'Last Man Standing'

DATE January 17, 2007 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Producer Zarqa Nawaz talks about her new CBC sitcom,
"Little Mosque on the Prairie"
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

A new sitcom called "Little Mosque on the Prairie" premiered last week in
Canada on CBC television and was a big hit. The show follows a group of
Muslims in a small Canadian town called Mercy who have rented space in an
Anglican church for their mosque. The comedy surrounds the constant
misunderstandings the town residents have about Muslims and the mosque, but
there's plenty of comic misunderstandings between the Muslims, too, because of
generational differences and the differences between Arab, black African and
white members of the mosque. My guest is the creator of the show, Zarqa
Nawaz. It's loosely based on her experiences when she moved from Toronto to
Regina in Saskatchewan. Nawaz also directed a documentary called "Me and the
Mosque" about women who objected to newly created partitions in their mosques
dividing women from men.

In the opening episode of "Little Mosque on the Prairie," a new young imam
from Toronto is coming to replace the mosque's more old-school imam who is
originally from Pakistan. The young imam is in line at the airport talking on
his cell phone to his mother. A woman standing next to him overhears his end
of the conversation, misinterpreting what he's saying, and suspecting he's a
terrorist, she reports him to the authorities. Here's the scene.

(Soundbite from "Little Mosque on the Prairie")

Mr. ZAIB SHAIKH: (As young imam) Mom, stop it with the guilt. No, don't put
dad on. I've been planning this for months. It's not like I've dropped a
bomb on him. If dad thinks it's suicide, so be it. This is Allah's plan for
me.

Unidentified Woman #1: Oh, my!

Mr. SHAIKH: (As young imam) I'm not throwing my life away. I'm moving to
the prairies to run a mosque. What?

Unidentified Man #1: (As security officer) Step away from the bag. You're
not going to paradise today.

Mr. SHAIKH: (As young imam) Excuse me, what's going on? You must have the
wrong person. What? Those are my bags.

(End of soundbite)

GROSS: That's a scene from the new Canadian sitcom, "Little Mosque on the
Prairie."

Zarqa Nawaz, was that scene controversial?

Ms. ZARQA NAWAZ: You know, when we wrote it, we didn't think it was going to
be controversial. And, you know, for the most part, it hasn't been, but I
have gotten some feedback from some reporters who felt that, you know, was it
too sensitive of an issue to make a joke of. And I thought, you know, it's
really interesting to me because I thought, you know, I had to be really
careful when it came to Muslim issues not offending sensibilities, but there
are sensibilities even around 9/11 that one has to sort of respect and to take
into consideration. So I did find it interesting that I got a few phone calls
where people wanted to know, you know, did I think I had crossed the line by
making fun of, you know, being a potential terrorist in an airport and getting
arrested. So, yeah, it was really interesting to me when I took those calls.

GROSS: Was part of the problem, as it was perceived that you were taking too
lightly security concerns?

Ms. NAWAZ: That, you know, what had happened in 9/11 was a very serious
thing for the Americans, and that things that happen in the airport are not
things to be trifled with or to make jokes about, you know. It was almost
like talking to Muslims about, you know, a Muslim joke in this series. When I
listen to, you know, some people, `Wow, that's interesting to me.' I never
realized that I--you know, that there would be some sensitivities around those
issues, too. So, you know, to me, you have to be careful, you know, not to
offend both groups.

GROSS: But let's take a subsequent scene after he is detained at the airport
because somebody thinks that he might be a terrorist. He's interrogated in a
room at the airport. Let me play that scene.

(Soundbite from "Little Mosque on the Prairie")

Mr. SHAIKH: (As young imam) What's the charge? Flying while Muslim?

Man #1: (As security officer) No, that's not the charge.

Mr. SHAIKH: (As young imam) I was joking. Muslims around the world are
known for their sense of humor.

Man #1: (As security officer) I did not know that.

Mr. SHAIKH: (As young imam) That was another joke.

(Soundbite of Zaib Shaikh sighing)

Man #1: (As security officer) Whoa! What is that? Some kind of signal?

Mr. SHAIKH: (As young imam) No. That's because you didn't get the...

Man #1: (As security officer) You lived for over a year in Afghanistan.

Mr. SHAIKH: (As young imam) I was volunteering with a development agency.

Man #1: (As security officer) Why did you leave your father's law firm?

Mr. SHAIKH: (As young imam) While I was in Egypt doing my Islamic studies, I
found my true calling.

Man #1: (As security officer) Explosives?

Mr. SHAIKH: (As young imam) Yeah, explosives. Look, I am going to the town
of Mercy to work as an imam. You know? Like a priest? Hold on, I can prove
it.

Man #1: (As security officer) Eh-eh.

Mr. SHAIKH: (As young imam) I have the ad that I answered for the job. You
can call the mosque if you like. If the story doesn't check out, you can
deport me to Syria.

Man #1: (As security officer) Hey, you do not get to choose which country we
deport you to.

(End of soundbite)

GROSS: That's a scene from "Little Mosque on the Prairie," and as we could
hear, both the people doing the interrogating and the imam who was being
interrogated are completely misunderstanding each other every step of the way.

