Help write lyrics for Song of Contagion – Saturday November 5 – All welcome

Lyrics over musical staff

The Song of Contagion project continues apace. Tony and the musicians have been working through musical ideas and now it’s time to think about the lyrics for the songs.

We’ll get together this Saturday, November 5 from 2 PM to 5 PM at The Chapel, 15b Old Ford Rd, London E2 9PJ (Map)

We’ll be kicking around ideas for lyrics for the Song of Contagion performance. On the cards: The Dengue Merengue (why you know more about zika than dengue); Infectious Activism (how HIV activism went viral); A Tale of Two Cities (cholera in London and Calcutta) and much more. All welcome. Please come, bring your friends and your ideas.

Facebook event - Help write lyrics for Song of Contagion Facebook Event page

Superbugs: “Not like Ebola” — but soon will be

Not any longer...
Not any longer…

Last week, nearly every country in the world got together at the United Nations General Assembly to commit to doing something about the spread of superbugs: bacteria, viruses and other pathogens that are evolving their way around the medicines that treat them. It’s an important step, and one the UK has taken credit for, not without reason. At a bunch of side meetings ahead of the big political discussions in New York last week, speaker after speaker said that the threat of antimicrobial resistance (or AMR, for those who want to avoid the mouthful) had been neglected because it was “not urgent, like Ebola”, “not visible, like zika”, “there are no activist groups shouting about it, like HIV.” It could have been an introductory talk for the concept behind Song of Contagion.

What eventually put AMR on the global agenda was essentially the dedication and clever strategising of a single “champion” — Dame Sally Davies, the UK’s Chief Medical Officer. She looked at the evidence: we’re overusing antibiotics in both medicine and farming, they’re developing resistance fast, and there are no new ones in the pipeline because it’s more profitable to develop drugs that people have to take every day. She decided it was important, and rallied the UK Prime Minister to the cause. Then, very cleverly, Dame Sally outsourced a lot of the lobbying to an economist, Jim O’Neill. Bestower of BRICS, Goldman Sachs superhero and (briefly) UK Treasury minister, Jim is listened to by many in the corporate world (and in the all-important Chinese and Indian governments) who wouldn’t take much notice of even the most energetic health official. Lord O’Neill was the public face of a hard-working team that put together a lot of scary info-graphics based on a lot of solid evidence (and some less solid but certainly scary “blue sky” estimates) that captured the front pages of newspapers as influential as The Economist.

We didn’t actually specify “Champions” on the list of parameters that we think influence decision-making about health priorities.

parameters

But thinking more about the “human influencers”, well, they very rarely act as an undifferentiated group. Sally Davies is a technocrat, certainly. But many technocrats before her recognised the threat of AMR without getting 193 nations to sign up to work together to do something about it. She is a technocrat who is also a visionary, a strategist, and a bit of a terrier. She just doesn’t give up until she gets what she wants. So it was with the early AIDS activists. Which raises a question for the musicians engaged with Song of Contagion: what do “champions” sound like?

PROJECT UPDATE:

After a summer researching various options, we’ve come up with a shortlist of disease stories (.docx) that we think provide good illustrations of some of the key factors affecting which diseases are considered “important”. (There’s a one-page summary sheet here(.docx).) AMR is not currently on the list — somewhat ironically, because it is the issue Song of Contagion epidemiologist Elizabeth Pisani is working on right now. So that might change…

We expect to gather anyone who’s interested together to start writing lyrics the first week in November — please contact Sheelah (sheelah@btinternet.com) if you’d like to join in. Soon after that, it’s over to the musicians — we welcome all-comers with open arms. There will be a few music workshops and rehearsals over the winter, ahead of a performance in spring 2017.

The HIV band plays on… and on….

My personal Groundhog Day is the biennial AIDS conference, bustling with passionate activits, hopeful researchers, singing orphans. This year’s conference (held in Durban in July) had a greater sense of deja vu than most. After a brief blip of “End of AIDS” optimism at the 2014 conference, even Bill Gates was brought back down to earth: biomedical solutions alone won’t work.

