Health

By Michele Leight

The good news is that the New Delhi Government in India has promised free HIV/AIDS medications to all infected residents by April, 2004. Experts report that progress is being made by China in beginning to deal with the AIDS problem. India is now ranked second in HIV/AIDS infections after South Africa.

The bad news is that child prostitution and sex trafficking is increasing worldwide, therefore raising the specter of further HIV infections. At the same time, baby selling rackets are flourishing in Southeast Asia.

In an article entitled ""The Politics of AIDS" in the February 2004 issue of "Foreign Affairs," published by the Council on Foreign Relations, Holly Burkhalter, the director of U.S. Policy and of the Health Action AIDS campaign at Physicians for Human Rights, delivers a broadside to those who continue to turn away while millions around the globe become infected with HIV/AIDS, and many more millions languish without care as the world's most pernicious virus attacks their immune systems, erodes their dignity and threatens their lives:

"Seven years after the development of the "cocktail" of drugs now widely used to treat AIDS in the West, fewer than one percent of sub-Saharan Africans and five percent of Asians who need it have access to it. The single most important impediment to universal treatment is the exorbitantly high cost of the medications. Pressure from AIDS activists has driven down the price of treatment from thousands to hundreds of dollars annually. Yet even at these prices, generic drugs remain well out of reach for the poor in the developing world; extensive foreign aid for treatment programs is therefore essential."

Where is the outrage? Ms. Burkhalter asks. A good question - without an answer at present - because in most of the countries experiencing a rapid escalation in HIV/AIDS infections, the subject is engulfed in silence, despite valiant efforts by activists and increasingly inlvoved governments.

There are several reasons why AIDS is a taboo subject, but mainly it can be isolated to one overriding issue: it is, to a great extent, a sexually transmitted disease. The bedroom or brothel are off limits. As the global HIV/AIDS pandemic continues to gain momentum, threatening the economy and stability of countries like India and China, with vast populations, it will not be possible for anyone to deny the existence of this plague much longer. Increased prosperity will be continually undermined by the cutting down of families and communities as the virus maintains its forward march.

Ninety-five percent of people with AIDS live in the developing world.

As I was writing this report a young Hispanic man who has become a good friend of our family came to visit. He lives in one of the most notoriously unsafe and drug infested housing projects in Brooklyn - which means in the nation. He is one of the kindest and gentlest 18 year olds I have ever known, and is the father to a two year old son who he adores.

Despite his youth, I have not seen any father take care of a baby the way Carlos takes care of his son. He works night shifts when he loses his day job, he works day and night jobs: whatever it takes to keep his family afloat. All the jobs he has been able to get are underpaid, require long hours, weekends and few holidays - but he says he will do anything to avoid pushing drugs, which is what most of the young men in the projects do to earn a living. "I don't want my son around drugs," he says. By drugs, Carlos means all kinds of drugs, including heroin; he hopes some day to go to college.

Carlos said he had been consoling a close friend whose mother had died recently. I asked him what she had died of. He paused for a moment and said very softly, not taking his eyes off me for a second: "She died of AIDS."

Months ago,when I first raised the issue of Black and Hispanics being particularly vulnerable to HIV/AIDS in this country, Carlos did not say much. He just sat silently - in denial - because it was painful. Now, each time we meet, he tells me of another death in his project or a neighboring one - deaths that could have been prevented with ARVs and care, but the stigma and shame associated with a disease causes many infected African Americans - and increasingly Hispanics - to hide their HIV status.

It must be said here that one can only imagine the isolation of someone who is locked indoors dying slowly from an illness, coupled with the fears inherent in raising a family in surroundings known for drug busts, shoot outs and constant intimidation of family members who do not want to buy or sell drugs. Because of the additional fear factor, this is almost worse than dying alone in a developing nation - and it is going on right here in the United States.

Carlos describes it best:

"When my friend asked his mother to go to the doctor she said: 'Just leave me alone. I do not want to live.'' It is hard to imagine a more hopeless sentence that that. It is the circumstances of her life - poverty and AIDS - that result in despair.

