30Years30Lives

Archive for 2010|Yearly archive page

Participant 01

In 30/30 Participants, Open Arms of Minnesota, United States on August 12, 2010 at 8:15 am

“Participant 01” is a gifted musician whose love of poetry graces his journal entry. He quotes Kafka: “Anyone who keeps the ability to see beauty never grows old.”

“When I put my hands on your body, on your flesh, I feel the history of that body. Not just the beginning of its forming in that distant lake but all the way beyond its ending. I feel the warmth and texture and simultaneously I see the flesh unwrap from the layers of fat and disappear. I see the fat disappearing from the muscle. I see the muscle disappearing from around the organ and detaching itself from the bones. I see the organ gradually fade into transparency leaving a gleaming skeleton gleaming like ivory that slowly resolves untilit becomes dust. I am consumed in the sense of your weight the way that your flesh occupies me—momentary space the fullness of it beneath my palms. I am amazed at how perfectly your body fits into the curves of my hands. If I could attach our blood vessels so we could become each other I would. If I could attach our blood vessels in order to anchor you to the earth to this present time I would. If I could open your body and slip up inside your skin and look out your eyes and forever have my lips fused with yours I would. It makes me weep to feel the history of you and your flesh beneath my hands in a time of so much loss. It makes me weep to feel the movement of your flesh beneath my palms as you twist and turn over to one side to create a series of gestures to reach up around my neck to draw me nearer. All these moments will be lost in the tears in the rain.” —David Wojnarowicz, 1990

“There are no diseases. There is only ONE disease that manifests in different forms.” —O.Z.A. Hanish

“Every disease is a musical problem, every cure is a musical solution.” —Novalis

“Anyone who keeps the ability to see beauty never grows old.” —Kafka

“May I, composed . . .
of Eros and of dust,
Beleaguered by the same
Negation and despair,
Show an affirming flame.” —Auden

“From love comes grief; from grief
comes fear; one who is free from
love knows neither grief nor fear.” —verse 215 of Ohammapada

The light of God surrounds me, the love
of God unfolds me, the power of God
flows through me. Wherever I am, God is,
and all is well. —21 August 2004, Nagano

The cool rain falls silently,
Blinded by a bright bed of black-eyed Susans
I wonder if I’ve learned,
If I’ve changed, what pieces are missing still.
Can I find the strength
The mosaic to survive? —9 August 2005, Nagano


Participant 02

In 30/30 Participants, Open Arms of Minnesota, United States on August 12, 2010 at 8:00 am

"Participant 02" is engaged in humanitarian response to HIV/AIDS. She is at prayer, a collection of her favorite words in her journal.

Love. Envision. Imagine. Hesed. Illumine. Compassion. Wisdom. Justice. Purity. Unity. Precious. Sacred. Create. Discover. Beauty. Grow. Hope. Forgive. Gentle. Kind. Explore. Spirit. Believe. Laugh. Ubuntu. Peace. Safe. Sanctuary. Breathe. Rest. Inspire. Together. Community. Trust. Holy. Divine. Faith. Life. Wholeness. Charity. Touch. Flower. Embrace. Wonder. Delight. Home. Contemplate. Calm. Content. Curious. Prayer. Mindful. Solitude. Promise. Thankful. Memory. Truth. Ritual. Gift. Miracle. Image. Reconciliation. Meditate. Adore. Luxurious. Light. Shalom. Cherish. Thoughtful. Warm. Moment. Nurture. Console. Goodness. Beloved. Lovely. Simple. Refuge. Womb. Soul. Mystery. Ultimacy. Integrity. Joy. Courage. Tender. Companion. Garden. Tranquil. Service. Abundance. Breathtaking. Generous. Patience. Dream. Art. Virtue. Aspire. Friend. Play. Celebrate. Smile. Dance. Nestle. Think. Wish. Share. Honesty. Educate. Inquire. Help. Gratitude. Excellence. Remember. Capture. Yearn. Blessing. Path. Journey. Sincere. Always. Awe. Enjoy. Charm. Magic. Care. Reflect. Haven. Vision. Secure. Time. Pleasant. Being.


Participant 03

In 30/30 Participants, Open Arms of Minnesota, United States on August 12, 2010 at 7:45 am

Blinded by an infection, "Participant 03" is a public policy student who advocates for those living with disabilities. HIV has taught him about the beauty and fragility of life.

“I am so grateful and blessed for the richness that fills my life today.” That may seem like an odd statement to begin a reflection on how HIV/AIDS has affected my life over the past 20+ years, but to be absolutely honest with myself, it is a completely true statement. Oh sure, I could choose to focus on the misery and physical pain I experienced as I lived HIV/AIDS in the mid 1990s, and surely no one would blame me. But, they are not how I choose to “remember.” It does me little benefit to dwell on them today. Even as I now live as a totalblind person, one more “gift” that HIV/AIDS presented me with, I would not be alive and in the throngs of wonderful opportunities had those experiences never happened.

I believe we each have incredible power to control how we choose to approach life, and how we choose to move ahead with that life. Although we may not have complete control over what happens in our lives, we certainly can control how we react to the experiences. To me, the beauty of the lives that have intertwined with mine in the name of HIV/AIDS, the beauty of those fragile relationships I am the recipient from because of HIV/AIDS and my perceived role as one who continues to live in spite of so very many others who did not get the same opportunity as I, gives me pause each and every time my inclination begins to take on a negative tone; instead, to me, the best way I can honor those who have gone before me and who died from HIV/AIDS, honor those who taught me humility, compassion, and dignity as they took their last breath, and honor the very meaning of life itself, is to move forward while being cognizant of the richness that does still fill my privileged life today.

Even amidst my loss of sight, I can see and feel that I stand on the shoulders of those who have gone before me. It is therefore essential for me to move forward intentionally and purposefully, choosing to focus on the countless incredible opportunities ahead and thankful for the gifts I have been given all while being ever mindful and thankful for my past . . . for without my past, I would cease to be who I am today.

A Candle Lighting Prayer

O, Creator of Divine Light
Be upon us.
Gather from the Universe,
All the Elements needed
To create this Symbol
Of Your Divine Presence.
Let this Light Shine Brightly,
Here in this Sacred Space.
O, Creator of  Divine Light
Let this Light Shine Brightly
And Illuminate the Places of Darkness.
Let this Light Shine Brightly
Allow that which was Hidden
To be now Held.
Held by warmth,
Gentle Comfort,
Touching,
Caressing, with Peace and Harmony
The shadows All now Gone.
O, Divine Light,
Creator of the Universe,
Come upon us.
And Here, in this Sacred Space,
Be with us,
Be us,
Be!

Participant 04

In 30/30 Participants, J. L. Zwane Centre, South Africa on August 12, 2010 at 7:30 am

"Participant 04" is a widow living in Guguletu who has opened her home to twelve orphaned and abandoned children. She wishes she could do more.

I live in one of the low socio-economic group areas where the large part of it is still informal settlements; where people live in shacks. This creates overcrowding and hygiene is not that much observed. In this area HIV and AIDS are rife. The government and some of the non-governmental structures are trying to educate people about prevention of HIV and AIDS treatment available for it—but it is still a problem because people are unwilling to disclose their status due to the stigma associated with HIV and AIDS. Some people would rather go to sangomas (witchdoctors) for treatment and end up dying. Parents die leaving behind orphans some of [whom] are also infected. Some of these children are abandoned with none to take care of them, or would be left with an elderly lady who also needs to be taken care of. This is very pathetic. This is what touched my heart and I opened my home to such children. I am presently staying with children whom I take care of, to see to their needs and love them. I would do more if I had means and make a difference to my community.

Participant 05

In 30/30 Participants, J. L. Zwane Centre, South Africa on August 12, 2010 at 7:15 am

"Participant 05" is a seven-year-old boy who struggles with meningitis, among other opportunistic infections. His mother writes about their challenges in her journal entry.

In 1992, after being involved in a car accident, I was diagnosed HIV-positive. I knew very little about HIV and I had no sign of being ill or of the struggle that la[id] ahead for me and my family. I was healthy and fit until 2001, after I had fallen pregnant with my youngest son. I had two children already, so I thought it was no big deal. After a difficult pregnancy, I gave birth to a baby boy, [who] was immediately diagnosed as HIV-positive. His CD4 count was zero, like myself, and the doctors predicted a very short life span for him, forhe had TB at birth. Today I thank God, for he has celebrated his seventh birthday in July this year. In spite of being a very sick boy, he also goes to school when he can, and when you look at him some days, he looks and plays with other children like any seven year old. I try to make his life as normal as I can for in a house with lots of grandchildren and friends, he is the only one who is very sickly and sometimes does not go to school for long periods at a time, and misses a lot of school work, but he at least gets some kind of education. He has been put on the second line of ARVs, because of his very high viral load and very low CD4 count. At the moment, he is suffering from slow meningitis, and I am suffering from cancer and four other opportunistic diseases. Through all our past & future struggles, I thank God for the strong support system I have at my church & support group that I joined about four years ago. They are with me every step of the way & it makes my life a whole lot better than it could have been. I am also an HIV & AIDS activist, for I know that HIV [and AIDS] are maintainable, if you take your [medicine], and abstain from sex or protect yourself, and surround yourself with family and friends as a strong support system. Aluta continua!, the struggle continues. . . .

Participant 06

In 30/30 Participants, J. L. Zwane Centre, South Africa on August 12, 2010 at 7:00 am

"Participant 06" discusses helplessness in the face of the pandemic. She has opened her home to her "daughter" and "grandson," both living with HIV.

I do not know much about HIV, but I do know that it is a struggle that I won’t wish on anybody, as a mother staying with my positive daughter and grandson. [T]o see them struggling with this terrible disease makes me feel very helpless and heartbroken. When she first told me her status I was very worried, for I thought they would die soon, but after watching their struggle for many years, I do not know which is better, death or the struggle. I am thankful that they are still alive, but not being able to know how to help makes mefeel like an outsider, watching my children die day after day.

My helplessness makes me very thankful to God for the J. L. Zwane Support Group and Centre, for, if it was not for their daily help I do not know where we as a family would be. They are helping my daughter with everything and by helping her, they help my whole family. My own congregation is helpless in this epidemic, they can only pray when they happen to get into contact with us. My health is also going down faster, because of my anguish when my children are sick. I also have the support of the J. L. Zwane members [who] are my neighbours. May God bless them richly for their help to us. May he also give them strength, patience, and wisdom to keep up the good work in our community.

Participant 07

In 30/30 Participants, Scalabrini Center, South Africa on August 12, 2010 at 6:45 am

"Participant 07" is a refugee from the DRC. She addresses in her journal issues of promiscuity, fidelity, grief, and care of orphans, advising men to be faithful to their wives.

I am a 56 year old widow. I tested HIV positive in 2005. My CD4 count was 134. [At t]hat time I had TB. I did not know that I had the virus before because I was fit and healthy. I know I contracted the virus from my late husband who was a drunkard and very promisc[u]ous. I was a very faithful wife and to this day I never slept with any other man. I would like to urge men out in the world to be faithful [and] to stick to one partner. At the present moment I am looking after three grandchildren orphaned due to AIDS. My daughter married a manwho was also promisc[u]ous and she contracted the virus and they both died at an early age. The husband was 33 years old and the wife was 26 years old. People should be educated about these things. They should be made aware.

Participant 08

In 30/30 Participants, Scalabrini Center, South Africa on August 12, 2010 at 6:30 am

“Participant 08” shares how, even though she has lost trust in her promiscuous husband, she has learned to live positively with HIV. They are estranged but not yet divorced.

I discovered I was HIV positive six years ago. I was numb with shock and disbelief. “WHY. . . . HOW. . . . COULD THIS BE HAPPENING TO ME.” After the shock and disbelief I started wondering if my two sons were also HIV positive. I got flash backs of the times they ha[d] been ill and tried to figure out if perhaps they were HIV negative. Routine tests proved that they are negative. “GLORY TO GOD.” The love and trust I had for my husband vanished overnight. His denial left a bitter taste in my mouth. We are estranged. He does not wanta divorce yet. He refused to use protection during sex. I made a choice five years ago to move out with my children. . . . I got a job. . . . [Now I] lead a healthy and fulfilling life. . . . and have been on ARVs for five years now. I have forgiven my husband but I can never get back together with him as the love and trust is gone.

Participant 09

In 30/30 Participants, Scalabrini Center, South Africa on August 12, 2010 at 6:15 am

"Participant 09" migrated to Cape Town as a refugee from Zimbabwe half a decade ago, after losing three of his children to HIV/AIDS. He believes stigma destroyed their lives.

Way back I could not believe that the story of HIV/AIDS was real because I had not seen anyone who was a victim of it. I came to know this when I got married and lost my loving kids, one after another, [within] 3 months. I believe it was of stigma—that’s why my first two kids just died and we could not get tested for this HIV/AIDS. I came to know of this problem when my third kid was ill and tried to save her life but she died. The doctors told us that she was HIV positive, so we got tested and the truth of HIV/AIDS was real. [T]hen I got tested and accepted the results and came to understand what it means to live with HIV/AIDS. This came about after going for counselling. Now I understand what it means to be with the HIV/AIDS and [to] be able to live positively. To all people who cannot believe if they should be tested and [find] their status—it is just good to know and live positively and that [it is] not the end of life. It has not been my wish to [lose] my three kids but because of stigma HIV/AIDS took advantage and destroyed their lives. My life still goes well though [I am a] refugee.

Participant 10

In 30/30 Participants, Inzame Zabantu, South Africa on August 12, 2010 at 6:00 am

"Participant 10" was tested for HIV only recently, and has disclosed his status to his wife, but not to his daughters. He advises others to protect themselves, and to be tested.

I’m staying in Brown’s Farm (in Siyahlal, an informal settlement). I’m married. I have two children. The first is 15 years old; the second is 8. They are both girls. I was only diagnosed this August [2009]. The first sign was shingles. I went to a private doctor. He said I must come to the clinic to check for HIV. I am still working. The children are in school. I have disclosed my status to my wife. She has been tested, and so far she is negative. The three-month window for retesting is almost here. My wife and I have agreed to use protection to prevent her frombecoming infected. At the present moment, only my wife and I know. Even our daughters do not know. They are still too young. . . . Before I knew my status, I was drinking a lot. Since I got the news, I’ve stopped. I don’t know how I got HIV because I am an honest person. I’ve looked after my wife. My only advice is to use protection, and to share any information you have with your spouse. You must trust no one. You must protect yourself.

Participant 11

In 30/30 Participants, Inzame Zabantu, South Africa on August 12, 2010 at 5:45 am

"Participant 11" describes his situation in Samara, a section of Philippi, where access to food and water are scarce. He is especially concerned about the safety of his daughter.

I am from the Eastern Cape. I’ve been here for four years now; I came to Cape Town in 2005 looking for work. I was employed, and was on treatment in 2005. And I was married. But she was very sick—vomiting, with diarrhea. Her entire body was aching. She was unable to walk. She was not on medication; she did not go to the clinic to see what the problem was. Instead, we went to our church to ask the pastors to pray for her to be healed. But she passed away earlier this year—in June. We have a daughter who will be thirteen years old this year (grade 6).She is staying with me. We are alone now. This is the second month I have been unemployed because of poor health. I was losing my eyesight; I have gone completely blind now. Also, I had terrible pains on the right side of my chest. I went to the doctor to see if it was TB. I am still waiting for the results. I am underweight. We have very little food to eat, and no money. We are staying here in a very poor community. We live in a shack. More than 15,000 people share one tap of water here. Four families share every toilet. The situation is very difficult. The government distributes porridge to try to avoid a famine. When they are able, our neighbors sometimes give us their leftovers. Because I am HIV+, I may qualify for a grant to help subsidize us. We are waiting for the CD4 count to come back to know whether I qualify. But it is taking so long. It is terrible for my daughter. She goes to school hungry. I am worried about her. I’m worried she will be abused—that when I’m gone, people will offer her bread to sleep with her. We have no one to look after us. Can anyone help us? Please, can anyone help us?

Participant 12

In 30/30 Participants, Inzame Zabantu, South Africa on August 12, 2010 at 5:30 am

"Participant 12" works as a nurse in the communities most affected by HIV/AIDS. She speaks of the hope clinics like Inzame Zabantu provide patients accessing its services.

There is nothing as fulfilling as seeing someone smile having arrived at the clinic groaning with pain. I have seen people turn their lives around, walking through the entrance of the clinic on their feet having spent [a] few months of their lives in a wheelchair. Running an HIV/AIDS clinic before the roll out of the [a]ntiretrovirals was depressing but now that the [a]ntiretrovirals are available one is able to say that indeed there is life after an HIV-positive diagnosis. People who were once lost in hopelessness, lost in despair, are now fullof hope and that is exactly what keeps them going and getting better day after day.

Participant 13

In 30/30 Participants, South Africa, Wola Nani on August 12, 2010 at 5:15 am

"Participant 13" is a member of the team at Wola Nani. She reflects on the changes she has seen in the lives of those now living positively because of the work of this organization.

I’ve been working with Wola Nani since 1994. We were working then only with HIV+ women. It was very difficult at that time because of stigma. The clients we saw—they didn’t want to attend the clinics. We used to do home visits: helping the people, washing them, referring them to the hospital. In 2002, most people broke the silence. We were assisting them to live positively in support groups. As a result, most of our clients were talking about HIV and spreading the word about the work of Wola Nani. Wola Nani planned to enter the townships, and played a big role in our communities—[in] Khayelitsha, Philippi, Guguletu, Mfuleni, and Nyanga, through support groups from these areas and in the IDC [Infectious Disease Clinic] at the Red Cross Hospital. So if I compare 1994-2000, and 2000 until now, I feel like Wola Nani changed a lot for the clients. They make paper maché bowls and bead work. Wola Nani trained them, and now they can be with their families, and do something to earn money. Most of our clients manage their HIV well. We’ve started a support group for children. Our staff taught even the children how to live positively, and to be confident about speaking about HIV. I’m very proud of the work we are doing at Wola Nani.

Participant 14

In 30/30 Participants, South Africa, Wola Nani on August 12, 2010 at 5:00 am

"Participant 14" is a counselor for Wola Nani. She informs HIV-positive expectant mothers how to prevent mother-to-child transmission of the virus.

I was diagnosed [in] 1990 in Cape Town. I found [out after] giving birth. [Then I] got sick with TB. By 1998, I treated it. So [during] all [those] years there was no medication. By 2003 I started the ARVs so that I [could] be healed. Because I was [at] Stage IV and my CD4 count was 175, I discover[ed] that I had pneumonia. By 2004, [I treated it.]. By 2005 I develop[ed] asthma, so I [have been] using [Asthavent] to make it better. I [joined] Wola Nani in 1998 at the support group whereby I get very strong and I [learned] that I . . . [amnot] alone living positive. I started to do bead craft [in] that year. By 2000 I started to train the other[s in] doing craft[work]. By 2007 I started to work as a counselor at Wola Nani. [I have been conducting] the program of mother to child transmission. There I’m telling mothers to prevent their children [from becoming infected] by doing HIV test[s] when they are pregnant. When they [find] out that they [are] HIV positive there is a treatment that they get during [their] seventh month [of] pregnancy. They get dual therapy but if their CD4 count is less than 250 they go on ARVs to protect their babies. [I also teach them] about feeding options [that are] their choice: breast or formula feed[ing].

Participant 15

In 30/30 Participants, South Africa, Wola Nani on August 12, 2010 at 4:45 am

“Participant 15” writes about her own quest to prevent mother-to-child transmission, and about how she works to empower others to do the same through Wola Nani.

I [was] born in [the] Eastern Cape. [In] 1999 [I] tested for HIV. [I t]ested positive. Not sick. Just [was] curious to know. Then [I planned] to have a child. 2001 get pregnant. Was hungry [to] prevent mother-to-child transmission (PMTCT) because I need to prevent my child from HIV. I [read a] book [about] PMTCT. Then my child tested when he was nine month[s] old. He was born [in] 2002. Tested negative because of PMTCT. [I w]as in need of support. I got lot[s] of support from my family. My CD4 count was 870 in 2003. Also attending clinic for myself.Because I was hungry [for] informationI [I] started to join a support group where I met others [where we could] also share our stories. Then 2003 NGO FAMSA [sent] me for intensive counselling course. Also 2003 started to join Wola Nani as a client. Attend support group each and every weekday. [We shared]  our ideas with others. Then 2004 I started to work for Wola Nani as a home carer. [This i]s whereby we visit sick clients [and] also check their meds (those [who] are using [them]). Also deliver food parcel[s]. Then 2005 January I have been promoted to work as a counsellor at Red Cross Hospital [through] information I have because I was . . . involved with TAC, ARK, and FAMSA [who] provide[d] me with training. At Red Cross I’m working as a counsellor doing pre, post-test counselling, adherence counselling. [I'm] also helping [with] interpreting for doctors. To work in a HIV facility, it empower[s] me a lot because I was helping clients to deal with stigma, denial, discrimination. Also [I am helping] them adhere to their treatment. Challenges that we [face include] denial [and] also disclosure which lead to adherence problem[s] but we deal with [these by] giving them information.

Participant 16

In 30/30 Participants, South Africa, Yabonga on August 12, 2010 at 4:30 am

"Participant 16" writes about the painful realities of working with children living with HIV/AIDS. She has served Yabonga as a peer educator and counselor.

I started knowing [my HIV+ status] in 2002 while I was sick. I had TB and it was for the second time and my doctor decided/advised that I should do an HIV test. It was something new for me and I did it. Unfortunately I tested +. I just thought it was the end of life for me but [the] one thing [that] kept me going was my child. I prayed to God that he must not take me because my son is still young. Apart from that was to join Yabonga support group in 2002 at M/Goniwe Clinic in Khayelitsha. The lady who was a team leader there gave me all thesupport that I needed and I felt very strong after that. In 2005 I was so lucky to be trained as a peer educator at Yabonga. Then [in] 2006 I started working and fortunately for me I was a youth counselor. I had to deal with children who are infected with HIV/AIDS and affected. Some of them are orphans through HIV/AIDS. Finally it started as something good for me because I was working, but later I discovered that, this is worse to deal with children’s challenges. I worked in different places where Yabonga is having containers at the clinics. [Shipping containers are used as freestanding buildings in many township communities.] I remember while I was in Kraai-Fontein [in] 2007, there were two children. [O]ne of them is HIV+ and their mom didn’t have any means to provide for them but because in our OVC programme we give these children all the support [they required] including [a school] uniform and some food, and they come to our centers after school for food as we have community moms to cook for them. These community mothers are our clients who volunteer themselves to cook for the children after school. The food and everything is from Yabonga and they just open their homes for our children. But with a [stipend]. So for some children it is a great priviledge for them to be part of Yabonga at least to have them all to get the support they need. Some of these children become infected, so we have to deal with these problems but we refer them to [relevant] places for counselling. There is a boy in Gugulethu who touched me. He is HIV+ and is always sick. He is [in and out of the] hospital. I was so worried when the doctors said they are going to stop him from taking ARVs because he doesn’t improve, but through our prayers, I again heard that there is doctor who said he wants to monitor him and he is not stopping medication. I think [his] story is touching everybody because he is really a fighter. That is not something nice. People might think we are happy because we have accepted our statuses and our families do, but what about the fact that [we are] going to be on medication for the rest of [our lives]? [the s]truggle continues

Participant 17

In 30/30 Participants, South Africa, Yabonga on August 12, 2010 at 4:15 am

“Participant 17” writes about how the Institute for the Healing of Memories conducts retreats to help caregivers cope with the trauma of HIV/AIDS.

I live in a community [where] people are confronted by the reality of HIV&AIDS on a daily basis. People choose to respond to the pandemic in many different ways. [The Institute for the] Healing of Memories and HIV/AIDS is about creating a safe space for those infected and affected by [this disease]. Many people infected and affected by HIV&AIDS continue to experience rejection and isolation. This [leaves] people with a lot of feelings, [like] pain and disappointment. [The Institute for the] Healing of Memories create[s] an opportunity for people to dealwith the negative feeling[s] they have because of how we respond to those living Read the rest of this entry »

Participant 18

In 30/30 Participants, South Africa, Yabonga on August 12, 2010 at 4:00 am

"Participant 18" is a peer educator for Yabonga, and credits the organization for teaching him to live positively. He has turned his life around, and is studying for a bachelor's degree.

I [was] born in 1968 [on] the 19th September in the North West Province of South Africa. I went to school in 1975 at Makgori Primary in Makgori Village. We then relocated to Tshidilamolomo in 1977. I continued with my education until 1985 when I pass[ed] my STD8 [standard eight, or eighth grade]. I couldn’t continue with my studies due to [a] lack of finance[s]. I stayed at home doing odd jobs to earn some income. [In] 1991 I went back to continue with my studies and I completed my matric. In 1994 I was employed as a temporary teacher. When mycontract was terminated in 1997 I went back to do my odd jobs to earn some income. In 1999 I tested HIV-positive but didn’t believe in HIV/AIDS. I then moved to Cape Town where my brother is staying. I continued working in building construction as I liked working with sand and stones. In 2004 I went to do VCT [voluntary testing and counseling] again, hoping to be negative but FORTUNATELY I tested HIV-positive. I couldn’t do anything about it but to accept the results. I met the Yabonga HIV/AIDS Peer Educators who encouraged me to accept and forget about where I [got] the virus [from] but to continue living my life but differently. That’s changing my lifestyle. Living positively with positive mind. I joined the support group and that is where my future with Yabonga started. I went for an interview in 2006 at Yabonga and I went through. [In] 2007 I was trained to be an HIV/AIDS Peer Educator. I could speak openly [about] my status to everybody including my family and friends. A person living with HIV is a normal person. It was also my step forward. I am presently a student at the University of South Africa and am going to be graduating in years to come. Every person can fulfil his dreams living with the HI Virus. I am now taking my ARV medication and keeping well everyday. Thank you Yabonga for having me as [your] employee.