Ms. NAWAZ: Mm-hmm.

GROSS: What kind of response did you get to that scene?

Ms. NAWAZ: Well, it was interesting. That scene was actually inspired by
the Maher Arar case in Canada. I don't know if you know about that case, but
a Canadian citizen who is on his way back home, he had been away on vacation
and he'd traveled to New York, to come back home, was arrested by American
authorities and with, you know--and in collusion with the Canadian authorities
was deported to Syria where he was imprisoned and tortured for one year. You
know, this man was completely innocent, and eventually he was exonerated, you
know, on his return back to Canada because of the efforts of his wife.

And, you know, it was a huge, huge issue in Canada. How could we have allowed
this to happen to one of our own, that we would, you know, have allowed these
sort of stereotypes to cloud our judgment, that we would've sent a man that
was innocent of these charges to, you know, to a country to be tortured. And
so to me, you know, that was saying something that I felt I had to comment
about. And so, I wrote--you know, we wrote this scene together, myself and
the writers about, you know, being interrogated, you know, by a Canadian
police officer. And you know, some people felt that maybe, you know, that
scene, you know, took the issue too far. But, you know, I mean, there are
different responses. Even some people thought it was absolutely hilarious and
loved it because it made the point absolutely as it should have. You know,
other people felt that, you know, did I go too far with that scene.

So it was interesting to me how people responded because it was a very, you
know, politically sensitive scene because, you know, you're actually talking
about something that happened to someone and affected someone's life. And,
you know, to me that's the only way for me to deal with it is through a
comedic take on it so that people can understand how serious it was for one
person.

GROSS: Now in the second episode of "Little Mosque on the Prairie" which I
have not yet seen, the older imam, who's from Pakistan, wants to erect a
barrier in the mosque to separate the women from the men.

Ms. NAWAZ: Right.

GROSS: Now you actually made a documentary called "Me and the Mosque" about
how more and more mosques in Canada have been erecting partitions between the
men and the women, and that even happened in your mosque. Would you describe
the change in your mosque and how that affected your experience of praying
there?

Ms. NAWAZ: Well, when I first came to Regina, the women prayed behind the
men and there was no issue about that. You know, nobody even questioned it.
But as our community started to grow and we started getting more conservative
immigrants coming to our community, there, you know, people started talking
about how this wasn't really Islamic. It wasn't really appropriate. Women
shouldn't really be seen by the men. And it, you know, at first I was like,
`OK, you know, we can fight this.' This isn't really going to affect us in any
way, except that the voices started getting louder and louder, and at one
point I think we had a visiting imam from Saudi Arabia, you know, which is a
very conservative country from an Islamic point of view come down and say
publicly that what we were doing was wrong. And this sort of emboldened the
more conservative members of our community. And one day, you know, I came to
the mosque, and there's this shower-like curtain hanging where the women are
praying and we're expected to pray behind it. And that's when the problem
started.

Some of the women wanted to show that we weren't going to accept this
decision, and so we prayed in front of it to show that it was unacceptable to
us. You know, and I admit that there was some women who preferred it and
wanted a more private space, so they prayed behind it. But I felt that, you
know, it wasn't fair that it was a unilateral decision where everyone had to
pray behind it and that there should be some accommodation for women who
wanted to pray, you know, in front of it without a barrier between them and
the hadith, the leader of the prayer.

GROSS: What kind of explanation did your imam give you about why there was
suddenly a barrier between the men and the women?

Ms. NAWAZ: The explanation is always like, well, it's just a more Islamic
thing, you know. Women don't dress properly anymore. Men are more
distracted. We're in the West. Things are more loose and lax, and we've got
to tighten things up. And you know, because they can't really defend it from
theology because, you know, there was never a barrier during the time of the
prophet. You know, men and women interacted freely with each other.
There--you know, there was a much more normal behavior. Like I read stories
of the time of the prophet, you know, and women used to speak up, used to ask
the men questions. They ask--you know, they couldn't hear the prophet, they'd
ask the men to repeat it, they would challenge each other. There was this
normalcy between them. They still preserved their modesty, but there was more
of an interaction between them which I feel has disappeared now from many
aspects of the Muslim culture.

GROSS: Let's talk about the casting. Did you want all the actors who play
Muslims to be Muslims? Did you care?

Ms. NAWAZ: No, I didn't care. I wanted the best actors we could find in the
country, because ultimately that's the best for the show. You know, because
there's no point in getting Muslim actors and getting really bad acting and
nobody watching it and the ratings go down the tubes, and then you're
cancelled. So it's best for me and the show that we got the best actors that
we could possibly get. And, you know, if they happen to be Muslim, that is
great. Unfortunately, you know, acting is not a career that most Muslims go
into because of, you know, some of the limitations that would have to happen.
You know, a lot of Muslim women wear head scarves and wouldn't be willing to
take it off, or if a man was quite devout, he wouldn't want to be touching
members of the opposite sex or having sex scenes. So, you know, it becomes
very difficult for a lot of Muslim actors to go into the entertainment
business. So we were lucky that the best actor that we chose to play Amaar
Rashid, the new imam, turned out to be Muslim in real life, and, you know,
with a good solid base of religious knowledge and the ability to recite
Arabic, which is a huge advantage to us.