Carlos has had the benefit of sex-ed in school, has a "can-do" attitude, and understands that AIDS is preventable. He also understands that he represents a new generation, born of freedom and education: "It is different with them, the older people," he said. "I would definitely get the medicines to keep me well." Carlos has changed completely in his attitude to AIDS and will soon be involved in an AIDS outreach and advocacy program in his housing project. Barely six months ago he never said the word AIDS: now he knows that silence does no good.

While we as developed nations have earned freedom and wealth and stability - and healtcare and human rights - we stand apart from the misery poverty and bondage of others. We have the medications that can ease their suffering, and the power to change their circumstances, but thus far we have chosen not to act so that ARV medications reach the world's poor faster.

Every day lost results in more senseless deaths, and the anti-retroviral medications debate hangs like a hatchet over the dying while world governments and pharmaceutical companies, economists and policy makers haggle over generic versus patented drugs, further prolonging the agony of those whose lives hang in the balance - including very small children.

In "Sex Slaves on Main Street," a disturbing article published January 6, 2004 in The New York Times Magazine, Peter Landesman chronicles atrocities that compare with the worst in the world - at any time in history - right here in the United States. Why is he so harsh on Americans asks an Asian friend, who has witnessed atrocities in South East Asia all her life?

In the context of this particular story, Mr. Landesman indicts American men who are creating a demand for sex with young girls and allowing sex slavery to continue under their noses - where the girls earn no money but are owned, body and soul, by the traffickers who profit from them - all under the banner of democracy and freedom. Perhaps these men do not know the girls earn nothing. No one seems to care about their circumstances because they are not American girls - they are Mexican and other nationalities. How would these same men feel if their American daughters - or sons - were kidnapped and sold into sex-slavery in a foreign country?

It is inconceivable that the men who use 12 year olds for a "quicky" at lunchtime in a quiet suburb of metropolitan New York do not know that they are supporting an industry that rapes innocence, rents out toddlers to pedophiles and trafficks in kidnapped girls and women from as far afield as the Ukraine, Latin America and all of South East Asia: Mr. Landesman also indicts Russian sex-traffickers on every count, closely followed by their Asian and Mexican counterparts. Money is the motivator to traffickers and we learn in his story that a beautiful, blond Russian girl of 17 can fetch $10,000 in Baja California. It does not appear to sink in to either party that what they selling and purchasing is not a Rolex watch but a human being.

It is easy to see how all sexually transmitted diseases, including AIDS, can enter the monogomous or innocent population when secretive sex of this nature flourishes: the standard of hygiene reported in Mr. Landesman's story is terrifying. The well dressed men who drive fancy cars to suburban homes to rendevous at lunchtime with Mexican and Russian girls their daughter's age also go home to wives and children - and who knows whether protection has been used? What is especially chilling is that women are used by the sex traffickers to 'break the unwilling girls in.' They are usually women who were once in the sex trade themselves, but are now" past their prime."

In a recent raid on a respectable looking suburban home in Plainfield, New Jersey (where American flags flutter in the wind notes Peter Landesman), police found several undernourished, 12-16 year old girls of Mexican origin who spoke little English. Mr. Landesman writes:

"The police found a squalid, land-based equivalent of a 19th-century slave ship, with rancid, doorless bathrooms, bare, putrid mattresses, and a stash of penicillin, "morning after" pills and misoprostol, an anti-ulcer medication that can induce abortion. The girls were pale, exhausted and malnourished."

Mr. Landesman also describes the reaction of a government agent:

"I consider myself hardened...I spent time in the Marine Corps, but seeing some of the stuff I saw, then heard about, from those girls was a difficult, eye-opening experience," said Mike Kelly, now a special agent with Immigration and Customs Enforcement (the largest investigative arm of the Department of Homeland Security).

According to Mr. Landesman:

"In reality little has been done to document sex-trafficking in this country. In dozens of interviews I conducted with former sex-slaves, madams, governments and law-inforcement officials and anti-sex trade activists for more than four months in Eastern Europe, Mexico and the United States, the details and breadth of the sordid trade in the US came to light."

According to State Department estimates, there may be as many as 50,000 sex-slaves in captivity in the United States at any given time. Due to the nature of their work, these girls wear out fast, and are immediately replaced by fresh recruits by the traffickers. The girls are without documentation, so it is reasonable to assume that many die when they try to escape - and they do try to escape, which is how Mr. Landesman got his story in the first place. In almost all cases, the ex-sex slaves who were interviewed reported violence.