Participant 19

In 30/30 Participants, Ikamva Labantu, South Africa on August 12, 2010 at 3:45 am

"Participant 19" cares for an HIV-positive daughter and her children, sharing openly their struggles with alcohol and drug addiction.

I am a 67 year old mother of 2. [My] daughter is 44 and son is 42. In 1994 my first-born daughter was diagnosed HIV-positive. She grew up in the Eastern Cape [and was] brought up by my mother. At first I blamed myself [for] not bringing her up myself. But later I accompanied her to the clinic for counselling. It took time for her to accept [her status]. She kept saying it can’t be her blood. I kept taking her to different places to be tested. At last she believed it and kept it [a] secret at home. I tried to go to workshops to learn more about this disease.It is very difficult to live with my child. She turned to drinking and gets very aggressive when drunk which is almost every day. She has two sons. I brought them up myself and put them through education. They are both working but [are] affected by the situation. The younger one is on drugs. They all stay with me. I am only sane by the grace of God. We pray together most of the time. I support them with my pension. I struggle to have [her take her treatments]. It is a miracle she lasted so long taking medication and alcohol. I praise the Lord for all blessings. I[t] affects me [for] whenever she is in pain she comes to me and I can feel the pain. The big blow was this year when I phoned a place she went to for chest X-rays. I was told she has no lungs. I nearly died. All in all it is not easy to nurse someone who sometimes blames me for wanting her to die. I pay for funeral policies. She doesn’t get [a] disability grant because she drinks. It is depressing. I just trust in the Lord to make me strong when the time comes.

Participant 20

In 30/30 Participants, Ikamva Labantu, South Africa on August 12, 2010 at 3:30 am

"Participant 20" raised her grandchildren when her daughter passed away. She advises people to get tested in order to prevent further spread of the virus.

I am 59 years old. I live in the township[s] of Cape Town. Ten years ago I discovered that my 27-year-old daughter was infected with HIV. I was very shocked, not knowing what to do, and at that time I was still in the dark about HIV. I knew my daughter was dying. I didn’t know what to do, but I manage[d] to share with my neighbours, my church collegues, and my fellow workers. They supported me with prayers. She became very sick and there was no help of ARVs at that moment. There was nothing I could do but to wait and pray. 

Apparently, I came to Ikamva Labantu for help, and the only help I could get at that time was support. She was fully blown and after a long time she died. I was in a trauma of accepting the death of my daughter and [taking] care of her two children, a boy of 9 and a girl of 3 at that time. I was open about it although I was depressed, but through [counseling] I survived.

I raised those two children out of my income. Now the boy has turned 20 and the girl is 14. They are very beautiful and fortunately they are not infected.

I would like everyone to accept the d[i]sease, but to try and prevent it. If you happen to be HIV[-positive], it is not the end of the world. There is help at the clinics. [I]f you don’t know your status go and get tested before it’s too late.

Participant 21

In 30/30 Participants, Ikamva Labantu, South Africa on August 12, 2010 at 3:15 am

"Participant 21" lost two daughters to HIV, and cares for their children. A third daughter is also HIV-positive. She encourages parents to accept their children.

I am a 61 year old who lost children, 2 daughters: 1 in 1999 and 1 in 2005. And [they both] were infected by HIV. The eldest daughter left me with 2 children who are now at the age of 25 and a boy of 13. Fortunately they are not infected. The second daughter died in 2005. [She] also left 2 children, a boy of 20 and another boy who is now 4 years. I struggle to raise them, but with the help of Ikamva I do survive. I was very hurt, but what can I do? The d[i]sease is here and everybody must accept the fact that it is here. I miss my daughter. I pray to God that I can live longer to take care of the little ones, because I am the only hope for them.

I have [a] third daughter who is 31. [S]he is also infected. I sometimes think that I am cursed, but again I know that is not the fact. It is just that we must be careful, and try [to] educate our children about HIV. To the parents out there, I would like to send a message: Accept your children and support them. They need you as a parent to give them hope.

I would like to plea to everybody: let us hold hands as parents and support one another in this pandemic. We have become carers and I support them out of my little pension. Its not enough but I survive.

Participant 22

In 30/30 Participants, South Africa, Treatment Action Campaign on August 12, 2010 at 3:00 am

"Participant 22" is a treatment literacy trainer at the TAC offices in Khayelitsha. After trusting traditional healers to cure him, he joined TAC to help get the truth out.

I was born in the Eastern Cape, [in a p]lace called Sterkspruit in the former Tran[s]kie. Then I came to Cape Town in 1990. I have two children girl & boy. She is 8 years and the boy is 2 years old. In 2004 I was diagnosed with HIV on the 7 of August because I was very sick. [I had] shingles, [diarrhea], skin problem[s]. The nurses d[e]cided that I should do VCT [voluntary counseling and testing]. The result came back positive and my CD4 count was 34. I couldn’t believe when they told me that I am HIV positive. I then did not want to go to theclinic as we believe in traditional medicine most of us. I went to Free State where I met Read the rest of this entry »

Participant 23

In 30/30 Participants, South Africa, Treatment Action Campaign on August 12, 2010 at 2:45 am

Among other roles, "Participant 23" works as a TB coordinator for TAC. More than anything, she wishes to be a healthy mother to a healthy baby.

Originally I am from Eastern [Cape] from the place called Butterworth. I was diagnosed HIV+ in 2002 when I was having TB of the pulm for the second time. At that [time] my CD4 was 39, and I had to start ARVs. I started ARVs on 13 of April in 2002. Two months after my CD4 was 90. I felt good. In 2004 towards the end I decided to get pregnant because my CD4 was very high at 880. My doctor advi[s]ed me to do the papsmear and CD4 and viral load for my pregnancy. I was referred to Hanover Park. That [is where] I delivered an HIV negativeboy from the weight on 4.2 kg [9.25 lbs.]. I was working at the hospice in 2003 up to 2005. It’s where I’ve noticed that I have to work closely with HIV client[s] to give them the education and information that the community need[s] outside. In terms of stigma and discrimination I didn’t experience anything. I experienced lots of side effect because AZT, 3TC, Effavirenz. When I decided to get pregnant & was [switched] from Effavirenz to Nevirapine. Currently I am working for TAC since 2006 for the integration of TB and HIV clinic as a TB coordinator. I am good, healthy and my CD4 is 940. I want to s[t]ay a healthy mom to [a] healthy baby. Let’s come together and fight this epidemic. Alluta || continua || Amandla

Participant 24

In 30/30 Participants, South Africa, Treatment Action Campaign on August 12, 2010 at 2:30 am

"Participant 24" goes to clinics for TAC to share information about how to prevent HIV. She believes the South African constitution secures the "right to adequate healthcare."

Originally I am from Eastern [Cape] in the place called Carth-cart. I am 46 years of age. I started to know about my status in 1999. In 2001, I started my ARVs Effavirenz, AZT, 3TC. I had experienced asthma and I had TB and asthma. I joined TAC in 2000 as an activist. Now I am doing Prevention Treatment Literacy at the clinics and I joined the P-WA sector within TAC. Also I [am] participating at the women’s sectors as a chairperson. I know how to challenge the denialists of HIV. As [our] constitution says, “We have a right to adequate healthcare.” I know HIV treatment literacy and [challenge] the homophobia in our community. I am doing workshops, education within the community. To be an activist—it means a lot to me. Currently my CD4 is 775, but I started ARVs when my CD4 was 179. My concern is only asthma. I don’t worry about HIV. Alluta Continua!! Amandla.

Participant 25

In 30/30 Participants, New Life Center Foundation, Thailand on August 12, 2010 at 2:29 am

"Participant 25," now seventeen years old, was sent away from home at the age of eleven to work in a restaurant. The owners arranged for her to meet several "customers" daily.

When I finished the third grade, I did not think I would meet with the issues that I faced next but shouldn’t have. But when we have passed a certain stage, we shouldn’t destroy ourselves. We are bearing the consequences of what we have done.

Sometimes I think of having HIV, and I think that nobody will love me. And sometimes when I see others enjoying their lives while I am suffering in my life with the virus, [I am sad because] I should not have it. Sometimes it also causes me to think back to the past. It gives me an experience [to say] that we do not have to work in those kinds of jobs again. There are many other people who are suffering more than me, and they are not going into despair about the problems they are encountering.

When we come to a safe place, it gives us happiness and joy. I want to tell everybody that is like me that I wish they did not have to go through this. Please obey your parents. If [girls] want to work, [I want to tell them to] find appropriate work for their age, and to find work that is legal. Don’t think that all work is good work. It is not true. It might not be suitable or appropriate [what people are asking you to do]. I don’t want any woman to do the work that I have done.

I have had this experience. I want to share this with people who have not done this work in the past. I cannot change what happened that gave me the virus. The only thing that I can do is to look after my health and to exercise regularly.

I am concerned about women because we have the same hearts.

Participant 26

In 30/30 Participants, New Life Center Foundation, Thailand on August 12, 2010 at 2:28 am

"Participant 26" is a graduate of the New Life Center Foundation. She hopes to protect her daughter from the trafficking to which she was vulnerable.

I remember the Lahu New Year’s celebrations when I was little. It was so much fun. It was the only time of year that we had new clothes made and we enjoyed showing off our clothes with our friends. I remember playing games in the village with the other kids, catching fish and swimming in the rivers. It was so much fun.

I am interested in the well-being and development of my daughter. If I was well, I’d be able to work and earn more money for my daughter. But I can’t really do that. But my main interest, the thing that is most important to me, is my daughter.

I’d like the broader public to understand how vulnerable young women are, to being trafficked and becoming HIV+. Becoming aware of exploitation and AIDS after the fact is too late. You must have awareness beforehand. Why do young women believe the people who lure us into these types of places? Why do we believe others so easily? You must not be so vulnerable, so easily tricked (like I was).

My hope for my future is that I’ll live long enough to see my grandchildren. I hope and pray that we can find a medicine that allows me to live for many, many years, so that I can see my grandchildren. Right now, I don’t know how long I’ll live, but please help find medicines that will keep me alive. This would be a good thing.

Participant 27

In 30/30 Participants, New Life Center Foundation, Thailand on August 12, 2010 at 2:27 am

"Participant 27" has been traumatized by the experiences that ultimately brought her to the New Life Center Foundation. She is charting a course free from exploitation.

When I was a little girl, I loved to go fishing with my big sister. This actually is my happiest memory, because I was living in the forest [at the time]. There was a river and I loved the environment with fresh air and clear skies. Even though during my childhood I did not get to eat delicious food—and even went without meals sometimes—I was so happy because I was with my family—my father, my mother, and my big sister. In terms of my interests . . . I like to play the guitar. I like to look after the fish (in the fish pond), and plant trees and flowers—especially orchids. I like orchids so much because they have beautiful fragrance and beautiful colors. In terms of the things important in my life . . . my relationship with God is important to me. God has provided me with a place to live, food to eat, and medicine to care for me. Also, what is important is that God is healing my heart and making me stronger.

I’d like to tell tribal women in northern Thailand to have awareness, to have knowledge and not be so easily manipulated. Because in today’s society, [there are] many areas in which you can be duped or tricked. If you believe people too easily you might be tricked easily, into many different things.

I want to recover fully from this disease. I dream that one day there will be medicine to heal me. I place my hope (and trust) in God because if that day could truly come, I’d like to have a complete family.

Participant 28

In 30/30 Participants, Mexico, OMIECH on August 12, 2010 at 2:15 am

"Participant 28" is a traditional healer at OMIECH. He believes he has successfully treated people living with HIV, but keeps the treatment a secret due to fears of biopiracy.

I have taken care of three people in the community: San Antonio Naranjal [Orange Grove], in the Municipality of Simojovel, Chiapas, that are infected with AIDS. I treated them with medicinal plants for 10 days or up to a year. [The length of treatment depended upon] how they reacted to the medicine. In this way, I verifiably cured them. As to which plant I used, I will tell no one, for this remains among us, since it is a secret among indigenous doctors, so that later on we [are able to] retain the authority to patent it, as the case “Pozol y Frijoles Rojos” [the case of "boiled barley and red beans"] already demonstrates. I knew that a person in the city of Guadalajara patented Tepezcouite, that is, a plant that serves [to treat] the burns of the skin. Then, an announcement followed that our plants served their needs, so they stole them from us and patented them. [Once they are patented,] we no longer have them to use.

I have said to them also in the United States, in Arizona, where I have visited, that if they already patented our pozol, this means that it is no longer ours. For us rural folk, pozol is our only food, and already they took it away from us. Our pozol, that is made from corn, is, for us, sacred.

When one knows the illness and its symptoms, one can apply medicine by means of the plants. I am old, but I do not need to go for a [doctor’s] analysis, because I know the plants than can cure me.

AIDS spreads because there are many women who are sold to be with men. But also the infected males transmit that illness to their spouses or to other people. That is very serious, because sadly they do not take care of themselves.

I have seen that there are people who have been infected—they do not disclose [their status] to the public, because they are afraid to be rejected, or mistreated by the community, friends, and family. [Their status] remains a secret. Other times, what is even more worrying, is if a man is infected who wants to have sexual relations with his spouse, but he tells her nothing, the consequence is that he infects his spouse. And this is also very serious. More should be communicated to couples to prevent the illness. This is not only the case with AIDS, but also with other contagious viruses.

In another case, I encountered patients who came from Germany. They came to visit us at OMIECH. I also treated them with medicinal plants, because they suffered from infections, one with syphilis and the other with AIDS. They told me that during the treatment, they functioned well. Before, they burned and itched a lot. After two months of treatment, they went on living. This means that we can cure illnesses by means of our herbs.

Participant 29

In 30/30 Participants, Mexico, OMIECH on August 12, 2010 at 2:10 am

"Participant 29" is a Tzeltal midwife, who shares what is known about HIV/AIDS in her indigenous community. She emphasizes an ethic of treating all people respectfully.

I have taken care of three people in the community: San Antonio Naranjal [Orange Grove], in the Municipality of Simojovel, Chiapas, that are infected with AIDS. I treated them with medicinal plants for 10 days or up to a year. [The length of treatment depended upon] how they reacted to the medicine. In this way, I verifiably cured them. As to which plant I used, I will tell no one, for this remains among us, since it is a secret among indigenous doctors, so that later on we [are able to] retain the authority to patent it, as the case “Pozol y Frijoles Rojos” [the case of "boiled barley and red beans"] already demonstrates. I knew that a person in the city of Guadalajara patented Tepezcouite, that is, a plant that serves [to treat] the burns of the skin. Then, an announcement followed that our plants served their needs, so they stole them from us and patented them. [Once they are patented,] we no longer have them to use.

I have said to them also in the United States, in Arizona, where I have visited, that if they already patented our pozol, this means that it is no longer ours. For us rural folk, pozol is our only food, and already they took it away from us. Our pozol, that is made from corn, is, for us, sacred.

When one knows the illness and its symptoms, one can apply medicine by means of the plants. I am old, but I do not need to go for a [doctor’s] analysis, because I know the plants than can cure me.

AIDS spreads because there are many women who are sold to be with men. But also the infected males transmit that illness to their spouses or to other people. That is very serious, because sadly they do not take care of themselves.

I have seen that there are people who have been infected—they do not disclose [their status] to the public, because they are afraid to be rejected, or mistreated by the community, friends, and family. [Their status] remains a secret. Other times, what is even more worrying, is if a man is infected who wants to have sexual relations with his spouse, but he tells her nothing, the consequence is that he infects his spouse. And this is also very serious. More should be communicated to couples to prevent the illness. This is not only the case with AIDS, but also with other contagious viruses.

In another case, I encountered patients who came from Germany. They came to visit us at OMIECH. I also treated them with medicinal plants, because they suffered from infections, one with syphilis and the other with AIDS. They told me that during the treatment, they functioned well. Before, they burned and itched a lot. After two months of treatment, they went on living. This means that we can cure illnesses by means of our herbs.

Participant 30

In 30/30 Participants, Mexico, OMIECH on August 12, 2010 at 2:00 am

"Participant 30" is a health promoter working with indigenous communities in Chiapas, Mexico, who shares in her journal some Mayan perceptions of HIV/AIDS.

I will talk about my experience with AIDS, working with women in traditional Indian medicine.

In communities where there is an AIDS infection, or an illness, [the diagnosis] is not clear. What is AIDS? [in Tzotzil] People only speak of “potz lomal chamel,” which is found in bed, so to speak. (For example, when someone invites us to go swimming in the river, we encounter the spirit of disease.) For diagnosis, it is necessary to ask: How did we encounter it? When did it come? What symptoms do we have? When did they start? Traditional doctors make the diagnosis by [reading] the blood, whereas the doctors at the hospitals make the diagnosis by means of special machines. “Potz lomal chamel” is not the same as AIDS, but it also causes the body to weaken. Sexually transmitted diseases are complicated. And so this is presented as AIDS.

When men and women go outside of their communities, and migrate, they spread the illness when they return, infecting their wives or husbands. So grows the seed.

The AIDS community is called [again in Tzotzil] “veel chamel” because it is something that eats you from the inside. It is difficult to speak of AIDS, due to grief, prejudice, customs, and because you must not speak publicly about the private parts of men and women (the penis and the vagina).

When we speak of AIDS, we speak about how to prevent it by using medicinal plants. People who are sick, only they know in their hearts [that they have AIDS]. They do not speak of it due to grief [and] fear. It is not made public—only the one who tested [the blood], only the doctor knows. It is not God’s punishment! On the contrary, lack of self care is bad. We are to protect the body and to prevent illness, and to treat the body. God has given us medicines and plants, which we respect. We listen to those who know (doctors and midwives) that it is the devil’s work simply to have sex with anyone. Furthermore, there is no communication between the young, who do not understand advice and who do not care to prevent diseases. So there are herbs that we can use, but we must not condemn people, for it is most important to prevent discrimination among the population. There are some herbs that we take but because of a lack of economic resources, they have not been researched to show their effectiveness and thereby help to prevent and cure AIDS in the population.

AIDS Denialism

In 30/30 HIV/AIDS Structural Drivers, AIDS Denialism, HIV/AIDS, Public Health, South Africa on August 11, 2010 at 3:00 am

Denialists and Conspiracists

AIDS denialists deny that the human immunodeficiency virus (HIV) is the cause of acquired immune deficiency syndrome (AIDS). While some reject the very existence of HIV by perpetuating the myth that the virus has never been isolated, others promulgate the idea, following Peter Duesberg, a professor of Molecular and Cell Biology at the University of California, Berkeley, that HIV exists but is a harmless passenger virus rather than the cause of AIDS. Another group believes that researchers created HIV in a laboratory with the aim of using it as a biological weapon against people of African descent. Still another group claims that pharmaceutical companies created AIDS hysteria in order to turn a profit. That these views are opposed to scientific consensus is of marginal consequence; each view has acquired a following. Although the effectiveness of the anti-retroviral treatments has caused a large number of former dissidents and denialists to change their opinion, myths about HIV/AIDS continue to spread, mostly online, but also by means of misleading films.

The fact that HIV causes AIDS is considered scientifically conclusive. Fulfilling all three of Koch’s postulates, which serve as kind of a “litmus test” for determining the cause of any epidemic disease since the nineteenth century, HIV has been shown conclusively to be the cause of AIDS. According to a helpful article published by the National Institute of Allergy and Infectious Diseases, these postulates pertain to epidemiological association, isolation, and transmission pathogenesis. “With regard to postulate #1, numerous studies from around the world show that virtually all AIDS patients are HIV-seropositive; that is they carry antibodies that indicate HIV infection. With regard to postulate #2, modern culture techniques have allowed the isolation of HIV in virtually all AIDS patients, as well as in almost all HIV-seropositive individuals with both early- and late-stage disease. In addition, the polymerase chain (PCR) and other sophisticated molecular techniques have enabled researchers to document the presence of HIV genes in virtually all patients with AIDS, as well as in individuals in earlier stages of HIV disease. Postulate #3 has been fulfilled in tragic incidents involving three laboratory workers with no other risk factors who have developed AIDS or severe immunosuppression after accidental exposure to concentrated, cloned HIV in the laboratory. In all three cases, HIV was isolated from the infected individual, sequenced and shown to be the infecting strain of virus” (niaid.nih.gov).

Despite scientific evidence that has been supported by medications that have produced something of a “Lazarus effect,” bringing people even with CD4 counts of zero back to health, perpetuation of AIDS denialism is conducted mostly online, though two films have also been created to twist the facts and to mislead people into believing falsely that HIV is not the cause of AIDS. The Other Side of AIDS, a 2004 film by Robin Scoville (the spouse of Christine Maggiore, a prominent AIDS denialist who followed her infant daughter into death in 2008 after contracting several AIDS-related conditions), is predominantly a collection of interviews with people who have refused to take drugs, believing the opinion promulgated by Maggiore and others that drug companies were attempting to make profits off of common illnesses that have afflicted humans for centuries.

More recently, the 2009 film House of Numbers by Brent Leung has been criticized by a review for the New York Times as “willfully ignorant.” It resurrects the denialist’s claims by interviewing legitimate scientists, but then editing their words to promote Leung’s denialist agenda. According to Jeanne Bergman, writing for AIDStruth.org, “Leung in fact got the information he sought from the legitimate scientists, doctors, and advocates he interviewed, but he then edited it out of the film to deceive and confuse viewers. The audience is manipulated to reach the wrong answers.” More poignantly, Bergman goes on to articulate the implications of Leung’s willful ignorance and manipulative technique. “Since Leung leaves his own positions unstated, he dodges accountability for the film’s potential impact—namely, that people might decide that they don’t need to protect themselves or others from being infected with HIV, or that people living with HIV might reject medical care and the medications that could keep them healthy.” AIDSTruth.org has published an article to counter the untruths spread by the film.

To be sure, the history of AIDS denialism is a fascinating case study about how easily and effectively a body of information can be manipulated, challenged, and discredited in the minds of those so predisposed, often in this case by homophobic and racist viewpoints. Tragically, however, its impact has been extremely harmful. In South Africa, for example, people whose lives could have been prolonged by obtaining the medications that were available elsewhere were denied access under the ill-informed presidency of Thabo Mbeki, who subscribed to the denialist position, as did his appointed minister of public health. A Harvard University study recently estimated that 330,000 lives were unnecessarily lost between 2000 and 2005 as a direct result of that country’s government and its position on AIDS.

In agreement with a statement by AIDSTruth.org, my intention here is not to debate denialist claims. “Debating denialists would dignify their dangerous position in a way that is unjustified by the facts about HIV/AIDS. The appropriate way for dissenting scientists to try to persuade other scientists of their views on any scientific subject is by publishing research in the peer-reviewed scientific literature. For many years now, AIDS denialists have been unsuccessful in persuading credible peer-reviewed journals to accept their views on HIV/AIDS, because of their scientific implausibility and factual inaccuracies” (AIDSTruth.org). Such a refutation of denialist claims has been conducted well, and this work is widely available online.

Rather, here I would like simply to direct people to some websites that are useful when trying to grasp the harmful impact of AIDS denialism.

To contrast the two positions, visit: AIDSTruth.org (one site promoting sound scientific approaches to HIV/AIDS), and VirusMyth.com (one site promoting unsound and unscientific claims in relation to HIV/AIDS).

To read arguments against each claim, one by one, I recommend articles published by AIDSTruth.org, the Treatment Action Campaign, and Aegis. Nicoli Nattrass’s article “AIDS Denialism vs. Science” is also thorough and instructive.

To understand the emergence, biology, and history of HIV/AIDS, several sites are beneficial, including one from the National Institute of Allergy and Infectious Diseases, the AIDS Education and Global Information System, and Tibotec, a pharmaceutical research and development company specializing in antiretroviral therapies. NOVA and Frontline, too, have broadcast high-quality programs in relation to HIV/AIDS. The Body and Avert also publish reliable information about HIV/AIDS.

Inequitable Access to Education

In 30/30 HIV/AIDS Structural Drivers, Education, HIV/AIDS, Literacy on August 11, 2010 at 2:45 am

Please check back to read about how inequitable access to education feeds the HIV/AIDS pandemic.

Inequitable Access to Healthcare

In 30/30 HIV/AIDS Structural Drivers, Health Care, HIV/AIDS, Public Health, South Africa on August 11, 2010 at 2:30 am

1400 a Day

Despite the election of a president who is more astute in relation to the HIV/AIDS epidemic in his own country of South Africa than his predecessor, global funding to make medicines to treat an HIV infection widely available, and a network of community health clinics and NGOs working to distribute information about prevention and treatment of HIV/AIDS, 1400 people daily become newly infected with HIV in South Africa. These account for nearly 20% of the estimated 7,400 new infections occurring daily worldwide. Likewise, the actual number of deaths related to HIV holds steady at about 1000 a day in South Africa, again accounting for about 20% of the 5,500 people dying daily worldwide from complications arising from an infection.

Although South Africa is among the most severely affected countries in the world by this pandemic, only about a third of those testing positive in South Africa are accessing the antiretroviral therapies (ARVs) that can prevent the virus from multiplying, thereby restoring the immune system to healthy levels. The reasons for this are complicated, as 30/30 is attempting to document. In addition to the social and structural complexities that have been mentioned in this collection of essays, there are a host of complications around access to healthcare in South Africa. During apartheid, for example, the government focused on the development of providing primary care to the public through a nationwide system of hospitals, leaving the masses living in townships with little access to a network of quality care. Under the new government, community health care centers like Inzame Zabantu are being built and are increasingly providing access to primary care in impoverished communities, but the patient load at these clinics is astoundingly high, and clinics are still inaccessible to tens of thousands of people. Government grants are making it possible for people to access ARVs, but the odds are still stacked against the poor. Drugs are accessible to those who do come forward to test, who live near a community health center, who test positive, who return to take a second test to find their CD4 counts, whose CD4 counts measure less than 200, who navigate the application for a government grant, who wait for a decision in relation to their application, and who qualify for assistance. Moreover, the effectiveness of treatment relies on consistency and good nutrition. The drugs are not effective if taken on an empty stomach. Since most people on the drugs are living on about $1.75 a day, hunger remains a serious issue. Finally, despite the work of NGOs to blanket the community with information about HIV/AIDS, even in the post-Mbeki situation, the stigmatizing effects of an HIV-positive diagnosis continue to prevent people from seeking medical attention.

