‘The last time I saw my mum alive, she was vibrant.’
In March 2015, Amani Haydar’s father killed her mother, Salwa Haydar. He also injured his youngest daughter, Ola, during his frenzied attack. Pregnant with her first child, Amani had to go to the Kogarah Police Station to give a statement. Her father had turned himself into the police.
Why did Haydar Haydar kill his wife of 28 years, the mother of his four children? While the Haydars had recently separated after an unhappy marriage, Amani recalled that while her parents had fought a lot, her father had never bashed her mother.
In this memoir, Ms Haydar writes of her family’s experiences of war in Lebanon, of her parents arranged marriage, of her grandmother’s brutal killing during the 2006 war. Culture and context are important, as is the complexity of intergenerational trauma.
In the six years that have passed since Salwa Haydar was murdered, Ms Haydar has reassessed what she knew of her parents’ relationship, and the different faces and layers of domestic violence. She wonders if she should have realised earlier that her mother was at risk? There may not have been an history of what she recognised as physical domestic violence but there certainly was of emotional abuse and of coercive control.
How can Ms Haydar’s book be both terribly sad and tremendously uplifting? How can anyone move beyond the trauma of losing two parents to looking for ways to make a difference for others as well as for herself? And, importantly, how does Ms Haydar negotiate the ‘othering’ experienced when negative stereotypes (both in relation to domestic violence and to Muslims) are applied? Ms Haydar and her sisters have also had to deal with being ostracised and abused by family members who support her father.
‘Storytelling cracks the crust of shame imposed on victims and shifts the burden to where it rightfully belongs: spitting and smouldering in the palms of the abuser.’
This is a difficult book to read, and I admire Ms Haydar’s courage in confronting so many issues to write it. There is despair here and grief. There is also hope, support, strength, and resilience. Ms Haydar invites us to look at the stereotypes of victims as well, reminding us that it is okay to be angry. Ms Haydar recounts the trauma of her father’s trial, with its victim-blaming and false accusations against her mother.
In 2018, Ms Haydar had an entry in the Archibald Prize. Her painting is a self-portrait in which she holds a photograph of her mother, who holds a photograph of her own mother. I find this moving and uplifting. Three strong women, together.
This is not an easy book to read, but it is important. Highly recommended.
‘We are in a process of breaking cycles, and we are imperfect.’
Note: My thanks to NetGalley and PanMacmillan Australia for providing me with a free electronic copy of this book for review purposes.
‘To those who remembered him, it was typical that Nicholas should sail into Venice just as the latest news reached the Rialto, causing the ducat to fall below fifty groats and dip against the écu.’
In 1464, Nicholas vander Poele returns from Cyprus to Venice. His stay is brief: he has financial concerns and is under threat by several powerful business rivals. He sets sail for Africa:
‘The country where there is gold in such abundance that men prefer to barter in shells.’
Nicholas is intent on trade and exploration, and Africa offers possibilities. Africa: the legendary home of the Fountain of Youth, the myth of Prester John, descendant of Sheba and Solomon. It will prove to be an arduous journey, full of danger and hardship for Nicholas and his companions. They will make it (some of them) to Timbuktu, a great Muslim centre of learning and trading. Not all aspects of the mission will be successful, suffering will accompany discovery for some.
This, the fourth instalment of the House of Niccolò, will end in Europe with a cliff-hanger which had me tearing my hair and gnashing my teeth. And so, I moved straight onto book five, ‘The Unicorn Hunt’.
I loved this book, with its journey of self-discovery (for some) and exploration. Nicholas continues to develop, as do the intrigues around him. Another complex, intricately plotted novel in a series which is best read in order. I have read this series at least three times, and each time I discover new possibilities.
‘The Plague virus required the absence of a specific gene sequence.’
Yes, this is another pandemic novel. But this is one with a difference, and it certainly held my attention.
This novel, set in the near future, leads us into a world where a new virus has emerged – a virus which seems to only affect males. The story opens in Scotland in 2025, when a new and mysterious illness emerges with a high mortality rate. Dr Amanda MacLean reports the illness but is dismissed as being hysterical. By the time her warning is heeded, the virus has become a pandemic. While not all men die, all the victims are men.
