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Friday, March 25, 2005
Subject: AFRICA DIARY 13: WHAT YOU CAN DO WITH A LITTLE $$
Time: 11:42:48 AM EST
Author: ajuddinafrica
For two days I have been hosted by De Beers. They rightfully wanted to show us their extensive programs that offer incredible health services to both their miners and the communities in which they mine. They fund not only detailed HIV/AIDS prevention work (via the tried and true peer education method), they provide ARV’s for HIV positive employees and their partners during their careers and after they retire. The mine health clinic teaches wonderful, empowering life lessons about everything from medically accurate sex education to clean water basics to preventable disease protocols, as well as offering psycho social support.
It was a totally happy two days that got even better when I visited the mentally and physically challenged children, ranging from mild to profound, who live full time at a major complex De Beers funds (that also includes a hospice). In developing countries that already have so many problems, handicapped kids are all too often isolated and neglected. When the needs of otherwise healthy kids are barely met, you can imagine what happens to those with special needs: not much. I salute De Beers for their quiet campaign of intensive social responsibility and hope they can inspire other companies to set up similar HIV/AIDS prevention programs. As we all know, most companies have a mixed past (at best), and De Beers is a fine example of walking humbly into the 21st century with a positive agenda. Plus, the minors are totally fine!!!!
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Subject: AFRICA DIARY 12: SOWETO SOUL
Time: 11:31:36 AM EST
Author: ajuddinafrica
How I have always elegized Soweto, seat of the struggle, angry, righteous Africans persecuted by a monstrous minority government that perverted even its church in its preposterous reach for justification of racism. Images from the news, bulletins from Amnesty International, U2 records. I followed it all. To actually go to was akin to a pilgrimage.
And, as with so many other things in life, I was quickly disabused of my romantic fervor. My Soweto was a hotbed of political activism, militant youth, and safe houses for underground freedom fighters-- I overlooked the shanty town and slum part, population 4 million, entirely.
I visited an HIV+ woman in her small 3 room shack. From oppressively crowded streets I entered through a lean to kitchen that had a vintage stove that would suit an upwardly mobile cottage in America and good pots and pans; turns out, she’s a baker, and were she well enough to work, she’d love to do catering. The living room and bedroom were crammed with furniture; the floor was covered with dirty, loose linoleum. She has buried 2 children from HIV related illnesses, and her remaining daughter came home from school doing things familiar to kids everywhere: dumping her rucksack, kicking off her shoes, looking for a snack (but there was none). Immediately a chatty neighbor came in, and at first I resented that she dominated the conversation. Also HIV+, she spoke at (great!) length about stigma, her upcoming lung operation, immune vulnerability, the rancid toilet 10 families share and how sick it keeps making them, the bucket she sneaks back and forth from her house in the dark, and the 1water tap in the neighborhood, and my resentment gave way to realizing that this was my Soweto after all: poor but informed, sick but informed, neglected but informed. I struggled to reconcile the disconnect between their smart eloquence and ongoing victimization, but whether women rail against it or remain mute, the problems of HIV, poverty, gender inequality, lack of education, lack of opportunity, etc., don’t get any easier. I listened to their phenomenal woes and asked what I could do. Even though this was a YouthAids visit, they most specifically asked me to complain on their behalf to the city about their toilet, which I have done. I had to go once in a bad toilet in Madagascar, and it was a horrible experience. I cannot imagine having to cope with one several times a day. No wonder people end up going in the streets.
Next we pulled into a small, tired yard with a hand painted doubled decker bus decaying on one side. A hand pump for water was in the center, and around it were afew small tin outbuildings. In one of them I discovered about 30 calm, wide eyed babies sitting in an orderly row. It was amazing. This is the part of the work Sister could never do, as they are mostly orphans, most from HIV. Some are positive, some are not. The “program” is an extremely modest foster care scheme run by a local woman. 13 years ago, all she had was that bus, but someone has donated the caravans. They get food from neighbors and churches—but some days the kids do without. They have little, if any, funding. They spread the kids around to locals who can handle them, and a child might not stay in the same house 2 nights in a row. The children were so subdued because many didn’t feel well, and it was terribly hot. After their dinner (rice and pap with gravy) they became a little, but not much, more active. (I am sending details and photos to a brilliant French friend who funds programs for orphans and vulnerable children.)
Seconds after walking in, all 5 of us had babies to look after. It struck us how each child was totally placid about being approached and held by strangers, and in fact they reached up trustingly, undoubtedly because they are passed around so much. Papa Jack ended up with a big toddler sound asleep in his arms, proudly telling me he can put anyone out. He held him the entire time. Another very touching aspect of being with them was seeing how nurturing the older ones are to the younger. One can only hope that they do so limitedly, and don’t end up care givers with total responsibility for them, as so many orphans do. This leads to the horrible cycle of cross generational and transactional sex, when the young girls trying to feed themselves and babies have sex with older men for food and supplies, and are then of course at major risk for HIV. Insist on a condom? No power to. Abstain? This is sex for food. If you abstain, you and the little ones starve.
