E.P. was a US expat kid who lived all over the world growing up and therefore naturally enough I guess wound up getting a superlatively useless liberal arts degree in Classical Chinese* and becoming a reporter for Reuters across Asia. She then jumped ship to epidemiology, getting a PHd in same in London and then working in Asia for the UN or for UN-affiliated NGO’s on AIDS transmission reduction programs for another decade or so. The book is her first-person account of her days in the trenches in the worldwide war against AIDS, and it is written in her distinct and delightful own voice. Her writing is in parts a model of skillful expository prose explaining the technical scientific issues of epidemiology and AIDS biology to the lay reader. It is also in parts a surprisingly informative sociological study of sexual practices in several Asian countries, first and foremost Indonesia. Another part is sociology of drug useage–sex and drugs being the two leading vectors for AIDS transmission–which gets frank and honest treatment, too. Other parts are first-rate explanatory reportage of the political issues in both the first and third world’s responses to the AIDS epidemic. And then there’s the autobiographical parts which are by turns wise, funny, brave, relentlessly honest, and full of human understanding and human decency.
A careful reading of this book is going to give readers a fair amount of knowledge of all the things above. Now with knowledge, there’s more different flavors of knowledge than ice cream. Factoid knowledge, like what most journalism is, is the most common, the vanilla variety, and that’s readily enough available anywhere. This book is full of one of the less common flavors of knowledge, that of understanding. There is much understanding to be gained, and savored, from this book. Her scientific writing skill is apt to for most readers to replace scattered science factoids from years of reading news articles with a coherent picture of the biology issues involved. Ms. Pisani’s sociological writing on sex, pay-for-sex, and drugs in those parts give us understanding of the societies and peoples there that we would never get otherwise, on account of these topics being generally off-limits for polite news coverage. What is most impressive is her political coverage meshing with her biographical war stories. Reading this book is going to give you a real understanding of how the foreign aid bureaucracies work, their strengths and weaknesses, what can work and what won’t. Not just on the AIDS issues, but on any other foreign aid/development issue.
So why is this book ignored here in the States? I’d say that there are three different reasons for it, all bad. First is Ms. Pisani’s willingness to step hard on any ideological toe that’s in the way of scientific truth. As politicized as AIDS has been here in the US, this means that there are many toes being trod on hard. Gay AIDS activists and fundamentalist bible-thumps both come in for their hard licks. Both of these groups are quite capable of large quantities of high-volume moralistic outrage in newsmedialand whenever they so choose, and consequently to avoid same these two groups are generally respectfully treated and placated by editors and owners to whatever degree required. Generally the best way to avoid having to do this is to ignore them as much as possible, and let them get on with their own business unmolested by that pesky reportorial inquiry. Best to ignore this book then.
Second reason concerns President Bush and his administration, which has authored of late a major expenditure of $60+ billion of US taxpayer funds, much to the UN and NGO’s, for AIDS treatment and prevention. Mainstream US newsmedia traditionally acts as cheerleaders for the US government, whoever is running it at the present moment, and for whatever they are doing. Currently even the present crew of servile dullard editors are having a very hard time of doing this job with BushII at the helm, what with two wars of aggression failing, and the painful economic policy stupidities of his administration impossible to paper over. This initiative might be the only major humanitarian legacy of the 8 years of BushII, and consequently it is getting more respectful reportage–EP would call it another beat-up–than it would otherwise. It is also being exempted from hard scrutiny about how the funds are being spent, and the question of if we–the US and the world both–are getting results for the money spent is not being asked.* If this book has any real weakness it is that it does not go into enough detail on how badly we probably are wasting money with the BushII AIDS initiative. In the author’s defense, it can be fairly stated that this is beyond the scope of her book, both in its time frame and in its personal/autobiographical framework. But someone needs to look into it–last I heard $60 billion was still real money.
The third, and most disturbing reason why I think this book is ignored stateside is that I suspect that the issue of AIDS is mostly out of fashion here these days, and has been for some time now. In ’96 here in Austin I caught snobby fashion grief at a party for wearing an AIDS ribbon to it, and I doubt things would be any different today. Editors are creatures of fashion as much as anyone else, hell they try harder than most people to be hip and in tune with what is going on, and for reasons impossible to rationally explain AIDS is out of fashion and therefore we need not spend much time and effort on it. Right?
All three of these reasons, working together***, are causing this fine and important book to be ignored and neglected by the US newsmedia, and the American people and nation, and the worldwide effort against this horrible scourge, are thereby hurt. It reflects poorly on the US and its literary/political/scientific intelligentsia that this is the case.
I recommend this book most highly. It is a truly rare mixture of sex and science, wit and heart, entertainment and learning. A rare book, a timely book, and an important book. I’m looking forward to her next.
*Well, almost superlatively useless liberal arts degree. On pp195-196 E.P. tells of how she quite dropped a bomb on a senior Chinese government health bureaucrat who was giving her a brushoff about how Chinese sexual practices meant low AIDS risk. EP whipped out her knowledge of the (Mao-banned) Ming Dynasty literary porn classic The Golden Lotus on his ass. It is an outrageously funny if a bit mean episode and should give all us liberal arts majors some hope of yet pulling out some arcane knowledge rabbit out of our degreed hats at the appropriate time to wonderful effect like here. Myself, 25 years on I’m still waiting for my chance.
**Ms. Pisani makes plain that US ideological constraints on AIDS funding, implemented to placate fundamentalist Christian Republican voters cause many of our AIDS programs to be ineffective and hence to be a waste of money. There are also cases cited of fundamentalist-sponsored and/or hindered programs causing damage to other effective, non-ideologically/morally hamstrung programs, simply by either competing for scarce in-country resources, or by irritating target groups or governments with unwise, irritating acts and policies. Case in point are the various ‘let’s save the sex workers and prevent AIDS from spreading by teaching them sewing’ programs that we’ve sponsored in the past, and probably are continuing today. That sort of stupid nonsense just pisses everyone there off, and they might still be pissed off the next time you come up to them with something useful.
***There may well be a fourth reason. I am suspicioning that the word “Whore” is in the process of becoming a word that can no longer be used in proper society, under any circumstances, here in the USA. Can’t say nigger, and you can’t say nigger-rig either. Why this is the case–I certainly don’t see any movement towards sympathy or political empowerment or liberation from discrimination towards prostitutes going on–needs looking into.