GROSS: This is, from what I've read, this is like the first Muslim sitcom in
North America.

Ms. NAWAZ: Mm-hmm. Yeah. As far as I know.

GROSS: Are you the only Muslim on the writing staff?

Ms. NAWAZ: I am. We don't have, like I mentioned before, Muslims going into
the entertainment field. They're very few and far between. So I don't think
we really have any or maybe extremely few Muslim writers in Canada. And
because we are Canadian and we protect our cultural product, we have certain
rules which means we don't use writers from other countries. Like in the US,
there's no rules like that. You know, you don't have to protect your cultural
product because you have global dominance.

GROSS: We're king.

Ms. NAWAZ: You are. But we compete against you.

GROSS: In the world of pop culture.

Ms. NAWAZ: You absolutely do. The only way to protect--you know, if we
didn't have those rules, I think everyone would like automatically cast Brad
Pitt in every film they could if they're going to get Canadian funding. So
our rules are we use Canadian actors, Canadian writing teams, to keep the
culture of our product Canadian. And so, what that does is, you know, it's
difficult to find Muslim writers. But, in a way, I think that it's an
advantage to us because bringing in other writers from different faith
communities opens up the writing and makes sure it isn't insular that people
can't relate to the subject matter. That, you know, we do tell stories that
have to do with Muslim communities, but it's not written in such a way that
you would have to belong to that community to understand. Because, you know,
ultimately, this show is going to be seen by the non-Muslim community in order
for it to survive and get the ratings to carry on. So we have to make it as
universal and as accessible as possible.

GROSS: My guest is Zarqa Nawaz, the creator of the new Canadian sitcom,
"Little Mosque on the Prairie."

We'll talk more after a break. This is FRESH AIR.

(Announcements)

GROSS: My guest is Zarqa Nawaz, the creator of the new Canadian sitcom,
"Little Mosque on the Prairie."

Well, I know you wear a head scarf. I was wondering if you think that that is
a sign of the inequality of women?

Ms. NAWAZ: I don't think so. I mean, to me, it's the choice of a woman to
decide how she wants to wear, what she wants to wear and her level of modesty.
And to me, I prefer a certain level of modesty. And I think, you know, if you
look at the society, you have people like Britney Spears or Paris Hilton, and
if they choose not to wear underwear and flash people when they get into cars,
I mean, that's acceptable in this society. So, if that's acceptable, then if
a woman wants to cover her hair because she believes in a higher degree of
modesty, then that should be acceptable, too.

To me, the problem comes in when men decide `This is how you're going to dress
and you have no choice and we're going to force you to dress this way.' That's
the point where I think it starts to become problematic because I think, you
know, you can sexualize a woman in two ways. One is to take--I'm sorry,
objectify a woman sexually two ways. One is to take off her clothes
completely, and one is to completely shroud her, you know, in a veil that's
head to foot where you can't see anything. I think those are two extreme ends
of the same thing, ultimately. And I feel like the middle is where I want to
be, where it's, you know, you're comfortable dressing modestly. You know, I
think it's a woman's right to decide if she wants to wear the head scarf. I
know that there are Muslims who believe it's mandatory and that's fine, but I
don't think it's right to impose that upon a woman.

GROSS: How old were you when you started wearing the hajib?

Ms. NAWAZ: I was 13. I was starting high school.

GROSS: And was it your idea to wear it or your mother's?

Ms. NAWAZ: Yeah, very much my idea. My mom didn't wear it. I just felt
more connected to my faith by wearing it, and I just felt a stronger sense of
identity as a Muslim woman wearing it. And it just, you know, it just made me
feel better about who I was as a Muslim because people recognized me. People
knew where I was coming from, what I had to say, what my beliefs were. And
I've always felt very empowered by it.

GROSS: Do you have any daughters?

Ms. NAWAZ: I have two daughters and two sons. So equal.

GROSS: Do your daughters wear the head scarf?

Ms. NAWAZ: No. I want them to decide later in their life. They are only 10
and 12, and I feel that's a decision that they have to make when they're
older. I want them to sort of, you know, enjoy themselves as young women
growing up. And these are--I don't--you know, to me, modesty goes beyond the
head scarf. For me, I'm more concerned with sort of neck down. I'd rather,
you know, they learn to dress modestly as women because, you know, I think
both men and women need to dress modestly just, you know, just as themselves,
and I would--the same rules I have for my daughters I will have for my sons,
and if they choose to wear the head scarf, that will be up to them, but I'd
rather they wait until they're much older.

GROSS: Since you wear a head scarf, where do you find beautiful ones to wear?

Ms. NAWAZ: It's a good question because living in Regina, it's a huge
challenge finding really good head scarves. So I make sure that when I'm in
Toronto, I scour the Islamic stores to find, you know, the most beautiful ones
I can find. And then I go to the biggest Islamic convention in North America,
which is the Islamic Society of North America in Chicago Labor Day weekend.
So I go there every year, and I do a giant shopping trip where I get as many
scarves as I can possibly cram into my suitcase and customs will let me come
across without fining me. There is a limit, you know. And I wish they would
change that limit.