The virus results in a new world, one in which women will dominate. But what form will the world take and how will the survivors adapt?
The story unfolds through several different viewpoints and eight different stages. Ms Sweeney-Baird takes us from before the pandemic, through the panic and despair into survival and recovery as a vaccine is developed. But be warned: recovery cannot be (at least not yet, if ever) to the pre-pandemic world. The path into the future requires new strengths and abilities in order to adapt, and also requires the past to be remembered.
I really enjoyed the way in which Ms Sweeney-Baird developed the world of her novel. No, I did not particularly like a world in which males became a small minority, but the impact of this virus and the changes required to the world consequently made me think. How would such a world work?
I finished the novel and returned to the real world. One in which a pandemic is real and now in its second year.
‘Not to every young girl is it given to enter the harem of the Sultan of Turkey and return to her homeland a virgin.’
Sixteen-year-old Philippa Somerville, wife in name only to Francis Crawford of Lymond and Sevigny, returns to England. While awaiting a divorce from Lymond, she is keen to find answers to some of the mysteries about his past. Meanwhile, Lymond himself is in Russia, with Güzel. His mission? To help Tsar Ivan create a modern army.
Now an accomplished young lady, Philippa is summoned to the English Court, to serve as a lady in waiting to Queen Mary. She is surrounded by both friends, (a couple of whom would compete to marry her once she is freed from marriage to Lymond) and foes (including Margaret Lennox).
Lymond and his highly skilled band of mercenaries have their own challenges in Russia. Self-interested factions compete for Ivan’s attention in a volatile court. Lymond has no intention of returning to England but does so at the Tsar’s command.
Philippa’s investigations into Lymond’s past reveal mystery about his parentage. And, once he is in England and the Tsar’s envoy, he is bound to cross paths with Philippa.
This is the fifth instalment in the Lymond Chronicles. It is also where I started my Lymond journey after my failed attempt to read ‘Game of Kings’ in 1974. This novel caught and held my attention from beginning to end, especially the descriptions of the Russian Court and the Tsar we have come to know as Ivan the Terrible. I enjoyed the history, the drama, the wonderful descriptions of people and place. Once I finished ‘The Ringed Castle’, I went back to the beginning and read my way through the series. I am now on (I think) my third re-read of the series and still enjoying the journey.
Dorothy Dunnett remains my favourite historical novelist. I continue to enjoy (and to learn from) these novels.
Australia’s immigration policy debates over the past 30 years have largely consisted of the usual suspects trotting out the usual lines. They generally divide into two camps – the high migration crew, hungry for the Government to go hell for leather on growing the intake, lining up against the ‘keep immigration to the minimum possible’… Continue reading »
The change is based on the advisory group’s assessment of the risks of the clotting disorder, called thrombosis and thrombocytopenia syndrome or TTS, versus benefits of the AstraZeneca vaccine in protecting against COVID-19.
While the risk of TTS is still very low overall, it is more common in younger age groups. And younger people are less likely to die or become seriously ill from COVID-19.
What is the clotting disorder and how common is it?
Thrombosis with thrombocytopenia syndrome (TTS) is a rare clotting problem that can occur after vaccination with the AstraZeneca vaccine.
We don’t fully understand why TTS occurs, but we know it’s caused by an overactive immune response. This is a very different mechanism to clots people might get after travelling or being immobile for lengthy periods.
The condition involves blood clots as well as a depletion in blood clotting cells known as platelets. The clots associated with TTS can appear in parts of the body where we don’t normally see blood clots, like the brain or the abdomen.
Of the 12 recent cases, seven occurred in people aged between 50 and 59.
Sadly, two people have died.
The risk of TTS reduces with age. For people aged under 50, there are 3.1 cases of TTS per 100,000 doses. This reduces to 1.9 cases for those aged 80 and above:
As awareness of TTS grows, clinicians’ ability to detect and diagnose the condition has also improved. This means the risk of becoming severely ill and dying from this condition has fallen dramatically.