I stayed for a long while, working my way through the babies, when I decided to walk with one in my arms to where I heard singing. A cinder block building apparently serves as a church on Wednesdays for a few adults who come to worship and be fed a snack. There was white bread, peanut butter, juice, and Big Mama, next to whom I sat, passed over her sandwich to my baby, who serenely ate it on top of his rice and bap. I took his sweaty shirt off, and he cooperated perfectly, holding out one arm then the other, and it occurred to me he needed water. I was not supplementing his care: I was his caregiver. He was, in fact, dehydrated, and I stayed in church with the praise and dancing filling my eyes with tears, on the floor with my boy and the other dears who scooted over to me, until he was rehydrated and a reluctant Papa Jack said everyone was waiting on me. I panicked. I couldn’t set him down. We sang Amazing Grace, and I waved another crying woman over to me. I prayed over her and that helped me pull myself together so I could come to grips with leaving my sweet boy (Little Nonno, which means lucky) and all the other children behind.
*
On a busy road with rough tables set up selling sundry goods, one of our audio/video mobile units was doing its thing. Timed perfectly as the market place was busy and kids were let out of school, Fats, our peer educator, entertained the shifting crowd with music in which the ABC’s of prevention were embedded. I floated around, tried to stop counting the malnourished kids (identifiable by the rust color of their hair), and kept it more upbeat, chatting up shy (defiant?) young men about safe sex. I climbed some high stairs to where the too cool crowd was aloofly observing at a distance, and a young man explained the goat bracelet on his wrist was worn to ensure his ancestor’s protection. I passed out anti-rape fliers (SA is the rape capital of the world, unfortunately.)
As Fats was winding down, the peer educators were dancing in the street. I began to make my way toward them, then decided instead to ask some small girls to dance with me in a cool spot under some stairs. A party broke out amongst us, and we added more girls, then boys, and they competed and grabbed to be the one holding hands with me. I led, then they led, and I tried to pick up the words to the songs they loved. Soon the shy ones couldn’t stand being left out and became the most animated. I can’t count how many times I fell in love, how many times I said, “You are so beautiful,” how many times I said, “You are so smart,” how many times I said, “Just 5 more minutes!” But, as all things do, it came to an end, and I left Soweto perhaps the filthiest I’ve ever been, covered in dirt, snot, rice and gravy, slobber, my own sweat, and the sweet, tangy sweat of scores of children I hope make it out of Soweto someday.
Back at the hotel, I soothed and calmed myself with normal, stable routines, such as hand washing my things in the tub. I skipped my stained, caked linen pants, though, and decided I’ll retire them dirty with a few other special things I keep in my closet, such as the sandals I wore my first summer in France, and the sneakers in which survived the Ashram’s hikes. After 18 years of following the liberation struggle, my pants are my own little piece of Soweto’s soil, sun and soul.
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Subject: AFRICA DIARY 11: ONE PERSON AT A TIME
Time: 10:56:43 AM EST
Author: ajuddinafrica
At a hospice today filled with very ill HIV patients, I went placidly from room to room, just finding where I was welcome and sharing friendship where I could. I sit on beds and once I am sure contact is okay, stroke and caresses people, and usually end up rubbing their foreheads and temples. There is something so sweet about the way a face changes when you touch it gently, in a way it probably hasn’t been touched a very, very long time (perhaps ever). I used to ask a lot of questions to try to inform myself about each person in particular and the AIDS pandemic in general, but I am doing that less. Reminded recently and emphatically that I can still be shocked, I don’t need their stories to be more interested in their sad, wasted state, or to add to my reserves of gruesome tales. I might find out some detail so I can relate to them, such as a child’s name, or perhaps a concern, which can lead to an idea for a prayer that might bring some peace and relief. At times, none of these things happen, such as in room 4, where a woman, recently blinded by some creative AIDS ailment, after I fussed over her teddy bear, asked if I was going to take it away from her.
One especially grieving woman sat paralyzed in her own world of chronic physical and emotional pain. I rubbed her back for a while, and then her head fell forward and she let out a slobbery groan and began to cry. The nurse and I conferred with each other and concluded it was about her daughter, a bad story,and I asked if she prays. She said yes, and a long silence ensued. I didn’t say anything. I didn’t have the nudge. Then she eventually said she didn’t want to pray, and I hugged her and left the room. I felt very awkward, but knew I had respected her wishes, and that, by far, is the most important thing.
Some of these patients are the super grotesquely thin ones you see in shocking photos; thigh bones the size of a child’s arm and pelvises like a shallow bowl. Moyra was hanging back, and at one point, eyes full with wet, asked how I do it. I said to just pick one, make one friend. Maybe you never leave that room, never make it to the sitting area where the stronger ones are taking in a dry, flaccid breeze, laps covered with ratty knit blankets, but that doesn’t matter at all. Pick one and stick with her/him. You’ll get the hang of it. Just wash your hands before and after and mind the sputum. There’s an awful lot of TB in here (as well as meningitis).
