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(单词翻译:双击或拖选)
Why visas are a hot topic right now at the International AIDS Conference
Within minutes of the kickoff of the opening session of the 24th International AIDS Conference in Montreal, the emcee — actor and activist2 Omar Sharif Jr. — stepped onstage and immediately addressed one of the hottest topics of the gathering4. It had nothing to do with the virus. Rather, he admonished5 his home country of Canada for its visa and immigration policies that left numerous people from low- and middle-income countries unable to attend in person.
"Come on Canada!," he bellowed6 from the lectern. "We can do better than this, eh?" His comments drew immediate3 attention on Twitter, including a tweet from attendee Dr. Trevor Crowell.
Tanaka Chirombo knows what Sharif is talking about. For months, Chirombo was afraid he wouldn't make it to the meeting because of visa issues.
Chirombo lives in Malawi, and his life work revolves7 around HIV. His interest in the virus began with his father, who delighted him with made-up stories as a boy. His dad contracted HIV but delayed seeking medical help because of the stigma8 of the disease and the cost of treatment. It progressed into AIDS, and he passed away when Chirombo was 4 years old.
Tanaka Chirombo of Malawi, whose life work revolves around HIV, was at first rejected for a Canadian visa to attend the international AIDS conference in Montreal this month. "The main issue was me coming back from Canada," he says. "They thought I was going to stay in Canada." He did find success with a follow-up application.
Zintombizodwa Nyasulu
As Chirombo grew up, he witnessed others in his community die of complications stemming from AIDS. When he was a teenager, he volunteered at a clinic, where he mentored9 a 10-year-old girl with HIV. He helped her secure treatment, but it came too late and she too passed away.
It's these issues — of battling stigma and getting people the care and information they need — that are at the heart of Chirombo's HIV advocacy today. As the board chair of the Global Network of Young People Living with HIV, he works to help young women who are HIV positive by reducing discrimination and improving access to HIV services.
So when this year's International AIDS Conference was announced, he knew he wanted to be there. "I would love to meet stakeholders in Montreal to be able to get funding to expand our projects," Chirombo says. In fact, he's serving as the meeting's youth representative and is on the organizing committee as a co-chair for the Global Village and Youth Programme Working Group.
But to go to Montreal, he needed a visa. For someone from a low-income country like Malawi, getting permission to travel abroad can be an expensive obstacle course. It ran Chirombo about $1,100. "I spent money for the online application," he explains, "and then had to book a return flight ticket to South Africa to do the biometrics," referring to fingerprinting10. He sent a copy of his passport and a letter describing the international conferences he'd attended before.
Within two weeks, the answer from the Canadian government arrived. Chirombo's visa application was denied. "The main issue was me coming back from Canada," he says. "They thought I was going to stay in Canada."
The letter he received stated, "I am not satisfied that you will leave Canada at the end of your stay as a temporary resident ... based on your personal assets and financial status ... the purpose of your visit ... [and] your current employment situation." None of it made sense to him.
"I don't think I would ever live abroad because I want to be able to change the landscape in my country — the country I love the most," Chirombo says. "That's the whole reason I'm doing this sort of work."
The rejection11 was really hard on him.
"When I read that letter, I was sad first thing," he recalls. "I went online, I thought I could write a post to bring out my anger. But then I deleted it. I was like, 'No, that's irrational12 for me to do something like that.' But basically, I just slept. It was the easiest way to get over the pain of being rejected."
Since that initial denial, Chirombo submitted a revised visa application. He attached additional bank statements, his return ticket and letters of support "to be able to show my commitment that I'm still going to go back home."
A couple weeks later, Chirombo heard that his visa had been granted — and just in time.
Kareem Samsudeen Adebola, an advocate for youth who are HIV positive in Nigeria, was initially13 rejected in his application for a Canadian visa to attend the upcoming international AIDS conference. Adebola says when he takes note of everyone who's been rejected for a visa, the feeling can be boiled down to a single word — "inequality." His second visa application was accepted.
Kareem Samsudeen Adebola
Chirombo's experience isn't unique. Kareem Samsudeen Adebola is the deputy national coordinator14 for the Association of Positive Youth in Lagos, Nigeria, where he works to reduce stigma and provide access to public health services to young people living with HIV. He too lost his father to AIDS-related complications when he was a boy. Adebola has HIV as well and has been on antiretroviral therapy for close to 20 years. He does his advocacy work today in his father's memory. "I have to fulfill15 his dreams that AIDS could not allow him to fulfill," he says.
Like Chirombo, Adebola wanted to attend the International AIDS conference in Montreal to connect with scientists in the field and network with global experts. But within a week of submitting his visa application to Canada, it was denied for the same reason as Chirombo's initial rejection.