Holly Burkhalter takes on the issue of sex trafficking in her article in Foreign Affairs, entitled "The Politics of AIDS":

"Conservatives have highlighted another neglected but significant source of AIDS transmission: the violent sexual exploitation of trafficked women and children. The issue is hardly minor; the State Department estimates that India alone has 2.3 million women and under-age girls forced into its sex industry, and in Africa AIDS is fueling an epidemic of sexual predation against ever-younger girls as older men seek safe sexual partners. The pandemic is also generating millions of orphans and street children throughout the developing world who are especially vulnerable to rape and to being forced into the sex industry."

Outraged at the idea that sexually exploited children and women are "sex workers" Ms. Burkhalter continues:

"Forcibly prostituted women and sexually exploited children are not 'sex workers' but victims of crimes, including multiple rapes daily. They are particularly vulnerable to AIDS transmission, but their needs are not addressed by conventional prevention programs, which are designed for voluntary sex workers and stress empowerment, health care and access to condoms. Reducing harm for trafficking victims involves not encouraging safer sex but removing them from the sex industry." The article reports that several of the most prominent service providers in Thailand actively oppose rescue and rehabilitation, and some rehabilitation facilities in India refuse to accept child prostitutes who have been rescued.

One has to ask oneself a simple question after reading Mr. Landesman's story in The New York Times Magazine on a Sunday morning after a hearty breakfast of eggs and bacon: has our society ever been as depraved from the perspective of children as it at this moment in history?

The Internet has hardcore porn and kiddy porn sites that are grotesque beyond imagination, and experts in child and female sex trafficking say there is a direct link between the proliferation of harder and harder porn on the Internet and the corresponding demand for "harder" paid or unpaid sex with children, girls and women: the 'copycat' syndrome.

Members of pedophile clubs from the United States, Australia and England (in that order), land in Bangkok and other cities in South East Asia and party on small children lined up specifically at their request by traffickers, 'madams' and pimps - and they have the dubious distinction of having created the demand. The children are grouped in age ranges from 2-4, 5-12 and upward. Some of these children do not survive the physical punishment required in their "work" for more than a couple of years.

The good news is that any American caught using a child for sex in another country will find themselves subjected to the same laws governing sex with minors when they return to the States. It is no different in the eyes of American law as violating a child at home: it will result in lengthy jail time.

America is not the only country with pedophiles: most countries have them. Our are easier to spot because they advertise themselves on the internet.

A colleague who lived in New Zealand for 4 years describes following reports in the local paper accusing groups of New Zealand and Australian men of flying to South East Asia to "have a weekend of sex with kids." These men did not consider themselves pedophiles, and thought sex with a 5 year old boy or girl perfectly normal - as long as they weren't New Zealanders.

When these men learned that the New Zealand and Australian governments were about to pass a law that would prosecute citizens at home for crimes perpetrated against children abroad, they made multiple phone calls to local travel agents, asking them to book them on a "trip" before the law was passed. The travel agents passed their names and phone numbers on to the police and child welfare agencies.

The single most challenging aspect of the AIDS epidemic in the developing world today is to assure those who are suffering with HIV/AIDS that the stigma that surrounds them is unjust and that they have the human right to health. It is still an alien concept in countries without a health care infrastructure or a belief that a dying person should be cared for by society.

"Are you crazy.?" someone asked when I suggested that their company pay for medical costs and ARVs for people with AIDS in a local Delhi AIDS shelter:

"They are dying, what is the point?" My response is unprintable, but those views are typical of the fatalism and entrenched beliefs of the healty and wealthy in the developing world: Something bad those people did - in this life or a past life - has brought this plague upon them. It is their fate; their karma; not my problem.

In a country like India where "untouchability" is factored into an ancient and ingrained caste system, a diseased person or a prostitute is potentially an "untouchable" and putting your hands on them or even being in the same room as them defiles your sanctity if you are a high caste Hindu.

What is going to happen when these same high caste human beings acquire HIV/AIDS? The tentacles of this virus have no boundaries: AIDS will attack a high caste, wealthy person in just the same way as it will a low caste poor one.