I will say that in South Africa the stories have been very, very troubling in that all the women say they either don’t know how or from whom they contracted the virus, and they are/were very disempowered in their relationships. They rarely varied from this terrible script, expect for the one who was left by her boyfriend when she tested positive and came home raging about it. He took up with another woman, and our valiant heroine approached the other woman, saying Look, you might want to know, he’s HIV+, and he’s never going to tell you, because he already knew he was when he infected me, and he refuses to use a condom. The other woman said, No he’s not, you’re just jealous he left you.
Sigh.
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Wednesday, February 16, 2005
Subject: AFRICA DIARY 10: PRAYING WITH MY PRESENCE
Time: 4:53:21 PM EST
Author: ajuddinafrica
We are born alone and we die alone, and in my experience so far the loneliness of this work resonates with that type of individuated experience. I write to you to try to comprehend, process, heal, share news of the human community with those who cannot travel as far and wide as I, to raise consciousness, to raise money, to be of service, but I am ultimately alone with my response to my experiences. We all are. That is why mentors are so important, because they have gone ahead to where we have not yet been, perhaps not even in our dreams, and they look back at us with the love born of wisdom, grace, mercy, and compassion to give us hints as to how to have our own experiences with integrity. Such a mentor to me, in spirit and now in the flesh, is Archbishop Desmond Tutu.
My friend wrote to me this morning reminding me that since she has known me, which has been for 18 years now, I have been talking about the Archbishop and meeting him today was exactly what I needed, emotionally and spiritually. God will always provide.
He was smaller than I expected but as elegant and lively as I knew he would be. We took a few photos in front of a beautiful unity quilt, and then went to his office to sit behind closed doors for a moment. He asked if I had seen myself in the paper, to which I replied no, and he laughed, saying that I am less vain than he, for he always scoops up the papers straightaway if he suspects he’ll be in them. So, yes, he was funny and self-deprecating, as I also knew he would be, but I was surprised that he asked me a lot of questions. One would expect certain exchanges of information, biographical stuff and whatnot, but for him to ask in detail about our workand my impressions of my voyage and what I’ll go home to tell my people conferred a status upon me that vis a vis him I just do not think I have. In his askings, however, he revealed his own thoughts, and I referred to them to organically weave us back to him so I could selfishly enjoy his musings. He spoke about gender inequality, prejudice, the purpose of sex between married couples as an instrument of love, expression, and becoming more God-like, and the foolishness of advocating abstinence without a balanced approach that acknowledges we do not live yet in a world (meaning spiritual world) in which ideal behavior is sensible to expect in everyone all the time (he made history 10 years ago by saying the church must stop condemning condoms as immoral, and has done PSAs for us). I was respectful and rapt, and also learned anew that no one, not even a person of his stature, experience, faith, and perspective, has the HIV/AIDS bullet, and that we all, governments, NGOs, FBOs, and corporations must powerfully rally around education and prevention, as it is our only hope.
I don’t know exactly how I will handle myself in these ongoing situations, such as with the young HIV+ mother at the hospice who is in a profound grief over herself and her child, whom she never sees, and her mother, who has disowned her, with whom I could not summon that palpable sweetness God has so often given me in difficult, complex situations. But I do know this: I don’t always have to pray with words or thoughts, or have that buzz that comes with them, because I am praying with my very body,with my presence, and none other than Archbishop Desmond Tutu, my mentor in spirit and now in the flesh, helped me realize that today. And I thank him so much forit, as well as for every other thing he has ever done in his beautiful, difficult, profound life as a freedom fighter and servant.
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Tuesday, February 15, 2005
Subject: AFRICA DIARY 9: TRANSITION
Time: 11:53:23 AM EST
Author: ajuddinafrica
Elated by the CSWs’ negative status, I did a long narration of my trip for VH-1 (a documentary that will air in June 2005), which took me over the emotional and practical terrain of my 8 day visit in Madagascar. I remembered my 15 hours of sleep in a moldy smelling room, serenaded by the sights and sounds unique to this island, and the ups and downs of seeing programs for youth and the hardship of high risk groups. I was totally and completely wrung out, but not done yet, as I also had to recap everything to a curious press corp.
At the press conference I thanked the government for its helpfulness as well as our financial partners, such as The Global Fund and USAID. I answered questions serious and silly, and found myself losing the poise required of a global ambassador! We moved on to our party that officially kicked off our thrilling collaboration with the Top Reseau health clinics.
Our energetic peer educators did a dance that tells the story of the ABCs (abstinence, being faithful, correct and consistent condom use), and after celebrating their commitment and spunk, I slinked away to sit quietly in our hotel room praying for guidance about Nini. I told Dario that it if I leave here without helping her, her life and the lives of her children are on my conscience. He offered to also help; I decided to present my dream plan to our country director in the morning.
