Ashley Judd's Africa Journal

AFRICA DIARY 4

Wed, 02 Feb 2005 16:02:58 GMT

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.

The HIV/AIDS story is that the sero-prevalence is still fairly low, 1.1 or 1.7% depending on whether you ask us or UNAIDS (ours is the lower estimate), but the epidemic is accelerating and stigma is extreme. I have, for example, spent a good deal of my time here chasing down an HIV+ person who will admit he or she is infected. We have located two women and the one I am waiting to see now is afraid her family will reject her bones upon her death and that she’ll not be buried with her ancestors, the importance of which we can barely understand in the west. Another woman I have met with is an otherwise empowered, poised, modern mother who founded the first and only HIV+ support group in the country, which meets secretly in her home weekly, but she will not step out in a public forum. If people can’t talk about it, how can they be educated against it?

These two women represent the crux of female vulnerability to transmission and demonstrate why we are so passionate about saturating the country with messages, not just the classic high risk groups such as commercial sex workers. The first woman had multiple partners and was infected by one of them while her boyfriend was away studying, and the latter was infected by her husband, with whom upon marriage she had tested negative. The husband contracted HIV during their marriage through an outside partner, and she learned of her new status when she was 7 months pregnant with their twins. The first woman has already buried one of her children due to HIV/AIDS.

We walked a narrow, red dusty street lined with tiny shops selling small goods. The businesses here are smaller than the stands in American parks where you can buy a snow cone. On a café patio I met with Annie, a tiny, lovely looking woman, terribly frail and missing some teeth but quick to smile and giggle. She explained that she has a message for her people: “Be wise. AIDS is here, and it is not something PSI/YOUTHAIDS made up as reason to spend money (one of the rumors here). It will infect and kill you if you don’t protect yourself and your family.” She will not, however, say this message to other Malagasy, only to me and the cameras, albeit to be aired on VH-1. She believes she’ll be dead in a year and her entire outlook is geared toward that; I told her that in the name of Jesus I rebuked that fear, and she smiled. It turns out we have in common that our favorite thing is to pray. I asked how she goes about it, conversationally or with recitations, and she said she gets on her knees and talks to God. It made me remember how long ago Sister told me we’re taught to do that so we remember we are small but God is big. She liked that, too. She had a glass of cow’s milk and told me her husband is also infected. They don’t know who gave it to whom. Her kids are 11 and 14, and her mother is the only person, other than me, she has ever confided in. She once was on medication, but was too malnourished to be able to swallow the pills.

Moyra suggested we take a good picture for her to keep to help her create something she can leave behind for her kids, and also brought up the good idea that Annie write something for them. She is literate, so that is totally a possibility. Naturally, we told her about the secret meeting for HIV+ people and she was very keen to go, although she won’t tellher husband…even though he’s HIV positive, too. We’re sending a car to pick her up from a remote spot so no one in her neighborhood will see her leave. That is consistent with her palpable fear of being found out, as we’d had a lot of drama finding a place to meet with her. Our first choice was another café but one of her family members works there and she absolutely panicked until we found a different spot in which she felt guaranteed her anonymity.

Our next activity was a blast, a classic YouthAIDS moment of fulfilling our mission of upbeat and positive HIV prevention amongst young people. We drove along a road that is not so much a road as it is clay that is dug up to make bricks. The result is a rutted, pocked stretch that curls between rice fields, out to a lovely (although high Malaria risk) field. We were near a rural village where one of our mobile video units was set up to entertain and help educate 300 villagers. Our DJ was working the mike with fun music and chat, and everyone was shouting and partying down, only there was no misogyny or violence in these videos! The messages were about abstinence, staying in school, being faithful to one partner, and correct and consistent condom use. The shining faces were joyous and for some reason even remembering them is making me cry: so sweet, so dear, so terribly excited. Fewer than 6% of Malagasy have television, and only 16% make it through high school, so mass media and anything that needs to be read are not effective tools of information dissemination. The evening is a huge thrill, sort of like the drive in movies showing up in the field next to your house on a Friday night, when you’ve never seen a movie before in your entire life. The young adults randomly selected to come up to play games and take pop quizzes handled themselves with such poise, and shyly danced with me after they answered questions well. I went over to the crowd to play with some kids, one of whom looked at me plaintively with her arms raised, wanting to be held, many of them jumping up and down in their fashion of dancing.