How does this compare to the chance of dying from COVID-19?
Globally, 177 million cases of COVID-19 have been reported, with around 3.83 million deaths, or just over 2%.
The risk of dying from COVID-19 increases with age. The rates depend on the country you live in and your sex. In China, for instance, the death rate was reportedly:
for under-50s, less than 1%
50 to 59 years, 1.3%
60 to 69 years, 3.6%
70 to 79 years, 8%
80 and above, 14.8%.
In terms of data from Australia, in 2020, for every 600 people with COVID-19 aged in their 50s, one person died and 18 required admission to a hospital intensive care unit (ICU).
For every 600 people aged in their 70s with COVID-19, 24 died and 42 were admitted to ICU.
So the benefits of vaccination to prevent severe COVID-19 are greater among older age groups.
If you’re aged 50 to 59 and have already had one dose, and didn’t have a significant reaction, the advice is for you to return for your second dose.
Relatively few Australians have received a second dose of the AstraZeneca vaccine. But data from the United Kingdom shows TTS appears much less commonly after second doses – 1.5 cases per million doses.
If you have concerns about the risk of TTS, talk to your doctor or vaccine provider.
In the future, as more evidence emerges and is assessed by Australia’s regulators, we may use other vaccines for follow-up doses. But this is not currently the recommendation.
ATAGI is a group of experts that closely monitors vaccines both in Australia and internationally for side effects, as well as how well they are working.
It also considers the amount of disease circulating that the vaccine is designed to protect from.
These factors are considered at the time of initial approval, and then monitored continuously. When some of these factors change, the way we use vaccines also needs to change.
Today’s change demonstrates the strength and robustness of the ongoing surveillance of adverse events of vaccines and our regulators’ commitment to ensure the safety of the community receiving these vaccines.
We’re fortunate to have excellent control of COVID-19 in Australia and low rates of severe disease. We’re also fortunate to have an alternate vaccine in the form of Pfizer, albeit still in relatively short supply.
Out of an abundance of caution and considering all of these and other factors, it makes sense to increase the age cut-off for the use of this vaccine in our country at present.
This may be subject to further changes in the future, in either direction, as the situation around us continues to evolve.
‘Life can be cruel at times; it can steal as much in one hand that sometimes we just have to cling onto what it leaves behind, however small an offering.’
A chance conversation with an acquaintance I have made while walking led me to this book. We were talking about dementia, and Wendy Mitchell’s experience was mentioned. I had to track down her book for myself.
This is an inspirational story, of how Wendy Mitchell, diagnosed with early-onset dementia at the age of 58, has adjusted to life with dementia. She writes of how her world became blurred, how it became harder to do things, how right hand turns in the car led her to plot different routes (only involving left hand turns) until driving was beyond her.
‘That’s what Alzheimer’s does: it’s a thief in the night, stealing precious pictures from our lives while we sleep.’
Wendy held a responsible position in the British NHS, had raised two daughters alone and had been an active woman, running and climbing mountains. Living with dementia has provided challenges but for now Wendy is able to live independently. She uses Post-it notes and calendar alarms to remind her of appointments and routines and labels to find things that she otherwise might not recognise.
Wendy had to retire from her position with the NHS and she has found a role educating others about living with dementia. Wendy has found a way of living with dementia which, for now at least, allows her a degree of independence. I found this book inspirational.
‘But I was still me. Still me, but with a diseased brain.’
‘In some imaginary universe, he might be revered as Professor Sir Andrew Wakefield.’
Who is Andrew Wakefield, and why is he referred to as ‘the father of the anti-vaccine movement?’ Why has this movement gained so much momentum?
Once again, vaccination is a hot topic. Once again, those for vaccination and those against face off. Social media provides an additional vector for the spread of (mis)information. Rumour becomes fact. People remember horror stories. Fears cloud judgement. And, because of non-vaccination, some diseases are returning. Why are people choosing not to have their children vaccinated?
