Stephanie Nolen discusses 28: Stories of AIDS in Africa.
Stephanie Nolen is one of only three North American journalists dedicated exclusively to reporting on AIDS in Africa. Her greatest challenge in the last six years has been in communicating the magnitude a crisis that is in many ways too overwhelming for us to comprehend.
"In 28: Stories of AIDS in Africa" she focuses on over two dozen emblematic figures in Africa today: one for every million afflicted with HIV-AIDS. The result is an unprecedented, uniquely human portrait of the continent in the midst of a catastrophe- Cody's Books
A Canadian journalist and writer. She is currently the Africa correspondent for The Globe and Mail, working out of Johannesburg, South Africa.
There are 28 million people living in sub Sahara in Africa, who have HIV or AIDS and I have livingthere for last four years reporting on this issue full time for The Globe and Mail, which is the nationalnewspaper of Canada and came to see along the way that the idea of 28 million people is so big and soparalyzing that there is no way that people can engage with that. And you know, before we can start tohave an intelligent conversation about how we want to respond to this issue, we need to know whothose people are and so that's where the idea for this book came from. I have been on, I have beenfortunate enough as a reporter to be on the big story, lots of time, to be in Iraq for the end of SaddamHussein, to be in Afghanistan for the fall of the Taliban. There is a big gratifying thing for a reporterthat comes with being on the big story. There was lots of satellite trucks, there was the heavily made upCNN producer, you feel like you are in the center of the world but when I wasn't doing those stories Iwould go to Africa and I started to see after a couple of years that what was happening there wasactually much bigger than anything else that I covered anywhere in the world. I started to wonderwhere all the other reporters were and I came to understand that HIV was not just one disease in a placethat had lots of diseases, but was affecting everything, you know, my editor said to me when I said Iwanted to go right about this full time they said, well why HIV why not anything else and I said thatHIV under lays so many of the other things and that it was crippling economies, when it took away, itaffects people between 18 and 35. They are the most infected people in every country. So they are yourproductive workers, they are people who could grow your food and earn your wages in the city andthey are the parents right and you were losing a whole generation of parents and that this was thatHIV was having an impact that you know, we had countries where one in three adults had this fatalillness and that this was doing something to societies that we haven't seen since 1300s and that's why I moved to write about this.And so I guess, what I would like to do is just tell you a little bit about a couple of the people in thebook. One of my favorite stories about couple of kids in Addis Ababa in Ethiopia called (Tigus)and(Yohanus) , they have been living on the streets in Ethiopia since their mom died. Tigus was nineand Yohanus was six and five - he was five and they went back to the village to bury their mom andwhen thank you - after the funeral their aunt and uncle said are you going to come and live here with usnow, their father had already died of AIDS and they said they said they looked around and they sawall these kids who were plowing and fetching water and carrying firewood and doing all the stuff youdo in Ethiopia to survive as a kid and there was no school and they said no actually we want to go backto the city and their aunt and uncle who already had more orphans than they could care for, said well,okay good luck and they went back to the city and Yohanus started making a bit of money braiding hairor Tigus made money braiding hair, you know couple of cents here and there and Yohanus startedmaking a couple of cents here and there shining shoes and they have managed to keep themselves inschool and keep it together for the last six years living on their own in a house, the house is a sort ofsize of area in front of these chairs. It's made out of little bits of scrap metal and they share a little bed.They go to school everyday and Tigus remembers when her mom was alive Yohanus doesn't, butTigus remembers and she remembers a little bit what it's like to be parented, so she tries to do thethings for Yohanus that she thinks her mother would have done. She says don't scratch ,don't pick yourscalp, don't pick your nose, do your homework, wash your uniform and at the end of the couple of thedays that I spent with them I asked them separately first I asked Yohanus if you had a little money whatwould you do and the first thing he said was I'd get a TV and that was kind of funny because theydon't have electricity. Right?And then he said no, I had any money I would pay for us to go to best school in all of the Ethiopia andthen he said, you know, if I had any money I would use it to take care of my sister and then he wentoutside to play and I said to Tigus if you had any money what would you do and she said that if I hadany money I would use everything to take care of my brother because it is up to me now. I am the onlyperson he is left and they are you know, they are doing okay. I check in on them every so often andthey are still in school and they are doing pretty well and pretty soon Tigus will over in that - school isfree in Ethiopia up till but she will be in grade 10 and then she will have to pay school fees and therewon't be she would like to start a little restaurant business, she thinks but there won't be a way for herto stay in school unless they can find some one to pay the fees for them but for now they are doing okay.The next person that I would like to tell you about is a guy named Noe Sibisaba and he lives in Burundiin a little town called Serenjuru and Noe comes from a family of peasant farmers who nobody hadin the family had ever been to school, but Noe wanted to go to school and graduated from HighSchool which his parents were very his parents were confused. They have never really known anyoneto go school before but Noe loved school. They sold their only cow and they put him through schooland he graduated and he got a job with the local government because in Serenjuru only six peoplehad ever graduated from High School and so that qualified him as a heavily educated person. And hewhen he started working for the government in early 1990s Burundi's periodic civil war wasreemerging and he Noe great flaw is that he is a pacifist and a believer in compromise and so whenHutu rebels with threatening this Tutsi government, Noe advocated a dialogue and talking to the rebelsand that had the effect of making everyone suspicious of him. And so Noe is a Hutu, the government ofBurundi is Tutsi, and was Tutsi and a very violent repressive military government and one day whenNoe was away on business, the government decided to teach him a lesson, believing that he supportedthe rebels and they sent a squad of soldiers to his house and they gang raped his wife, (Agrapine)she was five months pregnant at the time. And so when Noe got home and found her herealized that they had to leave and they fled over the border, they waited till she had the baby becauseshe really couldn't travel before then, but as soon as she had the baby they fled the border intoTanzania and they joined 800000 Burundians who were living in refugee camps all along in these hugeopen plains in western Tanzania. And Noe talks with great eloquence about what it's like to have beena respected person that, you know, for we and the west room, when we see refuges, we see thesecolumns of people with their stuff on their heads and we think one more refugee. But he had been aperson, he was really respected in his community and he had all his ambitions for how he was going tobuild up Serejnuru and now all of sudden, he was just this guy in this camp reliance on handoutsthat he went one day to try and get a pair of pants, because he had no clothes and they said well wedon't have any pants but here have a dress because that's was there was in the cast off clothing box thatday. When Noe fled he took a little bit of money and his family photos and a couple of clothes and hiscopy of Les Miserables by Victor Hugo which was his most treasured possession.So living in this camp one day Noe was walking by the clinic and they say we really need blood forblood transfusion, there is no sort of permanent blood supply, could you donate blood and he is so sureI am an universal donor, I am type O. So he donates blood and then they don't use his blood and that'show Noe finds out that he has HIV and at that point there are 800000 people in these camps andnobody who will say openly that they have HIV because of this incredible fear and shame that goesalong with the disease, the way it used to be here 25 years ago. And Noe wants to tell people, he isteaching by this point at the school in the refugee camp and he wants to tell people that he is infectedand his wife won't let him. She says if we do, we will be completely ostracized and so he has to keep ita secret and he is really worried about his students because he sees these girls who are having sex withaid workers or with men from town to make a little money to support their families or to buy a pair ofshoes and he knows that they are risk for HIV but he keeps the secret. Agropine died and their secondbaby Lena also died of HIV and at that point Noe figured, I have nothing to lose and he went public inthe camp and said I have HIV. And like Agropine had feared older people in the camp completelyostracized him but his students organized a rally and when Noe got there, they were singing and theywere singing this traditional [0:09:09] (Kirundi) song that's reserved for heroes who come back from awar and he listened to them for a long time before he realized that actually they were singing for himand his students completely supported him and started this organization that took care of orphans, tookcare of people who were sick and started to organize, made it possible for a lot of people to comeforward and say that they had HIV. By the time he left the camps three years later he was repatriated toBurundi which is now at peace and rebuilding, there were 1700 people living openly with HIV and hetook all of those skills back to Burundi where he was trying to setup the organization. Noe is a- yeah heis pretty amazing, he is a very quite gentle person with his unbelievable strength.And the last person that I will tell you about is a guy named Pontiano Kaleebu who is a microbiologistand I like to talk about Pontiano because we and the west often have this perception that the response toAIDS is about us going to help and we forget that almost of what's been done to respond to thepandemic has actually originated in Africa from Africans and that includes