Actually, with 17 million people on effective treatment, we’re much closer to the end of AIDS than we imagined when the AIDS circus last came to Durban 16 years ago. We’re just not any nearer to the end of HIV. As deaths drop off, the number of people living with the virus rises. If you take a squint at the graphs that the musicians are “playing” in the video below, you can see the shape of AIDS deaths (dramatic peak, steep decline — the data are for the US) but also the steep and continuing rise in cost of treatment. Not shown, but even more dramatic, is the rise in the number people who have HIV and are sexually active. So despite the fact that effective treatment reduces the chance of passing on the virus, the number of new HIV infections added to the global pool each year is not falling: around 2.1 million new infections in 2015.

The video comes from Song of Contagion’s very first music workshop; we’ve moved on a bit since then but it does look like HIV will be one of the disease stories we’ll be taking on. (By “we”, I mean the talented musicians shown in this introduction to the incomparable Grand Union Orchestra.)

You can see from their final performances how much work composer Tony Haynes puts in to each piece. Here, with a cast that includes public health nerds and some fine HIV researchers, you can see the very first seeds of what I hope will eventually turn in to one of those classic Grand Union performances:

A single dose of drains would be enough to stop cholera

Image of poor sanitation in London, 1850s
Image: Wellcome Library

The image above comes from a book with the sort of snappy title the Victorians were good at: “Sanatory progress:- being the fifth report of the National Philanthropic Association for the promotion of social and salutiferous improvements, street cleanliness; and the employment of the poor : so that able-bodied men may be prevented from burthening the parish rates, and preserved independent of workhouse alms and degradation.

Basically, it’s about drains. Good plumbing is a one-off investment that saves lives across all age, income and ethnic groups. You need maintenance of course, but basically, decent sanitation is switch we could flick to end cholera and other water-borne killers in much of the world. Which is why I’m still a bit surprised to find studies like this one, published a couple of weeks ago in the New England Journal of Medicine, trying out a single-dose cholera vaccine.

If you’re a adult in Bangladesh, it turns out, a single dose vaccine reduces your chance of getting cholera any time in the next six months by around half. Researchers don’t know how long the effect of a single dose of the vaccine might last; earlier research on a two-dose vaccine suggested that it reduced the risk of getting cholera by half for somewhere between two and 5 years, but the results only included the people who took all of their vaccines at the full dose. In the real world, getting people to come back for a second dose of vaccine after two weeks is a pain. That’s why they’re trying a one-dose regime. But the new study suggests that if you’re a kid under 5 — the group most likely to get cholera in the first place, the single dose vaccine had no measurable effect. And of course the cholera vaccine has no effect on all the other causes of diarrhoea and other infections that are water-borne.

Dreaming up new vaccines, developing and testing them, then delivering them to millions of people — potentially every few years — is a noble (if expensive) enterprise, heavily underwritten right now by the Grand Masters of 21st century philanthropy, the Bill and Melinda Gates Foundation. But we know from the history of cities such as London that investments in “salutiferous improvements” by an earlier generation of philanthropists achieved broader and longer-lasting benefits than a single- disease-specific vaccine, and in a relatively short time. So why the obsession with drugs not drains?

Help choose Contagion stories: July 11th @ Elizabeth’s

Which diseases will stalk the Hackney Empire next spring? It’s a question we’ve been thinking about since Song of Contagion began. We’ve made a lot of progress to date, with help from many of you. That’s helped refine our thinking, and we’ve a better idea of how the show might work than we did at the start. So we want to ask for a final round of disease input before handing over to the music creatives. We hope to end up with a shortlist that the songwriters and composers can use to start creating the show. If you’ve got ideas, please join Elizabeth for beer, pizza (or other forms of booze and sustenance, depending on how many of you email and say you’re coming) and discussion at her place in north-east London on the evening of Monday July 11th.