Recently, two activists were killed in India for the crime of working to empower "untouchables" or low caste human beings. They were put to death by extremists because they were guilty of allowing untouchables to think that they were the equal of any man or woman. While this is a minority point of view in India, it demonstrates how menacing things can be for an activist in the developing world even now. India is a democracy: countries like Burma and China are even riskier for AIDS activists.

In an unprecedented and heroic move, the New Delhi government has promised free anti-retroviral medications to all Delhi residents - rich or poor - by April 2004. This is a welcome and committed sign that the leadership of India is trying to do its part. However, Dr. Peter Piot, Director of UNAIDS says that government officials meet resistance at every level of Indian society because the stigma associated with the disease is so entrenched. Many philanthropic Indians do want to help PLWHA (people living with HIV/AIDS) in their country, but they need a more supportive environment to make any impact. The AIDS epidemic is in danger of spiralling out of control and Dr. Piot warns that now is the time to challenge the virus, before it is too late.

With repeated violations against females within and without marriage, no sex-education for millions of unkowing youngsters in schools and no mandatory blood tests for HIV and STDs prior to marriage, (a blood test is mandatory before marriage in developed nations), India is gambling with a potential health catastrophy. While voluntary HIV-testing is advisable in a situation where stigmatizing individuals will be the inevitable outcome, and treatment at present unlikely (except in New Delhi), in the arranged marriage scenario HIV-testing is vital.

Marriage in the context of AIDS also involves the likely creation of a new life: innocent babies should not become victims of an incurable disease for want of a simple test. More and more young Indian - and African - girls are acquiring the virus because they have been married off to HIV-positive, older men, often as part of land or property settlements. In Africa and increasingly South East Asia, older men are seeking very young virgins as wives or sexual partners for fear of AIDS. Anti-sex trafficking advocates are finding more clients in the sex trade requesting "virgins," for the same reason.

What is also compounding the global epidemic is that those who are continually violated in the developing world - predominantly women, children, and prostitutes - know that there are no laws in place at present to protect them from scenarios that are guaranteed to infect them with STDS, HIV/AIDS - or death. Clients in the sex industry, rapists withing the family or an angry spouse who is HIV infected but does not take kindly to being denied his conjugal rights - will most likely not use a condom because the woman has no right to insist upon one. It is the woman who is punished by society if she gets AIDS, so she develops a "What's the use?" fatalistic attitude. A woman of 'low caste' is especially vulnerable.

Two years ago I was in New Delhi when the Parliamentarian Phoolan Devi, "The Bandit Queen." was gunned down on her own doorstep by thugs who disappeared without a trace. As a low-caste child and young girl, Ms. Devi had been gang raped several times in her small rural village in Uttar Pradesh. The high-caste Hindu men who raped her were committing no crime in the opinion of the village elders, or themselves, because she was an "untouchable" of low caste. It is interesting that untouchability did not extend to sexual relations in the case of these men.

Ms. Devi armed herself with a gun and systematically killled most of the men who raped her, with the help of local insurgents who sympathized with her sense of outrage. Phoolan Devi became a member of parliament, elected to office by thousands in her home state who adored her because she mirrored, and opposed, the atrocities they were forced to endure in silence every day.

Rumors spread that the thugs who murdered the "Bandit Queen" were linked to village and region of the high caste men who had raped her as a young woman. Ms. Devi had applied for a gun license a week before her murder because she said she was being followed. Her life story has been documented by the BBC (BBC Productions) and is entitled "The Bandit Queen." Her memoir is a devasting chronicle of atrocities committed by "respectable" family men - pillars of their own communities - who believed they were 'superior' human beings. It is easy to see how a person's sense of self-worth can be severely undermined in such an environment. Caste is a deadly serious business to a large number of people in India.

Recently I was shown a photograph through a third party from South East Asia, (who asks to remain anonymous), which at first I could not comprehend. I thought the image had been manipulated on the computer by someone with a sick sense of humor.

Four babies lay packed together in a crate or box. Their mouths were bound with cloth, although it might even have been duct tape. The hasty photograph was taken by an activist, who at great personal risk, had infiltrated a baby-selling racket. His "job" was to help move crates, boxes, baskets, bundles - whatever was handy - in the dead of night or in broad daylight if it was a rural area - of tiny babies. The traffickers he worked for "deal" in babies, who they move to big cities in Asia to "sell" to the highest bidder.