*
At the airport, I told our country director Jean Patrick I want to set Nini up in a house with no obligation for 3 months, to allow her simply to care for her newborn (and other 2 kids), and to begin to heal. (She has had no chance to grieve the death of 2 of her babies.) After 3 months, we’ll explore what her interests are, and put her into some kind of training or school. We’ll wean her off our provisional support when she gets a job. We also agreed I would regularly wire Dr Rene a secret stash of money for the CSW’s children’s healthcare needs. Although I wish I could do this for every CSW in the world, I left Antananarivo somewhat satisfied and slept most of the way to Capetown, waking up only to write, my life line in this work, and glance out the window expectantly at the approach of the South African landscape.
*
A day to heal
We checked into the Cape Grace, a 5 star hotel that has been voted best hotel in Africa and which has donated all 5 of our rooms here and in Johannesburg. My room had a view of the sea, but I was more drawn to Table Mountain and landmarks Nelson Mandela could see from his view in prison on Robben Island. Dario breathlessly told me all he’s read about Table Mountain and how intimately he feels he knows the area.
I was served a lovely, cool fruity drink and chewed all these bits I wasn’t supposed to, lemon and lime rind, but kept my composure. I was definitely rough around the edges, but my next activities soothed me back into being more myself. I had a fitting for a ‘Traveler’ magazine cover shoot who’s inside story will include a large story about YouthAIDS and our journey through Africa. The photographer showed me a sketch of the cover’s proposed composition, and I asked if the other person sketched had been cast…and he said yes…and showed me a gorgeous picture of a CHEETAH. I haven’t been speechless many times in my life, but at that moment I was breathlessly so for a good 5 minutes. They thought I was scared to death of animals and was trying to figure out how to tell them, when in fact I was desperately thrilled. I immediately began sending the cheetah my energy and love so he would like me, and succumbed to a few imploring prayers, such as, “Dear God, please let the cheetah like me, please please please.”
The next day Moyra and I drove in the countryside to Meerlust farm and winery, and she sentimentally pointed out various lovely aspects of her homeland. Our set was in an open field with a gorgeous, traditional Cape Dutch home in the background (coincidentally her friend’s house where we had already planned to meet her family for supper!), and soon Joseph, a 2 1/2 year old, 50 kilogram cheetah joined me on set. I nearly DIED. He was gorgeous beyond description, and he (loss of all modesty coming) totally loved me. We sat together for ages, him purring his heart out as I adored him, rubbing, talking, hugging. What a dream come true for me. I have been wild about big cats all my life!. His handlers became confident we were a match, and encouraged me in even moving him about the set, such as leading his head toward the camera, because cheetahs can see for 3 to 3.5 miles and he was more interested in the open view than in turning toward the camera. We put our faces together, we leaned into one another, he stretched out and plopped his front paws in my lap (total highlight, nearly died). I sensed when he eventually became distracted and announced it was a wrap for Joseph. I had actually gotten so much of his respect and affection I could initiate sending him home without agonizing over our good bye. One last brag: his handlers said they’ve never let anyone pet him above the neck, but they could tell he was confident and relaxed with me. YEEEEEEEEEEHAW!!!!!!!!!!!!!!!!
Later, I walked barefoot through soft fields, and hiked up my skirt to wade through a thigh deep river. I tasted wild growing things and spied into birds’ nests. The light was special, and the perfect serenity and lushness was a balm. Moyra led, so I was able to be in a fully receptive mode, and I stayed quiet the rest of day, even at supper, which was a simple homemade meal served at a large farm kitchen table. The stories were fascinating and steeped in an African perspective one simply never hears in the west. Perhaps most memorably, they spoke of Nelson Mandela, and the miracle of his not emerging from prison a bitter man, and what that has meant to all South Africans. I tore myself away later than I had intended to, and hoped my quiet day on a beautiful farm with all its animals, not to mention Joseph, would sustain for me for yet another tough week in country with a huge HIV/AIDS problem and people who expect so much of me—and to whom I want to give so much......
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Friday, February 11, 2005
Subject: AFRICA DIARY 8: TEST RESULTS
Time: 3:00:34 PM EST
Author: ajuddinafrica
Moyra and I sat in the public health clinic waiting room, tense about what might happen, waiting for our friends. They arrived calmly and shyly, but Dr. Rene, we were told, was stuck on a bus in traffic. We did not want to receive our results without him because he would need to help with the counseling in the very likely event 1-or more-of us tested positive. We inquired about how work had been the night before (they fell asleep on the street chatting), and how they had spent the day thus far (typical housekeeping and child minding chores were rattled off, including doing their wash with our water purification product, Sur Eau—they said it’s great on stains, and we know it’s cheap!). The latter topic led us to all the illnesses the kids have, and we did some follow up on everyone’s diagnosis and prescriptions. Although satisfied we would be leaving everyone in good shape, I was momentarily distracted as I remembered the horrible, deep coughs of two CSWs who did not come for testing, knowing they will not get medical treatment, and I prayed they don’t have something as serious as TB.
