some romantic victory over a single virus alone.

South Africa’s AIDS Orphans: Breaking the Silence

A child in the Phomolong center for AIDS orphans in Tembisa, Johannesburg, 2003

When I first visited South Africa in 2000 to report on the AIDS epidemic there, one adult in five was HIV positive, and a million children had lost one or both parents to the disease. But what really amazed me was that no one was talking about this. Silence gripped the nation like a spell. People with obvious AIDS symptoms told me they were suffering from “ulcers” or “tuberculosis” or “pneumonia.” Orphans said their parents had “gone away” or had been “bewitched” by a jealous neighbor. Now, five courageous teenagers from a Cape Town slum have made a fifteen-minute film called Young Carers: Through Our Eyes about what it’s like to lose a parent to AIDS. It’s one of the most powerful films about the epidemic I’ve ever seen.

New York: The Besieged Children

Shirley, a former foster child and now a mother in Borough Park, Brooklyn, commented about foster care,‘I was just a puppet on a string; I was so used to being pulled wherever I was told.’ From the book Everybody Needs Someone: The Aging-Out of Foster Care Project, which collects the stories of fourteen former foster children and has just been published by SalaamGarageNYC. A companion exhibition will be on view at the Long Island Children’s Museum, June 16–September 2, 2012.
Across the country poor families have suffered more than any other group from budget cuts in recent years. In New York alone, thousands of subsidized daycare, preschool, and after-school programs have been eliminated, along with treatment programs for parents with drug and mental health problems and emergency financial assistance to help struggling families. Meanwhile, welfare rolls have shrunk, even as poverty has risen.

What the US Is Ignoring in Uganda

A woman running away from tear gas that was used by Ugandan authorities to disperse well wishers welcoming opposition leader Kizza Besigye back to Uganda, May 12, 2011

During the Cold War, Western nations supported numerous African tyrants who brutalized their own people and held economic and social development back for decades. This did our international reputation no good, and helped create some of the most serious foreign policy problems we face today. Now it seems, we are doing it again in Uganda.

Beware Tamiflu!

I wish to draw readers’ attention to some new research on the neuropsychiatric side effects of Tamiflu of which I was unaware when my article “Flu Warning: Beware the Drug Companies!” went to press.

In an article dated December 2010 (but published in March 2011), Toshiharu Fujita and colleagues presented a study of 9,386 influenza patients under the age of eighteen. They found that episodes of loss of consciousness were roughly 80 percent more common among those who had taken Tamiflu compared to those who had not.

Flu Warning: Beware the Drug Companies!

A leaflet ready for issue to the public in the UK in response to growing fears of a global pandemic of swine flu, spring 2009
On June 11, 2009, Margaret Chan, the director-general of the WHO, announced that a “pandemic emergency”—or worldwide epidemic—of H1N1 influenza was officially underway. Governments around the world placed immediate orders for anti-flu drugs and vaccines. The predicted dire emergency did not occur. The WHO maintains that its decisions were based on the best available evidence, but last year European governments, stuck with hundreds of millions of euros’ worth of unused medicines and vaccines, began asking questions.

Cruel Ethiopia

Ethiopian Prime Minister Meles Zenawi, Addis Ababa, July 2008
Parts of southern Ethiopia resemble the scenery in a Tarzan movie. When I was there last fall, the green forested hills were blanketed in white mist and rain poured down on the small farms and homesteads. In the towns, slabs of meat hung in the butchers’ shops and donkeys hauled huge sacks of coffee beans, Ethiopia’s major export, along the stony dirt roads. So I was surprised to see the signs of hunger everywhere. There were babies with kwashiorkor, a disease caused by malnutrition, which I’d assumed occurred only in war zones. Many of the older children were clearly stunted and some women were so deficient in iodine they had goiters the size of cannonballs.

America’s Prisons: Is There Hope?

Jean O’Hara, founder of the group Survivors of Murder Victims, talking to inmates about her murdered daughter and grandson during a victim impact class, one of the programs in the Resolve to Stop the Violence Project (RSVP) at the San Francisco County Jail in San Bruno, circa 2003
America’s prison system is in a dire state. Some 2.3 million people in this country are now behind bars, five times more than in 1978. Our incarceration rate is now higher than that of any other country in the world. Many, if not most, inmates probably should not be there.