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World Cup Could Cause Spike in AIDS?

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This year’s World Cup will be held in South Africa, with up to half a million visitors expected to flock to the country. That means big money for much of South Africa’s businesses, and it also means big business for the country’s sex workers.

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This poses many problems, the most worrisome, however, is that up to half of the area’s prostitutes are carrying HIV.

Eric Harper, director of the Cape Town-based Sex Worker Education and Advocacy Taskforce (SWEAT), told CNN that the World Cup would inevitably lead to a demand for sex workers.”And where there’s demand there will be a supply,” Harper told CNN. “It could be a potential recipe for disaster both for the clients and the sex workers,” he added. Harper told CNN that while there are no accurate figures for the number of sex workers in South Africa, his organization believes there are 3,000 in Cape Town alone.

The above article references a 2005 University of Michigan study that found that 46% of female sex workers in Johannesburg had HIV. Though that amounts to one scary statistic, authorities are also worried about the possible spread of other STDs, the chance of unwanted pregnancies and the threat of rape.

Currently, prostitution is illegal in South Africa. Some are calling for the legalization of the crime to help curb the spread of the disease.

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It seems these pro-prostitution advocates are taking their example from the well-known Red Light District of Amsterdam. There, prostitution is indeed legal and those employed in the lucrative industry are rigorously tested and protection is used to ensure the safety of both parties. And as with all legal industries, it is taxed.

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Should South Africa decriminalize prostitution to help tackle the spread of HIV? One might think so. It has been well documented that HIV has had a serious impact on the country’s economy. South Africa has the chance to turn one extremely risky, illegal occupation to a revenue-generating, safe industry. What do you think?

More Headaches for the NFL

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In recent months, the concern about concussions and their long-term effects among NFL players has gained widespread attention. In the past month alone, two high-profile players — running backs Clinton Portis of the Washington Redskins and Brian Westbrook of the Philadelphia Eagles — have sustained concussions that have put their seasons in jeopardy. Meanwhile, in a hearing before the House Judiciary Committee last month, NFL Commissioner Roger Goodell defended the league’s policies amid heated criticism and accusations that the league has failed to protect and care for its players.

“I have been clear: medical considerations must always come first,” Goodell said. “We are changing the culture of our game for the better. Our goal is to make our game as safe as possible for those who choose to play it and treat our retired players with the respect and care they deserve.”

But after a weekend that saw both starting quarterbacks from last year’s Super Bowl — Ben Roethlisberger of the Pittsburgh Steelers and Kurt Warner of the Arizona Cardinals — leave their games early after suffering blows to the head and three members of the St. Louis Rams — quarterback Marc Bulger, linebacker Chris Chamberlain and offensive tackle Jason Smith — forced to undergo tests for possible concussions of their own, the NFL has decided to implement a new approach to handling concussions.

According to the plan, teams will be required to use independent neurologists to treat players with brain injuries. While teams already employ their own medical staff, outside consultation will eliminate potential of conflicts of interest from team owners and coaches who want injured players to return to the field more quickly than is medically advisable. While no deadline for implementation has been put in place, about half of the league’s 32 teams have approved doctors in place already.

But the independent, objective aspect of this is the key change.

These newly appointed neurologists would be “independent of the teams themselves, and they’re rendering an opinion that is guided by expertise in concussions,” the NFLPA’s Mayer said. “They’re not part of the club medical staff, so they’re an independent voice with regard to whether the player’s ready to return or not.”

The league has also called for other players to report teammates who they suspect are suffering from concussion symptoms but the players’ union opposes the requirement.

“If every player were a medical doctor that could recognize symptoms of concussions, then that would be a great idea,” said NFL Players Association assistant executive director George Atallah. “I hope that the league — instead of asking players to police each other — would consider calling on team medical staffs and independent doctors to police the situation closely.”

Some players, like Washington Redskins fullback Mike Sellers have even gone so far as to characterize players who report teammates as “snitches,” which speaks to a larger cultural problem among NFL players. Evidently in a game that values “toughness,” acknowledging an injury of any kind is frowned upon. According to an Associated Press survey of 160 current players, 30 report having hidden concussion symptoms from team personnel and half reported having at least one concussion during their career.

So it would seem that the NFL’s fight against brain injury will not only require a change in policy but a change in attitude as well.

For more on the NFL and concussions, check out the December issue of Risk Management, coming soon.

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Unnecessary Roughness

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Anybody who watched the Tampa Bay Buccaneers play the Carolina Panthers last Sunday got to see one of the more egregious fouls in recent NFL history. With only 0:10 left to go in the first half, Carolina punted to Tampa Bay for what was supposed to be an otherwise normal return. What happened, however, was anything but.

As Tampa Bay receiver Clifton Smith waited for the ball to land in his arms, he was leveled by a flying tackle to the head courtesy of Panthers safety Dante Wesley. To say this was a cheap shot grossly understates the term “cheap shot,” as the ball was nowhere near landing in Smith’s hands when he was hit. In fact, when you watch the video of the whole thing, it is clear that by the time Wesley had launched off the ground at Smith, Smith still did not have the ball.

The impact knocked Smith out cold for a good minute before he managed to get back to his feet and was taken off the field. As for Wesley, he was disqualified for the rest of the game and he was also later suspended by the NFL for another game.

This all comes at a time when the NFL is already under pressure to address concerns that the constant head impacts experienced by football players – even those at the college and high school level – are causing brain damage that can lead to early onset dementia, depression and suicide.

Be sure to check out the December issue of Risk Management, when we discuss this topic more fully in an article written by Emily Holbrook. In the meantime, Malcolm Gladwell wrote an outstanding article on this in The New Yorker that is not to be missed. Clearly, the issue of player head trauma has only a little emerging science behind it. But the science that is there suggests that the NFL, along with college and high school football, has a potentially game-breaking liability issue on its hands.

Can Rio Hold a Safe Olympics?

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This weekend, a fierce gun battle between two drug gangs in Rio de Janeiro’s “Monkey Hill” slum left some ten suspected gang members dead and entire neighborhoods fearing for their lives as the sound of automatic fire could be heard all day long. At one point, a police helicopter, loitering over the area to direct anti-gang police measures, was hit by gunfire, caught fire and crashed, killing two police on board and injuring several others.

The drug violence of Rio’s favelas is nothing new. But the helicopter shoot-down was shocking, just as it was to hear of such incredible violence in a city that just a month before had been tapped over contenders such as Chicago and Tokyo to host the 2016 Summer Olympics.

In light of the recent gun battle, Brazilian officials have sent thousands of extra police into the slum to crack down on the violence and lawlessness there, but clearly, they face an uphill struggle. Even though the Olympics are several years away, the level of the security problem in the city will surely cast as much of a shadow over the coming games as terrorism fears did over the 2004 Olympics in Athens. At the moment, the U.S. State Department notes that Rio is a fairly dangerous city, crimewise, and that all of Brazil has a crime rate that is quadruple that of the United States. The Overseas Security Advisory Council echoes the State Department’s assessment of things, noting that the “Government of Brazil (GoB) is locked in an intense struggle against drug gangs for control of large areas of the Rio de Janeiro metropolitan area.” After this weekend’s carnage, even that assessment seems to be putting things mildly.

Hopefully, Brazil can marshall the resources and the will needed to address the security problem in a permanent fashion, rather than temporarily suppressing it or displacing it elsewhere. The Olympics have a nasty habit of costing its host cities far more in the long run than they bring in, revenue-wise. After this weekend’s Monkey Hill bloodbath, it might be tempting to wonder if money spent on stadiums and athlete villages should be first spent on keeping the poor sections of town free of machinegun fire.