Though our discussions so far have been wide-ranging we now want to get focused, not on diseases themselves, but on the different social, political and physical forces that shape our perception of the importance of a disease or illness. We want to choose a handful of diseases which illustrate specific parameters, then develop musical stories in which those parameters can be heard. With input from lots of you, we’ve now come up with a more rigorous list of the parameters which affect our perception of disease. They look like this:
parameters
(click image to download the Word file)

I’m lobbying for a diarrhoea story (Drain Brain?) that starts in 1830 and tells the story of poo-related deaths in London and Calcutta. The British and the Indian music will start off at the same volume because back then, diarrhoea was killing roughly the same proportion of the population in those cities. Then in the 1850s the British music gets deafening — that was the Big Stink and the cholera epidemic that followed. This rattles the Victorians into action, and they start to build drains — represented by the introduction of a didgeridoo as a bass-line to the British music (I’m hoping for a dij because it both looks and sounds like a drain…) As a result, diarrhoea deaths in London plummet. While the dij bass-line carries on, the rest of the British music gets quieter and falls silent. The Indian music, on the other hand, never gets a bass-line. Neither the colonial government nor the many subsequent Indian governments have invested sufficiently in basic sanitation, and tens of thousands of children continue to doe of diarrhoea in Indian cities to this day.
Parameters illustrated: Prevalence, near/far, infrastructure, time.

Other current contenders:
Dengue Merengue (HT Andrew W). Contrasting dengue with zika. Both are viruses spread by the same mosquito, in the same places. Dengue has been quietly killing people for years, and gets virtually no attention. Along comes zika, throwing up pin-head babies at a faster rate than the Brazilians can build Olympic stadiums. Front page news!
Parameters illustrated: visible vs. shocking, cute victims, near/far, press as influencers.

Shell Shocked: the story of mental illness resulting from war and violence. A century ago this was a “pull-your-socks-up” condition. Eventually it became diagnosable (as post-traumatic stress disorder), then pathologised and treated, though arguable only if you are lucky enough to experience it as a soldier from a rich country with a big health-care budget for veterans. The vast majority of civilians in conflict zones are exposed to more shocking violence and loss than intervening troops, but get no care.
Parameters illustrated: Unrecognised to pahtologised, near/far, us/them, Pharma as influencers.

We’ve got a couple more up our sleeves, but you get the picture. We want to hear YOUR suggestions. Please contact Elizabeth with ideas, or if you’re in London, come along at 7.30 on July 11th. If you e-mail info@songofcontagion.com, we’ll send you directions.

How would PJ Harvey sound out Contagion?

PJ Harvey at Field Day
Photo credit: REX via The Telegraph

Yesterday, I had the great pleasure of seeing PJ Harvey perform. Her most haunting song was probably “Dollar dollar”, a song about a boy begging at traffic lights in Kabul. It wells up out of an experience that clearly moved this thoughtful singer deeply when she was collaborating with photographer Seamus Murphy. But for me, standing under London sky pregnant with thunder, it was a song about Nairobi. I could feel my low grade irritation with matatu drivers rising; I could feel my foot hovering over the brake of my tiny (tinny) Jimny jeep; I knew that I hated being confronted with hungry kids with no prospects in life and with a pot of glue hanging from their top lip; and I knew that I hated myself for hating it.

It reminded me that music can prompt emotions (and express injustices) that are at once so universal and so deeply personal. The very emotions that swept me when I first saw the Grand Union Orchestra performing Undream’d Shores, and that led to the Song of Contagion collaboration.

Think we should invite PJ Harvey to contribute some disease music to Song of Contagion?

(Originally published by Elizabeth Pisani on June 13, 2016)

Music really IS ecstasy

Ecstasy spectrogram

I spent Sunday hanging out with the good musicians of CM Sounds, who showed us what the sitar and the sax could look like if you turned them into musical graphs. What they looked like, in fact, was Ecstasy, when you put it through a mass spectrometer. So many parallels between music and well-being…

(Originally published by Elizabeth Pisani on May 25, 2016)

Contagion goes digital

On May 22nd, a Sunday, an extraordinarily diverse range of musicians dragged themselves untimely from their beds to keep playing with the Contagion concepts, this time electronically. The workshop was run by Sam Johnson , presiding genius of CM.

sam-johnson-picIt continued to develop the ideas explored by acoustic instruments in the first workshop, developing and applying the musical parameters through digital means and music technology.