Adebola says when he takes note of everyone who's been rejected, the feeling can be boiled down to a single word — "inequality." Adebola says that "it saddens my heart when I think about people from countries who can't attend." Fortunately, his second visa application was accepted.
Not every visa applicant16 is as lucky as Chirombo and Adebola. Researchers, scientists and medical professionals from the global south (which encompasses17 low- and middle-income countries) are among those who simply can't attend professional meetings abroad because their visas arrive too late or not at all. It's a problem that many from high-income countries never even think about.
Dr. Ulrick Sidney Kanmounye of Cameroon — currently a research fellow at Geisinger Health System specializing in cerebrovascular neurosurgery — detailed18 his inability to receive a Schengen visa to travel to Europe and attend the World Health Assembly (the annual meeting of the World Health Organization in 2019 while living in Cameroon. "The truth is that I lost more than just money," recounts Kanmounye. "I lost faith in those that organize these events in high income countries."
Dr. Mohamed Bella Jalloh, recalls how in 2018, as a recent medical school graduate, he traveled from Sierra Leone to C?te d'Ivoire to apply for a Belgian visa to attend the InciSioN19 Global Surgery Symposium20. Jalloh was denied for "no definite reason." He says, "They just sent back my passport without any further explanation."
In January 2019, Dr. Dian Blandina (currently with the organization People's Health Movement) received her EU residency card. Two years earlier, when she had only her Indonesian citizenship21, she was invited to speak at the International Association of Health Policy meeting in Thessaloniki, Greece. Although her visa was approved, the process was costly22 and took a month and a half. Blandina nearly missed the conference.
After that, she stopped trying to attend international meetings. "It's just not worth the trouble for attending just one event," Blandina says, "especially if I'm not [an] organizer or a presenter23. Almost all my colleagues back home feel the same."
Then there's Dr. Mehr Muhammad Adeel Riaz. Earlier this year, working as a junior doctor at the Allied24 Hospital in Faisalabad, Pakistan, he was invited to attend the 75th World Health Assembly in Geneva, Switzerland. "Having the chance to attend and advocate on behalf of my community at this high level [meeting] was a dream come true," he emailed NPR. He received a scholarship to cover his visa fees, roundtrip airfare, accommodations and food.
But his request for a visa was rejected. According to the Swiss Embassy: "the information submitted regarding the justification25 for the purpose and conditions of the intended stay was not reliable." It made Riaz feel as if having a passport from Pakistan was a failing on his part, and he regrets missing the opportunity to meet global health professionals "to increase the visibility of my work as a young global health advocate," he says.
These types of experiences are discouraging. Dr. Ankit Raj, a junior resident at Sawai Man Singh Medical College in Jaipur, India, says the interview process for a visa feels designed to intimidate26. "The questions are highly specific, detailed and often beyond the scope of purpose of visit," he explains. "The entire process often feels like a criminal interrogation and the applicant ends up feeling guilt27 ridden toward the end of the interview."
As for the International AIDS Conference, organizers worked with the Canadian authorities to clarify what was needed to avoid visa rejections28 for global south applicants29. And they offered scholarships and fee waivers to make it cheaper to attend. If attendees can't come in person, they can log into the proceedings30 virtually.
But Madhukar Pai, an epidemiologist at McGill University, says virtual participation31 is far from ideal. "What happens to all of the side room discussions, the coffee, the chat at the bar at night?," he asks. "How do you network, make deals, get opportunities, all of those intangible benefits of in-person meetings?"
And this exclusion32 of people from lower resource countries means, according to Pai, that it's often attendees from higher income countries who make the decisions that can shape funding and the research landscape. It's an issue compounded by disparities in COVID vaccination33 status, especially earlier in the pandemic, that allowed many people from higher income countries to receive two shots and a booster and to travel with ease, while many in low- and middle-income countries struggled to get even a single dose.
"The fact that we left behind people without even the first shot worries me a lot because they will always struggle to go anywhere," Pai says. In his view, the impact on global health gatherings34 is profound. "People from the global south might be relegated35 to a secondary status," he says. If we're not careful, he adds that "we will dramatically worsen the inequities already in global health."
The problem isn't new, explains Adnan Hyder, vice-chair of the Board of Health Systems Global, a group that promotes health policy. "The historical tendency was always the high-income countries were able to put forth36 resources to attract those meetings," he says.
The locations of these gatherings matter. When Kanmounye and a research team from Harvard University's Program in Global Surgery and Social Change looked at publicly available data, they found that conferences hosted in low- and middle-income countries were more likely to have diverse participants. In addition, "hosting a conference in Latin America, Africa or Asia significantly increased participation of researchers from the region and minimally37 impacted high-income country attendance," he says. NPR reached out for confirmation38 to a few organizations that host global health meetings, but they all replied that they don't track how many people from low- and middle-income countries are denied visas to attend their conferences.