The men in this particular baby-selling cartel are so violent and immoral that everyone, including the police, fears them. In fact most of the police give up and become complicit in the trade. The activist who showed me the picture said that the fate of the babies who were not "selected" or not "beautiful or winsome" enough was unimaginable to a Western person. It is impossible to write what he said.

The traffickers, pimps, brothel owners, club dons etc who are all cogs in a giant wheel of exploitation and profit, have no remorse for what they do, and there are no laws as yet in South and South East Asia to clamp them down in jail for years. The sex trade in children feeds known foreign pedophile rings; young girls who come from poor rural families are tricked into thinking that there is a wonderful job waiting for them in the big city, and instead they find them selves sold - literally - into sex slavery, and shipped off to destinations as diverse as the Emirates, other parts of Asia, Australia and increasingly the US.

The thugs who operate sex trafficking cartels and networks are pathologically unscrupulous men who intimidate everyone in their path, including their young victims, and they do not flinch at murdering objectors instantly. They often "deal" in drugs as well as human beings and craftily employ benign, credible men and women to solicit young girls and boys in remote villages or even large cities across Asia, Mexico and Russia. These "procurors" are also trained to solicit poor parents, who succumb to their requests because they do not know where the next meal is coming from. They employ relatives who know the children well, making the "deal" that much smoother and easier to accomplish.

It is not easy to get a seven year old boy to leave his rural home and family in Asia and go to a big city far away - but if he goes with someone he trusts, like his auntie or cousin, it is much better than going alone. Stressed parents are assured that their children will, through honest jobs, secure the family a brighter future financially. These salesmen and women are selling lies, crimes and even death, because all these trafficked children are without documentation, which means they are expendable if they become an inconvenience or do not 'work' efficiently. The parents never see their children again, except in a few miraculous cases.

In a report an anti-child trafficking activist writes that in the Phillipines, a 13-year-old girl was kidnapped and sold as a virgin for $30. She was raped by 8 to 15 men every night even when she had menstruation or fever. His report also noted that another girl went off to another Asian country because a friend of her mother offered her work in a restaurant for forty Australian dollars a day. Her mother, hoping she could help the family, agreed. Her mother's friend sold her. She learned later that this woman earns one-hundred-and-seventy Australian dollars for every girl sold.

There are many such cases presented in the same report, compiled by a well-known and highly respected anti-sex and child trafficking organization in Asia, whose members often face intimidation by police and traffickers. Many Asian anti-trafficking activists have become involved because they have lost their own children to the sex trade. They have disappeared without a trace. There are cautionary tales of young girls who are solicited by "maid agencies/babysitting services," local and overseas job recruiters (who never insinuate the real nature of the 'work'), adoption and pedophile rings, begging syndicates, middlemen at borders, peer groups, sexual exploiters etc.

There is no sign at present that any protective measures or laws are likely to be implemented in the countries with the most atrocities perpetrated upon children, because child prostitution and sex-traficking are lucrative businesses and represent a significant percentage of the national GDP. There are crimes so diabolical against children it is impossible to print them, but they take place every day.

It is difficult to absorb irrefutable evidence that crimes perpetrated against the very youngest - and the most vulnerable - in society, are worse than crimes commited against adults.At no time in history has there been such a systematic focus on the destruction of innocence, outside a warzone. The full impact upon the AIDS epidemic of the conitnued sexual exploitation of children, teenagers and women through trafficking, has yet to be documented.

On January 13, 2004, the Asia Society in New York hosted a video-conferenced, Washington/New York panel discussion entitled "Challenges Facing China's Response to AIDS. The New York panel, which included Dr. Peter Piot, Director of UNAIDS, and David Ho, Director and CEO of the Aaron Diamond AIDS Research Center, was moderated by Elizabeth Rosenthal of The New York Times.

The Washington panel was moderated by Bates Gill, Freeman Chair in China Studies, Center for Strategic and International Studies, and included Sheila Mitchell, Senior VP, Institute for HIV/AIDS, Family Health International, and Marwyn Samuels, Founding Chairman, US-China AIDS Foundation.