Madagascar has one of the highest rates of STIs in the world, including 20% male sterility due to diseases such as syphilis and gonorrhea. STIs are such a part of the life here that they are considered totally normal, rites of passage, and something brought on by, say, getting tired from riding your bicycle. So, what’s over those kids’ heads is over their heads, BUT if some of them do understand the medically accurate reproductive health we teach, it will soon be relevant in their young lives and help empower them to prevent a huge variety of health problems for both them and their partners. Given the reality of STIs and HIV, it’s likely to even save their lives.

The fun of the Mobile Video Unit was soon left behind as we went to the streets to visit commercial sex workers in the most drastic and unimaginable setting. Remember that thing I said about not being able to be shocked anymore? It was total crap.

AFRICA DIARY 12: SOWETO SOUL

Fri, 25 Mar 2005 16:31:36 GMT

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.

AFRICA DIARY 10: PRAYING WITH MY PRESENCE

Wed, 16 Feb 2005 21:53:21 GMT

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.

AFRICA DIARY 9: TRANSITION

Tue, 15 Feb 2005 16:53:23 GMT

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......

AFRICA DIARY 6: SAHOOLY AND A BETTER CLASS OF BROTHEL

Wed, 09 Feb 2005 18:22:57 GMT

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....

AFRICA DIARY 13: WHAT YOU CAN DO WITH A LITTLE $$

Fri, 25 Mar 2005 16:42:48 GMT

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!!!!

AFRICA DIARY 8: TEST RESULTS

Fri, 11 Feb 2005 20:00:34 GMT

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.

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….

AFRICA DIARY 2: PART ONE: MALARIA

Sat, 22 Jan 2005 17:04:54 GMT

In the morning we met James, a tall, elegant Masai who works with the Minister of Health, and drove along ridiculously bad roads to a malaria program at a rural clinic. On the way I received a full education on malaria, the world’s biggest killer of children, from Des, a global expert who works for PSI (Population Services International, YouthAIDS’ parent.) Our program is well-funded, but faces immense challenges when distributing both education and treated mosquito nets throughout rural Africa. However, brilliant, motivated people like Des coupled with responsive governments like Kenya’s equals creative problem solving instead of the usual apathy and tragedy. Our program here is fast becoming the best model in the world for fighting malaria.

We sell repellent treated nets for 50 schillings, about 60 cents, which is heavily subsidized. Entire families often sleep under a single net together, so it must be treated with repellent or arms and legs touching the net would be bitten right through. The government allows us to sell our nets via its rural health clinic infrastructure: we supply the goods, they supply the means of distribution.

A large crowd of nearly 200 was gathered for our health lesson. Pregnant women and babies sat on the grass and were very curious and attentive. There was pomp and circumstance and some fabulous singing to liven things up. I presented the malaria lesson to the mothers using a plastic basin and gloves. I demonstrated how to “treat the net,” and after talking to the women, felt confident of our day’s success.

None of them had ever used nets, and now all would go home with their own net and malaria information . They said they would stand up to their husbands, who often sleep under the family’s sole net alone, though they know mothers and children need them most.

Some wild women sang for me, getting quite carried away and creating a mosh pit as we boogied over to tour the clinic.

I saw the colorful facilities where the water source was a bucket and small spigot. The nurse said to me, “We have to improvise!” I chatted with some fairly gorgeous women about their malaria knowledge and how relieved they were they could protect their families. I helped withthe sales transactions, and held their babies. (As a kid I loved playing library, so working with the receipts was as much fun as I’ll have this whole trip.) The paper was thin and lovely and I worked away to my heart’s content.

Why do we sell nets, versus giving them away? It has been proven that people value things more if they pay for them, even if they cost a few cents. If free government goods dry up, it leaves citizens high and dry. So PSI makes life saving supplies available at a cost that reflects what people can pay.

On the way back to Nairobi we enjoyed the stunning Kenyan countryside and James and I talked about customs such as courtship, marriage, family and spiritual life. He was extremely curious why I didn’t marry until I was in my 30s; such an age is considered high risk for his people, as malaria often takes a toll on child bearing years. The later she marries, the less likely a Kenyan woman is to deliver a live birth, or survive pregnancy. Our nets are helping to remedy that.