Sam began with a fascinating account (lavishly illustrated with familiar and unfamiliar tracks) of the development of recording techniques from the 19th century up to the present day, demonstrating the effect records have on the making of music.

Then, focussing on the role that technology can play in the creative process, Sam took participants – many of whom had limited experience of working with technology to record and edit music – through some of the incredible range of creative options available in processing sound, applying effects, editing and arranging. Some instruments, and some of the musical ideas, associated with the previous workshop were then recorded. This material was then manipulated in response to suggestions form the group to create characteristic profiles of diseases; and finally each participant was given their own workstation to try things out for themselves.

Here’s a grainy video of our discussions around distorting a sitar and a trombone to represent diarrhoea:

(Originally posted by Tony Haynes, May 2016)

What do diseases sound like? First soundings

Horn and table - Grand Union Orchestra

The first exploratory music workshop took place on Saturday 7th May at St Margaret’s House, Bethnal Green. It was run by GUO composer/director Tony Haynes with three Grand Union Orchestra musicians: Claude Deppa, South African trumpeter and percussionist; Yousuf Ali Khan, tabla player and singer from Bangladesh; and Carlos Fuentes from Chile, exponent both of Andean and Brazilian folk instruments and Latin-American music. This group of musicians was specially chosen to reflect the intended global span of Song of Contagion

As well as musicians, many students and global health professionals who participated in the launch workshop on April 23rd returned, and – whether they regarded themselves and musical or not! – joined in all the activities with grace and enthusiasm.

Carlos berimbau Grand-Union Orchestra Song of Contagion

Elizabeth began the day by profiling various diseases and isolating the parameters by which they can be defined (and the relative importance we attach to treating and funding them). Tony then identified ‘musical parameters’ in a similar way; and with the aid of the musicians, demonstrated how variations of a piece of music can be achieved, while the separate elements of which it is comprised – melody, harmony, rhythm and so on – still remain recognisable.

AIDS_story_graphic

To kick off the practical exploration, joining the disease parameters to the musical ones, Elizabeth produced some very vivid graphs, turning statistical data effectively into pictures, which the group proceeded interpret through music, turning them into some very dramatic and colourful musical pieces. or ‘vignettes’. As a result, we now have some emergent ‘repertoire’, but more importantly a number of creative strategies for generating further musical material.

(First posted by Tony Haynes, May 2016)

Enough PowerPoints, already!

solar_system

I’ve just emerged from three days buried in a bunker at the Geneva Health Forum, which focuses on health in lower income countries. There was a great cartoonist, but otherwise it was all quite po-faced: power-point presentations,* incomprehensible posters and much thanking of sponsors. LOTS of rather earnest, mostly white people suffered from the Public Health Fallacy: the idea that if only they had the (technical) evidence, all governments would do the best thing for their poorest and most neglected. Despite all of the (historical, political, social) evidence that the poorest and most neglected mostly get, well, neglected by those that govern them.

I propose adding this to the evidence base: po-faced conferences with power point presentations to an audience that has seen them all before do not generate new ideas about inequality in health. And I propose trying something different: let’s put the technical evidence up against the historical, political and social evidence in a piece of music, and see what gets drowned out.

Does that sound crazy? Maybe? Will it change the world? Of course not. Will it allow us to think a bit more creatively than another powerpoint presentation in a bunker conference? Probably. Will it be a lot of fun? Certainly!

Come along tomorrow, Saturday April 23, and add your voice to the project, which we’re calling Song of Contagion. (It’s supported by the Wellcome Trust, and most of what they support turns out pretty well.) We’re meeting in Hackney, East London, to begin to decide which diseases to songify, and what, besides the technical evidence, we should be adding to the musical mix. The fact that the Minister of Health’s wife owns a Pharma company, maybe? We didn’t hear THAT at the Geneva Health Forum…

*The illustration for this post came from one of my PowerPoint presentations, questioning whether data sharing presentations are creating an asteroid field of repositories where really we need a solar system. Pretty abstruse, eh?

(Originally published by Elizabeth Pisani on April 22, 2016)