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Authors: Uzodinma Iweala

Tags: #Social Science, #Travel, #Africa, #West, #Disease & Health Issues

Our Kind of People: A Continent's Challenge, a Country's Hope (7 page)

BOOK: Our Kind of People: A Continent's Challenge, a Country's Hope
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Black shapes crouched, lay, sat between the trees leaning against the trunks, clinging to the earth, half coming out, half effaced with the dim light, in all the attitudes of pain, abandonment and despair … they were nothing earthly now—nothing but black shadows of disease and starvation, lying confusedly in the greenish gloom.

Conrad’s Africans begin as feeble creatures too weak to hold themselves up, too racked by the misfortunes that their blackness has bestowed upon them to stand tall and act with agency. They end as quasi-humans, of another world, their forms merged fully with disease and despair generated in the bowels of a continent composed of primeval otherworldliness. It is a testament to Conrad’s descriptive genius and literary influence, and unfortunately also to the strength of the associations he so vividly captures, that present descriptions of HIV/AIDS in Africa stray very little from this script.

“Soon Africa will be a continent of AIDS orphans,” begins CNN’s former chief international correspondent Christiane Amanpour in that television network’s 2006 documentary
Where Have All the Parents Gone?
A musical score of mournful reed flutes plays as a map of Africa appears on screen, emphasizing the exotic otherness of the continent. There follows an image of young “African” (in reality, Kenyan) children lolling in the dust as a baby cries and heavy breathing interspersed with despondent moaning is amplified over Amanpour’s voice.

Next we are introduced to Mukhtar, who we are informed is “another African boy who wonders whether he too will become one of the million AIDS orphans in Kenya.” The camera zooms in on his face while he watches his cachectic HIV-positive father breathing laboriously in bed. As Amanpour narrates Africa’s struggle with AIDS, the screen fills with images of shabbily dressed people in shantytowns shrouded by red dust. Later we learn that Mukhtar’s father, who was rejected by his family once they discovered his HIV-positive status, had considered killing himself, his wife, and his son with rat poison because they are “a burden” and he does not “want them to suffer.” This snippet of a modern HIV/AIDS film echoes Conrad at his best, playing up that which sets Africa and Africans apart. Never mind that there is no monolithic African identity; Kenyans stand for all Africans. They live in otherworldly dwellings surrounded by filth. They even have a different, warped sense of morality. We are left wondering what kind of creature would consider killing not only himself but also his young wife and only son—of course, a person “infected with HIV.” This is all before anyone questions whether it is ethical to display a young Kenyan boy with HIV-positive parents for millions of people to see. One wonders whether a white European or American child would have received the same treatment.

If this was but one representation, it might be excusable, but it falls into a panoply of images of HIV/ AIDS in Africa that play up stigmatizing identifiers. As recently as 2006, the
New York Times
displayed headlines screaming “Traditional Ways Spread AIDS in Africa, Experts Say,” deliberately evoking thoughts of strange ritual and exotic practices. We later find that one of these “traditional” ways is the universal practice of breastfeeding. Associations like this remind me of the poster I own from the AIDS charity Keep a Child Alive. Their public relations campaign unwittingly plays to ideas of African otherness while cementing the link between African-ness and HIV/ AIDS. In this image, the two are inextricably linked. Disease is African-ness and African-ness is a disease. So powerful is this association that a condition attributable to approximately 4 percent of the African continent’s population becomes the narrative for the other 96 percent. It results in the following conclusions relayed to me by a young Canadian woman working in Lagos, who described the reactions of her family members to her decision to move to Nigeria for a year: “My dad’s mom, when she found out I was going, she said, ‘You’re going to catch AIDS.’ I had an aunt who told me that I should bring a bag of my own blood with me … if I needed a blood transfusion.”