To add yet another layer of complexity to this difficult situation, information about the virus is received tentatively by a culture that is torn between African tradition and European ways. The denialism of Thabo Mbeki only fueled an already latent distrust of Western medicine in many African minds. Rumors of the virus coming in the needles of the “white man,” promises of herbal cures by medicine men, and traditional ritual treatments continue to compete for the allegiance of those struggling to survive in communities where the unemployment rate often hovers around 70%. Medical aid workers widely note that, despite testimonies of people “coming back to life” once on ARV treatments, there is a continuing resistance, especially among men, to seek treatment and live.

These realities and their attending statistics are inherently alarming. In trying to process them himself, Jonny Steinberg, a South African journalist, attempted to understand the situation to a greater extent than the newspapers and academic papers were able to provide. For eighteen months, he periodically visited a village in the Eastern Cape Province of South Africa in an effort to understand the choices of a man he calls Sizwe Magadla. Despite a high risk of having been infected, when Steinberg met him, Sizwe adamantly refused to test for HIV. The result of Steinberg’s investigation is published in a masterwork of literary journalism entitled Siswe’s Test: A Young Man’s Journey through Africa’s AIDS Epidemic. In it, Steinberg explores with tremendous insight what is often at stake for men in still traditional villages as they confront this modern-day disaster, navigating his way through the “architecture of shame” that surrounds the illness, the struggle to lift oneself out of poverty and the reality of envy which threatens to pull the successful back in, and the constant push and pull of cultures as traditional African beliefs and practices encounter, accommodate, and resist European beliefs and practices. Indeed, it is Steinberg’s navigation of these competing beliefs, and what is at stake in concession, that is pertinent here, for they point to a terrible albeit unforeseen complication that is the legacy of colonization in Africa and apartheid law in South Africa: the understandable even if catastrophic mistrust of white “man” and “his” needles.

Steinberg recounts a telling conversation he had with Sizwe, who shares with him a “black people’s secret”: ‘Some people believe that the whites have developed a cure for AIDS,” Sizwe told Steinberg, ‘but that they are holding it back. They are waiting for enough black people to die so that when we all vote in an election the whites will win and F. W. de Klerk will be the president again’ (138). Sizwe’s own distrust of the medicine of white men was corroborated by Kate MaMarrandi, a community health-care worker also interviewed by Steinberg in the Eastern Cape. She told Steinberg,

‘In 2003, Dr. Hermann came. He started to tell us he has got help—ARVs. Nobody believed him. Some said this one has come to kill the people. Even the doctors didn’t believe him. People thought he had come to destroy the people with his needle and his blood test. They believed AIDS was caused by politics, by white people.’

Steinberg reflects on these disclosures, writing, “For all our talk on the causes of AIDS, it had taken this trip . . . to out [Sizwe’s] strongest suspicion about the origin of the epidemic. It was brewed, not by witches and their demons, but in the vividly imagined laboratories of Western science” (146). Steinberg’s book goes on to try to understand this mistrust of Western medicine. First, he turns to tales of the ordeals experienced by Dr. Hermann Reuter, the doctor for the MSF (Medicines Sans Frontieres / Doctors Without Borders) who set up a clinic to bring ARVs to Lusikisiki, the region of the Eastern Cape where Steinberg’s story about Sizwe unfolds. He was told,

‘When [Hermann] arrived, there was a big crowd outside the clinic. Many were not sick; they had come to see Hermann. They said they had heard that here is a doctor who has come to inject AIDS into people. They came to see what he looks like. When he came out, they all stared at him, but no one said anything.’ . . . . During his early days in Lusikisiki, he had on two occasions arrived to packed clinic waiting rooms; some of the people assembled there had not come to be tested but to ask him to explain what was in his needle. He had had to stand in front of his audience and convince them that he had not come there to kill them (147-148).

Ultimately, Hermann won the trust of many of Lusikisiki’s residents by treating patients with ARVS, which rapidly put life back into those whose immune systems were shutting down, and by offering scientific explanations for what was happening in the bodies of his patients in an attempt to override any association of the onset of illness with the needle that pierced the skin to draw blood. Hermann also allowed his own blood to be drawn publicly, in order to dispel fear (156).

The fears in the community about which Steinberg writes are fears to which I, too, have been witness in my work in relation to HIV/AIDS—both in Minneapolis, and in South Africa. In 2008, I attended a service-learning conference sponsored by the National Youth Leadership Council in Minneapolis. A luncheon discussion featured the work of Dr. James Hildreth, the Director of Meharry Medical College Center for AIDS Health Disparities Research and Professor in the Department of Internal Medicine, who was sharing advances in scientific understanding of how the virus was transmitted, and of how it might be stopped pharmacologically. I sat at a table where the pre-lecture discussion ultimately turned to the origin of HIV/AIDS, and several attendees at my table disclosed how they very much believed HIV was concocted in a laboratory in the bowels of the CIA. When asked about this during the Q&A after his talk, Dr. Hildreth, having credibility in the African American community, said in no uncertain terms that HIV predates the technology that would have been required to develop such a virus as HIV—and that this is indeed a vicious rumor that must be stopped for the health of the disproportionately high number of people in the African American community now testing positive for the virus. It is a rumor that persists, nonetheless, both in America and in Africa. This became evident to me again in 2009. While facilitating a refresher course in systematic theology for pastors working in the townships outside of Cape Town, South Africa, we welcomed a guest from the ministry of health. She quite openly admitted that she believed that “white men” had devised HIV in order to bring harm to Africans.

Although it is easy to dismiss the persistence of the rumors about HIV coming with malicious intent from the laboratories of Western science as superstitious and ignorant, it is important to acknowledge episodes in history that contribute to the perpetuation of such “dis-ease.” In South Africa, such episodes are not in the historical annals that students study as some remote lesson from the past, illustrated by pictures of murky liquids percolating in glass flasks and printed on glossy textbook pages in sepia tone, but rather these are stories that occupy the modern-day press. Wouter Basson was on trial in 1999 for allegedly developing biological weapons, including pathogens, for the apartheid government. Although amnesty and an acquittal prevented his arrest, he was also widely believed to have provided lethal toxins to be used against African National Congress (ANC) activists whose resistance the apartheid government so feared. He continues to face legal proceedings for crimes against humanity.

Of course, South Africa is not alone in its history of mistreatment of people with dark skin pigmentation. The Tuskegee syphilis experiment is perhaps the most infamous example in the United States, when researchers, between 1932 and 1972, undertook to study the progression of syphilis in people of African descent. Penicillin had become the standard treatment for syphilis by 1947, but in order to continue their observations, the scientists for the U.S. Public Health Service prevented nearly 400 African American subjects from gaining access to the drug that could have treated their illness. In addition to this notorious example, Harriet Washington has provided many other episodes in her book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. Among them are these:

In 1945, Ebb Cade, an African American trucker being treated for injuries received in an accident in Tennessee, was surreptitiously placed without his consent into a radiation experiment sponsored by the U.S. Atomic Energy Commission. Black Floridians were deliberately exposed to swarms of mosquitoes carrying yellow fever and other diseases in experiments conducted by the Army and the CIA in the early 1950s. Throughout the 1950s and ’60s, black inmates at Philadelphia’s Holmesburg Prison were used as research subjects by a University of Pennsylvania dermatologist testing pharmaceuticals and personal hygiene products; some of these subjects report pain and disfiguration even now. During the 1960s and ’70s, black boys were subjected to sometimes paralyzing neurosurgery by a University of Mississippi researcher who believed brain pathology to be the root of the children’s supposed hyperactive behavior. In the 1990s, African American youths in New York were injected with Fenfluramine—half of the deadly, discontinued weight loss drug Fen-Phen—by Columbia researchers investigating a hypothesis about the genetic origins of violence (Nelson).

In the long and winding path that has been the history of public response to HIV/AIDS, both in South Africa and globally, the world community faces another fork in the road. In one direction, there is death. In his recent presentation to South Africa’s parliament, the health minister spoke of his fear that the population of South Africa would soon begin to decrease as the numbers of deaths in his country threaten to surpass the rate at which South African babies are born (Kgosana). In the other direction, there is life. The situation truly is this stark. The reversal of the trend toward a decreasing population largely attributable to HIV/AIDS depends on a successful campaign to make drugs accessible to the two-thirds of the positive population still going without treatment. The issues that attend access to these life-saving and life-prolonging medications, as this essay has shown, are complicated to be sure, for in this multiply wounded society there are reservoirs of resistance that betray the naïveté of even the most benevolent attempts to provide treatment. According to projections through 2012, the lives of 1.2 million people in South Africa hang in the balance, dependent upon the rate at which the government is able to scale up access to ARV treatment (Walensky, et. al.).

Such a campaign in the direction of life is going to require the unified effort of government, academic, and religious sectors to shift the paradigm in which response to HIV/AIDS is conceived and conducted. This shifting of paradigm is a service to which 30/30 attempts to contribute, such that the direction we take at this critical juncture, rather than in favor of death, celebrates life.

Bibliography

Mistreatment of Vulnerable Persons

In 30/30 HIV/AIDS Structural Drivers, Elderly, HIV/AIDS, Orphans, Public Health, South Africa on August 11, 2010 at 2:15 am

Elders and Orphans

In 1993, the Henan provincial health council in China decided to establish blood collection networks in order to supply blood plasma to biomedical companies, who used it in the manufacture of medicine. More than 200 stations were established throughout the province. However, an unknown number of illegal stations also operated throughout much of the rest of the decade. Peasants were paid the equivalent of $5.00 (U.S.) for 400cc of blood. The Japan Times reported that illegal stations “collected at one time from a number of donors who share[d] the same blood type. Afterward, the blood [was] pooled, the components needed for medical use [were] separated and the remaining blood [was] divided up and re-infused into the original donors. This unsafe procedure expose[d] people to the blood of six to 12 other donors every time they donate[d], facilitating the spread of not only HIV but hepatitis and other serious diseases” (Chan). The practice was banned in 1998, but official action came too late. In villages like Wenlou and Donghu, infection prevalence rates were measured at one time to be as high as 65% and 80% respectively. According to Xie Yan, a woman who tested positive for HIV and who was interviewed by The New York Times in 2002, “‘I try not to think about myself since I know I won’t be cured,’ she said. ‘But at night I can’t sleep—I have nightmares and wild thoughts—worrying about what will happen to the [children]” (Rosenthal).

Xie Yan’s question is one that has haunted leaders in HIV/AIDS response for over a generation. What happens when parents die, leaving behind millions of orphans?

According to The Orphan Foundation, there are more than 143 million orphans in the world today—a number that far surpasses the expectation announced a decade ago that there would be 100 million orphans in the world by 2010. When combined with 20 million children who have been “displaced” in the world, the number of orphaned and displaced children number more than the entire population of Russia. Fewer than 50% of these will live to see their twentieth birthday, and half of those that do will end up working in organized crime or sex work, or will become addicted to drugs. In many countries of the world, orphaned and homeless children are recruited as child soldiers to fight in wars and in militia movements.

It is not an overstatement therefore to say that the impact of HIV/AIDS on children has been profound. In 2004, the United Nations published a volume called The Impact of AIDS. The volume dedicates chapters to the impact of AIDS on demographics, households, firms, agriculture, education, the health sector and economic growth. Taken collectively, the report paints a sobering picture about the impact of a pandemic that has to date directly affected 58 million people, .008% of the world’s current population of 6.8 billion, with ripples that emanate outward, affecting a range of enterprises, from the world’s ability to conduct business to its production of the food supply.

Because the numbers are so large, it is difficult to process the staggering statistics that fill page after page of the booklet. Unlike most of the chapters, however, the article on the impact of AIDS on households is immediately jarring, so basic are its observations. The authors write, “The HIV/AIDS epidemic threatens the social fabric of the most affected countries. . . . The evidence shows that the AIDS epidemic is having severe effects on households” (39). The report goes on to outline “three kinds of economic impacts,” as well as four social implications (39). The economic impacts include loss of income, higher household medical expenditures, and indirect costs related to caregiving:

The first is the loss of the income of the family member, in particular if he or she is the breadwinner. The second impact is the increase in household expenditures to cover the medical costs. The third impact is the indirect cost resulting from the absenteeism of members of the family from work or school to care for the AIDS patient. . . . If a household member dies from the disease, the funeral, mourning and other costs may also add to the burden of the household (39).

There are also four social implications that the book outlines, including “change in household composition, with the gradual disappearance of the parental generation and children being cared for by grandparents and other relatives . . . [or] an increase in one-generation households headed by the older children” (39). In addition, the book outlines how many children withdraw from school as the result of an infection in the household, how many households enter into poverty, and how welfare is correlated to the willingness of the community toward helping households in need (39-40).

All of these implications of high HIV/AIDS prevalence rates are painfully evident today in South Africa, among other places. Grandparents—grandmothers, in particular—are caring for their grandchildren, even in the midst of mourning over the loss of their own children. Participants 19, 20, and 21 in “30 Years / 30 Lives” all share stories of children acquiring an infection, leaving grandchildren behind for them to look after. Others, like “Participant 04” in “30 Years / 30 Lives” who opened her shack to twelve children not biologically her own, are stepping up to care for children without family to look after them. She recognized an enormous need in her community, and she refused to turn away.

The UN document on The Impact of AIDS on households goes on to discuss this impact of AIDS on older persons. “Recent survey data . . . confirm that orphaned children are more likely to reside with grandparents than with other relatives or non-relatives” (45):

[O]ne effect of the disease is to change the structure and composition of households. In many affected regions in developing countries, more and more older persons are taking care of AIDS orphans. Older parents may also provide end-stage care to their adult children afflicted with AIDS. A study conducted in Zimbabwe showed that older caregivers were under serious financial, physical, and emotional stress owing to their care-giving responsibilities. . . . The AIDS epidemic not only puts more stress on older persons, but it also impoverishes them at the very same time they themselves may need to be taken care of. . . . [S]urvey data confirm that substantial proportions of the older population of many countries are living in skipped-generation households and that such households tend to score lower than average on an index measuring quality of housing and household amenities (45).

The three stories that participants in “30 Years / 30 Lives” shared with me upon meeting them at Ikamva Labantu, an organization providing integrated care for seniors and orphans, confirm these findings. On a tear-filled morning in Cape Town, I sat down with all three. One by one, they wrote their stories into the journal, reading their own entry aloud to us at the table when they were finished. We wept for the daughters they had lost and for whom they were providing care—and they spoke of caring for the little ones their daughters left behind.

But the stories grow more complex even still.

In 2006, I visited with a director of a senior center in one of the townships outside of Cape Town. When I asked her about the impact of AIDS in her community, she explained how senior citizens, in the post-apartheid situation, often live off of a governmental pension check equivalent to about $100/month. She spoke especially poignantly about how many young adults in their late teens and twenties, experiencing hopelessness from grinding poverty, inadequate education, and joblessness, are becoming addicted to drugs. And then she spoke about how these two disparate observations about seniors and their pension checks and young adults and their drug addictions are connected. One of her seniors, she told us, leaning in and speaking softly, had been locked into the public toilet facility in her community. After she stole her mother’s monthly pension check, the drug-addicted daughter used the money to buy drugs.

Jonny Steinberg, in his book Sizwe’s Test, recounts a similar story. Sizwe, the young man from the Eastern Cape Province in South Africa who Steinberg shadows for a period of eighteen months, approaches an elderly woman on a late Sunday afternoon. The woman is negotiating with a taxi driver to take her out of the village of Ithanga, and Sizwe bids her farewell, insisting she come back often.

‘Who is the old woman,’ [Steinberg] ask[s].

‘She is a customer of mine,’ [Sizwe answers]. ‘She has been coming to drink since the day I opened.’

‘Why is she leaving?’

‘Because of the gangsters. She has been robbed twice.’

He points to a hilltop on our right. It is among the highest in the village and is particularly steep. A solitary round hut sits incongruously near the summit. It appears as if its inhabitants might open their front door, step outside, and roll down the hill.

‘That is her home. It is very isolated at night. Twice, on the night after pension day, very late, maybe one in the morning, they have knocked on her door, and when she opened they pointed a gun at her. After the second time, she said enough is enough. She has gone to live with relatives. . . .’

To be sure, the HIV/AIDS pandemic has focused the spotlight on complexities of social safety nets. Monthly pension checks, intended to provide food and shelter for the elderly, do not necessarily secure the future, but endanger it. Access to antiretroviral therapy, intended to prolong lives so as to limit the number of vulnerable children left without parents, is threatened by constriction of the global economy, drying up the financial wells from which the treatments have been funded. When access to the drugs that enabled a Lazarus-effect that encouraged more and more to be tested and to be enrolled for treatment is reversed, more and more lives will be lost. Children will again be made vulnerable. Seniors will be expected to care for them. And not everyone throughout the world was able to afford access in the first place.

“Perplexity is the beginning of knowledge.” —Kahlil Gibran

“To know and not to do is not to know.” —Ancient Proverb

Political Violence

In 30/30 HIV/AIDS Structural Drivers, HIV/AIDS, Political Violence, Public Health, South Africa on August 11, 2010 at 2:00 am

Please check back for a posting about how the political violence of South Africa’s apartheid, and Mexico’s oppression of the indigenous communities, contribute to the continuing spread of HIV/AIDS.

Poverty and Hunger

In 30/30 HIV/AIDS Structural Drivers, HIV/AIDS, Poverty, Public Health, United States on August 11, 2010 at 1:45 am

Interruptive 96%

If epidemiologists are correct, 33 million people throughout the world are living with an HIV/AIDS infection today. 96% of these live in the “developing” world. This is a stunning statistic. 96% is a number that ought to interrupt those of us with financial means to question how it is that the vast majority of those contracting this disease are living in conditions of poverty. 96% means that about 31,680,000 people are living in places with challenged economic, educational, and health care systems. In other words, presumably only about 4% have some (even if modest) access to decent care, while the rest presumably do not—at least, not without governmental assistance. Another 25 million people have already died from the virus’s devastating impact on the body’s immune system. Why has this virus traveled to the poorest parts of the world?

The statistics are shallow. Like all statistics, they conceal as much as, if not more than, they reveal. Behind each of these numbers is a man, a woman, a child, a daughter, a son, a mother, a father, a spouse, a partner, a friend. Each one has a name, a heritage, a history. Each one has a story.

But their stories often go without attention, or are left entirely untold, supplanted by an overpowering narrative that edits their own. The dominant story line unfolds to express the view that HIV/AIDS is about individual behaviors. These behaviors, mainly drug use, promiscuous sex, and homosexual relations, mean that the infection (so goes the narrative) is in some way merited, the logical consequence of a foolish choice. The madness of this kind of reasoning needs to be interrupted.

No one deserves HIV/AIDS.

They are called “voiceless.” But people living with HIV/AIDS have voices. It is just that louder, more powerful ones have drowned them out, rendering them silent. These are the voices that shush neighbors in clinic waiting rooms when frightened patients whisper news of an infection, stigmatizing those testing positive. These voices shame those testing positive for having acquired the virus. These voices attempt to justify turning away to other, more “worthy” recipients of dollars.

But the narrative is more involved than we’ve been led to believe, its characters more complex, its plot not so linear. Certainly, individual behaviors play a part in the plot line. But when 96% of those living with the virus are concentrated in the poorest regions of the world, it is insufficient to point only to the individual, and to call for a higher morality. Reducing the rates of HIV/AIDS in the world is also going to require moral accountability in the so called “developed” world that gives shape to world economies. Reducing the numbers of people infected with and affected by HIV/AIDS is going to require dedication to the task of making resources accessible to all, rather than to the advantage of some and to the distinct disadvantage of the rest.

This revised narrative is evident, for example, in a story about a young woman in Thailand by the name of Lek, told by filmmaker Rory Kennedy in her documentary Pandemic: Facing AIDS. When she was raped as a young girl, Lek left her family’s rice farm in order to prevent shame from falling on her father’s name. She later married, but was abandoned after she had given birth to a son. She sent her baby to her parents so that she could go into the city to try to earn a living wage to assist her parents in supporting him. Without an education, her options were limited. She tried tending bar, and ultimately sold sex for money. By the time she was in her mid-twenties, she had contracted HIV/AIDS. Medicines were out of reach financially. The film documents the wasting away of her body, and the agony of her final days without medications even to alleviate the pain.

Paul Farmer, a medical anthropologist who teaches half of the year at Harvard and spends the other half practicing medicine in Haiti, all the while writing books and leading Partners in Health, indicates that this kind of story is more common than most of privilege dare to imagine. People become desperate when resources become more and more scarce, and resources are becoming increasingly scarce in many places throughout the world. Men feel forced to travel hundreds of miles away from home in order to work for months on end. Relatively few, it seems, return home having had no other encounters with women. In some communities in stories that Farmer tells, fathers who accrue high debts are stalked by dealers in the sex trade. Some sell their daughters to pay off debtors, or to feed the younger ones. Women coming of age know the way to financial security in the world is to marry, so they look for available men, not all of whom have been chaste. Uneducated women, also desperate to earn money to buy food to stave off hunger for themselves and for their children, often are vulnerable to human trafficking, or resort to trading sex for money.

In many ways, Farmer confirms, Lek is like the majority of people today contracting HIV/AIDS—people whose choices in life are measured by the degrees of jeopardy they carry according to their social location in relation to gender, ethnic background, economic class, age, orientation, accessibility of healthcare, accessibility of education, immigration status, and so on. However, when people have hope that they will find gainful employment that honors them as human beings, fewer become addicted to drugs. When people have access to an education that promises a place in the work force, fewer are made vulnerable to an infection by traveling hundreds of miles from home, or by trading sex for money. When people form cultures that do not tolerate human trafficking, rates of HIV/AIDS infection drop.

Such stories are often hard to hear. They involve violence far too often, and hopelessness some of the time. In encountering them, a seething but righteous anger begins to boil against the circumstances, not at all accidental, that have led us to the interruptive 96%.

Nevertheless, we must listen to these stories. We must hear them. Because in these stories is the potential to reverse the trajectory of one narrative, and the empowerment of another. In them is the possibility for a new story to unfold,  where fewer and fewer are made vulnerable, because more and more recognize the wisdom of “ubuntu,” that where one is diminished, all are diminished; where one is nurtured, all are nurtured.

“30 Years / 30 Lives” offers another opportunity to listen to stories that otherwise might go unheard—including the voices of those affiliated with Open Arms of Minnesota.

Bibliography

Religious Fundamentalism

In 30/30 HIV/AIDS Structural Drivers, HIV/AIDS, Public Health, Religious Fundamentalism, Shame, South Africa, Stigma on August 11, 2010 at 1:30 am

Deconstructing the Architecture of Shame

South African journalist Jonny Steinberg has been acclaimed for his book Sizwe’s Test: A Young Man’s Journey Through Africa’s AIDS Epidemic, not least of which for insights he provides into the “architecture of shame” that frequently accompanies an HIV/AIDS infection. In order to understand the limits of efforts to make ARVs accessible widely in the country of Steinberg’s birth, over a period of eighteen months Steinberg accompanied Sizwe, a young adult man in his twenties who lives in the Eastern Cape Province of South Africa. Steinberg is curious about why so many South Africans, like Sizwe, refuse to be tested for HIV. In the process of writing the book, Steinberg discloses how the pandemic brought into sharper relief in his own mind a parallel that existed between his privileged white South African upbringing and Sizwe’s own marginalized upbringing within a rural village in the same country. Both men faced the culture’s stigma in relation to HIV/AIDS. After considering the ramifications a positive diagnosis would have on Sizwe’s livelihood even beyond the infection, and after listening to Sizwe’s rationales for so opting, Steinberg dug deeper into his own experience for a framework in which to make sense of Sizwe’s decision. By sharing indiscretions of receptionists and of medical personnel who failed to protect Steinberg’s privacy and who then passed him off to another clinic under the guise of concern, Steinberg constructed in his book what he calls the “architecture of shame,” and the scrutiny under which those who agree to be tested live, regardless of the outcome of the test. Shame is internally present, stigma its external driver. Knowledge of shame is what he shared with Sizwe, along with its accompanying and requisite fear of social ostracization.

At [shame’s] root lie myriad watching, judging eyes that look at one and see a disgusting and gluttonous figure. They are the eyes of others, but one has internalized them. They are strangers’ eyes whose watchfulness is nonetheless experienced in secret on the inside. When one stands in a crowded room and a person shouts ‘HIV,’ the very name and embodiment of one’s shame, the secret opprobrium expressed by the strangers inside heads for the real strangers on the outside like electrons in a force field. You are suddenly struck with the sickening feeling that the contemptuous eyes have always been on the outside; that is their natural home (Steinberg, 293).

In a conversation with Edwin Cameron, a judge in South Africa’s Supreme Court of Appeal, among the first public officials to disclose his status and to advocate for nation-wide accessibility of pharmaceutical treatment, Steinberg records the judge’s reflections in relation to self-contempt and, as such, to shame. “‘I knew my status for eleven years before I started treatment,’ [Cameron] said. ‘During that time, I did not realize that this virus inside me represented an enormous contamination, a sense of self-rejection. I only began to understand these things when I realized that the drugs were working. Once the viral activity had been stopped in my body, I stopped feeling contaminated. . . . There’s a liberation from a sense of self-disentitlement which successful treatment brings’” (Steinberg, 181-182). The tragedy of this statement is that, by shadowing Sizwe for all of those months, Steinberg was studying the limits of the reach of ARVs on a population that, for many reasons, continues to resist white “men” and their needles.