Anyone who has followed The New York Times articles about the global AIDS epidemic in the past few years will know Elizabeth Rosenthal. Her report on blood gathering and selling amongst China's rural poor in Hunan Province changed China's approach to the disease from denial to headlines expressing a reversal in policy and a commitment to dispense free ARV medications to their infected citizens living with the virus.

In her opening remarks Ms. Rosenthal said: "AIDS is a disease we can at least face (in China) now," adding there were reasons for hope and reasons to work harder.

Dr. Peter Piot, Director of UNAIDS, told the gathering that China is now "moving on AIDS." For years the Chinese Government was engulfed in denial, but concern (and panic) finally outpaced silence. Current estimates put the HIV- infected at 840,000, which is low for China's population, but rapidly growing at 30% a year.

"It is not a matter of cover-up, but difficult to assess," said Dr. Piot. He stated that every single factor that makes for increased prevalence in HIV/AIDS is present in China: intravenous drug use, Men Sleeping with Men (30-40%), prostitution and blood selling by the rural poor.

Dr. Piot stressed that AIDS awareness amongst the Chinese population is the lowest in the world: "People need to know," he said.

Outdated legislation and the stigma against the disease, together with weak surveillance and virtually no co-ordination of health or awareness programs, are undermining local efforts. Those who are concerned in the Chinese community do not include China's top businessmen, who do not want to be associated with the disease. Dr. Piot also said that China needs more activists.

Bates Gill, Center for Strategic and International Studies, addressed the issue of China's 150 million "floating population," who indulge in risky behaviors and are difficult to target and motivate for awareness and prevention. Across China there is an upsurge in pre-marital sex, and far more prostitution. Mr. Gill said that in the years going forward prostitutes will be the largest single group at risk for HIV/AIDS. As with India, Mr. Gill predicted that AIDS will become increasingly heterosexually transmitted in China, mainly along the economically booming East Coast. It will not be a blood-sellers and IDUs disease:

"Chinese leaders know all the right things to say, but they need to make sure they implement them," said Mr. Gill.

Sheila Mitchell of Family Health International said NGOs are not readily accepted in China and they need to be recognized by the government. The NGOs have access to the marginalized and the stigmatized, like the "floating population." They also have the ability to address controversial issues like promoting clean needles. "NGOs at least have the respect of the community:"

Ms. Mitchell said. "In China the concept of the NGO is new and threatening to the government, who are limited in independence."

Marwin Samuels, of the US-China AIDS Foundation, addressed the issue of creating and sustaining public awareness in China. He said that media must be permitted to get information out to the population. CCTV, which reaches 200 million households, reported the First National Conference on HIV/AIDS on December 1, 2001. This was a signal from the center that HIV/AIDS was now a legitimate subject for mainstream China. Sustaining and growing this effort will be the challenge of the months and years ahead:

"It was only this month, " said Mr. Samuels,"that condoms could be advertized - it was against the law." Reporting the Hunam blood selling scandal was also forbidden he added.

Although hopeful, Mr. Samuels said that raising awareness in China will not be as much a matter of laws and policy, but about money and attention span:

"There is no 'free lunch' in China; filling time and space in the media will require holding the attention span against all the competition - which is moving in exactly the opposite direction. The Britney Spears generation has arrived in China. Safe Sex? Who is going to listen to us?" asked Mr. Samuels.

There are 350 TV stations in China compared with 1500 in the United States. 89% of China owns one TV set, and their teens watch 3 hours of TV per weekend compared with 7 hours in the United States. He stressed that getting anyone's attention via TV in China is tough:

"Are you tired of ads," asked Mr.Samuels? "Ads take up 23 % of air time in the US compared with 68% in China. Getting through the 'forest of noise' is difficult." A program on AIDS awareness might not be a top choice in this scenario.

Less than one percent of China's doctors have been trained in STDs and have very little experience of HIV/AIDS. Corporate funders do not want to donate to AIDS programs "in their own names" because of the stigma of HIV/AIDS.

The Asia Society panel were besieged by questions even after the Q & A session, a clear sign that there are many who are concerned for China's future. If India and China assign even a fraction of the predicted profits of the economic boom their respective countries will experience in the years ahead, they will be able to change the entire landscape of their countries from undeveloped to "developed' nations. But China and India will have to want health and human rights for all their people, not just the prosperous.The "them and us" divide will not halt the spread of AIDS.

