I visited New Orleans almost exactly one year after Hurricane Katrina devastated the Gulf Coast. I was there for the “Staying Alive” conference sponsored by the National Association of People With AIDS (NAPWA). The group chose the southern location because the American southeast remains the epicenter of rising rates of new HIV infections. It seemed fitting that 300 people who had survived AIDS would gather to plan for future fights against the deadly virus in a city whose resilience was unquestionable. Or so I thought.

I was taken on a tour of the aftermath of Katrina’s fury. I expected to see new construction, fresh lawns, restored hope. Instead, as the bus trundled deeper into the affected area, I saw a zone that looked like it had been hit weeks, not a year, earlier. On the side of one house, on an empty street still without electricity, someone had spray-painted the word baghdad. Whoever marked that house was prophetic; I spoke to a woman who had been in the Superdome post-Katrina. She described how the American troops—who had returned home from Iraq to assist the National Guard get thousands of bedraggled, homeless, hungry and sick people out of the city—were in a state of shock over the state of New Orleans. Filing onto a bus to leave the disaster zone, she overheard one soldier say to another, “This place looks worse than Baghdad. I can’t believe this is America.” As she told the story, I remembered seeing the word painted on the house.

Traveling abroad usually makes me appreciate the United States. However beautiful and fascinating the rest of the world is, I have almost always been happy to be back on American soil, grateful for the quality of life we have here. Yet this past summer, I traveled to the Pacific Rim and saw that the American way is not necessarily the best way, especially regarding the treatment of HIV/AIDS. I visited Australia, Taiwan and Vietnam, each of which offers health care access and treatment to all citizens, including those with HIV. The countries’ responses to controlling HIV put the United States, with all its resources, to shame. While I realize that for many, especially in other East Asian countries that I did not visit, the circumstances are more dire, it was eye-opening to see how so much more can be done with so much less.

The U.S. government had sent me to the Far East to talk about how we handle AIDS. I struggled to explain how 47 million Americans have no health insurance and how some of them will die of AIDS because of poverty, a lack of insurance, lack of access to care and the debilitating stigma that still prevents people from getting help. People overseas could hardly believe that in the wealthy utopia of America, people would perish from a lack of treatment and continue to become infected at the rate of tens of thousands a year.

Thinking about our failure to address the ongoing AIDS epidemic in America reminded me of our inept response to Hurricane Katrina. Reflecting on both, I really have to agree with that soldier and southern AIDS activists and ask: Could this really be America?