Steinberg and Cameron’s reflections provide three-dimensionality to the concept of stigma, shame’s more public companion. Ervin Goffman, a Canadian sociologist, defined stigma as the process by which the reaction of others spoils normal identity (Erving Goffman, Stigma: Notes on the Management of Spoiled Identity [Prentice-Hall, 1963]). By definition, stigma is “a mark of disgrace associated with a particular circumstance, quality, or person.” Scholars differentiate individual stigma from social stigma, the latter of which is “severe disapproval of personal characteristics or beliefs that are perceived to be against cultural norms.” According to AVERT.com, “AIDS-related stigma and discrimination refers to prejudice, negative attitudes, abuse and maltreatment directed at people living with HIV and AIDS. [This] can result in being shunned by family, peers and the wider community; poor treatment in healthcare and education settings; an erosion of rights; psychological damage; and can negatively affect the success of testing and treatment.” (See the article in full for an excellent overview of the stigma associated with an HIV/AIDS infection athttp://www.avert.org/aidsstigma.htm.)

Although different contexts will express the phenomenon differently, stigma has trailed the virus everywhere it has spread. The nuances in which it is expressed in a culture like ours in Minnesota, at a Catholic University where I teach courses in Christian doctrine, are instructive, for these stigmatizing forces are prevalent even in a climate where it is most uncomely to speak of them. They come to the surface, however, when I require students to participate in service projects related to HIV and AIDS. In doctrine classes, for example, students are required to work several shifts at Open Arms of Minnesota, an organization in the Twin Cities that prepares meals for and delivers meals to people living with HIV/AIDS, ALS, MS, and breast cancer. For some of my students, perhaps a quarter, the reluctance to engage is both rigid and immediate. Even once orientation to the project is complete, when fears about contracting the virus by paper cuts or whatever other ridiculous stories they’ve heard are dispelled, many of my students would prefer to engage in projects for other, it is revealed in class, more “worthy” recipients.

When we discuss this reaction, I ask, “In your mind, what makes people living with HIV/AIDS unworthy of the kind of care and concern we could offer by, say, delivering a meal through the work of Open Arms of Minnesota?” For these students, it always comes down to a judgment about very private behaviors they consider sinful—and which this virus makes public. These perceptions are the very root of the shame and stigma associated with HIV/AIDS and, as such, it is vitally important to investigate them, in order to overcome them. And so something like the following conversation ensues every semester. It is a compilation of numerous exchanges with students across years of teaching and, while the majority of students do not express verbally the attitude of the student depicted below, one cannot help but to sense that those who do speak up represent a fair number of students whose desire to be politically correct prevents them from uttering aloud similar thoughts.

“So,” I begin, “let me see if I am understanding this correctly. Firstly, you are making assumptions that the people to whom you are serving meals are HIV-positive when Open Arms delivers meals also to people who are living with breast cancer, ALS, and MS. Secondly, you are making assumptions about how the people acquired the virus, but regardless it automatically falls into the category of ‘sin.’ Thirdly, you are imposing your own religious views onto the person even though you don’t know if they share your view as their own and, moreover, you are making assumptions that the supposed sin has not been absolved. And, lastly, you are judging that person therefore to be unworthy of your own very valuable service hours. Am I tracking this correctly?”

“Well, basically—yes.”

“And if the people to whom we deliver meals have indeed committed an act that the church considers to be sinful—let’s say they’ve had intercourse outside of marriage—what if they have confessed their sins to a priest and have received absolution?” I go on: “They have received God’s forgiveness, but not yours? Does the recipient of care need to ask for your forgiveness, as well? And what about the person that delivers on Thursday? Shall they seek that care provider’s forgiveness, too? Do you expect them to confess to everyone who comes to the door?”

“I guess not. I never thought about it from their perspective before.”

“My suspicion, though, is that the mere idea of having sexual intercourse outside of marriage doesn’t offend you nearly as much when a sexually transmitted disease isn’t part of the equation.”

“I’m not sure what you mean.”

“The rumor in the quad is that lots of your classmates go to parties on the weekends. More than just a few are probably not going to their bedrooms alone afterwards. Do you shun them in the cafeteria?”

“I’m not the partying type, myself. I don’t shun them. I just hang out with a different crowd.”

“Fair enough.” Stopping for a minute to think about how to redirect the line of argument without losing the point, I say, “But what if one of your classmates were to get sick?”

“What are you asking?”

“If your dorm organized a food service, would you deliver him or her a meal?”

“Sure. Why not?”

“That’s all I’m asking you to do for the clients of Open Arms.”

“That was tricky,” my student says, defensively. “But my classmates aren’t like the people that Open Arms serves.”

“Now you’ve lost me,” I reply. “What do you mean they aren’t like the people that Open Arms serves?”

“C’mon Dr. Vrudny. You know what I mean.”

“I’m afraid I really don’t.”

“Most people who have AIDS in Minnesota are gay.”

“That is statistically true. What is your point?”

“That is my point.”

“Should we not deliver meals to people who are gay?”

My student was silent.

“Because that is what we’re doing. We’re contributing to the vision of Open Arms. They believe that no one who is sick ought to go hungry. Kevin Winge, the executive director of Open Arms always says: ‘It’s about food.’”

My student says nothing.

“Let me ask you this: Did you know that in Minnesota, epidemiologists are watching with great concern the numbers of people in between the ages of 16 and 24 who are becoming infected, because there is a disproportionately high number of new infections in young people, both homosexual and heterosexual?”

“I heard that during the orientation, but I’d forgotten.”

“And did you know that worldwide more than half of people living with HIV/AIDS are women?”

“No. I thought they were mostly gay men.”

“And do you know that many infants and children are living with HIV today, as a result of something they call ‘vertical transmission,’ or mother-to-child transmission?”

“Yes, I know about that. But I thought that was a small number.”

“Worldwide, more than 2 million children are living with HIV/AIDS today. That’s not exactly a small number.”

“Right. It isn’t.”

“There are also about 140 million orphans today, largely due to HIV/AIDS.”

“I can’t even get my head around that number.”

“I know. It is a particularly staggering statistic. That one keeps me up at night.”

“Hmmm,” my student acknowledges, nodding slowly.

“Do you know that many wives who have been loyal to their husbands are infected by the double standards in many cultures that tolerate married men having more than one sexual partner, but not married women?”

My student nods.

“And in places more numerous than I care to number, many people are poor and hungry. They are desperate for money. Women and children are often sold by families, often unaware, into human trafficking rings, or many women sell their bodies for money.”

“That can’t be too many.”

“I wish you were right. But I’m afraid you’re really in error . . . .” My mind trails off to memories of visiting a group of young children in a township in South Africa. The oldest was probably eleven. They told me they wanted to be engineers and doctors when they grew up. Then we drove up the road maybe a half-mile, and got out of the car to talk with a group of young women who were playing net ball. They were all sixteen to eighteen years of age. We asked them how HIV was affecting their community. They told us that they were playing net ball to build skills in sports. They thought maybe if they could make it athletically, they wouldn’t have to sell their bodies in order to survive. I emerge from the township again when I hear my student assert, “Still, if people would be responsible for themselves, infection rates would go down.”

“Yes, yes,” I say, holding my forehead for a minute. “And certainly no one is suggesting that we cease efforts to get information out there about how dangerous it is to have more than one sexual partner. But may I ask you a question?”

“I suppose.”

“Have you ever thought about what your responsibility is in relation to the pandemic? I mean, you’re talking a lot about responsibility. But the responsibility about which you speak seems to be ‘theirs.’ So I’m asking: what is yours?”

“What do you mean? I’m only twenty. I’ve not been infected, and I won’t infect anyone else. I’m a very responsible person.”

“Right, right,” I say, gathering my thoughts. “But I didn’t mean only your responsibility in sexual encounters. What I mean is: what is our collective responsibility as human beings toward people who have been impacted by this public health crisis of the modern day?”

“It isn’t my fault that so many people are getting sick.”

“I’m not suggesting it is your fault. Rather, I’m asking: what is our responsibility in the face of this illness?”

“I didn’t think I had any responsibility at all in relation to a pandemic impacting people half way around the world.”

“As well as here,” I quickly interject. Thinking it is time to share some of my own thinking about responsibility, I say, “I see the world as greatly interconnected. One country’s economy affects another’s. Some are winners in that contest. But the costs are high for the losers.”

“So? What’s your point?”

“So, as a human being, and as a Christian human being, I want to contribute to the creation of a world where the interconnectedness of humanity is honored, where we recognize that if one person goes hungry, we all are deprived.”

“I don’t get it. I’m rarely hungry.”

“How does that make you feel—that you rarely go hungry in a world filled with hunger?”

“Happy that I live here and not there. Grateful for my life. Blessed, even.”

Ignoring the projection of hunger to “over there,” when I know that there is too much hunger here, as well, I say, “‘Blessed’ is a theological word.”

“Yes. I am a Christian.”

“I see.”

“Catholic even.”

“Lovely. . . . So, when you say you are ‘blessed,’ does that mean that God does not bless, say, those who go hungry? So hungry that they are desperate for money? So desperate for money that they sell their body for money in order to buy food and contract HIV as a result? Are they forsaken by God, whereas you are blessed?”

“I never thought about it that way before.”

“I know. I know. It’s okay. I’m just trying to get us to think about all of this in relation to God. It is a theology class, after all.”

“Very clever.”

Pressing on, I say, “So what do you think God wants of us in this situation? To just shrug our shoulders, and to say: ‘too bad.’”

“I suppose not,” my student said, quietly. But I could see there was more. When pressed, my student relents in a whisper, “But my priest has said AIDS is a punishment from God.”

“Do you agree with him?”

“I’m not sure. I try not to think about it.”

“The idea that AIDS is a punishment from God is a fairly easy one to dismiss, you know,” I offer.

“Really?”

“Yes, really. We are taught to think of God as a Father, right?”

“Right.”

“Well, if your earthly Father intentionally exposed you to a virus in order to punish you for whatever you’d done wrong and it killed you, he would be tried for murder.”

“I follow you.”

“So, we arrest a human Father for murder for this kind of behavior, but we worship and praise God for the same behavior on a massive scale?”

“But he’s God.”

“Yes?”

“Nevermind.”

After stopping for a moment to let the previous analogy soak in, I continue. “The other side of the argument that often comes is that God sends HIV/AIDS in order to test us—to see if we’ll respond compassionately.”

“I’ve heard that, too.”

“Again, to use a parenting analogy: Let’s say that I have two kids. And let’s say that I shoot the first one to see if the second one will respond compassionately.”

“I see where you’re heading. You’re going to be carted off to jail, again.”

“Exactly.”

“I understand. But I still don’t know why God sends HIV/AIDS.”

“Are we sure that God sends HIV/AIDS into the world? Maybe it is just a natural thing—like a fungus that kills a beautiful tree, only this virus happens to kill humans?”

I was happy that my student was still hanging in there, and still listening. But it was time to bring it around to my main point, so I say, “Let me ask you something your generation seems to be asking yourselves quite often these days: What would Jesus do?”

“How am I supposed to know?”

“Fair enough. But what do you know about him?”

“He died on the cross to save us from our sins.”

“That’s a good start, and we’ll definitely be talking about all of that in due course. But I mean—what do you know about how he spent his time? What do you know about what he taught?”

“He called twelve disciples. And he went from place to place healing people. He taught people about how to inherit eternal life. And then he was crucified.”

“I see. And what did he say—I mean, when he taught about how to inherit eternal life? How do you inherit eternal life?”

“I dunno. I can’t remember.”

This time, I was silent.

Finally, my student answers, “You believe in him, maybe?”

“He talks about this rather directly. According to the Gospel of Matthew, in a rather forthright account providing a string of information about the kingdom of God, he talks about those who inherit eternal life. May I read it to you?”

“Is that a rhetorical question?”

Picking up my Bible, I read from the 25th chapter of Matthew, beginning with verse 34: “Then the king will say to those at his right hand, ‘Come, you that are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me.’ Then the righteous will answer him, ‘Lord, when was it that we saw you hungry and gave you food, or thirsty and gave you something to drink? And when was it that we saw you a stranger and welcomed you, or naked and gave you clothing? And when was it that we saw you sick or in prison and visited you?’ And the king will answer them, ‘Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me.’ He goes on to say that those who serve people in this way are welcomed into eternal life.”

“Are you trying to frighten me?”

“No, not at all. We are going to spend a great deal of time in class talking about the grace that makes it possible for us to feed the hungry, give drink to those who thirst, welcome the stranger, provide clothing to the poor, and care for the sick. In time, knowledge of grace should eliminate your fear. For now, I’m trying to get us to look at what God might expect of us according to a Christian understanding. . . . Does it make you think that maybe we have a responsibility in relation to the pandemic?”

“I’m beginning to understand what you’re saying.”

I smile. “May I say just one more thing about this?”

“If you must.”

“In my reading of Bible, Jesus doesn’t seem to think that anyone is unworthy of his time or attention. He reached out to all of the people who were excluded in his culture. All of the ‘untouchables’? He touched them. Lepers, menstruating women, Samaritans. He touched them all—even on the Sabbath, apparently. He befriended tax collectors and prostitutes, alike. The widows and orphans who had no one to care for them—he cared for them. So, if we were to take the question, ‘What would Jesus do?’ seriously, how might we respond?”

“I guess we should try to figure out who the untouchables are in our culture, and try to do likewise?”

“That is a really beautiful idea. Who are the untouchables in our culture? Who are the ones cast aside by our social systems?”

“Well, let me think for a minute. The homeless, maybe? Prostitutes, still? There are immigrants in my hometown. I’ve heard some pretty unkind things said about them. So they seem to be cast aside. And the uninsured, too.”

“That’s a great start. Anyone else?”

“Yes. I know where you are heading. You are wanting me to say: People living with HIV/AIDS. I suppose they’re like the lepers of Jesus’ day.”

“It’s been said.” Not exactly comfortable with the analogy given the cruelty of humans to those they perceive to be different, nevertheless I press on. “So. What am I saying? What is our responsibility in relation to the pandemic?”

“You’re saying that if I care for someone who has HIV/AIDS, I’m caring for Christ. And it is what God desires for me to do in this situation.”

“And what do you think about that?”

“It’s hard.”

“Is it? Lots of my students, by the end, talk about how ridiculously simple it was—to give an hour or two a week to pick up a cooler packed with food, and to get it to people who are not feeling well, but who need nutritious food to feel better.”

“Really?”

“Yes. Really. And you know what I hope?”

“What?”

“I hope that, one day, you might look back and think how meaningful it was—this experience, doing something that seemed so off-putting at first, doing something as simple as handing a person a bag of food across a threshold. Someday, perhaps years from now, you’ll hear something said about someone who is gay, or someone who has contracted HIV/AIDS, and maybe you’ll stomach will turn a little bit because you don’t like to hear such derogatory talk. I hope that this simple kindness you are offering this semester ignites a love in you that becomes your source of greatest joy.”

“That might be aiming kind of high.”

“I tend to do that.”

“I don’t get it,” my student persists.

“For now, that’s okay. You don’t need to get it. I just wanted us to have a straightforward conversation to get to the root of what troubled you about the assignment and in order to discuss what, in my mind, HIV/AIDS has to do with theology.”

“Quite a lot, as it turns out.”

“Yes,” I nodded, smiling. “Quite a lot. And we’ve only scratched the surface.”

Sighing, my student looks into the distance.

“Listen,” I say, pausing. “Give it a chance. Deliver a shift of meals at Open Arms of Minnesota, and we’ll talk again. And I promise: all of this will make more sense as we study theology this semester.”

“Do I have any choice?”

“Yes, of course you do. You can drop the course. There are lots of other sections in which you can enroll, even yet this semester.”

Thinking for another few seconds, I hear, “Okay. I’ll give it a shot.”

“Lovely! In the end, you may not agree with me. And that’s okay, too. But who knows?,” I suggest gently. “Maybe you’ll discover the face of God along the way.”

+  -  +  -  +  -  +

This imaginary yet all too realistic dialogue with a student demonstrates how deeply entrenched attitudes are about HIV/AIDS in our culture in Minnesota, if not nationwide, even still. Teenagers coming to college are under the impression that AIDS is only present among gay men and, given its presence in a population that engages in sexual activity the students consider to be offensive to God, they legitimize an unresponsive posture. Their immediate condemnation and judgment in relation to it all is the root cause of the shame and stigma that heap insult upon insult for someone living with the virus. There is something that we can do about these attitudes by analyzing them, addressing them, and working to eliminate them. In this case, we are able to do so within the context of a course in Christian theology, the very source of so much of the judgmental stance.

The service-learning project is intended to bring this kind of conversation into the open in the classroom, where we can reject ideas that marginalize, hoping ultimately to transform students’ lives into something more beautiful, even more Christ-like, by semester’s end. When we talk about human nature, which we call theological anthropology in systematic theology, students wrestle with prejudicial thoughts they may have had in relation to HIV/AIDS, thoughts that would otherwise remain unreflected upon if it were not for our engagement in the issue in the community through service learning. Students are forced to weigh that realization—that they themselves have had prejudicial thoughts—against their widely held belief in the essential goodness of humankind. And when we bring this recognition into conversation with the person and work of Jesus Christ, and contrast our own judgmental instincts with Christ’s wide embrace of humanity, we are able to talk about sin and redemption in a way that seems more relevant than it did before we engaged in service learning of this kind. And lastly, when we study the nature and mission of the Holy Spirit, we are able to get more deeply into the issue of altruism, and whether goodness is, indeed, naturally occurring or whether, just maybe, it is made possible by the gift of divine grace.

The issue of HIV/AIDS grounds our discussions in the real world and in the challenges that confront us, today, as a global community. The entire exercise points us to the vitally important issue of education in relation to HIV/AIDS—not only in terms of getting information into the public arena about what HIV/AIDS is and how it is transferred, and not only in terms of the ABCs of AIDS prevention, but also in terms of how we can shift the conversation about HIV/AIDS, especially within the churches, into a more constructive, even life affirming, pattern.

If our goal is the creation of a more just, a more forgiving, and a more beautiful global society, then this is our calling.

Bibliography

Trafficking

In 30/30 HIV/AIDS Structural Drivers, HIV/AIDS, Trafficking on August 11, 2010 at 1:15 am

The fastest growing criminal industry in the world today is the illegal sale and circulation of drugs, which is estimated to generate more than $320 billion annually. Two similar industries vie for the second position in terms of fastest growing criminal industries worldwide: the illegal sale of weapons (gunrunning), and the trafficking of humans (the modern-day slave trade). All three are contributing in their unique ways to the HIV/AIDS pandemic. The first, the trafficking of drugs, supplies the demand for illegal drugs that are injected into the bloodstream, often through shared needles contaminated by the virus. The second, gunrunning, arms and empowers people whose intentions are rarely for the common good, very often forcing the mass migration of people as cartels, militias and armed soldiers, sometimes children, destabilize societies and overthrow sometimes legitimate governments. In situations of social unrest, rape and survival sex are common, exposing people to sexually transmitted diseases. The third, the modern-day slave trade, exploits human beings for their labor in garment factories, agricultural fields, and sex brothels. Given these realities, any attempt to understand the structural drivers of the HIV/AIDS pandemic must take into account the unlawful trafficking of drugs, weapons, and humans, for all three are contributing to the spread of the virus in the human population.

Because the sale of drugs, weapons, and humans is lucrative, these industries are growing rapidly. Though public awareness about their activities is growing, prosecution of traffickers is difficult. Victims are often too fearful to further endanger their lives by testifying against individuals who abused them or who are involved with much larger networks against which there is little protection. And, too often, law enforcement is corrupted. Officials are paid with financial bribes or sexual services not to make arrests when drug dealers, weapons traders, and human traffickers are identified. The more information the public has about trafficking, however, the easier it is to identify illegal activities that are often occurring quite openly, and the harder it becomes for those who are the masterminds behind the trafficking of drugs, weapons, and humans to line their pockets by the sale of cocaine, guns, and slaves.


Drug Trafficking

The headlines are rarely front-page news in the United States, but they’re posted nevertheless: “Drug war death toll in Mexico since 2006 exceeds 28000, official says” (August 3, 2010; cnn); “UN: Drugs linked to Kenya’s Alarming HIV spread” (December 14, 2009; Nation); “Re-organized crime: Shifting battle lines bring violence to new parts of Mexico” (June 3, 2010; The Economist). Because the first and last of these deals with death on the far side of the Rio Grande, and the central one deals with a set of problems on a continent apparently rife with them, most Americans are simply not paying attention.

Nevertheless, Charles Bowden, an award-winning non-fiction author, journalist, and essayist, has covered the drug violence between Mexico and the United States for the last decade. In his most recent book, Murder City: Ciudad Juárez and the Global Economy’s New Killing Fields (Nation Books, 2010), Bowden attempts to track the causes of the disintegration of Mexican society, pointing specifically to failed international policies around trade. He is especially critical of the United States, and its role in the unfolding bloodbath along the border (interactive map 1; interactive map 2; interactive map 3). He writes of the illicit trade in drugs within this larger context, pointing to illegal immigration into the United States as the natural consequence of policies that drive the working poor of Mexico northward, from their families, from their land, and from previous means of income.

The migration of the Mexican poor is the largest human movement across a border on the planet. It was triggered by the destruction of peasant agriculture at the hands of the North American Free Trade Agreement, by the corruption of the Mexican state, by the growing violence in Mexico, and exacerbated by the millions of Mexicans working illegally in the U.S. who send money home to finance their families’ trips north. It should be seen as a natural shift of a species (Bowden, March 1, 2010, hcn.org).

For much of the last two decades, Bowden’s work has been focused on the disintegration of Ciudad Juárez. In his recent novel, Dreamland (University of Texas, 2010), Bowden poetically yet convincingly describes the deterioration of this Mexican city just south of El Paso, Texas, from the perspective of an astute fictional observer, who likens the violence in the city itself to a factory production line—the inevitable product of failed policies that favor the market over its minions.

The city thinks of itself as a bustling place with foreign-owned factories where over two hundred thousand people toil. This is a small part of the real work here. The city itself is the factory. It produces the human beings in quantities far greater than the market can absorb. The giant machines cut the babies from templates of mud, then malnourish them so that their minds and bodies never get too large or free-ranging. By age ten, at the latest, they are fed a diet of paint, glue, drugs, and alcohol. Training in guns and prostitution begins around age fourteen, also tattoos are added to the flesh as adornment. Like the foreign-owned factories, the giant plant of the city works three shifts, a ceaseless production line belching out little humans at the loading dock. There is very little quality control, but even so, some of the production is slaughtered for ill manners or for no reason at all. Schooling is limited since the factory managers believe the product is fully equipped once it leaves the plant. Every year, production quotas are raised and more redundant human beings are fabricated and cast out into the streets. / The noise of all this work is so great that no one ever hears it. They do not hear the screams, the gunshots, the knives sliding into flesh. They do not even notice the work. Instead, everyone says the city is about producing various objects for export—car parts, vacuum cleaners, things like that. Of course, such products are tiny compared to the real production line, the one nobody speaks of, the one slamming out human beings, a factory line of drill presses and lathes and huge stamping devices and intricate wiring and instant delivery. No one on the line gets a bathroom break or any other time off from this conveyor belt of flesh. (Bowden, Dreamland, 25).

The “way out of Juarez,” according to Bowden, is the legalization of drugs. Likening it to the battle over prohibition of alcohol in the early twentieth century, Bowden argues that legalizing drugs would do to traffickers what the legalizing of alcohol did to rum-runners and bootleggers when alcohol was legalized in 1933—they rather disappeared. As such, he boldly disagrees with a statement from U.S. Secretary of State Hillary Clinton who spoke of the interrelated nature of drug trafficking and gunrunning. She said upon arrival to Mexico City in March of 2009, using language the New York Times considered “unusually blunt”: “Our insatiable demand for illegal drugs fuels the drug trade. Our inability to prevent weapons from being illegally smuggled across the border to arm these criminals causes the deaths of police officers, soldiers and civilians” (New York Times). Without mincing words, Bowden responded to Clinton’s statement directly, “The official line of the U.S. government, one most recently voiced by Secretary of State Hillary Clinton, is that drug consumers in the United States are responsible for drug murders in Mexico. Only someone who is drugged could believe this claim. The sole source of the enormous amount of money in the drug business and the accompanying violence is the U.S. prohibition of drug use by its citizens” (hcn.org).

Clinton and Bowden voice two very different approaches to the situation: one defends the position that drugs ought to remain illegal and that resources ought to be allocated to prevent their entry into the United States; the other supports the view that drugs ought to be made legal so that the issue rather dissipates, enabling the resources applied to fighting the “war on drugs” to be reallocated to other causes—ones less prone to failure.

The extent of the problem is well known. The Centers for Disease Control and Prevention reported that in one month in 2007, the prevalence rate of illicit drug use among individuals in the United States aged twelve and over was as high as 8% (faststats). This was an increase from 7.1% in 2001 (fact sheet). “Illicit drug use” includes use of marijuana, cocaine, hallucinogens, inhalants, heroin, or nonmedical use of sedatives, tranquilizers, stimulants, or analgesics. A survey conducted in 2001, however, found that 41.7% of the population confessed to using one or more of these substances ever in their lifetimes (fact sheet). The demand for illegal drugs in the United States is undeniably high.

As the debate about how to handle the situation wages on, drugs continue to flow over the border—in ever more clever ways that are killing tens of thousands of people while lining the pockets of people who are ruthless, driven by little else than the power and riches that come with the acquisition of the large quantities of cash flowing in from sales in the U.S. While marijuana is, by far, the most illegally used drug in the United States, it is smoked, not injected. So here the focus will remain on the problem of the drug trade in relation to the HIV/AIDS pandemic, and as such will look at the transfer of drugs that can be injected: cocaine and heroine.

