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Facing the challenge

Mon 1 Mar 2004 In: HIV

New HIV diagnoses in New Zealand for gay men are the worst in a decade, returning us to the appalling figures of the late 1980s, and in the middle of this burgeoning new wave of sickness and dwindling treatment options, the organisation tasked with stemming this epidemic has someone new at the helm. Rachael LeMesurier is the first woman to become Executive Director of the NZ AIDS Foundation, and it would not be an understatement to say that her appointment comes at a difficult time. spoke to her only a few weeks after her appointment and before the latest diagnoses data was available. Standing resolute in the face of adversity is not something new to Rachael LeMesurier. Although born and raised in New Zealand, her formative years as a young adult were spent in the UK, where being both a woman and a foreigner did not serve her particularly well. “The teachers told me that there wasn't any real point in my attempting to study because I came from quite a backward colonial place, really I should accept that I should go to the lower level exam structure where, as I learnt, the working class kids went,” she explains. “So I learned to respond to adversity with everything I had and prove them wrong.” She went to university in Brighton, achieving a law degree and training as a barrister before realising that she was more interested in voluntary welfare work. She became politically active around lesbian/gay, feminist, and racial issues. “I then got paid work in an advice agency. I came into contact with people who were incredibly low income, and very disadvantaged educationally, who were also living with disabilities or were very unwell. I began to fully appreciate what a difference knowledge, information and real access to resources can do for communities and for individuals.” For the next five years, she continued to work in various agencies involved with community activism and served on government boards during the iron reign of Margaret Thatcher, a government that seemed ill-equipped to deal with HIV/AIDS in the early days of the epidemic. Censorship played such a part in the creation of health promotion campaigns that the messages were completely cryptic. “I remember the first public health campaign that they had, it was a great big floating iceberg, with doom and gloom funeral music. There was no sense that HIV/AIDS was here – no-one knew what it was about. There was no mention of the words “condom” or “sex”.” The media's response, which labelled HIV/AIDS a “homosexual disease” did not differentiate between gay men and lesbians. “I realised, as a lesbian, we had to stand with gay men on this, because we were going to get the hostility regardless. Society was going to lump us all together, and we needed to support each other, because the hostility was so huge.” She feels that support was especially important for a community dealing with frequent deaths and the impact of ongoing grief, a community which was already vulnerable to attack. LeMesurier returned to New Zealand in 1995. Despite being away fifteen years, she says she still felt a foreigner in the UK. Her work in community organisations continued here, starting as Executive Director of the Muscular Dystrophy Association, moving onto Citizens Advice Bureau, and Regional Director for the Family Planning Association before moving onto the NZ AIDS Foundation. “I don't think it can be underestimated the huge reputation and credibility the Foundation has,” she says. “It's one of the most significant players, I believe, in the public health sector in New Zealand, and has been instrumental in a range of really significant social changes in history, human rights legislation being one of those, and I think I was very attracted to that.” Complacency and bad attitudes have always lit the fire under LeMesurier's community activist spirit, something which has driven all her work, be it working with disabled people, new migrants, or those living with HIV. “I get very driven by iniquity. I can bore people silly with being outraged, and incredibly passionate about things that just aren't right, definitely HIV – both society's response and the lack of resourcing has always made me very angry.” Have there been any eyebrows raised about a woman being in charge of an organisation which largely supports gay men and MSM? “I actually did think that the board might not want a woman, but I applied anyway because I didn't want to make that assumption. The epidemiology is absolutely clear -the majority of people affected are men who have sex with with men. There are a number of challenges involved, and one of the challenges is that we have to crank the volume up on that issue, rather than it being diluted in any way, and I'm very committed to that.” LeMesurier's appointment coincided with the Foundation becoming very vocal on an issue which had been arguably neglected for some time – the growing concern surrounding lack of available HIV treatments, and the number of New Zealanders facing death because of it. “I see this as an urgency,” she explains. “My newness in the position cannot be an excuse for us to be keeping quiet in any way. For us to discover that not only are there two or three men who are coming to the end of their treatment options, there are at least 34... I was personally shocked by that. This is horrific and outrageous, there is no true rationale if you can get it in Australia but you can't get it here.” LeMesurier is clear on what must be done to shock a community and a country out of its complacency surrounding HIV. “The Foundation is going to be raising profile and doing as much as we can to put pressure on Pharmac, but also to inform MSM in particular that there is no cure, and treatment is not something that is a failsafe method of avoiding safer sex. Obviously, treatment is not all that pleasant, and secondly it's clear that it's not long term.” At the same time, she is also aware of the vast experience and opinions available within the gay community that she can draw on in moving the Foundation forward. She sees the definition of a healthy relationship with the community as one where the avenues of communication are very clear. “The bottom line is respect,” she says. “Acknowledging that each of these communities have their own life experiences and I have enormous repsect, particularly for the relationship between the gay community and the Foundation. It's probably some of the strongest community connections I've seen any organisation have... That may mean that sometimes there is criticism, or things said that aren't so welcome. But having said that, there is a willingess to engage, and acknowledgement that at the end of the day we're all wanting the same thing.” Since her appointment, LeMesurier's first priority was to meet all the Foundation's staff as soon as possible, across the country, as well as key stakeholders like Body Positive. It is notable that she took on the Executive Director's chair in the weeks leading up to World AIDS Day 2003. When World AIDS Day 2004 rolls around again in December, what does she hope to have achieved? “First of all, a review of infrastructure... is there anything we can do to make it more efficient, effective? The answer could well be no, but I want to go through that exercise. It's something I've done with every job I've taken on, no matter how good or not so good the organisation has been performing... The least I could hope for is that there is a perception of the Foundation being cutting edge, prepared to take on the tough discussions, fighting the good fight. Some of these are outside of our control, but I would love to see some movement around treatments. I would love to know we'd made a difference with not just two but maybe four more antiretroviral treatments... And - maybe this is too much to hope for - a slight drop in new infections. That's probably a bit tough. It's early days.” There has been some criticism that the Foundation has not been doing enough in recent years to prepare for the so-called “second wave” of the epidemic. Is the Foundation equipped to cope with it? Have we as a community gone off the boil? “In one sense it's an organisation in wonderful heart. There are some superb people here, and I actually think some superb people in the community support the Foundation. There are obviously those who care a great deal and may not agree with what has been done in the past, but I think we'd all agree that the world's a better place because it IS here... I think it would be quite shocking thinking what it would be like without an HIV/AIDS organisation in New Zealand right now.” - 1st March 2004    


First published: Monday, 1st March 2004 - 12:00pm

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