The Wisdom of Whores (Or Ranting of an Epidemiologist experiencing Burn Out): A Review

[Guest guest]

Dear All,I feel this is an excellent piece that Rajiv Dua Wrote on Pisani's " The wisdom of Whores " . Although he posted it on Facebook, I feel it should find its place on the AIDS and other listserves. So here goes with my thanks to Rajiv Dua. - Aditya B

The Wisdom of Whores (Or Ranting of an Epidemiologist experiencing Burn Out): A Review

Rajiv Dua

On recommendation of a colleague I picked up the book " The Wisdom

of Whores " by Pisani, a well-known epidemiologist and a

former colleague. Unlike a review that people write at the end of

reading the book I chose to write this one as I read but the book was

so interesting that I stopped writing and waited till I finished

reading the whole book.

The book is supposed to be an " exposé of the AIDS Industry " . Yes it is

an exposé from the perspective of an epidemiologist. One who has helped

formulate the surveillance system that many countries use today. I am

in the middle of the book and I am still not sure what prompted the

author to do an exposé at this juncture especially of an 'industry' she

is/was part of?

The book reminded me of Dr Arun Limaye, a medical doctor from India who

in the 1980s decided to write an exposé of medical (mal) practices in

India when he got cancer in his now famous and popular book titled

“Chloroform”. He had guilt feelings that he had been part of an

industry or may I say a profession that is supposed to be noble but is

more known for not so noble practices. I wish my friend the

best of health and hope that her intentions of writing this book are to

bring a meaningful change in the direction of the AIDS epidemic rather

than merely a book to cleanse oneself of all the guilt.

As a journalist and epidemiologist, has combined both the

writing styles in a marvellous fashion and makes a simple and lucid

reading that even the frontline people in the HIV and AIDS epidemic

will be able to understand. As I read the book, I could empathise with

Pisani as I am part of the shared history of HIV and AIDS.

brings in her own biases to the book. She focuses on

prevention probably rightly so as currently the amount of money and

'ideologies' supporting treatment over prevention are tilting the

scales, to the point where if not intervened we shall never be able to

contain the epidemic. Of course readers will say that I am trying to

'beat up' as Pisani would also put it. But working in Africa I find

that if one does not scream - one is never heard.

is very judgemental to the point of sounding condescending

when she talks about Eastern Cultures - as she describes the " ugly "

turquoise dresses of airhostesses of Malaysian Airlines. Or she forgets

to acknowledge that there were people like Purnima Mane, Carol Larivee,

Geeta Sethi in the region who not only researched but also did their

best to bring the epidemic to the world's attention long before the

current band of Beltway Bandits (as Pisani loves to call some of the

current INGOs) even stepped onto the scene.

Of course Pisani does a bit of disservice to the history when she gives

credit to gay men and other activists only in the last chapter after

she has denigrated the Beltway Bandits and then praised these same

Bandits for their achievements. She may have forgotten that Beltway

Bandits including our former employer FHI would not have been able to

break grounds in data collection or interventions had there not been

people like Dede, Ashok, Shivananda, Meen Seshu, Preeti Paktar on the

scene much before the bandits appeared.

The author tries to find an equation that " where there is money there

is ideology " . Well in the health sector there are diseases like polio

where there is no money and yet there are ideologies, or vaccine

development (apart from HIV) like HPV where there is money and ideology

and its not HIV or Reproductive Health that has ideologies and little

money now. Essentially if anyone has looked into the health sector

closely one would know that religious and political ideologies play a

great role in the designing of the interventions - money or no money.

I congratulate to be able to call spade a spade and point out

the key issues that let the HIV epidemic go unchecked even when we have

all the means to stop it. I highly recommend the book for all those who

touch the HIV and AIDS sector to see where they stand. Are they in the

sugar bowl or they are just collecting the sugar even without having to

touch the bowl?

As people read this book they will realise that HIV and AIDS is a fast

moving target. Since Pisani wrote this book, Thabo Mbeki with Manto is

out of power. Uganda is showing reversal in its gains of the HIV

prevalence, as it tables a bill in October 2009 in its parliament that

criminalises even talking about or advocating the rights of Men who

have Sex with Men and makes it a criminal offence, making us realise

that there are no permanent failures or gains in the HIV epidemic. We

need to be on our toes forever to control HIV.

I really hope that this books helps us all to refocus our energies on

the HIV and AIDS epidemic in a more scientific manner and address the

issues of Whores, Faggots and Shooters, the key populations without

whom one will not be able to limit this epidemic.