"Frankly39 speaking, the decision-making around where to host those meetings was not as sensitive to the concerns that we are talking about today," says Hyder. "But I think over the past decade or so that has improved. We have a long ways to go, but I think the intention is there for equity40."
He cites the biannual41 symposium that his organization hosts. In 2018, it was held in Liverpool, and the World Health Organization voiced concerns over colleagues having their visas denied. This fall, it will take place in Bogotá , Colombia.
But if the locations of meetings like these remain largely unchanged, some worry about the voices that won't be heard. The people whose visas are denied are often from the very countries where many global health concerns are most acute.
"Unless you are fully42 immersed and living and breathing in a country for years, you will not [know] what lies below, which is so much deeper, more complex," says Michelle Joseph, an orthopedic surgeon and an instructor43 in Global Health and Social Medicine at the Harvard Medical School. "You may have theoretical knowledge, you don't have lived experience. And lived experience takes years and that's only afforded to those who live and reside and work in that space. And those are the voices that require amplification44."
Voices like Tanaka Chirombo from Malawi ... who is one of the fortunate visa applicants who was able to make it to Montreal.
1 transcript | |
n.抄本,誊本,副本,肄业证书 | |
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2 activist | |
n.活动分子,积极分子 | |
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3 immediate | |
adj.立即的;直接的,最接近的;紧靠的 | |
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4 gathering | |
n.集会,聚会,聚集 | |
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5 admonished | |
v.劝告( admonish的过去式和过去分词 );训诫;(温和地)责备;轻责 | |
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6 bellowed | |
v.发出吼叫声,咆哮(尤指因痛苦)( bellow的过去式和过去分词 );(愤怒地)说出(某事),大叫 | |
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7 revolves | |
v.(使)旋转( revolve的第三人称单数 );细想 | |
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8 stigma | |
n.耻辱,污名;(花的)柱头 | |
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9 mentored | |
v.(无经验之人的)有经验可信赖的顾问( mentor的过去式和过去分词 ) | |
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10 fingerprinting | |
v.指纹( fingerprint的现在分词 ) | |
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11 rejection | |
n.拒绝,被拒,抛弃,被弃 | |
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12 irrational | |
adj.无理性的,失去理性的 | |
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13 initially | |
adv.最初,开始 | |
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14 coordinator | |
n.协调人 | |
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15 fulfill | |
vt.履行,实现,完成;满足,使满意 | |
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16 applicant | |
n.申请人,求职者,请求者 | |
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17 encompasses | |
v.围绕( encompass的第三人称单数 );包围;包含;包括 | |
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18 detailed | |
adj.详细的,详尽的,极注意细节的,完全的 | |
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19 incision | |
n.切口,切开 | |
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20 symposium | |
n.讨论会,专题报告会;专题论文集 | |
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21 citizenship | |
n.市民权,公民权,国民的义务(身份) | |
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22 costly | |
adj.昂贵的,价值高的,豪华的 | |
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23 presenter | |
n.(电视、广播的)主持人,赠与者 | |
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24 allied | |
adj.协约国的;同盟国的 | |
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25 justification | |
n.正当的理由;辩解的理由 | |
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26 intimidate | |
vt.恐吓,威胁 | |
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27 guilt | |
n.犯罪;内疚;过失,罪责 | |
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28 rejections | |
拒绝( rejection的名词复数 ); 摒弃; 剔除物; 排斥 | |
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29 applicants | |
申请人,求职人( applicant的名词复数 ) | |
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30 proceedings | |
n.进程,过程,议程;诉讼(程序);公报 | |
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31 participation | |
n.参与,参加,分享 | |
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32 exclusion | |
n.拒绝,排除,排斥,远足,远途旅行 | |
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33 vaccination | |
n.接种疫苗,种痘 | |
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34 gatherings | |
聚集( gathering的名词复数 ); 收集; 采集; 搜集 | |
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35 relegated | |
v.使降级( relegate的过去式和过去分词 );使降职;转移;把…归类 | |
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36 forth | |
adv.向前;向外,往外 | |
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37 minimally | |
最低限度地,最低程度地 | |
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38 confirmation | |
n.证实,确认,批准 | |
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39 frankly | |
adv.坦白地,直率地;坦率地说 | |
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40 equity | |
n.公正,公平,(无固定利息的)股票 | |
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41 biannual | |
adj.一年两次的 | |
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42 fully | |
adv.完全地,全部地,彻底地;充分地 | |
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43 instructor | |
n.指导者,教员,教练 | |
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44 amplification | |
n.扩大,发挥 | |
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