More in a moment about the rest of my day visiting a few brothels....

--A

AFRICA DIARY 3: MADAGASCAR

Wed, 26 Jan 2005 09:28:24 GMT

Today tears finally came. I’ve been surprised that I haven’t cried, but this morning they came when I woke up for a while at 5 am. I had written at length last night before bed, and woke up writing yet again; such a keen way for me to process. I share so much with you, but keep an awful lot in, too.

I had my tea in bed under a mosquito net with all the windows and doors open. We were in a national forest deep in the Madagascar mountainside, and the jungle was at my doorstep, replete with richness and lushness and life and noise.

All the animals, in fact, are very thin, and I say a compassion mantra each time I see some, OM MANI PEME HUNG. It’s how I feel somewhat useful in my total uselessness to them, and keep from crying. Yesterday, we visited an incredible little animal habitat that had chameleons, lizards, snakes, geckos, and the like, and I ended up wondering: how have these creatures so ingeniously and brilliantly evolved to where even their eyeballs make them blend in safely, and we have evolved into an 18 year old girl, 8 months pregnant, being bought and sold for sex so she can feed herself.

So, back to the crying. After I had sipped fromthe well of my solitude in bed writing, I trekked up the rich mountains by myself, where I immediately began to weep. I walked and cried, and nature, as always, was overwhelming enough to absorb my grief and allow me to heal some. I feel so much stronger than I did in Southeast Asia, somewhat because of the increase of my coping mechanisms and tools, but I think, too, that to a certain extent I can no longer be shocked. I can be touched, I can be moved, I can be distraught, but I can’t be shocked---at least not by bad stuff. It’s all different versions of the same tragic tale of poverty, lack of education, gender inequality, disease, exploitation, inhumanity etc., whereas nature, ah, love and Mother Nature, wonders there never cease. The beauty of the world breaks my heart and its ills can no longer break my spirit. At least, not today.

Before I left Nairobi I met 2 women from Equality Now. EN is a global NGO, and their emphasis in Africa is female genital mutilation (FGM) and co-ownership of property. We definitely can work together, as FGM contributes to the spread of HIV/AIDS and Kate and I are looking for synergy with them.

FGM is a tribal custom across Africa from time immemorial. It happens at various ages, but invariably, it happens. It’s so important that should a woman in -region Tanzania die uncircumcised, she will be post-mortem, or it is believed she will not go with her ancestors. EN is addressing it in a variety of creative cultural and legal ways, including lobbying the government to include protecting girls from it under the Child Welfare Act.

They attempt to explain, village by village, that the clitoris is an organ with essential function, just like an eye or a hand, using anatomical models of healthy genitals and ones that have been circumcised. They explain that the extraordinary pain and difficulties women have with childbirth are related to the lack of elasticity in all the scar tissue where the genitals have been mutilated, including the removed labia. When they do this education face to face with both men and women, it gets through, but Africa is a big place and it’s slow going. They also appeal directly to the circumcisers, essentially trying to persuade them to hang up their brutal tools by re-educating them into a small business of some sort, or taking the religious route. They are doing fabulous work and while it is hard going, there is progress, including an 80 bed safe house for young girls and women fleeing forced circumcision.

FGM contributes to the spread of HIV in a variety of ways, from the incredible amount of blood loss at time of circumcision, incomplete healing when sexual activity is forcedupon the girl, thelack of hygiene amongst the tools, which are used on more than one girl in succession, and its contribution to polygamy.

Regardless of how such belief came into being, and in what order they evolved, they are elaborate belief systems that can be undone only through passionate education by empowered people who aren’t afraid of talking about human reproduction.

My friend, Moyra, is here with me now, and we had a meal that feels of a Sunday night, even so far away from home: omelets. She’s gone to bed now, but I am so grateful for her company.

Oh yes, and thank you for the incredible emails and notes you’ve posted. I have really been moved by how much you reveal of your own spirituality as you encourage me. Thank you so much.

Love,

Ashley

AFRICA DIARY 2: PART TWO: BROTHELS

Sun, 23 Jan 2005 15:00:36 GMT

As if our day hadn’t already been full, in the evening after our malaria field trip we went to 3 brothels. In between, I had collapsed from fatigue born of incredible heat, the long, pounding drive, and basic over stimulation every developing country brings: intense pollution, traffic, noise, the throbbing of a million difficult lives as they scream from hand to mouth. My nap had the duel purpose of essential sleep and knocking me out so my unconscious could have some time to fortify itself for the assault on dignity and humanity that is a brothel. I woke up calm and ready.