As the world's freest, wealthiest and most democratic nation, America is always in the spollight. Everything we do is scrutinized around the globe, from Kid Rock prancing around in the American flag, angering senators - to films that glorify violence to an unprecedented degree.

Even though we object to certain things in our own society, as Americans we respect the right to free speech and individual freedom.We are a great nation but we admit we have shortcomings; we view and export imagery of the vilest and the most depraved kind, especially on the Internet, where photographs of children and young boys and girls being used as sex objects by degenerate and sick human beings is one of the prices we pay for freedom: in America we allow them to do this.

A Middle Eastern mother once asked me how I could let my child live in a country where such terrible things are done to children.

After some discussion, I realized the mother was talking about Amerian kid porn and pedophile websites, and clearly someone had done a good job of brainwashing her. I told her that it was more than possible that the same atrocities went on in her country, but they were not documented: they were censored or banned, which was something Americans did not believe in.

I could tell she was not convinced. I assured her that only the sickest - people woith sever problems - in our society did things like that to children. Most of the American people I knew did not condone such actions: "Then why do they show it?" she asked bluntly.

In America we flaunt our freedom in ways that are often misinterpreted and misunderstood elsewhere, and people around the world judge us harshly for that. Most people around the globe view kid porn and pedophile websites as our affirmation of depravity of the worst kind - not freedom of expression.

Films like Clint Eastwood's "Mystic River," a brilliant portrayal of the legacy of pedophilia and thuggery in small-town America, should be seen by every parent around the world. Its most strident message is that the young must be empowered to protect themselves - through early and direct warnings about pedophilia and sexual predators - because there are times when we as parents and caregivers cannot be physically present to protect our children against evil.

As a free nation we will not censor or forbid speech - or the right to express lifestyles and perverse sexual appetites: but we need to balance all the grunge and ugliness by showing ourselves and "exporting" more images and messages of hope and concern for humanity.

As the recipient of reports and eyewitness testimonials of the worst possible evils in the world, it is possible to lose faith in mankind: but then there are the countless caring individuals who give of themselves on a daily basis, like the ministers and doctors in "A Closer Walk": men like the American doctor Paul Farmer, (Partners in Health), who has helped "level the playing field" amongst the poor and the marginalized in Haiti.

Dr. Farmer's determination to bring landless Haitian peasants treatment for their HIV/AIDS infection has paid off against the odds. He has shown the nay-sayers that poor, uneducated people can undergo treatment like anyone else, against all the predictions of the public policy makers, the health establishment and the economists - who told Dr. Farmer he was wrong.

"My contract is with the patient," he said. "There is less hopelessness in the poorest circumstances in Haiti than there is in the policy people. They are a living rebuke to those who say 'It can't be done, it's not cost effective.' As a doctor I reserve the right to want the best for my patients. If they (the health establishment) want to help me - great -or they need to get of my way."

Dr. Farmer lives in a small tin roofed house in Haiti, an American miles away from home, re-affirming hope and establishing health in the lives of people who would normally be written off as a loss on the balance sheet of the world - because he cares.

Hollywood blockbusters, which are shown around the globe - touting destruction, vice and aggression - need to be balanced by more positive American messages.

Clint Eastwood's "Mystic River" chronicles the thought processes of both the victimizer and the victim in the context of pedophilia, abuse and murder; it is an essential chapter in parenting in the world today. It will disturb the heck out of anyone who sees it, but pedophilia and murder claim other people's children every day.

Yes, these movies are challenging - but they improve and can even save lives because they inform. What better American "export" can there be than the freedom of empowering others against the same evils that threaten us?

"A Closer Walk" will premiere at The Habitat Center in New Delhi, India on April 1, 2004.

The movie "Mystic River," directed by Clint Eastwood, starring Sean Penn, Tim Robbins, Kevin Bacon and Lawrence Fishburne is currently showing in movie theatres across the United States and has been nominated for Oscars for Best Picture, Best Director, Best Actor (Sean Penn), Best Male Supporting Actor (Tim Robbins) and Best Female Supporting Actor (Marsha Gay Harden).

"Harvest of Innocence," a book on coping with risky behavior by Michele Leight, is at www.amazon.com and at www.ashraya-ny.org