GROSS: Now, I want to play something from early in "Little Mosque on the
Prairie" in which the older imam, the imam who's from Pakistan, is preaching
at the mosque.

(Soundbite from "Little Mosque on the Prairie")

Unidentified Man #2: (As older imam) As Muslims, we must realize the enemy is
not only out there. The enemy is much closer than you think. The enemy is in
your kitchen.

Unidentified Woman #2: (As Meha) Maybe while the enemy's in there, he can do
the dishes.

Unidentified Man #3: (As Meha's father) Shh. Meha, the point.

Woman #2: (As Meha) Dad, Baba never has a point.

Man #2: (As older imam) My point is this, wine gums, rye bread, licorice,
Western traps designed to seduce Muslims to drink alcohol!

Woman #2: (As Meha) His sermons are going to drive me to drink alcohol.

Man #3: (As Meha's father) Patience, daughter, this is his last sermon. The
new imam will be on his way very soon.

Man #2: (As older imam) "American Idol," "Canadian Idol," I say all idols
must be smashed. "Desperate Housewives"? Why should they be desperate when
they're only performing their natural womanly duties?

(End of soundbite)

GROSS: That's a scene from "Little Mosque on the Prairie," and my guest is
the creator of the show, Zarqa Nawaz.

Have you ever been in a mosque with an imam who's so completely misunderstood
popular culture?

Ms. NAWAZ: Well, he's a bit of an exaggeration, but, yes, when I was, you
know, was growing up in a mosque, I did have an Islamic teacher who told us,
you know, we shouldn't be drinking root beer and, you know, hamburgers. These
words were a little bit, you know, embedded in the culture and, you know, and
I remember for years as, you know, as a kid growing up in Canada, I wasn't
allowed to drink root beer because my parents were genuinely confused by what
it really was. So, you know, it's a bit of an exaggeration, but there's a
grain of truth to it, too, because it was inspired by my Islamic school
teacher when I was a teenager. So I'm really hoping he's not recognizing it.

GROSS: Well, you just gave it away.

Ms. NAWAZ: Yeah, yeah. I'm hoping that he's retired and, you know,
peacefully in the Barbados or something.

GROSS: So did the kids laugh at him when he got it wrong, like that?

Ms. NAWAZ: At the time when I was growing up?

GROSS: Yeah.

Ms. NAWAZ: No, no, we took him quite seriously. I mean, you know, he was
sort of, you know, we were much younger and he was much older and he was
saying, you know, things like hamburgers and you know...

GROSS: He thought hamburgers were made out of ham?

Ms. NAWAZ: Yeah. He said, `You really have to be careful and look at the
words and why are these words there?' And he was sort of warning us to be more
careful about the ingredients and what the meaning of these words were and
were they sort of softening us to accept alcohol, and so, you know, I mean,
I'm sure he meant well, I really do, but I think he--you know, he was a great
inspiration for that scene and, yeah, I think people in my community are a bit
more careful when they talk to me now.

GROSS: Boy, yeah! Is that happening? When people are afraid to see you
around because they think they're going to end up on the show?

Ms. NAWAZ: Yeah, yeah. I think people are being a bit more careful because
they're realizing that it's all good material for me.

GROSS: But you do have a lifetime to draw on.

Ms. NAWAZ: I do, I do, and God knows there's enough stuff in the news that
you can just continue to draw on stuff that happens in the headlines
constantly about Muslims. And so, you know, it's great for me in terms of
material. I seem to have no end of it.

GROSS: Does anybody think that you're a traitor because, among other things,
you're showing comic divisions within the Islamic community? You're not just
showing like people from the outside who distrust Muslims and Muslims who are
skeptical of the outside world. There's a lot of divisions within the
community that you're talking about.

Ms. NAWAZ: Yeah, I think that--I think overall because I'm an organic part
of the community that I'm representing. There's not that fear because I, you
know, I still go back to the mosque. You know, the mosque is still very much
a part of my current life and, you know, you know, I have accountability to my
people. Like I'm not writing from somewhere far away who doesn't have to deal
with the Muslim community. I--there's a lot of accountability for myself. I
mean, I deal, you know, with my community on a daily basis. So, you know, but
I can understand some people's fears because there have been a lot of Muslims
who quote/unquote "sold out their community" to sell a book or, you know, get
ahead in their career by bringing out divisions or making Muslims very angry
and saying `See, this is how they react. This is the way they are.' Whereas
in my community, I think there is a sense that, you know, that's not what I'm
out to do. I'm not out to further my career by selling out my community.
What I'm trying to do is putting a better understanding between two
communities that really, really need a chance to look at each other and laugh
at each other and bridge the gaps of paranoia that exists right now. And
that, you know, for every, you know, kooky Muslim I have in my show, I have an
equally kooky non-Muslim. So it's an equal opportunity show for all people.