Dr. Rene arrived, his glorious smile in place, accompanied to my relief by Nini. That was actually why he was late; he’d been out searching the streets again for her, this time with success. She was, if it’s possible, in even worse shape. Her feet, bare as many Malagasy’s are, were filthy and crusty, and her legs were far too thin for a women in her 9th month of pregnancy. In addition to the glaze in her eyes her mouth was raw with open blisters, which Moyra thought she used the red lipstick she had on to try to cover with pitiful effect. Her recent news was that her 2 year old was sick and I cannot imagine where the baby has been throwing up and pooping, and how Nini, who of course is homeless, has been coping. Additionally, during the time Dr. Rene spent with her, he diagnosed her with parasites. Moyra and I made eye contact, confirming our inexorable wish to help her.
The clinic began to prepare to give us our results. I sat with yet another child on my lap, a lovely 8 year old girl in a fairly clean dress with only one tear, dotted with a sweet daisy print. She had on red patent leather shoes that did not match but were obviously worn with pride on her special day of meeting me. I braided her long ponytail to keep the sour smell of her hair more confined, then as I stroked her rested my other hand on Nini’s belly. Eventually, the first CSW was called.
I accompanied her into a small counseling room. She sat in chair across a desk from a social worker, and I kneeled beside her, arm around her shoulders, eyes fixed on the small stack of papers that I knew were everyone’s HIV test results. The social worker went very carefully over the number on the card the CSW produced, visually and verbally confirming that the number matched the certificate, and that she was the age and gender indicated (testing is name anonymous). The social worker then slid the paper forward with the test outcome validated by an official stamp: NEGATIVE. The woman went through a transfiguration rivaled by Jesus’ on the mount, from grim, fearful stoicism to an outburst of relief and joy. “Negatif, negatif” she kept repeating, shaking the social worker’s hand as if she’d been given a diploma, crying some, but really being far too overjoyed to do any one thing for more than a second. I bawled shamelessly, caught up in the miracle but also the knowledge that the next CSWs result could be disastrous. We had 6 more to go before we were done.
The process repeated itself again and again, the frightened but resolute woman in the chair, me on the floor beside her, numbers and details verified, and results presented. They were unbelievable:
NEGATIF.
NEGATIF.
NEGATIF.
NEGATIF.
NEGATIF.
NEGATIF.
A series of miracles and the most eloquent tribute possible to the power of peer education. 7 veteran sex workers with over 75 years on the streets and thousands upon thousands of tricks turned amongst them had tested negative for HIV.
We all reacted in our own way. The social worker immediately began reinforcing risk management behavior and correct, consistent condom use. Our stills photographer, squished in the corner, a veteran of some of the world’s grimmest scenes in countries I bet the U.S. State Department couldn’t find on a map, cried openly behind her lens. The VH-1 documentary crew openly declared it the heaviest thing any of them had ever been through. Moyra didn’t breathe until pregnant Veronica and the toothless granny were also negative, the two we had been most sure were positive. And the women themselves each responded in such a unique variety of ways, some with an outburst, some with collapse, some with giggles, that any actor who says she can’t find a different, human way to respond in a scene of which she has to do many takes has no imagination.
Back in the waiting room the fact that all of us were free and clear of this decimating virus allowed jubilation to break out. There was clapping, dancing, singing, and a prayer.
Now, I could leave my friends without the sense of panic and hysteria I had felt a day earlier when we had parted. They are free from HIV and I fully expect all of them to remain that way. Sahooly and I shared a quiet moment when she said she couldn’t wait to go home to tell her husband, although we both confirmed the importance of them using a condom together. Relief must be tempered by reality.
*
As we left, I spoke with Dr. Rene about passing him the money to pay for all the medical care everyone’s ailments required, and in particular what to do about Nini. We agreed that at our farewell gathering that night we would give him a small fund out of which he would settle prescription costs. It’s the least we could do, and in fact is very inexpensive. The costs for delivering Nini’s baby at a clinic, plus her meds, her 2 year old’s meds, and the med’s for all the other CSW’s sick babies, was les than $100.US….
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Thursday, February 10, 2005
Subject: AFRICA DIARY 7: TESTS AND TOP RESEAU CLINIC
Time: 11:45:57 AM EST
Author: ajuddinafrica
At a café, Moyra and I waited for our friends, who, to our delight, showed up numbering not 5, but 7, and were accompanied by beautiful children. We ate pizza and while we ate, I asked if they would prefer to wait to discuss out tests at the center, out of earshot of the café staff (remember how extreme the taboo is here), and again this remarkable group of strong woman surprised me: they didn’t mind discussing it one bit. But, really, there wouldn’t be all that much to say until we got our results back, so we talked about other illnesses, because I noticed one of the baby’s lungs were full of fluid, and I got Dr. Rene on that, and someone’s 2 year old is near needing to be hospitalized for malaria, so we took care of that, and we talked about Nini, the pregnant homeless woman from the rice tents, who unfortunately Dr Rene, even though he scoured the streets, had not been able to find.