A
New Yorker
article about the possible origins of a theoretical next big epidemic consolidates the associations of African-ness with strange or backward culture and disease. It follows a Stanford University virologist who is desperately trying to educate local villagers about the perils of consuming monkeys because they are receptacles for disease. “When I see a monkey like that, dragged through the street, bloody, on the way to market, it’s like looking at a loaded weapon,” he says after seeing a woman carrying a monkey on the back of a motorcycle. The piece features Cameroonians covered in buckets of monkey blood and stresses that in the present day, with easy travel linkages between Cameroon and California, it’s not hard for a virus to move between populations. This article is a striking example of what the medical anthropologist and AIDS activist Dr. Paul Farmer calls a “symbolic network that stresses exoticism and the endemicity of disease.” In other words, diseases like HIV/AIDS come from people with “weird” or “backward” cultural practices—Africans who eat monkeys.

HIV/AIDS was not always associated primarily with Africa. Thirty years ago, the initial concerns about the virus were decidedly localized to the Western world. Homosexual men were initially vilified as the prime culprits for the propagation of the epidemic. At some point during the mid-1990s, when it became clear that there was an epidemic in Africa primarily spread by heterosexual sex, and when it became clear that public health programs along with readily available treatment in the West had led to a stabilization and decline in the number of new cases there, AIDS became African. That Africans in countries like Nigeria have not managed to control the spread of HIV/AIDS, as has been achieved in developed nations, supposedly reflects a host of vices for which Africans are constantly berated. We are disorganized and inefficient, so the virus spreads. We lack the intellectual capacity to create our own drugs and treatment protocols, so the virus spreads. We are untrustworthy and misappropriate funds for treatment programs, so the virus spreads. We lack compassion for the afflicted, so people die. In what might be the most unfortunate of ironies, we are stigmatized for stigmatizing: that is, according to the narrative, in developed nations people are cared for; they are not ostracized; they receive services and treatment. In Africa the infected, like Mukhtar’s father, are savagely expelled—as if fear of contagion is a uniquely African sentiment—cast out into the vast darkness of a physically and morally undeveloped continent. This is not to say fear and stigma do not exist, but they are not uniquely African phenomena.

HIV/AIDS is an extraordinary illness, especially because it creates a social dynamic that in some ways mimics the biological process by which the HIV virus damages the human body. In the same way that the HIV virus causes a breakdown in communication among elements of our immune systems, leading to an inability to neutralize it and other diseases, so too does its associated stigma break down relationships among people, preventing many of those who have it from communicating their need for assistance and treatment. Indeed, a former senior World Health Organization (WHO) AIDS program official described stigma as a stage of the HIV/AIDS epidemic, “the stage of social impact … marked by stigma, grinding down its victims with shame and isolation, creating an environment of secrecy and denial which are both catalysts for HIV transmission.” If to be open about one’s status is to don a set of scarlet letters that says “not one of us,” not human, then it is understandable why so many would remain silent about or ignorant of their status. The more the virus spreads, the more people die, and the stronger the stigma grows.

F
or me the impact of this stigma didn’t really hit home until after a discussion I had with a young woman I met at a bar on a military base about an hour away from the village where Doc worked and lived. We decided to make a trip to the Nigerian Army cantonment one afternoon for a drink. Because the area is predominantly Muslim and governed in part by Sharia law, the military barracks, with its multicultural, multireligious makeup of soldiers from all over the country, was the only place to get a drink, a cold beer, maybe even a rudimentary cocktail. The environment was perfect for the large army base, which was home to an infantry and artillery unit. There were acres of open field for firing ranges and target practice. A sleepy barracks with one- and two-story living quarters in strict rows occupied one corner of the base. The officers’ quarters were in another section nearby. Between them was an open-air space with multiple bars where young women served drinks and heaping plates of food to soldiers in fatigues. That’s where I met Elizabeth. She was a server at one of the bars.

I can’t remember exactly how our conversation started, but it turned quickly—as many of my conversations then did—to the subject of HIV/AIDS. Elizabeth was eager to talk. We agreed to meet later at a hotel where I was to stay the night so that we could talk with greater privacy.

Later that night, Elizabeth said, “I’ve gotten a sister,” meaning a close friend. “She stopped the drugs and she died. I never knew that she has been hiding.” We sat on the concrete veranda outside my guest chalet just before dusk. The hotel compound was full of similar chalets, simple concrete boxes surrounded by small grassy gardens fenced by small shrubs. A few stray chickens pecked at the gravel path for insects hiding between the pebbles. There were two WHO trucks parked beneath a red-blossomed flamboyant tree. I would find out the next morning that they belonged to two older British men managing a polio eradication campaign.