GROSS: If your sitcom gets picked up by an American broadcaster or cable
network, are there changes you think you'll have to make because there's some
references that are so Canadian that Americans wouldn't get them?

Ms. NAWAZ: Yeah, I mean, even when we're shooting it, we're doing
alternatives for certain takes.

GROSS: Oh.

Ms. NAWAZ: So that if it does get picked up by an American broadcaster,
there won't be that many changes. So we're conscious of that, which is why we
haven't actually referenced where we are in the prairie. We just generally
say we are in a town of Mercy in the prairies. We don't actually reference
the province of Saskatchewan. Because, you know, it could be in North Dakota,
easily.

GROSS: Aha, I see.

Ms. NAWAZ: As well as--we don't actually say it's Saskatchewan. We're being
clever that way. Sales are important.

GROSS: Absolutely. Well, good luck and thank you so much.

Ms. NAWAZ: Well, thanks for having me.

GROSS: Zarqa Nawaz created the Canadian sitcom, "Little Mosque on the
Prairie." It premiered last week on the CBC.

I'm Terry Gross, and this is FRESH AIR.

(Announcement)

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Dr. Mark Kline talks about his work treating
HIV-AIDS-infected children worldwide
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

My guest, Dr. Mark Kline, has seen something he never thought he would:
watching children with HIV live long enough to have children of their own. In
addition to treating children in the US, Dr. Kline has started pediatric AIDS
clinic in Romania and four African countries: Lesotho, Botswana, Malawi and
Swaziland. He's the president of the Baylor International Pediatric AIDS
Initiative, which is now partnering with UNICEF and has become the biggest
pediatric AIDS initiative in the world. Dr. Kline is also the head of
retrovirology at Texas Children's Hospital.

How is the prognosis for children with HIV changed?

Dr. MICHAEL KLINE: Here in the United States, there has been a really
remarkable change in outlook for children with HIV, with the advent of highly
active anti-retroviral therapy. These are combinations of anti-retroviral
drugs that can nearly, totally suppress the ability of the virus to replicate
within the body, and these therapies became available in the mid-1990s, and
subsequently children with HIV in the United States have lived long and really
very healthy lives. But in the developing world where access to drugs has
been limited up until now, children continue to die at a very high rate.
About 600,000 children died last year alone of HIV-AIDS globally.

GROSS: Do most children with HIV get it from their mothers?

Dr. KLINE: Well, they do. Yes. Globally, more than 90 percent of the
children with HIV have acquired the virus from their mothers. The virus can
be passed across the placenta during pregnancy. It can be passed from mother
to infant at the time of delivery because of exposure of the infant to
maternal blood and vaginal and cervical secretions, and it can be transmitted
after birth through breast feeding, and so those are really the three
principal time points at which the virus can be transmitted from mother to
baby.

GROSS: And it must be hard in some places to convince mothers not to
breast-feed their children.

Dr. KLINE: It can be. In a number of settings around the globe, there
really isn't a viable alternative to breast-feeding. Water is not safe for
drinking. It often is contaminated. Breast-feeding, of course, is a
protection against diarrhea and other potentially life-threatening infections.
And formula is prohibitively expensive in very many poor settings around the
world. And then, in addition, across Africa, there's a certain stigma
associated with formula feeding. Mothers are expected to breast-feed, and if
the mother is not breast-feeding, the community may conclude that it is
because she is HIV-positive.

GROSS: Your interest in international work with children who have HIV started
in Romania in the '90s. How did you get there in the first place?

Dr. KLINE: Well, I had been taking care of children with HIV in the United
States from about 1987 on, and I had seen the transformation in the health of
children with HIV here, and in February of 1996, I made a trip to Romania and
I visited a number of orphanages where there were hundreds of HIV-infected
children wasting and dying of AIDS. And it had quite an impact on me. I came
back to the United States knowing that I had to do something to help. I
had--at that point in my career, I thought I had seen everything. I really
thought I knew everything there was to know about pediatric HIV, but I
realized at that point that this disease was having a terrible impact on
children in poor countries. And so we started a program at Baylor that
initially was focused on training doctors and nurses in Romania how to take
care of children with HIV, and it subsequently grew into a care and treatment
program for children with HIV in Romania, and from there we expanded to Africa
and to Latin America and then to Asia.

GROSS: Why were so many children in Romania infected with HIV?

Dr. KLINE: Romania is an interesting place. Fortunately, it's unique.
There were thousands of children infected with HIV in Romania in the late
1980s because of certain medical practices that were prevalent at the time.
In particular, the use and re-use of disposable needles and the injection of
unscreened human blood for a variety of reasons, for stimulating the immunity
of newborn infants, for promoting growth, for combatting iron deficiency
anemia and malnutrition. All of this was without any real scientific basis.
But thousands of children became infected with the virus, and many...

GROSS: So a lot of them were infected by doctors who were trying to help them
by injecting blood?

Dr. KLINE: Yes. So the epidemic in Romania really is a consequence of
medical practices. It is what is termed nosocomial or hospital acquired. And
so most of these children actually acquired the infections in the hospitals
or, in some cases, in orphanages, and many of them, at least six or seven
thousand are still alive today and, of course, as a consequence of time,
they're adolescents and young adults.