We took our tests and were disappointed to learn we could not get rapid results (35% of all people who are tested do not return to get their results), and our suspense was left in tact for another 24 hours. We hugged and kissed and bade farewell again…
*
Next I visited a Top Reseau clinic, a fine example of public health impact with private sector efficiency and delivery. Geared for youth, Top Reseauis a franchise expanding throughout the country, where a full medical examination, including education and counseling, costs 75 cents. I lovedthe doctor I met, an affable, approachable woman with fabulous bedside manner. I could have talked to her all day, but her waiting room was crowded, (a very, very good thing!) so I just visited her during an appointment with a patient who was sweet enough to let me sit in. He was 24, a typical Malagasy youth, and had first come to see the doctor because of his STI symptoms. He was back to ask if now that his symptoms (burning during urination, discharge, etc.) had stopped, did he still need to use a condom? (YES!)
Our young friend seemed to grasp he needed to continue using a condom, but when I asked him about HIV….even though he’s already had syphilis…he said it would never happen to him. Our conversation was apropos of the Malagasy denial that is so widespread, and I watched as the doctor did her thing, to which I added that I personally knew 2 HIV+ Malagasy. To say he was shocked would mild-he was totally floored. He is a prime example why the education and prevention work is so urgent. The sero-prevelance is low, but the recipe is in place for the kind of cataclysm that is wrecking the African continent, especially with Madagascar’s extremely high incidence of STI’’s (one of the world’s highest, also highest in sterility caused by STI’s). Being here is a unique opportunity to help avert disaster, a hopeful work as opposed to the sense of chaos one has in countries where it’s all already so out of hand. When I left Top Reseau, trusting the good doctor to reach her neighborhood’s youth, what the test results would be for my CSW friends came fearfully throbbing to my mind again……..
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Wednesday, February 9, 2005
Subject: AFRICA DIARY 6: SAHOOLY AND A BETTER CLASS OF BROTHEL
Time: 1:22:57 PM EST
Author: ajuddinafrica
Not far from the rice tents, on a larger, boulevard style corner, a group of older, more seasoned sex workers welcomed me. There was little traffic and they were happy and curious to chat with me, and we stood about shooting the breeze. There was a palpable simpatico amongst them and that some have worked for 15 years on this corner explains why: they have history. I would love to tell you about each of them, the older, a very thin one with blood shot eyes who smiled a bit like a toothless granny, the one with cropped hair (good personal hygiene choice given lack of regular bathing) with the rose bloom on her cheeks, the freckled, somber and 6 months pregnant Veronica, etc. But in the interest of time I have to play favorites, as much as I hate to, so I will tell you in detail only about the new love of my life, our peer educator and shining star of the streets, Sahooly.
One of the many great things about Sahooly is that she has been empowered to do reproductive health and HIV prevention education amongst CSW’s by herself, and Dr. Rene has worked hard to give that sense of self assurance and authority. Until now, peer education was run by Dr. Rene with CSW’s working alongside him, but now they can work the nooks and crannies of the streets and slums alone, reaching more vulnerable people in high risk groups than Dr. Rene alone can. We pay her a small salary, as we do all peer educators, but it is not, alas, enough to allow her to reduce the required number of 7 clients per night to feed her family and make ends (barely) meet.
Sahooly invited me to her home. I was having a “bad” day, crying uncontrollably during our short lunch break (thinking about baby Patrick’s likely life) and it was only the sweetness of her offer that motivated me to peel myself by the ponytail off the mattress (I had gone full fetal). I tried to dress, hardly able to see myself in the mirror for the tears, and played the outfit game, trying to choose something I thought she’d like.
Her home is two very small rooms, dirty through no fault of her own, as the courtyard she shares with 40 others is unpaved red, raw dirt that tracks unrelentingly. Her water source is a spigot not too far away, and she uses our Sur Eau water purification for everything to prevent diarrheal disease in her whole family. She has a suite of wooden furniture with no cushions and we sat directly on the slats. Her girls sang a few songs for us, and we chatted about this and that. I tried to help out the family dog, who was held on far too short a tether, by giving the kids some tips as to why they think he is mean when in fact he was terribly submissive and loving with me. The family cat, whom I was able to hold for a bit, is sorely thin. It’s understandable we were not offered anything to drink or eat.
We walked through the noisy neighborhood to her bus stop, and with knees pulled up like American school kids, she spoke more openly of her work. Although she’s been a CSW for 10 years, her children have no idea what she does. Each night she rides this bus to her corner, and aims for 7 clients, sometimes finishing in time to catch the 9 PM home but more often stranded in town until service resumes at 4 AM. Once home, she sleeps for a few hours, then does her day job: mother of 3,wife of 18 years.