Part of the answer lies in activities undertaken by Andrew Wakefield, then a doctor in the UK, trying to prove a link between the MMR vaccine and autism. His study was published in the Lancet in 1998 and has since been retracted. Mr Deer goes into painstaking detail to provide the background. He provides biographical detail of Andrew Wakefield, a description of the rigged research undertaken to try to prove a connection, and the hopes of those families struggling with a disability and looking for answers. Heartbreaking stuff.
Fifteen years of investigation: a long investigation, several different players (many of whom only had parts of the story) and plenty of statistics. I read page after page, wondering how on earth Andrew Wakefield got away with presenting misinformation as science. I felt sorry for the families caught up in his ‘proof’, and angry with the medical establishment for not acting earlier. So, Andrew Wakefield is banned from medicine and has left the UK for the USA where he is feted by conspiracy theorists. Sigh.
As Mr Deer writes:
‘The way I saw it, it was never about the science, the children or the mothers. It had always been about himself.’
I found this a difficult book to read for two reasons. Firstly, I really did not want to believe that the checks and balances that should apply to research had failed, and secondly, I feel incredibly sad that people continue to believe in a totally discredited study (some of the children involved had signs of autism before they had the MMR vaccine). The downside of children not being vaccinated is a rise in preventable diseases. Diseases which can cause serious illness and may result in death.
Yes, I am aware that there are some children cannot have some vaccinations for medical reasons. But those reasons do not apply to most. I am absolutely in favour of the rigorous testing of vaccinations, to identify possible side effects and issues.
I believe that vaccination saves lives. I remember standing with my father, a survivor of the poliomyelitis epidemic of the early 1950s, in a queue in the early 1960s to have the Salk vaccine. I remember how hard it was for my father to stand in that queue. He never fully recovered from polio.
I wish that those who don’t believe in vaccination would read this book.
‘Weakness is treating someone as though they belong to you. Strength is knowing that everyone belongs to themselves.’
This story starts in eighteenth century Ghana, with two sisters born to different mothers in different villages. Effia and Esi lead very different lives and will never know each other. Effia is selected as wife to an Englishman and lives a life of privilege in Cape Coast Castle. In the dungeons beneath, her sister Esi is, with thousands of others, destined for slavery in America.
From these two lives, we follow the impacts of slavery and British colonisation in Ghana, and the path of slavery and its aftermath in America. One thread follows the lives of Effia’s descendants through centuries of warfare in Ghana as the Asante and Fante nations wrestle with colonisation and the slave trade. The other thread follows Esi and her descendants into America.
Effia and Esi are the pivotal characters, and the ones to which I felt most connected. As the story passes from one generation to the next, I had to keep referring to the family tree at the front of the book to keep the characters clear. I know little Ghanaian history. While the characters inhabiting those chapters of the story gave me some appreciation of conflicts, issues, and the effects of British colonisation, I need (and want) to read more. With the characters in America, I felt on more familiar historical ground. And yet, while the history is important, it is the stories of the individuals that makes this novel shine. Disadvantage becomes real through the eyes of Yaa Gyasi’s characters, as does the sense of dislocation. Where (and how) do people fit when their family ties are disrupted or destroyed, when colour defines place? How do nations evolve when slavery is part of their history? Both Ghana and America are shaped by this history as are the individuals.
This novel took me into some uncomfortable places and made me think about belonging and about the impact of dislocation. I am ambivalent about the ending, but every fiction must end somewhere.
‘We cannot know which story is correct because we were not there.’
At the end of 2020, there was a strong hope that high levels of vaccination would see humanity finally gain the upper hand over SARS-CoV-2, the virus that causes COVID-19. In an ideal scenario, the virus would then be contained at very low levels without further societal disruption or significant numbers of deaths.
But since then, new “variants of concern” have emerged and spread worldwide, putting current pandemic control efforts, including vaccination, at risk of being derailed.
Put simply, the game has changed, and a successful global rollout of current vaccines by itself is no longer a guarantee of victory.