GROSS: What did you see on your first trip to Romania? What kind of
conditions were the children with AIDS who you saw living in?

Dr. KLINE: Well, the medical conditions of the children were just really
stark. The children had open sores on their skin. They had terrible lesions
in their mouths. They were wasted. Many of them literally were skin and
bones. They had terrible chronic pneumonia and chronic diarrhea. These were
the sickest children I had ever seen in my life, far more ill than any
children with HIV I had ever seen in the United States, and it was so striking
to me, I think, because, again, it came at a time when highly active
anti-retroviral therapy had restored American children to health, and it was
such a striking contrast to see these children so ill, without access to these
life-saving drugs.

GROSS: Do you still continue to make trips to Romania, and if so, can you
tell us the story of one of the children who is maybe not a child anymore,
whose story you continued to follow.

Dr. KLINE: Yeah, I do travel frequently to Romania. I was just there at
Christmastime, and it really is remarkable to see the transformation.
The--first, for the population as a whole in Constanta, the city where our
clinic, our center, is located, the annual death rate for HIV-infected
children dropped in three years from 13 percent per year to less than 1
percent per year. That's the difference between 109 deaths in a year and only
seven deaths. That obviously was a remarkable change. Children were living
instead of dying. We saw a 90 percent reduction in hospitalizations so that
the pediatric ward at the infectious disease hospital in 2001 on any given day
had an average of about 34 HIV-infected children hospitalized for various
complications. That number dropped to four by 2003.

But for the children individually, the transformation has been equally
remarkable. These little wasted, stunted children--in some cases, children
who were 10 or 11 or 12 years old but looked like three and four-year-old
children--have grown tall and strong. Many of them are taller than I am
today. They look perfectly healthy. Some have graduated high school. Many
of them are in job training. Some of them are living independently. Many of
them have married. We've had about 10 pregnancies and births of children,
from girls who were cared for in our clinic in the past year. Fortunately,
none of the babies are infected. So these children that I think just about
everyone thought would lead very short, painful lives and die young are
actually living, and not just surviving but thriving, and they can look
forward to very full lives. And this is a consequence of good medical care
and highly active anti-retroviral therapy.

GROSS: My guest is Dr. Mark Kline, head of the Baylor International
Pediatric AIDS Initiative.

We'll talk more after a break. This is FRESH AIR.

(Announcements)

GROSS: If you're just joining us, my guest is Dr. Mark Kline. He's chief of
retrovirology at Texas Children's Hospital, and he's the president of the
Baylor college of Medicine International Pediatric AIDS Initiative, and they
have programs in several African countries.

What are some of the big differences you've seen in dealing with AIDS in
Africa vs. dealing with AIDS in Romania?

Dr. KLINE: In Romania, the epidemic was what the epidemiologists sometimes
refer to as almost a closed cohort. It was a group of children who were
infected at a particular point in time, and then they aged through infancy and
into the school-age years and ultimately into adolescence and now are becoming
young adults. So even in 1996 when I began working in Romania, most of the
children were six, seven, eight years old.

In Africa on the other hand, the children have been infected vertically. That
is from mother to infant, either during pregnancy or around the time of
delivery or through breast milk, and that has been a continuous phenomenon
over a period of years now, and most of the children who come to medical
attention are rather young. Half are under two years of age, and so there are
special challenges associated with treating very, very young children,
particularly challenges to treating infants: getting the medications into the
infants, determining the proper dosages of the medications, making certain
that the medicines aren't producing any toxicity in an infant. All of that is
a bit more complicated than the treatment of older children.

The pace of the disease also in Africa is somewhat different. It's been
observed that about half of African children with HIV died without treatment
by the age of two, which means that you have really a limited window of
opportunity to intervene with treatment. If you haven't identified the infant
as being HIV-positive and instituted therapy within the first 18 months or 24
months of life, it's very likely that that child will have died.

GROSS: What are some of the biggest obstacles you faced in setting up these
pediatric AIDS clinics in African countries?

Dr. KLINE: Well, the challenge has been that there really was no blueprint
for it, and certainly early on, when we got started, authorities and very
knowledgeable people were questioning whether the kinds of treatment that were
given to HIV-infected people in the United States ever would be practical or
affordable for HIV-infected people in Africa and other poor parts of the
world, and so it was difficult to overcome that sort of idea that it was
futile, that basically people who were infected were just going to die and
that there was nothing that could be done.

GROSS: You know, the more clinics that you set up in Africa while also
dealing with the pediatric program in the United States at Texas Children's
Hospital, the more overwhelming it must seem. And I guess I'm wondering if it
ever gets so overwhelming to see like so many children with HIV.

Dr. KLINE: It can be. You know, the key, I think, is not focus on the
enormity of the problem but on the individual stories and the individual
successes, and any big problem can be dissected down into a number of smaller,
more manageable problems, and this is the way that I try to approach
everything that we do. I think one of the reasons that life-saving treatment
did not make its way to African children and other children living in the poor
countries earlier on was that people just simply threw up their hands in
despair. They said, `The problem is too big. There is nothing we can do.'