*
Morya and I had an extraordinary opportunity with Sahooly, and we seized it. We took her to our hotel room and bathed and fed her. She’d never taken a bath before, and as we explained and ran it for her, we were so pleased, only to be surprised when she popped back out into the living room, like, 48 seconds later. We hadn’t explained well enough. Relax, we said. Submerge your head underwater and let it all go. Fall asleep if you like. We ran the bath again after I cleaned the tub (her first dip, however brief, testified to her lack of running water at home), and gave her bottle of beer. We didn’t see her for a long while, and while I took my 2nd of 3 daily showers I thought of her down the hall, doing the same thing, united by this simple act and separated by so much.
We ordered off the room service menu and she left not a trace on her 3 plates. I scooted the bread and butter towards her, which she also ate. But more telling, far more telling, was that I happened to look her way as she figured out the napkin thing, and took hers off the table and put it in her lap. I saw the learning in her eyes, and the change in her demeanor (pride is so beautiful), and shining star Sahooly became what she truly is, a woman of stunning potential. Her hair was wet and lain in ringlets past her shoulders, and sitting there gorgeous, and clean, in her bathrobe.
*
Sahooly took us after dark to a peer education session at the brothel hotel where her neighborhood of CSW’s and their client’s often rent rooms. The hotel was actually clean, bare of furniture save the essential bed, but not that far off something I would have settled for as a backpacking college student. There were even boys on staff to change sheets and a place for the CSW’s to wash themselves between customers. Outside a long line of CSW’s were ready to discuss HIV and their reproductive health, and in minutes it was like a coffee klatch ,totally female, everyone sitting on the floor, chatting animatedly, interrupting, talking over one another, answering questions before Sahooly or Dr. Rene had a chance to, leaning on each other like puppies. They’ve learned a lot, but still have a lot of questions, including HIV risks to pregnant women, and this topic in particular allowed me to organically do something I craved but knew had to handle with perfect delicacy or I’d blow it: being tested.
Veronica, the 6 months pregnant CSW, was my entrée. Moyra, a mother of 2, pointed out how clear it was she was extremely concerned that she might be HIV positive, and that she was asking sorrowful questions about the baby. Dr. Rene and I talked about mother-to-child transmission, and how critical itis to know your status, and also about syphilis, which causes birth defects, and I pounced: Why don’t you and I go to the public health clinic tomorrow to be tested? She said yes. On a roll, I asked others. 5 said they would. I couldn’t believe it. As I sat there trying so hard not to do roar with joy, they bickered amongst themselves about the time, and finally settled on 3 p.m., plenty of time to grab a little sleep after a night’s work and tend to the kids. Our group dispersed into the night, and my satisfaction melted into worry about attrition, and who would blow it off and out of fear not show up.
More in my next entry about getting tested and who joined me....
Written by ajuddinafrica
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Wednesday, February 2, 2005
Subject: AFRICA DIARY 5: THE RICE TENTS
Time: 11:05:54 AM EST
Author: ajuddinafrica
We drove dark streets to an area that seemed from the car as all the others, dusty clay roads, tiny, ramshackle, colorful shacks, maybe a little grimier, but essentially the same. That perception was shattered, however, when I realized that the plastic on the sidewalk was itself the brothel I was visiting. They are called rice tents and the poorest women in one of the world’s poorest countries lie down in them directly on the pavement for as little at 15 cents. They are so poor that no individual woman can alone pay the dollar it costs to buy the sheets of plastic, so 2 or 3 or more go in together, and that type of clustering was apparent as they indeed swirled around me in pairs and threes. They were drawn to me but would hang off my translator’s neck, which I needed here as none of these community sex workers (CSW) speak French, only Malgache. They sniffed her out as a safe person and worked up their courage to touch me, which happened soon enough. (A quick note about Noosy, our translator and compassion partner: what a sweet sister to have in these situations. She is someone with incredible sensitivity in incredibly raw, delicate circumstances, who can facilitate remarkably vulnerable conversations. She and I held hands as much as we held hands with CSWs. )
Everyone was smelly. Often the people on my trips with whom I come into contact—and I like close contact—are, but this group was a different kind of smelly, a homeless smelly. The stinkest was Nini, and she is also the most destroyed person I have met so far in my capacity as the YouthAIDS Global Ambassador. Her problems are an acute distillation of poverty, lack of education, gender inequality, preventable disease, unplanned pregnancy, and no way out. Her mental health is precarious, and why wouldn’t it be? She’s about to have her 5th child any day now, and she’s already buried two of them. Even the abducted women of Cambodia and Thailand had something in their reserves that life in this developing country has drained out of Nini’s spirit. We gave her food, but Papa Jack saw an older woman take it from her and we fretted for days over whether or not she ever got it back. She never looked up, always holding her eyes in a dead, downward gaze. I would caress her, and something like the ghost of a smile, the memory of what a smile might have been in another life, would pass over part of her face, but never all of it, never completely.