Tracing the movement of cocaine and heroine through Mexico from Colombia and Afghanistan, respectively, into the United States, helps to express the scope of the problem. Colombia, for example, is the world’s major producer of the coca plant, the source from which cocaine is made. It is legal to grow the coca plant in Colombia, but only in small amounts and only for personal use—not for large-scale trade or sale. However, as the producer of three-quarters of the cocaine that is sold worldwide, Colombia produces only a small amount of its coca for legal purposes, including traditional uses by indigenous communities; the rest is sold to traffickers, whose job is to get the powder from South America into the United States, the world’s largest market for cocaine consumption (cia.gov). Approximately 65% of the cocaine entering the United States comes by land through Mexico, at points in Arizona, California, and Texas. The rest comes by sea or by air, predominantly into Florida (map). Some is dropped by air, while some arrives on hard to detect sea vessels. CNN reported in April 2009 that the U.S. Coast Guard “captured six hard-to-detect boats that travel at night and seized 30,000 pounds of pure cocaine,” noting that drug traffickers “have become much more aggressive in their smuggling tactics.” The article references “go-fast boats that travel at night” as well as “new self-propelled semi-submersible vessels” that can be sunk by the trafficker upon detection (cnn.com). Even so, most of the drugs continue to come by land. Authorities have discovered about 100 tunnels along the 1,950 mile border between the United States and Mexico (cnn.com). Moreover, officials have uncovered cocaine in tables, lollipops, toys, candles, tires, furniture, and shoes. There are also so-called “mules,” or humans who carry the drugs on their bodies across the border.

The trafficking of heroine is more complicated. According to a 2004 UN survey, Afghanistan is the producer of 87% of the opium or poppy plant, the organic source from which heroine is made (unodc). While the Taliban banned opium production in 2000 as “un-Islamic,” bringing its production down to only 30 square miles of land by 2001, one year later, after the U.S. and British forces had installed an interim government, farmers returned to the cultivation of opium as their most lucrative crop. By 2002, 285 square miles of land were dedicated to the production of opium, positioning Afghanistan to surpass Burma as the world’s greatest supplier of the plant (orwell). In 2009, the UN reported that opium production fell from 157,000 hectares of land, to 123,000 hectares. At the same time, each plant yielded a greater amount of opium (unodc). From Afghanistan, the opium is smuggled into Pakistan and India, through which it enters the United States (map). “According to a Drug Enforcement Administration report obtained by the Los Angeles Times, Afghanistan’s poppy fields have become the fastest-growing source of heroin in the United States. Its share of the U.S. market doubled from 7 percent in 2001, the year U.S. forces overthrew the Taliban, to 14 percent in 2004, the latest year studied” (paktribune.com). The same article reported that another DEA report said the share could be “significantly higher” than 14 percent, because “not only is more heroin being produced from Afghan poppies coming into the United States, it is also the purest in the world, according to the DEA’s National Drug Intelligence Center” (paktribune.com).

Obviously, the legalization of these substances is unlikely in the current political climate in the United States. Recognizing the crisis that is unfolding south of the border, however, other theoreticians are struggling to identify how to decrease this country’s demand for these illegal substances. One approach has been adopted elsewhere throughout the world, and is based on a philosophy of harm reduction. Harm reduction is a philosophy that attempts to keep drug users safe in their use of injected drugs until they are prepared to address their addiction. Free access to clean needles through needle exchange programs is at the heart of the philosophy (http://www.avert.org/needle-exchange.htm). Bowden, however, continues to advocate for the legalization of drugs and attention to the policies of the United States on the people of Mexico as the single most effective means by which to address the problem.

The planet is being skinned by my kind and this means people leave ancient ground and push out into some void called the future. The Mexican line is simply a detail in this movement and the Mexican war is simply one response, that of government, to a reality that is past denying or changing. Where I sit is the ground from which the lessons have entered my life. I first saw this patch of high-desert grassland and mesquite as a boy and then it was a lonely ground seldom visited and barely noted by mapmakers. Now it is the center of a war room where all kinds of marks on various plans see it as a stream of drugs, blood, and human beings heading north. The little village to the south averages a thousand people a day marching north and remains unknown except to the various forces seeking to control the border. Juárez, to the east, with its noise and slaughter, is simply another glimpse of this same vista, a vista where all can see that the land has failed people due to global trade and destruction of soil and water, a vista where human numbers have exceeded the ability of the earth to sustain them, a vista where criminal activities such as drugs or sex trafficking offer entrepreneurs the chance for success even though they begin with limited capital. / What commentators and politicians call problems are no more than how these facts manifest themselves. There is no drug problem, there is a drug appetite. There is no immigration problem, there is a flight from poverty and a demand for cheap and docile labor. There is no violence problem, there is simply an economic engine running without lubricant and without much hope of lubricant unless you count blood as a possible source, something our ancestors would simply see as a typical unregulated market. And the Mexican war is actual and it is fought by Americans against Mexicans because such a war is preferable to Americans. The only alternative is to recognize the implications of our appetites and policies and no one wishes to do this” (Bowden, Dreamland, 138).


Weapons Trafficking

Despite Bowden’s disagreement with Hillary Clinton’s statement in front of the press, he never disproved a relationship between the illicit drug trade and the trafficking of weapons; instead, he shifted the conversation to one about making it legal to consume cocaine and heroine in the United States. Clinton’s assessment, however, drew a legitimate connection between the violence in Mexico, and the illicit trade in weaponry originating in the United States. According to the findings of a June 2009 report of the U.S. Government Accountability Office:

Available evidence indicates many of the firearms fueling Mexican drug violence originated in the United States, including a growing number of increasingly lethal weapons. While it is impossible to know how many firearms are illegally smuggled into Mexico in a given year, about 87 percent of firearms seized by Mexican authorities and traced in the last 5 years originated in the United States, according to data from Department of Justice’s Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). According to U.S. and Mexican government officials, these firearms have been increasingly more powerful and lethal in recent years. Many of these firearms come from gun shops and gun shows in Southwest border states. U.S. and Mexican government and law enforcement officials stated most firearms are intended to support operations of Mexican DTOs, which are also responsible for trafficking arms to Mexico (gao.gov).

The ready availability of weapons is not only further empowering the drug cartels that are increasingly controlling Mexico. Whereas Mexico’s disintegration and its attending vulnerability to high prevalence rates of HIV/AIDS is attributable in part to the drug trade, and to the social unrest that is occurring in the overtaking of Mexico by the drug cartels, Africa’s is due in part to the trafficking of weapons, which is inextricably related, again in part, to the looting of that continent’s natural resources—most centrally its gold and diamonds. The link between “conflict diamonds” and armed conflict was addressed by resolution A/RES/55/56, adopted by the UN on December 1, 2000.

In taking up this agenda item, the General Assembly recognized that conflict diamonds are a crucial factor in prolonging brutal wars in parts of Africa, and underscored that legitimate diamonds contribute to prosperity and development elsewhere on the continent. In Angola and Sierra Leone, conflict diamonds continue to fund the rebel groups, the National Union for the Total Independence of Angola (UNITA) and the Revolutionary United Front (RUF), both of which are acting in contravention of the international community’s objectives of restoring peace in the two countries (un.org).

It is impossible to quantify the impact of the illegal trade in weaponry and ammunition. Perhaps it is sufficient to consider the role of guns on one life—the life of a child, Ishmael Beah—in a single region of social unrest, Sierra Leone. Then, by multiplying his story by 300,000—the number of child soldiers Amnesty International estimates to be active throughout the world, it might prod Americans to pay attention to what is happening in the rest of the world, and to weigh their own policy positions against the potential impact of that policy on a child living on another continent, desiring the same access to food, shelter, clothing, education, and security that so many on this continent are privileged to possess.

Sierra Leone was engaged in a war for eleven years. Rebels crossed the border from Liberia to Sierra Leone in 1991, and were supported for a time by civilians who were dissatisfied by the corruption of the government that had virtually dissolved the functioning of a peaceful society. But soon the guns were turned on the civilians. “By the time the war was declared over, tens of thousands had been killed out of a population of five million, thousands had been mutilated or raped, and an estimated 10,000 children had been abducted to be child soldiers. Up to two-thirds of the population had been displaced from their homes, and another 600,000 had fled the country” (iansa.org). Since Sierra Leone did not manufacture any of its own weapons, and since international laws were in place to prevent the entry of weapons into the region given its instability, every rifle shot, grenade detonated, and bullet fired after 1997 was supplied illegally.

In his memoir, A Long Way Gone, Ishmael Beah writes about having a new life in New York after having been a child soldier in Sierra Leone. “These days,” he writes, “I live in three worlds: my dreams, and the experiences of my new life, which trigger memories from the past” (Beah, 20). After capturing in vivid detail a nightmare he had experienced, in which he saw his own face on the body of a victim he pushed in a wheelbarrow through a blood-soaked field, Beah writes of awakening from his dream state and his subsequent struggle to disentangle one world he occupies from the others:

I lay sweating for a few minutes on the cool wooden floor where I had fallen, before turning on the light so that I could completely free myself from the dreamworld. . . . A shudder racked my body, and I tried to think about my new life in New York City, where I had been for over a month. But my mind wandered across the Atlantic Ocean back to Sierra Leone. I saw myself holding an AK-47 and walking through a coffee farm with a squad that consisted of many boys and a few adults. . . . As soon as we left the coffee farm, we unexpectedly ran into another armed group at a soccer field adjoining the ruins of what had once been a village. We opened fire until the last living being in the other group fell to the ground. . . . [Now awake,] I got up from the floor, soaked a white towel with a glass of water, and tied it around my head. I was afraid to fall asleep, [so] I stayed awake all night, anxiously waiting for daylight. (Beah, 19-20)

In his memoir, Ishmael Beah records his memories of how war first touched his life when he was twelve. He had travelled with friends on foot to a neighboring town to participate in a talent show when word came through that rebels had attacked his village. The next eighty pages recount how Ishmael struggles for weeks to find his family, sneaking into villages avoiding rebel fire to steal food, freezing in forested areas through the nights, only to rummage again the next day. Finally Ishmael met someone who recognized him, and insisted that she knew that his family was in the next village, about a two days’ walk from where they were. They headed for their destination and, on their way, Beah recalls meeting Gasemu, a former neighbor, who shared, “‘Your parents and brothers will be happy to see you. They have been talking about you every day and praying for your safety. Your mother cries every day, begging the gods and ancestors to return you to her” (Beah, 92). He guided them to the village where they all were staying. As they approached, Ishmael recalls:

I heard gunshots. And dogs barking. And people screaming and crying. We dropped the bananas and began running in order to avoid the open hillside. A thick smoke started rising from the village. At the top of it, sparks of flames leapt into the air. / We hid in the nearby bushes and listened to gunshots and the screams of men, women, and children. . . . The gunshots finally ceased, and the world was very quiet, as if listening. I told Gasemu that I wanted to go to the village. He held me back, but I shoved him into the bushes and ran down the path as fast as I could. I didn’t feel my legs. When I got to the village, it was completely on fire and bullet shells covered the ground like mango leaves in the morning. I did not know where to begin looking for my family. . . . / “They stayed in that house,” Gasemu said to me as he pointed toward one of the charred houses. The fire had consumed all the door and window frames, and the mud that had been pushed in between the sticks was falling off, revealing the ropes through which the remaining fire was making its way. / My entire body went into shock. Only my eyes moved, slowly opening and closing. I tried to shake my legs to get my blood flowing, but I fell to the ground, holding my face. On the ground I felt as if my eyes were growing too big for their sockets. I could feel them expanding, and the pain released my body from the shock. I ran toward the house. Without any fear I went inside and looked around the smoke-filled rooms. The floors were filled with heaps of ashes; no solid form of a body was inside. I screamed at the top of my lungs and began to cry as loudly as I could, punching and kicking with all my might into the weak walls that continued to burn. (Beah, 93-95)

In her report for the UN copyrighted by Unicef under the title The Impact of War on Children, Graça Machel begins her chapter on child soldiers with the words, “The increasingly widespread exploitation of children as soldiers is one of the most vicious characteristics of recent armed conflicts” (Machel, 7). With the UN, she defines “[a] child soldier [as] any child—boy or girl—under the age of 18, who is compulsorily, forcibly or voluntarily recruited or used in hostilities by armed forces, paramilitaries, civil defense units or other armed groups,” and reports that “most are adolescents, though many are 10 years of age and younger. The majority are boys, but a significant proportion overall are girls” (Machel, 7).

Ishmael Beah becomes a child soldier in chapter twelve of his memoir. Losing hope of finding his family, exhausted from weeks of hiding in the cold without food or shelter, he and his companions are captured. His report is succinct: “Suddenly two men put us at gunpoint and motioned with their guns for us to come closer” (Beah, 100). They took Ishmael and his companions to a village occupied by the military, and gave them sanctuary for several weeks. However, as the rebels came closer to the village, the lieutenant informed the orphans, Ishmael among them, that “‘[W]e need strong men and boys to help us fight these guys, so that we can keep this village safe. If you do not want to fight or help, that is fine. . . . You are free to leave, because we only want people here who can help . . . . [W]e need the help of able boys and men to fight these rebels. This is your time to revenge the deaths of your families and to make sure more children do not lose their families’” (Beah, 106).

Some of the boys, though not Ishmael’s companions, tried to leave the village. The lieutenant used them in his speech to help the boys make their “decision.”

‘The rebels shot them in the clearing. My men brought them back, and I decided to show you, so that you can fully understand the situation we are in.’ The lieutenant went on for almost an hour, describing how rebels had cut off the heads of some people’s family members and made them watch, burned entire villages along with their inhabitants, forced sons to have intercourse with their mothers, hacked newly born babies in half because they cried too much, cut open pregnant women’s stomachs, took the babies out, and killed them. . . . [The Lieutenant said of the enemy:] They have lost everything that makes them human. They do not deserve to live. That is why we must kill every single one of them. Think of it as destroying a great evil. It is the highest service you can perform for your country.’ (Beah, 107-108)

The lieutenant’s speech, and its manipulation of the children’s desire to avenge the pain inflicted upon them, is a telling entry to the minds of adults who place semiautomatic rifles into the hands of children, often after shooting them up with methamphetamines. But because of the lucrative nature of the business, the industry thrives.

The International Action Network on Small Arms reports that “Some 25,000 small arms, 1,000 light weapons, and almost a million rounds of ammunition were handed in during the various disarmament processes for rebel forces and pro-government militias between September 1998 and January 2002” (iansa.org). AK-47 weapons were traced to China, the Soviet Union, and Eastern Europe; G3 rifles were traced to Germany; FN-FAL rifles came from Belgium; and machine guns came from China. “Of the minority of transfers that are known about, weapons came from Ukraine, Bulgaria, and Slovakia. Supply lines went through Burkina Faso, Niger, and Liberia. Libya, Côte d’Ivoire, and Guinea are also reported to have helped in providing weapons to the RUF. Other countries were also complicit: air cargo companies from the UK, Senegal, and Belgium carried weapons to Sierra Leone” (iansa.org). Today, actually quite a lot is known about how the weapons were trafficked into Sierra Leone—especially pertaining to Leonid Minin’s involvement (frontlineworld).

The illegal sale or smuggling of contraband weapons is undeniably destabilizing entire regions of the world, and is often placing automatic and semi-automatic rifles into the hands of children, who are then forced to fight in guerilla style wars. The activity of these units forces the migration of people. HIV thrives in situations where encounters with drug use, rape, and sex work are high. War fuels all of these—so stemming the flow of weapons will inevitably contribute to the reduction of HIV/AIDS infection rates throughout the world.

In 2001, the United Nations adopted a “Protocol Against the Illicit Manufacturing of and Trafficking in Firearms, Their Parts and Components and Ammunition,” as a supplement to that body’s earlier “Convention Against Transnational Organized Crime” (UN General Assembly, Protocol Against the Illicit Manufacturing of and Trafficking in Firearms, Their Parts and Components and Ammunition, Supplementing the United Nations Convention against Transnational Organized Crime , 31 May 2001, A/RES/55/255). Moreover, members of the United States Congress requested a report from the Government Accountability Office examining the types, sources, and users of the firearms, as well as key challenges facing efforts to stem the flow of firearms, and an outline of strategies going forward. The complete report is available online (gao.gov). Together, these documents indicate that the trafficking of firearms is on the radar of national and international authorities. Lobbying for their enforcement would enable legislators and senators to hear that constituents are aware and concerned about these issues. It would be especially beneficial for informed constituents to educate their legislators and senators that the nature of trafficking in drugs and weapons is interrelated and, thus, to address the one is to address the other. Moreover, given the relationship between intravenous drug use and HIV/AIDS, to address drug- and gun-running is also to address public health.


Human Trafficking

Epidemiologists have long known that HIV/AIDS follows the routes of traffickers in drugs and arms. This is on top of a third practice in the category of sale of illicit substances and services: the trafficking of human beings. So, from the coca fields of Colombia and the diamond mines of Sierra Leone, to the brothels of Cambodia and India where pimps and madams hold modern-day slaves in bondage, the virus thrives.

Although technically human trafficking pertains to all trade of human beings for exploitation, because of the nature of HIV/AIDS as a sexually transmitted disease, the focus here will be on sex trafficking. The trade in humans to supply the sex industry is more widespread than news services have successfully conveyed. Each story is slightly different, sharing the common element that money is exchanged for the services of, typically, a young woman, who has been forced or coerced to perform sexually, with the profit from the exchange going to a pimp or a madam who holds the victim hostage in some way. Consider, just for a few examples, the following stories.

A twelve-year-old girl born to a tribal minority in one of Cambodia’s provinces is orphaned when her parents die of AIDS. Her extended family is too poor to take in another mouth to feed, so she follows the road through the countryside until she reaches a motel on the outskirts of the nearest town. The manager attempts to strike up a conversation with the girl, but recognizes she does not speak Cham. Through gestures, he communicates that he will provide her food and shelter in exchange for her doing the cleaning and the laundry for the business. She is relieved to have found a way to secure food, and a modicum of comfort. One day, a customer offers the manager a few extra riel for an hour with the girl. Soon, she is receiving several customers a day. The businessman is pleased to build an addition to his inn.

In India, a family receives a visitor who shares with them a flyer announcing the opening of a garment factory several hours to the north of where they live. Struggling to pull together the dowry for his third daughter’s upcoming marriage, the father agrees that his fourth daughter can travel with their guest to contribute to the economic well-being of the family. He is troubled when he loses touch with her, never receiving from her the wages she promised to send home. He is never able to confirm that the visitor was a human trafficker who made a profit when he exchanged the girl for cash to the brothel owners in Mumbai where she was brutally tortured and raped, seeing as many as ten clients a day, and never seeing herself any of the rupees exchanged for her services.

A teenager from an American suburb goes to her boyfriend’s house. After she drinks a Diet Coke that has been spiked with a sedative and she goes to sleep, an assistant videotapes and takes photographs of the rape, manipulating the girl to appear that they are having consensual sex. When she awakens, the boys show her the pictures, where she was staged to make it appear that she consented, and enjoyed, having intercourse. They threaten to post the photos on the internet, or to send them to her parents and priest, unless she does whatever they ask her to do. For the next several years, she is driven to various homes and hotels to have sex with clients who pay the boyfriend $50 per hour for the service she provides. Her parents are never suspicious, even when her boyfriend arrives in the driveway with a brand new car that he says his parents bought him for graduation.

The situations in each of these stories are adapted from true accounts. The first is derived from Nicholas Kristof’s reporting from Cambodia for The New York Times; the second is drawn from an account shared by Paul Farmer in his book, Women, Poverty, and AIDS: Sex, Drugs, and Structural Violence (Common Courage Press, 1996); the third is derived from Theresa Flores’ autobiographical account, The Slave Across the Street. Each story touches on ways that young women, especially, become vulnerable to those who seek to profit from the sex industry, either through deception (as in the cases of the suburban American girl as well as the Indian father of four daughters), or through desperate economic conditions (as in the cases of the Cambodian and Indian girls). Regardless of the scenario that has bound them to a pimp or madam, each is a victim of human trafficking, even though none of these stories has the girl being smuggled across a border.

Although the word “traffic” conjures the idea of movement, oftentimes in this context across a border, the term actually refers simply to the trade of a good or a service. In other words, “traffic” means only that there is a transaction—the buying and selling of illicit substances (as in the case of drugs and weapons), and/or of illegal services (as in the case of prostitution and underage or underpaid or unpaid labor). This definitional point is important to raise because often the term elicits the false assumption that drugs, weapons, and humans are only being trafficked internationally, across the borders of countries, through smuggling rings, cartels, and the like, and most stereotypically from impoverished countries to rich ones, most likely in cities closest to the borders. In reality, however, the illegal trade of drugs, weapons, and humans is occurring within countries, as well as across borders, affecting every socio-economic bracket in virtually every city in every country throughout the world. While those living in poverty are undeniably vulnerable to traffickers, boys and girls from the “’hood” and the “’burbs” alike are susceptible to the trafficker’s methods, capturing them in webs of violence from which they cannot readily disentangle themselves. Victims of traffickers can be tricked and then exploited under threat of injury or death, depending on the industry, into dealing drugs, running weapons, plowing fields, sewing clothes, pimping girls, or turning tricks.

According to article 3 of the 2004 United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime, “trafficking in persons”

shall mean the recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation. Exploitation shall include, at a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labour or services, slavery or practices similar to slavery, servitude or the removal of organs (pg. 42).

According to the 2007 U.S. Department of State Trafficking in Persons report, “there are 12.3 million people in forced labor, bonded labor, forced child labor, and sexual servitude at any given time,” though it admits that “other estimates range from 4 million to 27 million” (report). Annually, according to U.S. Government-sponsored research completed in 2006, approximately 800,000 people are trafficked across national borders, which does not include millions trafficked within their own countries. Approximately 80 percent of transnational victims are women and girls and up to 50 percent are minors. The majority of transnational victims are females trafficked into commercial sexual exploitation. These numbers do not include millions of female and male victims around the world who are trafficked within their own national borders—the majority for forced or bonded labor (report).

While it is difficult to know how widespread the practice of trading humans is in the United States, the Justice Department reports that there were 1,229 human trafficking incidents in the United States from January 2007- September 2008. Of these, 83 percent were cases of sex trafficking (report). The industry is believed to generate about $9.5 billion in annual revenue around the world. More statistics are available from the Polaris Project.

Unlike the industries of drug trafficking and arms trafficking, where the relationship to HIV/AIDS is more circuitous as the arms trafficker empowers the drug trafficker who supplies the end user who might, in turn, become infected, the relationship between human trafficking and HIV/AIDS is more direct. An August 1, 2007, an issue of the Journal of the American Medical Association published an article that puts the relationship between sex trafficking and HIV/AIDS into scientific terms. On Aug 22 of the same year, the UN Development Program (UNDP) released a report that likewise explored the connection between sex trafficking and HIV in six countries of south Asia: Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka. Silverman and Decker, researchers behind these studies at the Harvard School of Public Health, summarize their findings in this way:

[T]he Harvard School of Public Health collaborated with NGOs in Mumbai, India (Rescue Foundation) and Kathmandu, Nepal (Maiti Nepal) to conduct two small-scale studies assessing the prevalence and predictors of HIV infection among sex-trafficked South Asian women and girls. The first study reviewed case records and HIV-testing results of 175 women and girls trafficked to brothels in Mumbai; the second study examined medical and case records of 287 repatriated women and girls trafficked to India from Nepal. In both studies, we sought to determine HIV prevalence and risk based on demographics and trafficking/prostitution experiences. 

Approximately one-quarter (22.9 percent) of those in the first study, and more than one-third (38.0 percent) in the second study, tested positive for HIV. Across both studies, those trafficked at younger ages were more likely to be infected with HIV; in the second study, more than 60 percent of girls trafficked at ages 14 and under were infected with the virus. Girls trafficked at younger ages also reported a greater likelihood of servitude in multiple brothels and longer periods of brothel confinement associated with increased HIV infection risk of 2 to 4 percent for each additional month of captivity. 

Although the small scale and specific findings, represent only individuals served by particular anti-trafficking NGOs, this initial work clearly suggests that women and girls trafficked across India and Nepal face extreme levels of vulnerability to HIV infection and may constitute a priority population for HIV prevention efforts (Silverman and Decker).

While the interrelationship between sex trafficking and HIV/AIDS should have been obvious, prostitutes, like the gay men who were first diagnosed in the United States, were not, and are not, at the top of the priority lists for those managing huge national and international budgets in relation to public health. Even one who is a vocal advocate, like Nicholas Kristoff of the New York Times, does a disservice to advocates for funding when he writes that the nature of prostitution and the sex trade in the United States is substantively different than in Cambodia, India, and the other countries he has visited globally. For example, in his recent book Half the Sky: Turning Oppression into Opportunity for Women Worldwide (Vintage, 2009), he writes, “most prostitutes in America, China, and Japan aren’t truly enslaved” (9). In May of this year (2010), although he warns against making “the mistake of thinking that terrible abuses happen only on the other side of the world,” he nevertheless underscores the dangerous perception that, in his words, “the abuses tend to be worse in Asia” (Kristoff).

Susan Gaertner, the County Attorney for Ramsey County in the State of Minnesota, delivering remarks at a Criminal Justice Institute in Bloomington, Minnesota in August, 2006, approached the same issues that Nicholas Kristoff has been covering for some time, but she did so much differently. She pointed to the statistics in the United States, admitting that they vary widely, but reported that “the State Department says that about 15,000 people are trafficked each year [within our own borders], whether they are from another country or not. Their coerced labor has ranged from prostitution, exotic dancing and pornography, to field labor, factory sweatshops, street peddling and domestic service” (Gaertner). Showing a videotape about a case where a Mexican girl was promised a waitressing job in the United States, only to be abducted into a trailer upon her arrival where she was forced to have sex up to thirty times a day, Gaertner explained how the customers paid the girls’ captor even as he kept her trapped, ready for the next engagement. Gaertner went on to recount other cases on trial in Minnesota about men who approached girls where they hung out: at McDonalds and the Mall of America, for example. When they were promised wages for babysitting, the girls went to his home, where he held them against their will at gunpoint in order to make money from the services they would supply to customers (Gaertner). These were not isolated cases. According to Gaertner, “Between 2001 (when the TVPA legislation came into effect) and 2005 the U.S. Attorneys’ Offices filed 91 trafficking cases (a 405% increase over the number of trafficking cases filed between 1996 and 2000); in these 91 cases, 248 trafficking defendants were charged, and 140 were convicted” (Gaetner).