But you have to make that first step. You have to start somewhere and--so
that's what we've done. Put a few dozen children on treatment and then a few
hundred, then a few thousand. And you know, it's a life or death difference
for those children who you have provided access to treatment and--but it
really is a race against time. We have a limited window of opportunity here
to roll out treatment to hundreds of thousands of children, to bring to scale
treatment programs that to date really have just been established on kind of a
pilot basis, and we have to work quickly or we will lose a generation of
African children in particular.

GROSS: Can you tell us about one of the children who you've treated for a
long period of time who you've watched grow up with HIV and tell us how
they've handled it?

Dr. KLINE: Sure. Well, one patient who comes immediately to mind is a
little girl who I first saw at about two years of age. She had been born to a
crack-addicted mother, was infected with HIV at birth...

GROSS: This was in America?

Dr. KLINE: In America, yes, here in the United States. And was adopted at
about six months of age by a family who knew her HIV status. She was a sickly
infant and toddler. She had been hospitalized repeatedly. Had failed to
thrive. Had repeated bouts of pneumonia and diarrhea, and the doctors who saw
her initially had told her adoptive parents that it was unlikely that she
would survive to school age. But at about two years of age, she became one of
the first American children to receive highly active anti-retroviral therapy,
and it had dramatic effect in restoring her immune system to health. The
level of virus in her blood dropped to below levels of detectability, and she
literally has been completely healthy for the past 10 years, with no
detectable virus in her blood during that entire period of time, and over the
past 10 years, she's grown into a beautiful young teenager who is a great
student, who is an athlete and who is thriving in every sense of the word.
And this is really what we hope for for every child with HIV. This is a real
possibility. It is not fantasy to think that children so ill today in Africa
and around the world with HIV can be restored to health and can live long and
very full lives. We're not talking about the difference between dying at two
or three years of age or dying at five years of age. We're talking about the
difference between dying at two or three years of age and living to be 40 or
50 or 60 years old.

GROSS: Do you feel like you are capable of seeing an end to the AIDS
epidemic?

Dr. KLINE: I think we have a long way to go. I don't know realistically
that this is something we will see any time soon. We have to stem the flow of
new infections, and that depends at this point in time on behavioral change
and on the rollout for children, in particular, of programs to prevent
mother-to-child transmission, and I don't see a great deal of progress on
either of those fronts. A vaccine certainly is something a lot of people are
working towards but we may be a number of years away from an effective vaccine
for prevention of HIV. So I don't know that it's realistic to think, at least
in the foreseeable future, to think about an end to the HIV-AIDS epidemic.

GROSS: Well, Dr. Kline, thank you very much for talking with us.

Dr. KLINE: I'm happy to be here. Thank you so much for having me.

GROSS: Dr. Mark Kline is the head of the Baylor International Pediatric AIDS
Initiative which is now partnering with UNICEF. He's also a professor of
pediatrics at Baylor College of Medicine.

(Soundbite of music)

GROSS: Coming up, Milo Miles reviews Jerry Lee Lewis' new CD of duets.

This is FRESH AIR.

(Announcements)

(Soundbite of music)

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Review: Music critic Milo Miles reviews Jerry Lee Lewis' "Last Man
Standing" album
TERRY GROSS, host:

Piano-pounding Jerry Lee Lewis is invariably cited as one of the founders of
rock and roll, but since his last new release in 1996, he's kept as low a
profile as a pop legend can. Now he has a fresh studio album, "Last Man
Standing," recorded during the last five years with an impressive cast of
collaborators, including Mick Jagger, Keith Richards, BB King, Willie Nelson,
Bruce Springsteen and over a dozen more. Music critic Milo Miles has a
review.

(Soundbite from "Rock and Roll")

Mr. JERRY LEE LEWIS: Oh, I...(unintelligible)...rock and roll.

(Singing) "Well, it's been a long time since I rocked and rolled. Been a long
time since I did the stroll. Let me give it back, let me give it back, let me
give it back, baby, where I come from. It's been a long time, baby. A long
time, a long lonely, lonely, lonely, lonely time."

(End of soundbite)

Mr. MILO MILES: Jerry Lee Lewis' "Last Man Standing" includes a photo of the
so-called Million-Dollar Quartet. This is Lewis, Johnny Cash, Carl Perkins
and Elvis Presley, who ran into each other in late 1956 at Sun Studios and
recorded an enjoyable but not phenomenal sing-along jam session. Lewis was a
new-be and Presley was the king of rock and roll at the time. But there's
never been any question who Jerry Lee considered the number one performer of
the group, and if it seems indelicate for him to underscore his outlasting the
rest, it's worth remembering that in 1982, after Elvis was gone, Lewis, Cash
and Perkins recorded a tepid collaboration called "The Survivors." So you have
to grant "The Killer" this. During his hard partying and gun-waving period,
you would bet he would be the first man lying down. But at age 71, he has
released his first album in a decade and his best in at least twice that long.
Even more remarkable, "Last Man Standing" consists of 21 duets, yet it's not
like most duet albums. Usually duet albums prop up an aging, weakened
performer or display he's still a master of the game. But they inevitably try
to expand his audience by attracting younger fans of the duet partners. But
when Kid Rock is the youngest duet partner, this is an oldster get-together.
And on most tracks, Jerry Lee is so much in charge, that the partners seem
there to keep his juices pumping. "Last Man Standing" is exactly like other
duet albums, however, in that it's uneven and nobody will agree which cuts
work and which don't.