The other women were standard issue commercial sex workers. Does that sound crass? When I asked one particularly dark and beautiful woman how it all came about, she waved her hand and said dismissively, “Same old story.” And it’s true, the details (number of kids, how long they’ve been on the streets, number of client’s per night) might vary, but the broad strokes are numbingly repetitive in Madagascar, in Kenya, in South Africa, in Thailand, in Cambodia….One woman, when I asked her how it happened, began to cry, and buried herself in Noosy’s thin shoulder, too traumatized to talk about her past, her family.
The HIV story amongst these women has elements of uncertainty. They have received reproductive health and HIV education via our peer education programs, but having sex with strangers on the sidewalk obviously reflects that circumstances are so desperate that they cannot say no to that 15 cents, condom or no condom. However, when I sat inside one of the tents, easily the darkest moment of my life, the ground was littered with torn foil packets and damp condoms, which in its own way is good news. The bad news is that I could not summon God into that hell hole. I literally felt a rebuff.
There was a transcendent moment with this group, however, and that, coupled with the fact I spent time with them over a number of days, has seared them into my soul. They had their babies with them, even though they were working, and one especially young CSW let me hold her son Patrick. Oh boy. He was, naturally, completely precious, and looked at me wondrously. I might have been the first white person he ever saw! He did that thing babies do when they rest on your chest, then lift their heads a bit to consider the world, but decide it’s not worth it, why bother with all that, when you can simply sigh and burrow in that safe place of shelter within the bosom. I nearly died on the spot. I began to sing to him a French song, incongruously for January as it was a Christmas carol, but the words just came to me: “ Il est ne le divin enfant,” he is born, the divine baby, and is that not what all babies are? A spark of the divine is in us all, uncorrupted and pure, and the women on the street joined me as I sang. When we finished, the air was different, charged, sacred. We were outside of ourselves, outside of these lives, inside something wonderful and good, the love and promise a baby makes you feel.
We stood quietly for a long moment, then Dr. Rene, one of our world’s many unsung heroes, began a lullaby. This great man has ministered to the needs of CSWs on the streetsfor 10 years now, continuously declining other jobs, options, administrative work, raises, whatever, so he can stay with the least, the lost, the last. He deserves to be enshrined. Given the geometric movement of the HIV virus, it is impossible to estimate the number of lives he has saved by teaching high risk groups and their clients about condoms. Even more immeasurable is the humanity, so delicate in these circumstances, he has kept alive with lullabies such as the one he sang for Patrick and me that night.
Back at the hotel, we were all so torn up. I haven’t seen much of our small YouthAIDS team as Moyra and I are working alone while VH-1 films us, and so we took a moment, despite our exhaustion, to sit in the lobby and share the space. To cheer me Kate told me she had a surprise, a fairly standard trick of hers, but this one was extra special: in Capetown I am going to meet Archbishop Desmond Tutu. The floodgates opened, and I bawled, so Kate welled up and began to cry, which made Jenny and Suann cry, even though they didn’t know precisely why we were crying, and we all just sat there unapologetically laughing and crying in the well lit lobby, in full view of all whom looked our way.
As a university student I formed my politics and my activism listening to Archbishop Tutu’s speeches on LP records that banned South Africans brought to America when they fled the repressive, racist Nationalist government. The idea that I will meet this hero of 19 years standing to whom I can directly attribute the work I am now doing in Africa absolutely floors me. That he is a love filled, child-like man of abiding faith makes me feel like I won’t be able to walk in the room where he will be waiting for me,that I’ll end up lyingonthe floor in front of him.
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Subject: AFRICA DIARY 4
Time: 11:02:58 AM EST
Author: ajuddinafrica
For some reason I am very emotional today. Maybe it was the message I woke up to from Dario, who called as he watched a nearly full moon rise that made him think of me, and maybe it’s because I saw a man holding an infant as he supervised from the street his wife, a commercial sex worker, with a client in a nearby rice tent. What separates Dario and me, another married couple, from the grave misfortune of Malagasy I see all around me?
Today I have begun to see beyond Madagascar's physical beauty and into its totally extraordinary poverty. The land is lush, but 88% of rural Malagasy do not have clean water, and they suffer the consequences of that with the usual tragedies, including unacceptable high maternal and child mortality. The land produces fruit, but earns them no money as 60% of it rots before it can be exported; farmers cannot afford to transport it. And that seemingly lovely thing about there being no litter is because there are no goods to throw away. If people do have something, it is creatively recycled and too valuable at any stage to ever be tossed out. Only half the children have some vaccinations while half the children are malnourished and stunted. The rural infrastructure is minimal, and our mission of delivering life saving messages and goods, is confronted with a whole new galaxy of challenges. Fortunately, we do have some good funding here from both USAID and the Global Fund, money I am seeing in action both in terms of ideas/programs and the motivated, dynamic personnel who implement these positive health impact changes for the Malagasy people.
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