David Leonard

Oprah's appearance on Primetime Live did put faces and stories behind the devastating realities of the African AIDS crisis.

No longer able to attract viewers with George Clooney's smile or the emotional roller coaster of Dr. Green's (Anthony Edwards) battle with cancer, John Wells and his writers moved ER to Africa. In "Christmas in the Congo" (aired 10 December 2003), Dr. Carter (Noah Wyle) takes up the longstanding "burden" of white men to save the "uncivilized." Though the show's website claims that Carter "embarks on a personal mission to save a pregnant mother who is dying of AIDS... and bring joy and love to the local children of Kisingani," the good doctor is, ultimately, unable to affect this health crisis.

While courting Makemba (Thandie Newton), whom the website calls a "beautiful native AIDS worker," Carter attempts to save the disadvantaged with money, medical care, and a handful of gifts. Neither he nor the show suggests anything resembling a sustained solution. And so, ER illustrates the pattern of U.S. foreign policy as it relates to AIDS, poverty, and infant mortality around the globe. Still, the episode is not a total loss. Makemba lectures Carter about how U.S. drug companies and patent laws systematically inhibit treatment and contribute to genocide, even if the episode maintains its focus on Carter's nobility and her beauty.

Another angle on the subject is available in Oprah Winfrey's crusade against AIDS in Africa, which she promoted on Primetime Live, 17 December 2003. Oprah's concerns are more immediately emotional than the fictional Dr. Carter's: she didn't bring medicine, but shoes, jeans, footballs, and black dolls. "The clothes are what make you feel you're not as poor as everybody else and I know what that feels like," Winfrey told Sawyer.

Oprah's appearance on Primetime Live did put faces and stories behind the devastating realities of the African AIDS crisis. In South Africa, one in five people has HIV-AIDS; in Zimbabwe, one in four. Across the continent, 17 million people have died of AIDS-related illness since the pandemic began, 2.54 million in 2000 alone. If current patterns continue, the number of those orphaned by AIDS will soon exceed 40 million. Oprah brought her camera crew to a hospital with more orphaned children than beds; such imagery pushed the global AIDS crisis, for a brief moment, onto the U.S. media radar.

However, neither ER nor Oprah places the African AIDS crisis in a larger historical context of slavery, colonization or global capitalism. Contemporary Western discourses, typically blaming "Africa" for its own problems (usually referring to sexual behaviors and governmental incompetence), ignore the significant effects of the IMF and the World Bank. Both ER and Oprah repeat this tactic, blaming African governments for the spread of the disease, concluding that "their own people" don't care about the death and devastation of AIDS.

The problem is not lack of "caring." In recent years, African nations have been forced to eliminate food subsidies (during the 1990s, for example, food prices tripled in Zimbabwe). IMF policies throughout Africa, often referred to as "structural adjustment" programs, have contributed to the spread of HIV and AIDS. The West's emphasis on repayment and demands that the afflicted nations lower spending on health care has left African citizens vulnerable. In Kenya, 14 percent of its population is HIV positive, but in 1998, it spent three times more on debt repayments than on health care, leading to a situation where there was only one doctor for every 22,000 people. That same year, Zimbabwe's government was spending over 10 percent of its budget on debt reduction, and only three percent on health care.

Both ER and Oprah rightfully celebrate the efforts of Africans to fight this disease with images of doctors and civil servants who run its counties AIDS' clinics. Makemba, for instance, overcomes the lack of resources and support to treat hundreds of patients, yet the show reduces this lack of support to a local problem: political factions and warlords in the Congo. And again, the U.S., in the bodies of Oprah and Dr. Carter, is elevated to savior. But we must look beyond toys and shoes, helpful as these material basics may be for their recipients. We must examine policies, and we can use popular culture as an educational and inspirational forum.

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