First, we went to a crowded, heaving street lined with electronics shops. I was told to be prepared for a lot of screaming and total darkness; apparently, the electric bill goes unpaid and the women work by one candle per room, adding to the frightening, macabre nature of the scene.

The inside of the building has corridors and 30 dorm style rooms. 70 women come in every day and paid 150 schillings rent for use of a filthy mattress on a spring frame, separated from the other 2 or 3 beds in the room by sheets hanging from ropes.

We settled in a small room with 3 beds as I talked with 8 women. They were a fierce, proud lot. Their dreams were humble and realistic by our standards, yet remain out of reach for them: hairdresser, cook, own a small hotel, computer training. They all had children, had been abandoned in the rearing of them by boyfriends/husbands, and were starving todeath, entering sex work on the advice of someone already in it as a last resort means of feeding themselves, their children, and paying their kids’ school fees. (Education is the Kenyan ideal: skits and plays with happy endings invariably include a graduation. For most, it never happens.)

When we left, the women up and down the corridors covered their faces, but ironically, none of the men did. My bitter thought since then has been, why do women carry the shame? Why?

We could have walked to the next establishment, but the streets weren’t considered safe. It was a hotel, right out of a movie, a flea bag joint that rents rooms in segments as short as 15 minutes. Sammy, the owner, has had the place since he inherited it from his dad in ’67, keeping up the family business and all; he rents it to commercial sex workers (CSW’s) who score clients on the street below. For the cost of the room one must pay an extra 10 schillings for a condom, and we were checking on him to thank him for that. It was, to say the very least, an encounter about which I had very mixed feelings.

He escorted me to one of the room and it was ghastly, a cell with a nasty little bed and nothing else. Why bother with the extras? There was a hole toilet and shower in the corridor; I wonder how many of the women use them, or move on the next client without washing. I was ready to get the hell out of there.

Then, I was told a woman on the street wanted to talk to me. Bingo. I ran down the stairs to make her feel more welcome, and the beautiful Schola came into our lives.

She is at least 6’ tall; rail thin, heart breakingly gorgeous, with small, elegant features. She looked very, very different from the broken down women across the street. We settled into Sammy’s sofa, trying hard not to think too hard about what exactly I was sitting on and the dear girl, in a quiet voice, told us this story:

She is from the Meru tribe, one of 7 children. Her mother died in an accident when she was 12, and when she was 15 her father died of TB. Her father’s relatives took the land they lived on, and 3 of her siblings vanished. She has no idea where they are; tonight we wondered how old they were at the time and are grim about their fate. She had 6 years of school, a little sex education in year 5. She got pregnant at 15 and again at 18, at which time her boyfriend left her. 2 months pregnant, hungry, and unable to feed her toddler the increasing amounts he required, she began taking the bus to that street to sell herself between 5 and 9 every night while a neighbor watched her kids. She worked until her 8th month, and was back at it 1 month after delivering. The baby had an infection in his umbilical cord and ran up a 16,000 schilling bill, only a part of which she could pay, the outstanding amount causing her tremendous grief and anxiety.

She said it was difficult at first, she was very shy, and would only hitch up her skirt. She does not perform oral sex, saying it’s dirty, and no one has ever asked to perform it on her. She never lets anyone touch her breasts as she cannot stand to go home to breastfeed her son with the sweat of strange men on her as she holds him. We gave her our local staff’s contact information and said our goodbyes. We were all decimated, but our night was not yet over.

Next stop, if you can take it, was a bar with rooms attached. Actually, I don’t have much to say after all. Just use your imagination. A dirty, dingy bar in Nairobi, booze flowing, a crazily loud jukebox playing, and men choosing women for cheap sex.

We made a few friends, such as Margaret, who was 21 and comes in to earn about 300 schillings a night and 2 footballers who work 2 nights a week to make ends meet. I learned more about our amazing local staff, the grassroots operatives who live this reality day in and day out, trying to help empower women in such extreme circumstances -- God love them for it.

--A