In other words, Gaertner points to cases occurring in Minnesota that are not substantively different than what Kristoff is reporting from Asia. The difference between America and Asia may be only in volume rather than in substance—though, given the nature of the enterprise, even this is debatable.

As with drug trafficking, another debate is unfolding in the public square in relationship to what can be done. On the one side are advocates for lifting the ban on prostitution, arguing that legalizing and regulating the industry can protect sex workers by empowering workers to require clients to wear condoms or to disclose their HIV/AIDS status prior to an exchange. On the other side are advocates for ramping up efforts to enforce the prohibition of prostitution in order to create a climate in which disincentives, such as fines and prison sentences, outnumber the financial rewards, such that the availability of prostitution naturally decreases. In this debate, Nicholas Kristoff and Sheryl WuDunn make a compelling case for a third option. Rather than making the act of prostitution itself criminal, they would like to see the johns who create a demand for prostitution face criminal charges. Such a law, they report, has been successful in Sweden:

In 1999, Sweden took the opposite approach [than the Netherlands, which legalized prostitution in 2000], criminalizing the purchase of sexual services, but not the sale of them by prostitutes; a man caught paying for sex is fined (in theory, he can be imprisoned for up to six months), but the prostitute is not punished. . . . / A decade later, Sweden’s crackdown seems to have been more successful in reducing trafficking and forced prostitution. The number of prostitutes in Sweden dropped by 41 percent in the first five years, according to one count, and the price of sex dropped, too—a pretty good indication that demand was down. / In the Netherlands, legalization has facilitated health checkups for women in the legal brothels, but there’s no evidence that sexually transmitted diseases (STDs) or HIV has declined. Pimps in the Netherlands still offer underage girls, and trafficking and forced prostitution continue. . . . The bottom line? Customers can easily find an underage Eastern European girl working as a prostitute in Amsterdam, but not in Stockholm (Half the Sky, 31-32).

When I was in Thailand working on “30/30,” I visited with three women who had received support from the New Life Center Foundation, an organization that “works with ethnic minority women throughout Thailand and its neighboring countries who are at risk for, or victims of, labor exploitation and sexual abuse” (from the organization’s mission statement). It was inspiring to be at a place that is responding to the nightmarish situation being experienced by young women in Thailand, even as it was difficult to process their stories, one after the other, as they shared their perspectives in their journals. Although they were from very different parts of Northern Thailand, and grew up in different villages with different beliefs and memories, they shared with me the common experience of being ethnic minorities, which made them vulnerable to human trafficking. They were vulnerable, too, because the adults in their lives were unavailable to them, for various reasons: disabilities of their own, struggles with addiction, the stresses of mixing families from previous marriages, or other things that caused them to abandon or otherwise neglect their children. They all became entangled in the traffickers’ web in very different ways—whether it was through a deal that was made without their knowledge or consent between a parent or an employer and a broker, or following a potential employer to the city in the hope of making a living wage only to be trapped in a situation from which it seemed their was no escape. Finally, however, they shared one commonality. They each emphasized in their journals that they were too trusting—and that if they could communicate only one thing to young women, it would be to be cautious, and not to trust people too readily.


If you are moved to respond to the issue of the modern-day slave trade, as well as to the related issues of drug and gun trafficking, and the contribution of trafficking to HIV/AIDS infection rates both nationally and internationally, after donating to organizations like the New Life Center Foundation that are making a difference in the lives of those who have experienced trafficking firsthand, and that are attempting to prevent the same from happening to anyone else, the single most effective thing you can do is to write a letter to your legislators and senators. By communicating your knowledge about and concern for these issues, not only can you educate those in power—you can also influence their opinion. In the United States, with only your zip code, you can access contact information for your President, Senators, Representatives, and Governor by clicking here. Information about active federal legislation is available here, as well as here. Advice about writing a letter is available from the Minnesota AIDS Project. Finally, to participate in the election to office of those of like mind, please get informed about candidates prior to voting day. The League of Women Voters makes ballots, information about candidates, and regional initiatives available from its website before elections.

Violence Against Women

In 30/30 HIV/AIDS Structural Drivers, HIV/AIDS, Public Health, South Africa, Violence Against Women on August 11, 2010 at 1:10 am

“It is a fact that a woman born in South Africa has a greater chance of being raped than learning how to read.” —Carolyn Dempster, British Broadcasting Corporation

“When someone perpetrates an act of rape, it’s about reclaiming a sense of power.” —Kelly Hatfield, People Opposing Women Abuse

In 1973, Adrienne Rich published a collection of poems called Diving into the Wreck, including one called “Rape.” The poem explores how the survivor of rape is traumatized again by the male-dominated criminal justice system. This is evident from her first point of entry, when a male police officer records the woman’s account of the crime. His voyeuristic titillation by her disclosure implicates him in something of a gang that continues to perpetrate violence against her.

And you see his blue eyes, the blue eyes of all the family
whom you used to know, grow narrow and glisten,
his hand types out the details
and he wants them all
but the hysteria in your voice pleases him best.

The full text of the poem is available here.

Rich’s poem is an artistic observation about the banality of violence inflicted against women, so enmeshed is it with culture that it is scarcely recognized as out of order. Today, almost forty years since the poem’s publication, there has been little progress in addressing Rich’s critique, even while voyeuristic curiosity about violence committed against women is increasingly satisfied by online access.

Recognizing that the process of sharing painful memories can foster healing, but wishing to provide a space for storytelling beyond the criminal justice and psychological services sectors, many web pages have been launched to give survivors of rape a format by which to share their stories. While some sites have password protection so that visitors need to create accounts to gain access to the postings, others are accessible by nothing more than the click of a mouse, introducing the ambiguities of online access. Nonetheless, by sharing their stories, women who recount their experiences participate in a healing process by refusing to acquiesce to the culture’s desire that they bear their pain in silence.

Postings to web pages of this kind are numerous in South Africa, which has the highest ratio of reported rape cases per capita (per 100,00 people) in the world. Estimates suggest that a woman is raped every 26-36 seconds in South Africa, where a child is raped every 15 minutes. South Africa also has a high number of incidents of infant rape or “baby rape,” as it is more commonly called. Indeed, 41% of those raped in the country are under the age of 12, according to South African police reports. “A nine-year study by Cape Town’s Red Cross Children’s Hospital, published in the South Africa Medical Journal in December 2002, found that the average age of children raped was three. Research has shown that 40 percent of those raped in South Africa are at risk of becoming HIV-positive if they do not receive PEP [post-exposure prophylaxis].” (See Charlene Smith, “Rape has become a sickening way of life in our land,” Sunday Independent, 26 September 2004.) TIME magazine recently reported that more than a quarter of men in South Africa admitted to having raped. “46% of those said that they had raped more than once” (Lindow, TIME, 20 June 2009). As much as 75% of rape in South Africa is believed to be gang related.

In an effort to understand the underlying causes of the violence in South Africa, where democracy came only sixteen years ago after widespread brutality had been inflicted by the white government of apartheid against 80% of the population that was designated “black” or “coloured” (people of mixed ethnic heritage), scholars have articulated at least six theories that attempt to uncover the root causes of the violence directed against women in contemporary South Africa. These theories go beyond the obvious conclusion that individual men have made violent choices. The truth probably lies in an interweaving of theories that the individual choice to commit sexual assault against women is correlated to a combination of factors, including poverty, circulation of myth, persistence of cultural norms related to the subordination of women, male disempowerment, broken familial structures, and lack of legal deterrents.

1. Endemic Poverty. Most of the incidents of rape reported in South Africa occur in the poorest neighborhoods, including both township and rural types of communities, although according to Megan Lindow reporting for TIME Magazine, surveys have found that many of the men “most likely to rape . . . had attained some level of education and income.”[i] In a policy brief released by the South African Medical Research Council, its authors confirm, “the overwhelming majority of victims are found among the working classes and the poor.”[ii]

Poverty and unemployment are barriers to men and women accessing traditional sources of well-being, status and respect. Inequality in access to wealth and opportunity results in feelings of low self-esteem, which are channeled into anger and frustration, and violence is often used to gain the sought after respect and power, whether through violent robbery, rape, fighting between men, severe punishment of children or violence against partners.[iii]

Of course, there are many places in the world where there is a concentration of poverty without similarly alarming statistics pertaining to sexual assault. All the same, when perpetrators explain their behavior by saying that it was too expensive to pay for the services of a woman, the correlation between poverty and rape merits mention.[iv] When poverty is combined with additional factors described below, the situation foreseeably erupts, such that societies can expect to see increasing numbers of acts of aggression targeted against women when multiples of these factors coalesce.

2. Circulation of myth. As has been widely reported, there is a myth that has been circulated in South Africa, where HIV/AIDS rates are among the highest in the world, that it is possible to cure AIDS by having sex with a virgin. Although research has yielded mixed results in terms of evaluating the degree to which the myth is believed, it seems that the myth has greater tenability in some regions of the country than in others. The continuing circulation of the myth certainly does nothing to improve the number of incidents of rape in South Africa, though Helen Epstein, in The Invisible Cure: Why We are Losing the Fight Against AIDS in Africa, discusses how myths of another kind are playing a role in the spread of the epidemic in Africa. She writes, “In precolonial times, chiefs of the Sotho tribe would sometimes allow other men to have sex with their wives to secure the men’s loyalty. This was considered statesmanlike behavior and is celebrated in traditional myths and poems. Contemporary gang rape may be a violent reprise of this male-bonding tradition.”[v] Thus, mythic understandings of what it means to be male and cultural traditions practiced to secure alliances are implicated in violence against women in South Africa.

3. Persistence of cultural norms related to the subordination of women. Researchers have long recognized that male “domination is often so deeply embedded in social practices and the unconscious that the dominated scarcely perceive it as [dominance].”[vi] Research suggests male-inflicted violence against women is “pervasive yet largely unseen,” as it is “exercised through everyday practices in social life where political, educational, religious and economical macro structures are based in the ideology of gender differences.”[vii]

South Africa’s men from across the racial spectrum are raised to see themselves as superior to women and taught that men should be tough, brave, strong and respected. Heavy drinking, carrying weapons and a readiness to defend honor with a fight are often seen as markers of manhood. The violence that ensues between men often has very severe consequences. With most men perceiving that women should submit to control by men, physical and sexual violence are used against women to demonstrate male power, and thus teach women ‘their place,’ and to enforce it through punishment. Thus gender inequality legitimates male violence over women, as well as being accentuated by the use of such violence.[viii]

Gillian Paterson writes a concise synopsis about this normalization process in her book, Women in the Time of AIDS.[ix] “Physical violence against women . . . becomes accepted as part of the ‘normal’ way that things are.”[x] She goes beyond the description of the process, however, to suggest how HIV/AIDS is prompting a paradigm shift since survival itself is at stake. Throughout the book, she promotes a way forward through a participatory development model that wishes not to alienate men, but to involve them in the process so as to secure a lasting shift. Epstein, too, underscores how important it is to address male responsibility in programs aimed at reducing rape statistics in South Africa: “The epidemic of sexual violence in South Africa is part of a wider war between men and women that is as fierce and partisan as any other on the African continent, and it has been raging far longer. Empowering individual women without addressing the attitudes of men and society in general risks creating empowered women who antagonize men [thereby] playing right into the rapists’ hands.”[xi]

4. Male disempowerment. Sociologists have observed how men who are disempowered politically and culturally in colonized systems direct their power to spheres of influence that remain open to them. In a similar context of oppression as experienced by the indigenous peoples of Australia, Germaine Greer, for example, has argued in a book called On Rage that “the centuries of disempowerment, dispossession, discrimination, defamation, marginalization, murder,” and torture of Australian males has left a legacy of substance abuse and violence in Aboriginal communities that is directly traceable to oppression under an Australian version of apartheid policy.[xii] The pattern that Greer describes has parallels in many places, South Africa among them. According to Epstein,

[R]ape is an assertion of male power, not sexuality. [University of Pretoria anthropologist Isak] Niehaus speculates that men . . . found in acts of violence against women temporary relief from the humiliations of living in a society based on the presumption of white superiority. But these acts were not only misdirected expressions of racial anger. They were also ‘desperate protests against men’s loss of control’ over women. . . . The epidemic of rape may be a reaction to their perceived loss of status. In response they are reviving ‘scripts of male domination’ with deep historical resonance.[xiii]

5. Broken familial structures. In his book Spots of a Leopard, a collection of essays about male identity shaped by hundreds of interviews conducted with men throughout Africa, Aernout Zevenbergen asserts, “rape is a signal of a society that is sick to the core.”[xiv] Pointing to South Africa’s long history of migrant labor, Zevenbergen believes apartheid’s practice of migrant labor, of sending men to work hundreds of miles from home to work in mines, resulted in the breaking apart of families that “set the stage ‘for an epidemic of young men who, in the absence of positive male role models, are now consumed by a sense of anger and entitlement. What we have are the wounds of men creating wounds in women, creating wounds in children. . . . Who is going to stop the vicious circle?’”[xv] The South African Medical Research Council lends credence to Zevenbergen’s assertions:

South African families are highly unusual by global norms. In South Africa, growing up as a child in a home with two biological parents is unusual. A majority of children are born outside marriage and there is generally no expectation of fathers having a social involvement in the lives of these children. They often also provide no financial support. Frequently children are raised by family members who are not their biological parents. Without their parent’s protection, children are extremely vulnerable to abuse and neglect. Whilst this is a problem in its own right, it also gives rise to intergenerational cycling of violence. Girls exposed to physical, sexual and emotional trauma as children are at increased risk of re-victimization as adults. Exposure of boys to abuse, neglect or sexual violence in childhood greatly increases the chance of their being violent as adolescents and adults, and reduces their ability to form enduring emotional attachments. Trauma during childhood impacts on brain development, enhancing anti-social and psychopathic behavior and reducing the ability to empathize.[xvi]

Related to broken familial structure is widespread abuse of alcohol and drugs, for “South Africa has one of the highest per capita alcohol consumption levels per drinker in the world.” [xvii] The Medical Research Council again reports that many “acts of fatal and non-fatal violence occur after alcohol and drug abuse, especially fights, some types of homicide, and rape. Many victims of violence are also rendered vulnerable by alcohol.”[xviii] The report acknowledges the cycle of violence that alcohol and drug abuse perpetuates. “In a vicious cycle, victims of violence often start drinking heavily to deal with the trauma they have experienced, but their drinking makes it harder from them to escape from violence in their lives. Children are often left very vulnerable by their parents’ drinking.”[xix]

6. Lack of legal deterrents. It is estimated that less than 10% of reported rapes will result in a conviction in South Africa. The election of Jacob Zuma to the presidency in 2009 has not helped, for even he was accused of rape during his campaign, though he was later acquitted of the charges. In an interview with The Guardian, co-director of the Sonke Gender Justice Project, Dean Peacock is quoted as saying, “We’re at a complicated moment in South African history with revived traditionalism and there’s a danger of gender transformation being lost. We hear men saying, ‘If Jacob Zuma can have many wives, I can have many girlfriends.’ The hyper-masculine rhetoric of the Zuma campaign is going to set back our work in challenging the old model of masculinity.”[xx] Again, the Medical Research Council has stated,

With society accepting the use of violence in many circumstances, and the community very often protecting perpetrators, it is not surprising that law enforcement is generally very weak. Widespread corruption and general under-resourcing within the police force, as well as challenges of transformation and restructuring in the detective services, contributes to the problem. Few perpetrators are effectively punished, with the result that laws fail to provide deterrence and victims often have little faith in the system. / Despite the massive problem violence poses to the country, there has been a conspicuous lack of stewardship and leadership in the area of violence prevention from Government. The current policy of the Government which, simply put, is to ‘get tough’ on criminals, is unlikely to be a useful response to violence in the long term. Without widespread social and economic reforms, it fails to address the roots of violence and, equally problematically, it is both rooted in and serves to perpetuate many of the very ideas of manhood that underlie the problem of violence in society.[xxi]

All of this is to say that where poverty, myth of sexual cures for dreaded and prominent illnesses, cultural norms of male domination, male disempowerment, broken familial structures and lack of legal deterrents coalesce, risk is high for high incidents of rape and sexual violence to be committed against women. Where there are high incidents of rape and sexual violence committed against women, there is a high risk of HIV/AIDS infection.

Professor of medical anthropology at Harvard University Medical School and founder of Partners in Health, an organization devoted to provided high-quality medical services and pharmaceutical access to people living in the poorest communities throughout the world, Paul Famer has written extensively about gender inequality, poverty, and AIDS. Although his books tend to focus on his experiences in Haiti, the public health challenges he describes are relevant elsewhere, as the patterns to which he bears witness in Haiti have, in an age of globalization, replicated in many places throughout the world. In his book Women, Poverty, and AIDS: Sex, Drugs, and Structural Violence, Farmer explains how women are both biologically and socio-economically more vulnerable to an infection than men:

Certain studies suggest that per-exposure transmission from man to woman during genital-genital intercourse is two to five times more efficient than from woman to man. Other investigations have prompted researchers to argue that HIV is up to 20 times more efficiently transmitted from men to women than vice versa. HIV is more highly concentrated in seminal fluids than in vaginal secretions and may more easily enter the bloodstream through the extensive convoluted lining of the vagina and cervix. Vulnerable penile surface area is much smaller. . . . One recent study suggests that certain strains of HIV may grow better in a type of cell lining in the vaginal wall.[xxii]

Farmer also explains how female risk for HIV goes beyond biological risk factors alone.

[B]iological risk alone does not explain soaring infection rates among women. Women’s precarious social status, a direct result of gender inequality and amplified poverty, magnifies each of these biological predispositions. In addition to the gendered power differentials characterizing most sexual unions, women are denied equal access to economic resources, housing, health care, legal protections, land, schooling, inheritance, and employment in the formal sector of most societies. Wage-earning women may be obliged to supply sex to supervisors as a condition of employment. Domestic workers are particularly vulnerable to this kind of abuse. Women who work in the low-wage informal sector may also be forced to supplement meager earnings with sex work. Still others can find no employment in the informal sector except sex work. Male violence, whether threatened or actualized, is also all too commonly used to control women throughout their lives and increases their vulnerability to infection. In many cases, such violence is legally as well as socially sanctioned.[xxiii]

Any effort, therefore, to minimize the risk for replication of South Africa’s statistics pertaining both to sexual assault incidents as well as to HIV/AIDS prevalence rates must be multi-dimensional, addressing opportunities for income generation for both genders as well as financial independence for women, campaigns to distribute factual information about the biology of HIV/AIDS and its treatment, as well as information targeted to raise awareness about gender domination and its alternatives. South Africa has many NGOs working in these areas and their work is invaluable to the lives that are touched by their efforts and services. Also underway are governmental efforts to broaden the impact of endeavors aimed at eliminating poverty, ending the age of AIDS denialism, challenging a culture of female subordination, empowering males by creating meaningful work in every region of the country thereby also shielding familial structures from the harsh impacts of migrant labor, and enforcing laws already in place and revising unhelpful laws for the protection of women and children.

NOTES

[i] Megan Lindow, “South Africa’s Rape Crisis: 1 in 4 Men Say They’ve Done It,” TIME (20 June 2009; http://www.time.com/time/world/article/0,8599,1906000,00.html, accessed 30 August 2011).

[1] Ibid.

[ii] R. Jewkes, et. al, “Preventing Rape and Violence in South Africa: Call for Leadership in A New Agenda for Action,” MRC Policy Brief (November 2009), 1; http://www.mrc.ac.za/gender/prev_rapedd041209.pdf (accessed August 30, 2011).

[iii] Ibid.

[iv] Nicole Itano, “South Africa Begins Getting Tough on Rape, WENews (24 February 2003;http://www.womensenews.org/story/rape/030224/south-africa-begins-getting-tough-rape, accessed August 31, 2011).

[v] Helen Epstein, The Invisible Cure: Why We are Losing the Fight Against AIDS in Africa (New York: Picador, 2007), 228-238, esp. 234.

[vi] Diana Gibson, “Rethinking Domestic Violence: Case Studies from the Western Cape, South Africa,” in Amsterdam School for Social Science Research, Working Paper Series, October 2004.

[vii] Ibid, 3.

[viii] Jewkes, 1.

[ix] “His and Hers: A Note on Gender Analysis” in her book, Women in the Time of AIDS (Maryknoll: Orbis Books, 1996), 30-35.

[x] Ibid.

[xi] Epstein, 234-235.

[xii] Germaine Greer, On Rage, Melbourne University Publishing, 2010; see also Gideon Polya, “Book Review: On Rage by Germaine Greer,” MWC News, 27 June 2009.

[xiii] Epstein, 232-233; quoting Isak Niehaus, “‘Now Everyone Is Doing It’: Towards a Social History of Rape in the South Africa Lowveld,” research working paper presented at Sex and Secrecy, a conference of the International Association for the Study of Sexuality, Culture and Society, July 12, 2003.

[xiv] Aernout Zevenbergen, Spots of a Leopard: On Being a Man (Laughing Leopard Production, 2009); see also Lindow.

[xv] Lindow.

[xvi] Jewkes, 2.

[xvii] Ibid.

[xviii] Ibid.

[xix] Ibid.

[xx] David Smith, “Quarter of men in South Africa admit rape, survey finds,” in The Guardian (17 June 2009;http://www.guardian.co.uk/world/2009/jun/17/south-africa-rape-survey, accessed August 31, 2011).

[xxi] Jewkes, 2.

[xxii] Paul Farmer, Women, 47.

[xxiii] Ibid, 50-51.

Xenophobia / Xenophilia

In 30/30 HIV/AIDS Structural Drivers, HIV/AIDS, Public Health, South Africa, Xenophilia, Xenophobia on August 11, 2010 at 1:00 am

Last year, more than sixty people died as a result of xenophobia in South Africa. Typically, xenophobia refers to the unreasonable suspicion, distrust, or even hatred of foreigners. Although factors contributing to the xenophobic violence in South Africa are complex, it is clear in every report about it that tensions are running high because the country is experiencing unemployment rates nationwide of about 40%, a rate which soars above 70% in many so-called “coloured” and “black” townships established during apartheid, and in the informal settlements and shantytowns that continue to build up around them. Tensions erupted in 2008 when perceptions circulated that “foreigners” were taking jobs that could go to native-born citizens, creating a distrust that was fueled by accusations that drug trafficking was largely attributable to immigrants who, it was alleged, were bringing illegal substances across the border when they entered the country. These rumors caused immigrants in South Africa to become targets of attacks that captured the world’s attention in 2008.

In order to provide a sense of the scope and brutality of the attacks, consider an excerpt from this article published 19 May 2008 in the Mail & Guardian Online (Africa’s first internet-based news source begun in 1994, reputable internationally for quality reporting from inside Africa):

[P]olice recovered the hacked body parts of a Malawian national on a sandy road in Ramaphosa township and, near Primrose, one person with Mozambican identification papers in his pocket was found dead. Two other Mozambicans were seriously beaten.

In Zamimpilo, outside Riverlea on the West Rand, at least 50 shacks were burned. Foreign nationals in the area were taken to safety at a community centre.

In Kya Sands, an industrial area close to informal settlements, groups of people began throwing stones at each other after a community meeting, but the situation was brought under control, said police spokesperson Superintendent Lungelo Dlamini.

In the Jerusalem informal settlement, near Boksburg, police came under fire as they tried to stop a group of about 500 people from looting shops there.

Police in Cape Town were identifying possible flashpoints for xenophobic violence and would have units on standby, the city administration said on Monday.

These summary reflections by journalists for the Mail & Guardian about the week’s unrest, and the article in full, point to a further tragic dimension of the xenophobic violence in South Africa. The crimes are directed against those who are already suffering in townships and informal settlements where sometimes people are living in cardboard and tin-covered shacks built on nothing but dirt. An immigration status adds another degree of jeopardy to already jeopardized lives. Indeed, many of those who continue to flee here are leaving terrible and terrifying conditions, most arriving today from Zimbabwe and the DRC (Democratic Republic of Congo). They come here hopeful that they might find the refuge to which their designation as refugees attests—an illusion that is often broken swiftly when they enter a country with high rates of unemployment. On top of this, they too read the chilling words of those arrested for conducting the attacks, and the attempt of those involved to justify their activities. One unemployed man, for example, from his jail cell after he was arrested for destroying a few shacks in the Gauteng Province (in which Johannesburg and Soweto are located), is reported to have said, “We will keep on going; [the police] can’t stop us. . . . Foreigners are taking our jobs and our wives.”

Imagine, then, the increased anxiety felt by those immigrants who come with an HIV-positive status, or who acquire HIV once they have crossed the border. Their costume, accent, and location may already “target” them as “foreign.” To add fuel to the fire, in societies where all sexual subjects are taboo, word about an HIV infection present in the body of a refugee can fan the flame of violence all too ready to erupt.

Indeed, the issue of stigma was an omnipresent reality during my time at the Scalabrini Centre. The staff discussed with me how their clients often felt vulnerable, such that even coming to the HIV support group was difficult for them. When I presented the project to the members of the support group and invited each one to participate, two women made reference to the stigma of an infection when they politely and understandably declined the offer. Although two of my subjects permitted me to photograph their faces, one kept hers hidden for fear of being identified in her community. And all three asked that their names be kept absolutely confidential. Though one mindlessly wrote it nevertheless in the journal entry, I have used Photoshop to erase it from the subject’s journal page on the still life in order to honor the subject’s request for some degree of anonymity.

Of course, xenophobia is not the only option. Jesus himself drew on the ancient laws in his own Jewish tradition when Matthew records him to say, “I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me” (Matthew 25:35-36). The tradition upon which he was drawing was written in the ancient Israelite Code of Law: “When an alien resides with you in your land, you shall not oppress the alien. The alien who resides with you shall be to you as the citizens among you; you shall love the alien as yourself, for you were aliens in the land of Egypt: I am the Lord your God” (Leviticus 19:35-36).