The receding sunlight lingered on Elizabeth’s face. Her full cheeks had followed her from childhood into her twenties, and a rather delicate and un-imposing nose appeared almost as an afterthought between them. She wore dark eye shadow. Earlier, at the bar, I had watched her move gracefully from table to table serving drinks, seemingly flowing despite the long, tight purple skirt that forced her to take small steps.

Her friend, Elizabeth told me, had been an excellent tailor. For that reason, Elizabeth had encouraged her to come up north to this town near the military barracks, where there was more work. Arrangements were made, and her friend soon journeyed from Cross River to Niger State to set up shop, start sewing, and hopefully earn some money. Her friend wasn’t to stay for very long. “Her mom died and she travel home,” Elizabeth said. “Later, I went home because I lost a cousin’s sister. When I saw my friend, she was down. I sympathized for her sickness and everything. Something swell her under the chest there,” Elizabeth said. She placed her palm flat against the right side of her stomach.

“I don’t know the problem. I was always asking her, and she said she don’t know. She don’t know. When she came back to us,” up north, “I took her to so many labs. They said she has a liver problem, that her liver has been affected like that. So I now send her with my other sister to my pastor that they should go for prayers. I call on the pastor. I said, ‘Please, my sister is coming for prayers. She’s not well. If she come, please interview her and ask her if she’s gone for tests. It’s not as if you’re suspecting her, but tell her: go test for this HIV thing, that you may be sick.’

“The man of God now ask her those questions. The man of God even assisted, gave her a thousand naira, and we went to the lab and did the test. That day they did her the HIV test, she was afraid when she came out. She didn’t want us to know. The lab man said there are signs of HIV, that we will come back and do the test maybe in a month or three months later, but that she should first go and treat that liver problem.

“I was afraid. I now had to call and tell this girl’s father that she is sick and I wouldn’t want any bad thing to happen and have them say I kept her here. But the first question the father asked me is ‘Has she dropped her drugs?’

“I said, ‘Which drugs, Papa?’

“‘She didn’t tell you she has a problem?’ he asked.

“The man now explained everything to me, that she has been on AIDS drug, that maybe she drops the drugs and that’s why she has been sick. He said I should send her home.”

The darkness had stolen over us slowly as we sat chatting. It was night now and there was no electricity. I could see glowing orange hurricane lanterns floating through the night as the hotel staff crunched across the gravel while winding up the evening cleaning. Quicker steps could be heard across the path in front of us to a hulking building that housed the hotel’s diesel generator. There was a click followed by a sputtering low rumble, then light.

“I never knew that she has been hiding, pretending that she was afraid of the result. So I question her that morning: ‘How long did you stop taking HIV drugs? When did you last collect them?’ She said she collected lastly three months ago. Then for two months she has not taken the drugs. That is why she is down. So they took her back home. I was told that they went and did her CD4 count test and other test. But later we still lost her. That is how HIV kill.”

Elizabeth’s face was heavy with pain. Her mind seemed tortured by the same questions that left me unsettled. Why had her friend kept up this ruse, gone for multiple tests, and feigned nervousness in anticipation of a result she already knew? Could she have been hoping for some miraculous change that would render her normal again, that would remove the disease that had her living undercover? Why such elaborate deception? Elizabeth will never know, but the likelihood is that the stigma associated with HIV/ AIDS forced her friend to hide her illness and possibly to discontinue the care that would have kept her alive.

“It’s not everyone that will see you having that problem that will be embracing you,” Elizabeth said after some time. “It’s not everybody that will embrace you back—even your sisters in the house. You understand? Even in the village of my sister that died, many people were saying it: ‘Sure say no be AIDS?’ Even the old ones were saying, ‘Abeg oh! We hear say nah [it is] AIDS. If nah AIDS, make she die. Make she no come distribute.’ Old women! They were saying it.”

BOOK: Our Kind of People: A Continent's Challenge, a Country's Hope
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