No one is truly safe from COVID-19 until everyone is safe. We are in a race against time to get global transmission rates low enough to prevent the emergence and spread of new variants. The danger is that variants will arise that can overcome the immunity conferred by vaccinations or prior infection.
What’s more, many countries lack the capacity to track emerging variants via genomic surveillance. This means the situation may be even more serious than it appears.
As members of the Lancet COVID-19 Commission Taskforce on Public Health, we call for urgent action in response to the new variants. These new variants mean we cannot rely on the vaccines alone to provide protection but must maintain strong public health measures to reduce the risk from these variants. At the same time, we need to accelerate the vaccine program in all countries in an equitable way.
Together, these strategies will deliver “maximum suppression” of the virus.
There are currently at least three documented SARS-CoV-2 variants of concern:
B.1.351, first reported in South Africa in December 2020
B.1.1.7, first reported in the United Kingdom in December 2020
P.1, first identified in Japan among travellers from Brazil in January 2021.
Similar mutations are arising in different countries simultaneously, meaning not even border controls and high vaccination rates can necessarily protect countries from home-grown variants, including variants of concern, where there is substantial community transmission.
If there are high transmission levels, and hence extensive replication of SARS-CoV-2, anywhere in the world, more variants of concern will inevitably arise and the more infectious variants will dominate. With international mobility, these variants will spread.
South Africa’s experience suggests that past infection with SARS-CoV-2 offers only partial protection against the B.1.351 variant, and it is about 50% more transmissible than pre-existing variants. The B.1.351 variant has already been detected in at least 48 countries as of March 2021.
The impact of the new variants on the effectiveness of vaccines is still not clear. Recent real-world evidence from the UK suggests both the Pfizer and AstraZeneca vaccines provide significant protection against severe disease and hospitalisations from the B.1.1.7 variant.
On the other hand, the B.1.351 variant seems to reduce the efficacy of the AstraZeneca vaccine against mild to moderate illness. We do not yet have clear evidence on whether it also reduces effectiveness against severe disease.
For these reasons, reducing community transmission is vital. No single action is sufficient to prevent the virus’s spread; we must maintain strong public health measures in tandem with vaccination programs in every country.
Why we need maximum suppression
Each time the virus replicates, there is an opportunity for a mutation to occur. And as we are already seeing around the world, some of the resulting variants risk eroding the effectiveness of vaccines.
That’s why we have called for a global strategy of “maximum suppression”.
Public health leaders should focus on efforts that maximally suppress viral infection rates, thus helping to prevent the emergence of mutations that can become new variants of concern.
Prompt vaccine rollouts alone will not be enough to achieve this; continued public health measures, such as face masks and physical distancing, will be vital too. Ventilation of indoor spaces is important, some of which is under people’s control, some of which will require adjustments to buildings.
Fair access to vaccines
Global equity in vaccine access is vital too. High-income countries should support multilateral mechanisms such as the COVAX facility, donate excess vaccines to low- and middle- income countries, and support increased vaccine production.
However, to prevent the emergence of viral variants of concern, it may be necessary to prioritise countries or regions with the highest disease prevalence and transmission levels, where the risk of such variants emerging is greatest.
Those with control over health-care resources, services and systems should ensure support is available for health professionals to manage increased hospitalisations over shorter periods during surges without reducing care for non-COVID-19 patients.
Health systems must be better prepared against future variants. Suppression efforts should be accompanied by:
genomic surveillance programs to identify and quickly characterise emerging variants in as many countries as possible around the world
rapid large-scale “second-generation” vaccine programs and increased production capacity that can support equity in vaccine distribution
studies of vaccine effectiveness on existing and new variants of concern
adapting public health measures (such as double masking) and re-committing to health system arrangements (such as ensuring personal protective equipment for health staff)
behavioural, environmental, social and systems interventions, such as enabling ventilation, distancing between people, and an effective find, test, trace, isolate and support system.
COVID-19 variants of concern have changed the game. We need to recognise and act on this if we as a global society are to avoid future waves of infections, yet more lockdowns and restrictions, and avoidable illness and death.