All of this is to say that the Judeo-Christian tradition advocates against xenophobia in preference for “xenophilia”—a love and a deep, abiding respect for the inherent dignity of the foreigner in our midst. Certainly political questions become rapidly complex as priorities are juggled with limited Rands, Dollars, and the rest to be allocated to relieve varying competing and significant needs—but as “People of the Book,” these verses should guide our deliberations. First and foremost, we are called to recognize the “strangers” in our presence as also created in the image of God (imago Dei), possessing by virtue of their very existence a dignity that is absolute—a dignity that is inviolable.

Bibliography

OMIECH

In Education, HIV/AIDS, Literacy, Mexico, Non-profits / NGOs, OMIECH on August 10, 2010 at 3:15 am

Organizacíon de Médicos Indígenas del Estado de Chiapas

Founded in 1985, OMIECH is a non-governmental organization that is devoted to the promotion of Mayan medicine. Its vision is to develop and strengthen Mayan medicinal practices throughout the state of Chiapas by providing a unique model of healthcare centered on the philosophical and medicinal principles of the Mayan peoples. Currently, OMIECH serves 600 members who represent 13 indigenous communities from the highlands and the jungle, as well as the northern and central regions of Chiapas. Longterm objectives of the organization include:

• Defending the natural resources of indigenous peoples against biopiracy;
• Rescuing, conserving, systematizing, and developing indigenous medicines;
• Producing medicinal treatments for illnesses most prevalent in indigenous communities;
• Producing and distributing health-related instructional material into indigenous communities.

The key projects of OMIECH to support these objectives are:

Mayan Medicine Museum: Visited by school and church groups, as well as Mexican and foreign tourists, the museum project is an effort to present to a broader public the various elements of traditional Mayan medicine. The museum features:

1 – The Public Plaza shows the visitor the extent to which traditional medicine is practiced and preserved in the communities of Chiapas. Also on display here are the most common categories of indigenous medics that form part of the Organization of Indigenous Medics of the State of Chiapas (OMIECH). The most common categories of the Indigenous Medics are the J’ilol (pulse reader); K’oponej witz (mountaintop prayer healer); Tzak’bak (bone healer); Jve’t'ome (midwife); and the Ac’vomol (herbalist). The plaza also explains that becoming an indigenous medic is not something that can be learned. Rather, only those who have the gift or the “don” and have discovered this gift in dreams can practice indigenous medicine.

2- The church is a sacred space protected by saints who were blessed specifically for this space.

3 – The Mountaintop Prayer Healer’s Garden has on exhibit examples of plants, animals, and minerals that are used in healings by the traditional medics of the Chiapas Highlands. A mural representative of the magnificence and density of the southwest mountains of Mexico occupies one wall. At the center of this space the mountaintop prayer healer can be found.

4 – The Midwife’s House shows how a Tzotzil midwife assists in childbirth using just a few instruments.

5 – The Herbalist’s House demonstrates how to prepare sacred plants.

6 – The Candle Workshop shows the making of candles, for in indigenous medicine, candles are a fundamental element with a the curative capacity.

Herbal Program: Central to the herbal program is the defense of indigenous medicine against biopiracy. The herbal program disseminates medicinal plants and knowledge about them into member communities. An herbal pharmacy at the organization’s headquarters in San Cristobal de las Casas makes the plants available to those nearer to the city. Medicinal gardens in member communities enable the organization to provide herbs to outlying communities. The organization has also developed a number of workshops that train people in the care and use of medicinal plants.

Midwife Program: A fundamental principle of the midwife program is to provide a space where women can safely share with one another their experiences of pregnancy and childbirth within the context of indigenous medicinal practices. In this way, the community supports and defends the right of women to discuss, analyze, and make decisions over the reproductive process. The elderly and the young gather at these meetings, together with midwives, to share knowledge about the use of medicinal plants during pregnancy and childbirth, as well as in relation to infant care. Health promoters often attend these meetings in order to disseminate health-related information in the communities.

Media Production: The organization produces audiovisual materials with the objective of training members of indigenous communities about the use of Mayan medicines in treating the most common illnesses impacting indigenous communities. Materials are also made to promote health by informing the indigenous communities about emerging health issues, including HIV/AIDS.

If you would like to donate to OMIECH, please send an e-mail (omiech@prodigy.net.mx) including the following details:

1. Please specify the area you would like to support:

Mayan Medicine Museum
Herbal Program
Midwife Program
Media Production

2. Please specify the currency you are sending:

American dollars
European Euros
Mexican Pesos

3. Please specify the amount you wish to donate.

4. Please identify yourself:

Name
Residential or Commercial Address
Country
E-mail Address

If you wish to visit or write to OMIECH, the Organizacíon as well as the Mayan Medicine Museum are located at the Center for the Development of Mayan Medicine (CEDEMM):

Av. Salomón González Blanco No. 10, Col. Morelos.
San Cristóbal de Las Casas, Chiapas, México.
C.P. 29230. Apdo. Postal 117.
Telefax 01 (967) 67- 85438

Ikamva Labantu

In Elderly, HIV/AIDS, Non-profits / NGOs, Senior Citizens, South Africa on August 10, 2010 at 3:00 am

For more than 30 years, Ikamva Labantu (“The Future of Our Nation”) has been involved in building up communities broken down by the brutalities of apartheid. Today, it is an umbrella non-profit, non-governmental organization supporting the social development of tens of thousands of people through more than 1,000 projects fitting under four broader foci: health intervention and food security; educational access; skills and enterprise development; and land and building provision. Ikamva Labantu builds and supports crèches (pre-schools), schools, senior centers, and youth centers. It provides skills training programs, and undertakes building initiatives. And, finally, it develops programs for the disabled, the elderly, and orphans.

It was the creativity behind Ikamva Labantu’s senior care program that first captured my attention. Recognizing the pressure that seniors were under, given increasing responsibilities to care for grandbabies even in the midst of mourning for children taken by a virus or by violence, on top of demands from family and from community for a portion of the small, monthly pension they receive from the government, Ikamva Labantu created a place for seniors to find rest and play, as well as support and encouragement. In a day at any of the seventeen senior centers that have been established in the Western Cape Province, visitors might find seniors enjoying a meal, visiting with friends, exercising their bodies, playing a game, making crafts, tending a vegetable garden, or attending special events. Additionally, the centers provide assistance for seniors who are completing applications for pensions, social services, or disability grants.

Proudly developing “solutions by South Africans for South Africans,” the organization emphatically strives to maintain community ownership and direction of its initiatives. This principle is easily seen in today’s senior centers. They are being transformed into “Integrated Activity Centers” where child-care facilities, after-school and sports programs, life skill training workshops, and guidance counseling are offered for the young ones who are living with their grandparents. The integrated approach provides support and relief to over-extended grandparents, simultaneously providing high-quality care for the children. The idea for this integrated approach grew out of the community, and has been implemented by an organization that is listening carefully to those it aims to serve.

Equally significant is Ikamva Labantu’s program for vulnerable children. With the assistance of a grant from Remgro, a South African Investment Holding Company, Ikamva Labantu launched a pilot program in 2006 in Philippi, an impoverished community outside of Cape Town, to develop a program that could be replicated in other parts of the country. Ikamva Labantu standardized a model of intervention for vulnerable children that supported 73 families caring for 271 children over seventeen months and for just over R5/day. The model, called Siyakathala (“We care” in Xhosa), involves no fewer than eight stages:

  1. Identifying children in the community through informal talks and referrals;
  2. Assessing needs through standardized interviews with the children and/or caregivers;
  3. Obtaining documentation of birth, parental death or proper identification for grant applications;
  4. Applying for grants;
  5. Caring for children by offering emotional support through grief and loss counseling as well as by supporting their education by the sponsoring of uniforms, stationary, and school fees;
  6. Supporting care givers by providing training and reliable information;
  7. Fostering independence by providing peer-support group facilitation and entrepreneurial development;
  8. Disengaging from families when they become independent, while remaining open to the possibility of providing future support should it become necessary.

Please support the work of Ikamva Labantu, if you are able. Among the organization’s unique opportunities to provide support is its “Adopt a Grandparent” program. For R150/month (approximately $20/month), you can support a Grannie’s transportation to the Center, as well as ensuring her a daily nutritious meal. Other opportunities for giving are outlined on Ikamva Labantu’s website:

http://www.ikamva.com/donations.html

Account Name: Ikamva Labantu Trust
Bank: First National Bank
Branch: Adderley Street, Cape Town, South Africa
Account Number: 62054752467
Branch Code: 250655
Swift Code: FIRNZAJJ
Once you have completed the wire transfer, please e-mail the amount donated, your contact details, and the name of the program you are supporting to fundraising@ikamva.co.za. If the e-mail does not specify a particular program, Ikamva Labantu will allocate the funding according to its discretion.

Inzame Zabantu

In Health Care, HIV/AIDS, Non-profits / NGOs, South Africa on August 10, 2010 at 2:45 am

Community Health Centre

Inzame Zabantu Community Health Centre is a medical clinic situated in Phillipi, in an area called Brown’s Farm, about 20 kilometers from Cape Town’s city centre. Whereas many governmental clinics in South Africa are dreary structures, worn by time and lacking funds for proper maintenance, Inzame Zabantu is light and airy, with windows that wash the waiting area with warmth and sunlight. The walls are painted with bright colors, and the grounds are well tended, even with a garden outside its front door. In completing the portraits and still lifes for 30/30, I interviewed Zethu Xapile, an administrative nurse at the Centre, to learn more about this remarkable Clinic in the new South Africa.

Please tell me about the community in which the clinic is located.

Brown’s Farm is an informal settlement that was developed immediately after apartheid was overturned in 1994. Many people are still living in shacks in Brown’s Farm. Even those who live in houses made of brick and mortar have shacks behind their houses, as many families attempt to shelter extended family on the same plot of land. It is common to have about ten or twelve people living in a house with only two bedrooms.

The area has an estimated population of about 80,000. The unemployment rate stands at 60%. Those who are employed are working as laborers and domestic workers, and earn very little income. Pensions and social grants generate an average income per household of around R800/month. The situation is very difficult. Teachers from the local schools sometimes bring children to the clinic who have collapsed due to hunger; nurses learn that they have gone for days without food.

What is the history of the Clinic? Was there a medical facility here prior to the building of this structure?

In 1994, members of the Brown’s Farm community approached the government with the request for a health facility. They received a donation of old shipping containers from a company called Safmarine. Wellconel, a pharmaceutical company, also donated used shipping containers. The government then prepared the containers and furnished them. The health centre started operating in 1994. The facility was given the name “Inzame Zabantu,” a phrase in Xhosa that means “the people’s initiative.” From 1997 to 2003, the administrators of the facility repeatedly submitted requests asking the government to build a proper structure, but they did not allocate funds for this purpose.

Meanwhile, the facility formed a partnership with the J. L. Zwane Community Centre. The clinic benefited from this partnership by receiving donations of medical equipment and non-pharmaceuticals from partners in the United States. In the year 2000, a woman from Dallas, Texas, donated five more shipping containers to give the clinic more working space and a roof over the containers to create a waiting space for the patients.

Please tell me about the process of winning the grant to build the new clinic?

In 2003, Professor Househam, Head of Health in the Western Cape, visited Inzame Zabantu. The staff stated its case, explaining how the containers were very cold in winter, and how the heat in summer was equally trying. He immediately set up a team to work with Zethu Xapile, an administrative nurse at the Centre, to generate a design and plan for the new building. The current building, which was officially opened in September 2006, is the beautiful result of that visit.

Please, describe the clinic.

The new facility consists of six consulting rooms, a treatment room, a dressing room, a preparation room, a reception area, a pharmacy, a boardroom, a staff tea room, an office, and a waiting area.

How many people are on staff here?

The government employs the clinic’s staff, which consists of one medical doctor, three clinical nursing practitioners, one professional nurse, two nursing assistants, one pharmacist, two pharmacy assistants, two administration clerks, two general assistants, and two health promotion officers.

How many patients does the clinic service daily, on average?

200 clients a day visit the Centre, on average. The clinic could not cope without its partners including individuals and non-governmental organizations. The Antiretroviral Service is run by an NGO called Absolute Return for Kids (ARK). Lay counselors do the pre- and post-test counseling. Additionally, a pharmacist from the United States worked at the Centre for a year on a voluntary basis.

Inzame Zabantu operates at a Primary Health Care level, providing curative, preventative and promotive health care, which means it is the first point of entry in the health care system for residents of Philippi and its surrounding area. The clinic sees clients from the age of thirteen and up. The service is free. As the only facility in the area, the clinic adds services that are much needed in the community.

What are the most common illnesses that are treated here?

The most common illnesses are chronic diseases of lifestyle, like diabetes, hypertension, and HIV/AIDS. Clients who need further management are transferred by an ambulance to secondary and sometimes tertiary health care providers.

Do you offer services here for clients who are HIV-positive?

The rate of HIV/AIDS in the area is 1:5. For this reason, the antiretroviral service is growing very fast. Inzame Zabantu started offering this service in July 2007, and up to now, has registered 1,202 clients on antiretrovirals. 77 more clients are awaiting the start of the regimen. The facility is too small to manage so many clients.

What are your limitations? For what kinds of illnesses/tests must you send people away in order for them to receive treatment elsewhere?

As this is a small facility, with limited space, there are services that we do not yet provide, but would love to offer at a future stage:

Inzame Zabantu does not have a tuberculosis service. Rather, nurses investigate and diagnose clients, but then send them to another clinic for treatment. As tuberculosis is one of the opportunistic diseases associated with HIV/AIDS, the Centre would like to make it easy for its clients by providing both ARV and TB service under one roof.

Maternal health is a must for any health care facility but, in the case of Inzame Zabantu, there are not enough rooms to be able to provide such a service. Maternal health includes family planning, cervical screening, and basic antenatal care. Residents of Brown’s Farm have to travel more than 10 km to access such a service.

There is no x-ray facility, so again residents of Brown’s Farm travel on foot about 10 km for this service.

Do you have plans/hopes for expansion, or replication?

Given all of this, it is clear that Inzame Zabantu wishes to expand to be able to render a quality service to its clients, and to attend to every one who comes to the facility. All the same, its beautiful architecture, graceful garden, and warm interior design expresses the care this facility provides to the residents of Brown’s Farm, who took the initiative to develop a proper health care center in a deeply impoverished section of the townships outside of Cape Town.

Thank you for providing this information.

Inzame Zabantu stands as a place of hope and promise in the community. Please support its work, if you are able. Donations can be given through “Arm in Arm in Africa.”

J. L. Zwane Center

In Non-profits / NGOs, Religious Fundamentalism, South Africa on August 10, 2010 at 2:30 am

The drive into the townships is a startling exercise in contrasts. As border crossers leave Cape Town behind them, with its crowded promenade that runs along the ocean, bustling shopping centers, and active tourist industry, they encounter heavily concentrated areas where people designated “black” and “coloured” under the apartheid regime live in a variety of small homes: tens of thousands of shacks, government issue houses, and pride of ownership homes jumbled in a tangled network of neighborhoods built on every scrap of ground available between freeways offering access in and out of these poor but vibrant communities. The overwhelming sensation in the area is dryness: sand, dirt, concrete, and cardboard compete for attention. Water taps and toilets are shared by tens or hundreds of people, depending on the density of the population. Corrugated iron and sheets of metal form roofs and walls of places people call home, all of which seem strung together with cables of wire in a complex and unsafe network of electrical power. John de Gruchy, a longtime professor of theology at Cape Town University, writes about the striking disparity between Cape Town and the townships in this way:

Cape Town is a city of contrasts, awesomely beautiful, tragically ugly. Lying beneath Table Mountain, which rises sharply out of the Atlantic Ocean, it is situated on a peninsula that is the heartland of one of the six floral kingdoms of the world. The southern tip of the peninsula has been described as both the Cape of Good Hope and the Cape of Storms, depending on how it has been experienced by those who have sailed around its craggy sentinel. Cape Point represents the end of Africa, or its beginning, cleaving the icy cold waters of the Atlantic from the warmer currents of the Indian Ocean. Tourists are awed by what they see. Those who climb Lion’s Head to watch the summer sun set over the Atlantic are stunned by the beauty. Yet the city and its environs are saturated with aesthetic and moral ambiguity, the co-mingling of exuberance and pathos, creativity and destruction. A city of many cultures and political persuasions competing for space and control, yet bound together as one in the need to shape a common destiny.

As a human construct of several centuries, Cape Town embodies beauty in its architecture and its gardens. But alongside this beauty, whether natural or constructed, lies another, ugly reality, much of it the creation of colonial and apartheid legislation and oppression, an architecture that reinforces alienation from social others and the environment. Natural beauty has been scarred by greed and racism; by highways that separate citizens from the sea and its beaches; and by public works that reflect modernity at its worst. The stylish homes of the wealthy often reflect a vulgar opulence rather than the beauty of the surrounding habitat. Not too far from them, though designed to be out of sight and sound, are conditions of widespread poverty. These have spawned street children, gangs, drug trafficking, prostitution, and violent crime. The contrasting worlds of Cape Town are no different from those of many other cities around the world where rich and poor live and work cheek by jowl. But there are few cities where the contrasts are experienced so keenly simply because the beauty of the city and its environment is so breathtaking (de Gruchy, 176).

But rising out of the midst of all of this in Guguletu is a clock tower, creating an unmistakable landmark in the area representing hope to the impoverished community surrounding it. The J. L. Zwane Church was founded by Jeremiah Zwane who came to Guguletu in 1952 to reestablish the church as a vibrant presence in a region devastated by apartheid’s brutal practices. Operating initially out of a poorly constructed building, the church was a center of anti-apartheid activity until the elections voted the African National Congress into power in 1994, overturning decades of the cruel and racist practices of the former regime. In the same year, the J. L. Zwane Centre was established as a joint initiative of Stellenbosch University, the Church, and the Guguletu community to meet the needs of the people. Instrumental to all of this was the work and vision of Rev. Dr. Spiwo Xapile (his name means “gift” in Xhosa), who came to the church in 1989. In his tenure, he has developed a model for community-focused ministries made possible by creating strategic partnerships with people in business, academia, and government. By 2002, he had raised enough money to build the Centre with its striking architecture, hopeful interior, and tasteful art. He has nurtured the leadership potential of many men and women who have come through its doors by surrounding himself with an extremely capable and dedicated staff, among them both Edwin Louw (a Presbyterian minister who serves as project director for the Centre), and Bongani Magatyana (an accomplished musician and composer who works with the musical group Siyaya), and by thinking with precision about programs that will impact the community in a positive and sustainable way.

There are many such programs at the Centre, and readers can learn more about each one on the Centre’s website. Here, however, I will highlight only three:

The HIV/AIDS Support Group meets weekly to offer a safe haven to those who have tested positive. Members come together to share their struggles and challenges with one another. Staffed by social workers, members receive counseling and acquire quality information about the virus in a society still reluctant to receive medicine and information from the West. Through one another, they learn how to live positively and productively with an infection.

Siyaya is a 16-member musical group that practices daily at the Centre and takes its message of hope into the community to educate children about the dangers of sexual promiscuity and drug use due to the high prevalence rates of HIV/AIDS in South Africa. The group has traveled internationally, and has won acclaim for the quality of its music, message, and movement.

The Rainbow After-School Program hires teachers to sit with children from 3:30 to 5:00 p.m. Monday through Thursday to provide homework support and nutritional supplement to students from the township. As many as 150 children come for an after-school snack before settling in at tables in various facilities at the Centre to complete homework, play games, and socialize after a full day of school. The snack is provided through a wider program of nutritional support to feed the community, many of whom are undernourished due to high unemployment rates.

The J. L. Zwane Centre is a remarkable place with a staff that welcomes every human being who crosses its threshold. It lives out a spirituality of recognizing the inherent dignity of every human person in a context rife with racial, economic, and cultural tension and division. Please visit its website to learn more about this place of refuge and hope in Guguletu.

Bibliography

Scalabrini Centre

In HIV/AIDS, Non-profits / NGOs, South Africa, Xenophilia, Xenophobia on August 10, 2010 at 2:15 am

Immigrants to Cape Town, including refugees and asylum seekers, often have needs that are not uniformly and cordially met by governmental agencies and welfare programs set up to serve citizens, an observation made long ago by John Baptist Scalabrini who, in 1887, founded the Scalabrini Order in order to serve the welfare of migrants. More specifically, because millions of Italians were fleeing from Italy in the closing decades of the 1900s as crushing poverty coincided with political strife as the Holy See and newly formed Italian state were hammering out their differences, a priest by the name of Giovanni Battista (John Baptist) Scalabrini became concerned that his parishioners were in danger when they left for America without money, jobs, or knowledge of English. He felt compelled to assist his parishioners in their efforts to migrate, first by writing for them letters of introduction which they could carry with them, to deliver to a priest on the other side of the ocean wherever and whenever they settled. Once he was installed as Bishop, his social activism progressed:

In the next few years, while emigration continued to increase in the face of continued Italian poverty, the bishop involved himself in several large projects to help the poor. Scalabrini established a society to aid the mondine, impoverished women harvesting rice in the paddies of northern Italy. He also opened an institute for the deaf and mute in his diocese. During the famine year of 1879, he turned his episcopal residence into a soup kitchen, dishing out 4,000 bowls of soup each day, selling his horses and even a bejeweled cup, a gift of the pope, to keep the soup kettles boiling. But the immigration question kept preying on his mind (Robb).

Soon, the Bishop would write to the Vatican to request permission to form a religious Order devoted to the care of emigrants from Italy. His charter included the objectives to protect emigrants, assist migrants in finding work, provide migrants with material aid, fight human trafficking, and offer religious guidance. Today, the Scalabrinians are present in over 30 countries, and have more than 600 religious, both male and female, on the rolls of the Order. Their mission worldwide is “to safeguard the dignity and the rights of migrants, refugees, seafarers, itinerants, and people on the move.”

The Scalabrini Centre in Cape Town welcomes refugees and asylum seekers coming to South Africa primarily from Zimbabwe and the DRC (Democratic Republic of Congo), because of war and unstable economic conditions being faced by these countries north of the border. The Centre welcomes newcomers to the city through its weekly welcoming program which offers material support in the form of food parcels, clothes, and blankets. The Centre also links refugees with social services available in the city, operates an employment help desk, offers courses in English and digital literacy, runs a sewing laboratory to help women start sustainable businesses as tailors, and prepares food in its soup kitchen, also for displaced and homeless people. Finally, the Centre also oversees the Lawrence House, “a place of hope . . . where refugee children can regain their childhood and prepare for their future.”

Since it opened in 1994, the Centre has grown increasingly aware that where there is migration, there is HIV/AIDS. In response, the Centre has added programs to increase awareness about the virus in the refugee community and how to prevent infection. In addition to offering workshops on HIV/AIDS awareness and management, the Centre provides testing and counseling through a support group to enable those who have tested positive to share their stories, struggles, and insights with other immigrants to South Africa who, like them, are living with a positive status.

While my family and I have been in South Africa, we have gotten involved with the Scalabrini Centre in three ways: we’ve served meals in the Scalabrini’s soup kitchen during the welcoming program on Wednesday mornings; together, too, we’ve volunteered to cook meals on Saturday evenings for the children at the Lawrence House (the Scalabrini Centre’s home for orphaned and abandoned children). Lastly, for the past month, I’ve visited the HIV/AIDS support group weekly to listen to what is on the minds of refugees to Cape Town who are living with HIV/AIDS.

The stories I’ve heard, in session and in the corridors of the Centre, are painful to be sure—but there is an indomitability to the human spirit that is almost tangible in this place. This was especially evident one morning when I waited for the HIV/AIDS support group to assemble. Seated in the reception area, I introduced myself to the only other person who had come early—a woman who had fled, I learned, from the Congo six years earlier. As we engaged in conversation, she shared with me how she had witnessed the death of her husband. He had been shot, she told me, and when “they” came, referring to the men with guns, everyone ran. It happened so fast that she became separated from three of her four children. She, along with her then three-year-old daughter, fled to South Africa. They were joined in Cape Town sometime later by the woman’s mother, who had found the other children and emigrated with them. Subsequently, the woman learned she was HIV-positive. She had a baby six months ago. The test for the baby’s HIV status had just come back negative, she shared with me when we spoke, moving her hand to her heart in thanksgiving. But, she whispered, “I’m still suffering. There is no work. And I have to feed my baby formula. I cannot afford to buy can after can of baby formula.”

The three people I met through the Scalabrini Centre who are featured here likewise share in their journals complicated stories, where gratefulness is evident alongside sorrow for what has been lost, for what has been left behind. In their own words, they have responded to my invitation to share what they want people to know about them and their perceptions of HIV thirty years into the pandemic.

The Scalabrini Centre is doing important work that recognizes the inherent dignity of refugees and asylum seekers arriving in South Africa; please support its HIV/AIDS program if you are able. For more information about the work of the Scalabrinians, see:

http://www.scalabrini.org.za

http://www.scalabrini.org

http://www.cedomis-scalabriniane.org/en/links/default.htm

http://www.sedos.org/english/scalabrini.htm

Bibliography

Treatment Action Campaign

In AIDS Denialism, HIV/AIDS, Non-profits / NGOs, South Africa on August 10, 2010 at 2:00 am

Treatment Action Campaign

The deaths of two men in South Africa quickened the founding of the Treatment Action Campaign (TAC). Simon Nkoli, an anti-apartheid and gay rights activist, died from AIDS even when ARVs were available to wealthy South Africans. Shortly after Nkoli’s death, Gugu Dlamini was murdered due to his HIV-positive activism. In response, on International Human Rights Day (December 10) 1998, Zackie Achmat and ten other activists launched TAC, a South African AIDS activist organization that uses direct action techniques borrowed from South African trade union and anti-apartheid movements in order to achieve its aims. So far, the organization has been enormously successful—though not without nail biting suspense as each goal is achieved. TAC has been credited with South Africa’s implementation of a country-wide mother-to-child transmission prevention program, as well as forcing the reluctant South African government under its former President, Thabo Mbeki, to make ARVs widely available to South Africans.