(Soundbite from "Pink Cadillac")

Mr. LEWIS and Mr. BRUCE SPRINGSTEEN: (Singing) "Come on, let's go. Now you
may think I'm foolish for the foolish things I do. You may wonder how come I
love you when you get on my nerves like you do. Well, baby, you know you bug
me. Ain't no secret about that. Well, come on over here and love me. Baby,
I'll spill the facts. Well, honey, it ain't your money 'cause, baby, I got
plenty of that. I love you for your pink cadillac, crushed velvet seats,
riding in the back, oozing down the street, waving to the girls, feeling out
of sight, spending all my money on a Saturday night. Honey, I just wonder
what you do there in back of your cadillac, pink cadillac, whoo!"

(End of soundbite)

Mr. MILES: For me, Led Zeppelin rock and roll sounds as tailored for Lewis
as Bruce Springsteen's "Pink Cadillac." Buddy Guy, John Fogerty and Neil Young
are on fire, while Willie Nelson, Merle Haggard and Don Henley are damp and
dozy. Kid Rock is still hammy; he should come in a can. But what matters
more is that Lewis' darting live-wire piano boogie and his reflective
down-home trills are there whenever he needs them. And projecting his
unstoppable rakish personality as much as his voice, he makes rock, blues,
country and pop into Jerry Lewis tunes one more time.

(Soundbite from "Don't Be Ashamed of your Age")

Mr. LEWIS: (Singing) "Now don't be ashamed of your age."

Mr. GEORGE JONES: Lord, no.

Mr. LEWIS: (Singing) "And don't let the years get you down."

Mr. JONES: Whoo, boy!

Mr. LEWIS: (Singing) "That old gang you knew..."

Mr. JONES: Yeah.

Mr. LEWIS: (Singing) "...they still think of you."

Mr. JONES: (Unintelligible)

Mr. LEWIS: (Singing) "As you wander in your old hometown."

Mr. JONES: I hear you, Jerry.

Mr. LEWIS: (Singing) "I don't mind the gray in your hair."

Mr. JONES: Uh-huh.

Mr. LEWIS: (Singing) "Just think about all the fun you had putting it
there."

Mr. JONES: Yeah, boy.

Mr. LEWIS: (Singing) "As far as that old book of time, you've never skipped
a page."

Mr. JONES: (Unintelligible)

Mr. LEWIS: (Singing) "So don't be ashamed of your age, Mr. George Jones."

Mr. JONES: I hear you.

Mr. LEWIS: (Singing) "Don't be ashamed of your age."

(Soundbite of piano)

Mr. LEWIS: (Singing) "Now listen here to me..."

(End of soundbite)

Mr. MILES: It's a bit surprising that "Last Man Standing" hasn't gotten more
attention. Lewis obviously ignored the wise Johnny Cash tactic of
persistently recording and releasing material in order to keep on people's
minds. But even so, Lewis is too dark and demented, too much a fallen
creature, to become sainted like Cash, and as he would be the first to say, he
doesn't give a flip. His closing duet with Kris Kristofferson, "The Pilgrim,"
is an inspired choice. Lewis isn't a perfect match for the song's title
character, but they share a wild rambling spirit, and the tune delivers his
most enduring message: It is good to be "The Killer."

(Soundbite from "The Pilgrim")

Mr. LEWIS and Mr. KRIS KRISTOFFERSON: (Singing) "This world keeps right on
turning on the better, on the worse. All he ever gets is older and around.
From the rocking of the cradle to the rolling of the hearse, the going up is
worth coming down. He's a voice. He's a vicar. He's a prophet. He's a
liar. He's a pilgrim and a preacher, and a problem when he's stoned. He's a
walking contradiction partly truth, partly fiction, taking every wrong
direction on his lonely way back home. There's a lot of wrong direction on
your lonesome way back home."

Mr. LEWIS: (Speaking) From the rocking of the cradle to the rolling of the
hearse the going up was worth the coming down.

(End of soundbite)

GROSS: Milo Miles reviewed Jerry Lee Lewis' album of duets called "Last Man
Standing."

(Credits)

GROSS: I'm Terry Gross.

(Soundbite of music)

Unidentified Singer: (Singing) "I can tell by the way you're a little bit
lonely just like Jerry Lee. (Unintelligible)...someone that you're needing to
forget. Honey, that's the same thing with me. I've been wondering, baby, why
don't we just make believe it ain't the first time we have met. Now before
the night's over you gonna be in love. I'll bet you by the morning, I'll be
the only one that you're thinking of..."

(End of soundbite)
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