not only care for orphansand sick people but also Pontiano works for something, he heads something called the Uganda VirusResearch Institute where they have been doing work on an HIV vaccine and a vaccine is incrediblyimportant, it's the only thing that will eventually stop the pandemic but HIV is incredibly difficult tovaccinate for because of the way that it works. It targets our - the same immune cells that wouldnormally wipe out a germ is what HIV lives in and its really sneaky. It will get in your body and hidefor ten years. It coats itself in these sugar proteins so that your body can't recognize it even if youyou can give someone a vaccine and then the HIV will effectively put on a disguise so that the vaccinedoesn't recognize it. So what Pontiano was going to be a Pediatrician when he went to medical schoolin Kampala in Uganda and then along the way he got side tracked into into virology, into vaccineresearch because he saw the incredible impact that HIV was having on Uganda. When he graduatedfrom medical school one in five adults was infected and the other thing he noticed was that all the workthat was happening on an AIDS vaccine was on what's called Subtype B. HIV comes in a lot ofdifferent strains, Subtype B is the one that you have here on America. Fewer than 10 percent of thepeople in the world with HIV have that strain of the virus but that's where all the research was becausethose are people with the money. 90 percent of people have A or C but nobody was looking for avaccine for A or C because they don't have any money.So Pontiano helped to show that it was possible to do, he was the principle investigator on the first aidsvaccine trial ever held in Africa and he has helped over the last ten years to show that its eminentlypossible to do that kind of research in Africa. And they you may remember the press conference thatthe Reagan administration held in 1982 when they said they would have a vaccine for HIV within twoyears. There is still no sign of it, Pontiano is an optimistic guy but he on his best days says it will be tenyears before they have a vaccine. The thing that I really came to understand about when I spent timewith him at the Virus Institute is that its not only this great scientific puzzle for him as it is forresearchers here in US but when Pontiano needs to do a trial on a vaccine candidate to see if that worksyou know give half the people a vaccine and half the people a placebo and see what happens he has gotto get those people by going to his kid's school and to the church and to his community center andsaying to his own family I need you to come and be part of this and then every time it doesn't works hehas to go down to the church on Sundays and stand up and say you know, I am really sorry, we triedagain, it didn't work. We are going to do another one I need you to come back and let us to do thisagain and and its you know it's a great fascinating scientific puzzle for him and its also of courseincredibly close to home. So these are that are kinds of stories that are in the book and I have tried asmuch as possible to include not only the description of the destruction that's been caused by the virusbut also to tell the stories, you know, there how we think of this as an incredibly depressing story thataids in Africa is just this great monolithic disaster and in fact even in the four years that I have beenliving there, there have been incredible changes. When I moved there, there were fewer than a 100,000people on anti retro viral treatment, the treatment that has in America made HIV a chronic illness likediabetes. There are when I left two weeks ago there were 1.5 million people on treatment which is a 13fold increase. Everybody said you couldn't do it that you couldn't treat anybody in Africa and in factthey are treating millions of people and along with that with the role that the treatment has come a realchange in how people talk about the disease, the shame has lessened, the fear has lessened and peoplehave a a lot of the stories are in the book or of people who were just kind of minding their ownbusiness who were teachers or nurses or civil servants and kind of going through their lives, wanted tosee their kids grow up. Didn't have a set of ambitions that were particularly different, you know, thanprobably most of ours and all of a sudden get told that they have this bug something they can't see, thatthey have never heard but that's going to kill them and they well most of them were reluctantactivists but with no supports from within their own communities and almost none from outside theyhave noted these extraordinary moments that fought their families and their communities and theirgovernments and our governments and international pharmaceutical companies to to bring treatmentto Africa and to change it from being a fatal illness and they have been astonishingly successful and itis people say to me a lot. I am audience I was talking to in San Francisco today, asked me - a couple ofpeople asked me how do you do this job. It must be really depressing, and in fact its very rarelydepressing. It's often incredibly exhilarating because I get to meet and spend time with theseextraordinary people. So along with the very real face of the incredible damage done by the virus inAfrica I wanted to make sure that I told some adverse stories because I don't think that we hear thosenearly as often. So I will not stop prattling and if any body has any questions I would be glad to answer them.