The group’s methods are memorable, which perhaps explains their effectiveness. Very early on, members of the group (positive and negative alike) fought AIDS stigma by wearing HIV-positive t-shirts. Recognizing the vast inequities in access to pharmaceuticals, Achmat pledged not to take ARVs until all South Africans could obtain them. As Achmat grew weaker, TAC was instrumental in ensuring that generic medicines would be made available in South Africa at an affordable price. However, when the government blocked their roll-out, TAC staged a thousands-strong march in 2003 to pressure the government to make ARVs widely accessible. Building upon the energy from the march, TAC began a civil disobedience campaign in March 2003, and distributed unlawfully acquired drugs to its members, ceasing its activity when it received word that there was some progress in Parliament. Only then, when Nelson Mandela himself, in unison with members of TAC, pleaded with Achmat to take the drugs did he relent, having grown very weak in the meantime. In the autumn of 2003, the Cabinet overruled the President, and voted to begin a roll-out of antiretroviral access through the country’s still poorly developed system of public clinics.

Despite this maneuver, Mbeki continued to endorse the denialist position, as did South Africa’s minister of Health, Manti Tshabalala-Msimang. She became a target of TAC’s activism. She was removed as Health Minister in 2008, after President Mbeki left office. Access to antiretroviral therapy is now an official policy of the South African government. However, TAC continues to protest and file lawsuits to influence the speed of the rollout.

With its vision of a “unified quality health care system which provides equal access to HIV prevention and treatment services for all people,” and its mission to “ensure that every person living with HIV has access to quality comprehensive prevention and treatment services to live a healthy life,” TAC “has become the leading civil society force behind comprehensive health care services for people living with HIV & AIDS in South Africa” (http://www.tac.org.za/community/about).

For its efforts, TAC has received worldwide acclaim including a Nobel Peace Prize nomination in 2004. Please support its work, if you are able.

Donations can be made through direct deposit into TAC’s bank account.

Account name: Treatment Action Campaign
Bank: Nedbank Jorissen St, Braamfontein
Branch Account No: 128 405 1870
Branch Code: 195 005
Swift Code: NEDSZAJJ

All US donations are tax exempt and can be made by writing out a check, payable to: South Africa Development Fund with TAC as the beneficiary. The check can be mailed to:

South Africa Development Fund
555 Amory Street
Boston, MA 02130
tel: (617) 522-5511
fax: (617) 522-5591
e-mail:  freesa@igc.org
contact: Judie Blair, Director

Credit card donations to the South Africa Development Fund can also be made though Network for Good. Please write TAC in the relevant field

Wola Nani

In HIV/AIDS, Non-profits / NGOs, South Africa, Violence Against Women on August 10, 2010 at 1:45 am

Wola Nani is a Xhosa phrase, meaning “through our embrace, we develop one another.” Founded by South African activist Gary Lamont in 1994, Wola Nani’s mission is, simply put, “to improve the quality of life for people living with HIV and AIDS.” Without denying services to anyone, Wola Nani has focused on bringing relief to the communities hardest hit by HIV, recognizing that women have been disproportionately infected with and affected by HIV/AIDS. The organization’s concern for the welfare of women is evident in its areas of focus which fall broadly into three categories: client support; education and awareness; and skills development.

Client Support:

Client support is a fundamental aspect of the work of Wola Nani. Through its family and community support center in Khayelitsha, its Cape Town drop-in center, and non-medical voluntary counseling and testing (VCT) site in Guguletu, Wola Nani provides a full spectrum of services related to an HIV-positive diagnosis. By counseling those testing positive, encouraging involvement in Wola Nani’s support groups, providing home-based care and health monitoring, operating an emergency food relief service, giving clients referrals to the services of other NGOs, conducting workshops about how to access government grants, medical services, and legal services, and caring for vulnerable children by running child daycare facilities, assisting in the placement of orphaned children, and monitoring the vulnerability of children in the communities served, Wola Nani’s impact in the lives of those living positively with HIV and AIDS is thorough.

Education and Awareness:

Having been created in the very year of Nelson Mandela’s inauguration to the new South African presidency, and enduring the years of Thabo Mbeki’s denialism, Wola Nani places great emphasis on educating those testing positive about the virus and how to treat it, and on raising awareness about HIV and AIDS in order to foster greater support for those infected with and affected by the virus in the wider community. Wola Nani conducts the famous “Red Ribbon Campaign” each year, to keep HIV and AIDS awareness alive in the public square. As its own website proclaims,

Wola Nani has coordinated and run this major, high profile awareness and fundraising event since 1994. As part of the campaign, Wola Nani has lit up Table Mountain red as the world’s greatest living memorial to AIDS, waved Red Ribbon flags from a procession of Harley-Davidsons and fired a 6 cannon salute from Signal Hill in Cape Town. Activities vary from year to year but may include wrapping a prominent building in Cape Town with a giant red ribbon, distributing red ribbon and collection boxes in the streets, local shops, and restaurants, and live outdoor broadcasts with popular local radio stations. The Red Ribbon Campaign has become an event which allows people to acknowledge HIV/AIDS, a time when the whole City wears a red ribbon and sends a message to the millions of South Africans living with the virus that they are not alone and the people of the nation support them.

In addition, Wola Nani runs educational programming in the communities where people are most vulnerable to an infection to promote safer sex and prevention of transmission. For those who have become infected, Wola Nani offers seminars and workshops so that people understand the medical condition and their treatment options (including ARV treatment literacy), as well as rights and entitlements persons testing postive have under the law.

Skills Development:

Wola Nani has also been entrepreneurial in spirit, wishing to provide women with a practical means to support themselves financially. Income generation rapidly was identified as an urgent need for women testing positive with HIV. Soon, Wola Nani branched into sales of crafts, featuring products ranging from papier maché bowls and picture frames, as well as beaded bangles and AIDS ribbons. These products are marketed and sold overseas as well as at shops nationwide. When I visited Wola Nani’s administrative center in the Observatory of Cape Town, I was shown the storage room filled with craft supplies, as well as the bustling office where bowls and light bulbs were being shipped to European retailers. At present, about sixty craftswomen are employed by Wola Nani, enabling them to earn a regular and sustainable income. These women report that Wola Nani has provided them with a means by which to feed their families, send their children to school, and live positively.

Below is a list that gives a sense of how dollars will be used by the administrators of Wola Nani:

$25 will buy Home Health Kits for five clients;
$50 will enable ten child clients to receive supplemental, wholesome meals twice a week for a month;
$200 will provide HIV diagnostic testing procedures for 50 individuals;
$500 can fund the purchase of materials needed by a craft maker to create 1,000 papier maché bowls for sale and income generation;
$2,000 will allow 10 clients to be trained as certified home caregivers;
$5,000 would enable Wola Nani to hire 2 HIV counselors on a part-time basis for one year.

More information about each of Wola Nani’s projects is available on Wola Nani’s website, which also features stories about the women whose lives have been greatly impacted by the organization’s vision. Please support their work, if you are able.

Donate to Wola Nani

Yabonga

In Healing of Memory, HIV/AIDS, Non-profits / NGOs, Political Violence, South Africa on August 10, 2010 at 1:30 am

Within a few years of experiencing the ousting of the apartheid regime in South Africa, it was clear to educator Ulpha Robertson that high-quality school readiness programs in underprivileged areas would not be among the priorities of the newly elected government. Therefore, she collaborated with Austrian-born Ursel Barnes, herself a parent with an interest in shaping the direction of education within South Africa’s emerging democracy and, in 1998, together they founded Yabonga (a Zulu word meaning “they thanked” or “they saved”).

Educare Program. With an aim to strengthen young children’s preparedness for mainstream schooling, Yabonga focused initially on establishing educare centers—places that were dedicated to preventing an achievement gap from taking root in at-risk children from birth to age five. Today, Yabonga has assisted in training teachers at ten educare centers in underprivileged communities, and has established two preschools. However, within two years of Yabonga’s founding, the staff encountered their first child living with HIV—an experience that caused them immediately to expand their focus to provide education, support and skills development for mothers testing positive, so they could be present to their children to support them as they grew into adults.

Peer-Educator Program. In 2001, Yabonga began piloting its peer-group education program. Today, more than 200 women have undergone a four-month training program that equips them to educate peers within their communities about prevention and treatment strategies in relation to HIV/AIDS. Candidates showing potential are trained in home-based care, lay counseling, and youth counseling. By talking openly in their communities about the facts behind HIV/AIDS, these women are working to overcome the shaming and stigmatizing patterns that have isolated people living with HIV/AIDS.

HIV/AIDS Support Centers. As local clinics became aware of Yabonga’s peer educators, they created a demand to have the educators present in community clinics. Therefore, Yabonga worked with local businesses to purchase ten shipping containers (that function like trailers) to establish support centers. The centers maintain a staff comprised of a team leader, peer educators, lay counselors, home-based carers, and youth counselors in order to respond to the needs of those testing positive in the communities that are experiencing the highest rates of infection. In addition, Yabonga has a presence at an additional 20 clinics and 20 schools, providing HIV education, voluntary testing services, voluntary individual and family counseling sessions, support group facilitation, and nutritional support.

Income Generation Program. Access to reliable information about the virus and its effects on the body enables people to live positively, raising their own children and relying on their own abilities to generate income to support their families. While the support centers raise awareness, Yabonga’s income generation program equips participants with skills in beading, sewing, fabric painting, cooking, baking, wire working, or gardening, depending on the peer-educator’s preference. The items produced by Yabonga’s income generation program are available for sale from the Yabonga website: http://www.yabonga.com/site/support/.

Orphan and Vulnerable Children (OVC) Program. In addition to its educare and peer-education programs, Yabonga has supported 350 orphaned and vulnerable children by purchasing school uniforms and books, providing nutritional assistance and counseling, and supporting life skills and leadership workshops for children who wish to develop strategies for coping with the trauma associated with HIV, poverty, abuse, and the death of a parent.

Community Mothers. Community mothers provide a safe haven for children involved in Yabonga’s OVC program. The mothers are hired to provide a nutritious meal as well as homework support to the children. Trained in skills required to counsel children in relation to issues associated with HIV/AIDS, community mothers provide a safe place to talk about HIV directly in the communities where the children live.

Men’s Program. Lastly, Yabonga has established a men’s program. Fifteen men have been trained to run support groups for men living with HIV/AIDS. In addition, the men’s program aims to empower young men to stay away from drugs, alcohol, and gangs by running sports and enrichment programs for youth. By organizing community-based education programs in taverns (legally operated bars) and shebeens (bars that run without a license), the program attempts to raise awareness about HIV/AIDS and its attending issues in communities where the prevalence rates are as high as one in every three.

In all, Yabonga employs more than 100 people to run the network that supports the non-governmental organization’s extensive HIV/AIDS programs that have, to date, served more than 600,000 people. The reach of Yabonga’s programs is, indeed, impressive, as the peer educators participating in “30/30” attest.

Please support Yabonga’s work, if you are able, by sending food, clothing, toiletries, blankets, toys and stationary to:

Yabonga
2 Main Road
Wynberg 7800
South Africa

or by wiring a donation to:

Beneficiary: Yabonga
Nedbank Branch Code: 145209
Account No. 1452012563

For more information, visit Yabonga online by clicking here.

New Life Center Foundation

In New Life Center Foundation, Non-profits / NGOs, Thailand, Trafficking on August 10, 2010 at 1:15 am

In the hill tribe regions of Thailand, more than one million ethnic minority people—including the Karen, Hmong, Lahu, Akha, Mien, and Lisu—live. Each group proudfully preserves its own customs, language, dress, and spiritual beliefs. However, young men, women, and children are leaving their villages in pursuit of work dishwashing in restaurants, cleaning in private residences, and sewing in factories, as well as working in Thailand’s fishing and farming industries. Sometimes, their movement is initiated in answer to advertisements and personal promises that jobs are available to support their basic needs, paying wages that will enable families to secure food, shelter, clothing, and an education. In other situations, familial drug and alcohol abuse, parental disability, or destitution propels them from the village into Thailand’s larger cities.

Although Thailand’s laws legislate against exploitation, including child labor, when children are born in these regions, traditional midwives attend their births. Babies not born in hospitals are not issued birth certificates. Without birth certificates, people coming into Thailand’s cities in search of work are officially considered illegal laborers, much like those coming in from the countries bordering Thailand in the north: Myanmar and Laos, for example, until or unless their legal status and age can be authenticated. Acquiring such documentation can be a lengthy and expensive endeavor.

Business owners, in the meanwhile, desiring to turn a higher profit, know this kind of cheaper labor is available. Therefore, they hire from this vulnerable minority population in order to pay, for example, 50 baht per day (or about $1.50/day), rather than having to pay the legally mandated but higher minimum wage to of-age and documented workers (170 baht, or about $5/day). Cases have been heard in the Thai courts where workers were paid with rice rather than with currency. Moreover, working conditions are often poor and abusive.

The practice of human trafficking, the illegal trade in human beings for the purposes of forced labor or sexual exploitation, is pervasive in this context. Laws meant to stymie this trend are only marginally enforced. Too often, young women are especially vulnerable to trafficking that is prolific in a situation of poverty where thousands of migrant workers are also seeking a better life.

Young girls who travel an hour or more to the nearest cities to do their work too often learn that the advertisement or personal contact that attracted them was not truthful. In many cases, parents are unaware that their children are being exploited. Very often, the bodies of young girls are being sold by brokers for the sexual pleasure of men. The baht goes to the trafficker rather than to the girl, who is sometimes beaten until she complies.

During their careers that spanned more than four decades, anthropologists Paul and Elaine Lewis observed this pattern firsthand, so in 1987 they founded the New Life Center Foundation. The non-profit organization is headquartered in Chiang Mai, Thailand, with offices also in Chiang Rai, and is devoted to empowering and equipping at risk or exploited tribal women through education and training, in order to create positive change in their lives and in society. The founders were interested in creating an organization that could provide minority girls with skills that would enable them to find meaningful work, including fluency in the Thai language, while simultaneously preventing the loss of their tribal heritage. Today, the New Life Center has nearly 120 young women in residence. The girls range in age from 13 to 23. About 50% of these minority women are identified as at risk for exploitation; the others have been referred to the Center through the Thai welfare system after experiencing forced labor or sexual exploitation.

The Center has evolved over the year to provide eight primary services:

1. Education. By matriculating the residents of the Center into mainstream schools, running an adult education evening school, and providing education through a weekend school, the goal is to give the residents a quality education and literacy skills through the high school level.

2. Vocational Training. By paying for training for work in beauty salons, tailoring, and nursing, the Center equips its residents for meaningful work, free from exploitation.

3. University Scholarships. Due to a generous donation from a Foundation in Sweden, 75 residents are now receiving scholarships to attend University.

4. Citizenship Advocacy. Staff working in the area of citizenship advocacy undertake the lengthy and expensive process of helping residents acquire Thai citizenship through navigating the complicated labyrinth of offices and paperwork in the government that attaining citizenship requires.

5. Life Skills. Because many of the girls did not have good role models or mentors in the villages of their birth, the structure of the Center provides residents with the opportunity to develop valuable life skills through formal training, conducted by various professors and teachers from the region’s NGOs and Universities. Workshops cover a wide range of topics, such as health and human hygiene, reproductive health, recycling, care of the environment, fire safety, leadership, human rights, and gender equality.

6. Spiritual Development. The Foundation is supported by American Baptist International Ministries, as well as many other religious and private sources. The Evangelical Lutheran Church in America, along with the First Presbyterian Church of Berkeley, California, generously support the work of the New Life Center Foundation. In addition, the Foundation receives financial support from the U.S. State Department’s Office to Combat Trafficking in Persons, the Royal Thai Government, Diakonia, Sievert Larssen Scholarship Foundation, the Rotary Foundation, as well as from many private donors. The Foundation deeply respects the diverse spiritualities of the young women who arrive at the Center. The community is comprised of people from many religious backgrounds, including Catholic and Protestant Christians, Buddhists, and those practicing traditional tribal faiths. Residents are given the opportunity to participate voluntarily in Bible studies, devotions, and discipleship training in preparation for baptism.

7. Income Generation. The handicraft program is a supplementary program of the Center, and provides some of the women an opportunity for income generation by selling jewelry, dolls, handbags, and needlework through the Center’s shop. In this way, the Center is able to support the preservation of the traditional embroidery practices of the tribal women, and the young women earn an income as their skills develop.

8. Therapeutic Services. Rehabilitative and therapeutic services, such as art and music therapies, are offered to support the women in coping with the traumas they have experienced.

The New Life Center is a place that provides a more promising future for ethnic minority girls in Thailand. Please support their work if you are able, by writing a check to New Life Center Foundation, and sending it to:

New Life Center Foundation
P.O. Box 29
Chiang Mai 50000
Thailand

If you would prefer to send a wire transfer, please e-mail the Center for banking details: newlife@pobox.com.

Open Arms of Minnesota

In HIV/AIDS, Hunger, Non-profits / NGOs, Poverty, United States on August 10, 2010 at 1:00 am

Its mission is deceptively simple: “With open arms, we nourish body, mind, and soul. By preparing meals for and delivering meals to people living with HIV/AIDS, ALS, MS, and breast cancer in Minneapolis and St. Paul, Open Arms of Minnesota aims to provide meals to anyone who is living with a chronic or life-limiting illness in the Twin Cities metro area.

Open Arms of Minnesota has been in the not-for-profit business of providing nutritious and delicious meals since 1986 when its founder, Bill Rowe, prepared meals for a group of friends who had contracted HIV/AIDS and who had become too ill to shop for or prepare their own food. Soon, a group of volunteers formed to keep the meals going out the door—and they haven’t stopped, yet. Just recently, Minnesota Senator Amy Klobuchar delivered the organization’s two-millionth meal.

Over time, Open Arms of Minnesota was compelled to widen its reach. Its staff recognized its global connection to people living with, and dying from, HIV/AIDS in South Africa, and began partnering with the J. L. Zwane Center in Guguletu (a township outside of Cape Town) to provide nutritious meals to member of an HIV/AIDS support group that had formed at the Center, as well as to distribute food parcels twice annually to families with members living with the virus. Back at home, too often the staff took calls from people experiencing other chronic illnesses: ALS and MS, for example, and were torn apart when they had to say “I’m sorry, no—our mission is to provide meals only for those living with HIV/AIDS.” So, in 2004, Open Arms expanded its home delivery meal program also to women undergoing treatment for breast cancer, as well as to people living with ALS (better known as Lou Gehrig’s disease) and MS (multiple sclerosis). A capital campaign enabled the organization to move into a new building in 2010, where the kitchen is the obvious focus of its entire enterprise. As they emphasize at Open Arms, “the kitchen is the heart of who we are.”

I began working as a volunteer at Open Arms in 2003, and was impacted profoundly by the alternative universe represented by this determined organization, where compassion, kindness, and gentleness of spirit were the norm rather than the exception, where even small things were considered with great intention, and where the dignity of every person who passed through the door was recognized genuinely with warmth and with grace. I was intrigued by the ethos of the place, and was happy to deliver meals regularly for the next several years.

My engagement with the organization deepened in 2004, when I inquired about the possibility of teaching my course “Theology of Beauty” at the University of St. Thomas with a service-learning component in partnership with Open Arms of Minnesota. At St. Thomas, “Service-learning incorporates meaningful community partnerships into coursework, allowing students to contribute to the community while gaining knowledge relevant to their academic and professional lives.” Students would deliver meals twice monthly throughout the semester, writing in academic journals about how their observations and experiences informed an understanding of Beauty—in theology, understood not as something “pretty,” but as that which might cohere with the source of Existence, itself, the very nature of God insofar as such a nature can be known, and therefore associated with the True, Good, Just, Wise, and Compassionate. Open Arms was receptive to the possibility of establishing a partnership with the University that would be truly reciprocal: University students would supply the steadily increasing need for drivers to deliver meals to clients, while Open Arms would provide an opportunity for students to engage in response to a public health catastrophe about which they would learn more in class. Moreover, students would begin to see how people’s social location, and their “degrees of jeopardy” from power and privilege, coalesce to put them at greater risk to contract the virus, even while considering efforts of people like Paul Farmer (Harvard Medical Anthropologist and physician, as well as founder of Partners in Health), to mitigate the impact of structures of violence on those living in conditions of abject poverty.

The course was successfully piloted in 2004, and a grant from Minnesota Campus Compact enabled us to expand the partnership into other disciplines, and beyond the work of Open Arms, as well. Since that first course, fifteen professors representing thirteen different disciplines throughout the University have offered 50 sections of courses in partnership with Open Arms. For example, students learn about research methods in sociology by preparing and conducting surveys in application to real needs emerging for Open Arms, such as measuring client and volunteer satisfaction. Students in epidemiology courses learn about food-born illnesses and their greater threat to those living with compromised immune systems, and prepare food safety kits for Open Arms clients. In 2009-2010, the University reached a significant milestone. More than 1,000 students have interacted with the HIV/AIDS community in Minneapolis/St. Paul through the University’s HIV/AIDS initiatives.

The executive director of Open Arms of Minnesota, Kevin Winge, is often heard saying: “It’s about food.” In some ways, it really is that simple. Open Arms of Minnesota lifts the human spirit by inviting the community into its kitchen, that we might “break bread” together. Please support their work, if you are able. To learn more, visit Open Arms of Minnesota online.

Beauty’s Companion

In HIV/AIDS, Holy Spirit, South Africa, Theological Aesthetics, Theological Reflection, Truth on August 9, 2010 at 3:15 am

On Truth

(This article is now under review with a book publisher.) It speaks of a Trinitarian theology that proposes a manner in which one might retain belief in an Absolute Truth whose identity is in the mystery of God’s Being while celebrating all non-violent human endeavors to forward humanity’s understanding of holiness.

Beauty’s Trace

In Dignity, HIV/AIDS, Theological Aesthetics, Theological Reflection on August 9, 2010 at 3:00 am

On imago Dei

(This article is now under review with a book publisher.) It speaks of Catholic and Lutheran approaches to the question of the nature of the human person, defending an approach to theological anthropology that recognizes that there is an inviolable dignity to every human person. Dignity is not given or taken; it is violated or recognized as an inherent aspect of being.

Beauty’s Corruption

In HIV/AIDS, Sin, Structural Violence, Thailand, Theological Aesthetics, Theological Reflection on August 9, 2010 at 2:45 am

On Sin

(This article is now under review with a book publisher.) It speaks of the nature of injustice as that which might be offensive to God, suggesting sin has a corporate as well as individualized dimension.

Beauty’s Oracle

In HIV/AIDS, Prophetic, South Africa, Theological Aesthetics, Theological Reflection on August 9, 2010 at 2:30 am

On the Prophetic Voice

(This article is now under review with a book publisher.) It speaks of the prophetic tradition that Jesus stresses in his ministry, and its applicability in an age of AIDS.

Beauty’s Song

In HIV/AIDS, Lament, Theological Aesthetics, Theological Reflection, United States on August 9, 2010 at 2:15 am

On Lament

(This article is now under review with a book publisher.) It speaks of the need for Christians to reclaim from its tradition the form of the lament in order to express anger in faith to God in an age of AIDS.

Beauty’s Presence

In HIV/AIDS, South Africa, Theodicy, Theological Aesthetics, Theological Reflection on August 9, 2010 at 2:00 am

On Theodicy

(This article is now under review with a book publisher.) It speaks of the idea that Christ was Beauty incarnate, and asks, then, “what did Beauty look like?” Since he chose to be among those most marginalized by the culture of his day, such as the poor, lepers, widows, and orphans, so likewise might we find Christ among the most marginalized of our day—the poor, people testing HIV-positive, widows, and orphans. It encourages people to look at one another, face to face, to recognize the Beauty of Existence in one another, and to treat one another as Christ’s Beloved.

Beauty’s Expression

In Compassion, HIV/AIDS, Justice, South Africa, Theological Aesthetics, Theological Reflection on August 9, 2010 at 1:45 am

On Compassion

(This article is now under review with a book publisher.) It draws a distinction between compassion work or charitable work, on the one hand, and justice work, on the other. While both are acknowledged as essential, the essay discourages consciences to be cleared by charitable measures, alone, as these can attempt to justify lifestyles that perpetuate the underlying structural causes that are putting so many lives at risk throughout the world.

Beauty’s Narrative

In HIV/AIDS, Parables, South Africa, Storytelling, Theological Aesthetics, Theological Reflection on August 9, 2010 at 1:30 am

On Storytelling

(This article is now under review with a book publisher.) It speaks of the power of storytelling in relation both to the lives documented in “30/30” and to the parables of Jesus, particularly in relation to the parable of the Good Samaritan and the parable of the Persistent Widow in Luke, and the parable of the Workers in the Vineyard in Matthew.

Beauty’s Incarnation

In Forgiveness, HIV/AIDS, South Africa, Theological Aesthetics, Theological Reflection on August 9, 2010 at 1:15 am

On Forgiveness

(This article is now under review with a book publisher.) It speaks of the problem of the classical theory of atonement. Anselm imagined God’s justice, understood retributively, to be at odds with God’s mercy. By reconsidering the cross within its political context as an instrument of torture representing an act of brutality and injustice that God would oppose, I re-imagine the cross to represent God’s desire for non-violence. Jesus accepted death rather than to allow his disciples and the revolutionary spirit around him to raise in arms against the Roman Empire. By looking to African ideas about justice originating from a restorative rather than a retributive framework, I attempt to reconcile God’s justice and God’s mercy as coming from a unified and non-conflicted Being, whose incarnation in Jesus demonstrated a redemptive love for humankind—even for enemies who were out to destroy Life—redemptive by the degree to which we likewise live in love, made possible by grace.

Beauty’s Promise

In Education, HIV/AIDS, Mexico, Theological Aesthetics, Theological Reflection on August 9, 2010 at 1:00 am

On Hope

(This article is now under review with a book publisher.) It speaks of the hope that is present in a community that is working together for the common good.

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