Our Kind of People: A Continent's Challenge, a Country's Hope (2 page)

They begged him to go to the hospital; they begged him to submit himself for blood tests so doctors might determine the cause—beyond the bad luck of losing his wife and child. At Asokoro General Hospital, a collection of low-lying buildings in the center of the city, they drew his blood and admitted him to the wards.

The doctor was a young man. He entered the room with a worried look and drew in a long, slow breath. “Who is this person Jerome?” the doctor asked.

One of them answered, “It is my brother, my good friend, from the same side.”

The doctor spoke again, and slowly. “Wow. OK. There is nothing to hide from you. Before, we hide it. Now we don’t hide anything. Your friend has a bad deadly disease and he allowed it to go far, to destroy many things in his body. He has this new reigning disease HIV and AIDS. It is now gone far, to the extent that the blood system is now weak. So there is nothing we can do. If you keep moving him from hospital to hospital, it’s just a waste of funds.”

So Jerome’s friends did the only thing they could do. They took him back to Cross River, to his village. That’s where he gave up. That’s how Jerome passed on.

His baby boy was gone. His wife was gone. He too was now gone. And somewhere out there, his daughter is left behind to grow up without parents.

You know this story. You have heard it many times before. This is the story of HIV/AIDS in Africa.

Or is it?

F
or the rest of the world, Africa’s story has been one of exploitation, famine, floods, war, and now tragic demise as a result of HIV/AIDS. This troubles me. Despite growing up with exposure to both the Western world and Africa—in particular, Nigeria, where my family is from—even I sometimes succumb to thinking of Africa as a place beyond hope and Africans as sad creatures destined to slow-dance with adversity. I should know better, because I have experienced the continent, at least my small corner of it, as a place characterized by something other than tragedy, but it is hard not to think negatively, especially when the vast majority of media from the past few hundred years—the explorers’ accounts, novels, newspaper articles, documentaries—have focused on Africa’s pain. Though a relatively new disease, HIV/ AIDS and its stories have again brought to the foreground a whole set of images and stereotypes about Africans, our societies, our bodies, our sexualities. Many of these representations of Africa are deployed to elicit sympathy and encourage assistance with HIV/AIDS and other issues. Often, however, they unknowingly encourage the opposite, distancing and disconnection, because they provide an image of Africa and Africans to which few people can relate. The lives and voices of real people, who like everybody else in this world find ways to cope with adversity, are often lost amid the drumbeat of deprivation and demise. This confuses me. At times, this angers me. While I understand that Africa—its countries, its people—has endured a fair amount of adversity, the tragic Africa is not the only continent I know.

I grew up in Washington, DC, but my family is from Nigeria. From the moment I was born, each summer my parents would take my three siblings and me “home” to visit family. These trips were an often confusing exposure to the dynamic milieu of personalities, cultures, and languages, the stark contrast of privilege and poverty, and the innovation that such a mixture encourages. The Africa I got to know through summers spent in Nigeria while growing up was one of both struggle and promise. It was a place where issues like HIV/AIDS were part of a complex existence. I don’t want to minimize the scope and impact of the epidemic, just to say that it’s not all we are.

In early 2006, a year and a half after I graduated from college, I began working on health policy issues in sub-Saharan Africa with the Millennium Villages Project, a comprehensive development program headquartered at Columbia University and the United Nations with the mission of alleviating poverty and associated ills in sub-Saharan Africa. I was a very junior employee, mostly acting as an assistant to the team coordinating the project’s health programs. I was exposed to many aspects of health care in Africa, the different diseases, the lack of adequate health systems, and the language used to describe conditions on the continent. At the headquarters in New York, however committed we were to presenting a different view of Africa to the world, the rhetoric would sometimes slide into the usual images of helpless Africans and their saviors from abroad. When I spent time with our local experts in the field, I often found myself in an awkward position. They would complain bitterly to me about those people in New York who didn’t really respect Africans. “Those white people,” one of my colleagues said to me, “they really don’t think very highly of us at all.” His words seem harsh, but perhaps I can explain why he might arrive at this conclusion.

In the spring of 2006, in New York, I attended a talk about HIV/AIDS sponsored by the Earth Institute at Columbia University. The speaker stepped to a podium in the cavernous Lerner Auditorium bathed in bright white stage lights. His voice tremulous with concern and amplified by large speakers, he painted such a dire picture of HIV/AIDS in Africa that it seemed only a matter of months before all 800 million sub-Saharan Africans would contract the virus and perish.

“People don’t have access to information. People don’t have access to medication,” I remember him thundering as the mostly white, mostly Western audience sighed in sorrowful agreement. “People are dropping like flies.”

I sat up. I remember scribbling those words on a program that I have long since lost.

“Dropping like flies” is an often used and, as a result, rather innocuous simile, but in that context it made me wonder: is this how Africans are considered, as insects, animals, not human? Is resorting to a metaphor of inhumanity the only way to register the magnitude of the problem unfolding on such a vast scale before us? In fairness, “dropping like flies” can be used to describe any set of people, but historical associations of Africans with animals make such language very complicated. Sometimes it can even be perceived as outright disrespectful.

On the other hand, what does it mean to say that 33.4 million people in the world are HIV positive and 28.2 million of those in sub-Saharan Africa? What does it mean to say that 1.8 million people in Africa died last year as a result of the virus and its effects? There is no love or loss in a decimal point, no resilience and no redemption. Statistics, however beautifully rendered in tables or graphs or charts, cannot even begin to relay the tragedies and triumphs of this situation. Such large numbers defy comprehension and flout nuance, leaving people to seek explanation in simple narratives that stand as symbols for the epidemic:

There was a man from the country who went to work in the city. He slept with a prostitute and contracted HIV. When he returned home, he slept with his wife. Then she died. Then he died. Now their children are orphans.

Tragedy occurs without bounds and death piles upon death. Numbers feature prominently while the characters remain faceless. These stories exist, but they are not the only stories Africa has to tell about its experience with HIV/AIDS.

It would be too easy to write a polemic against past and even present depictions of Africans and our relationship to HIV and AIDS. There are too many instances in which egregiously racist beliefs and subtle prejudices have colored both descriptions of Africa’s HIV/AIDS epidemic and the responses to it. There are too many examples of how sensationalism—even when well-meaning—has impeded our understanding of this disease and the people it affects, creating distance where none need exist, making a terrible fantasy of something very real.

As I sat in that auditorium surrounded by a sea of well-meaning white Western colleagues and luminaries in the field of international health swooning in the presence of this powerful speaker, I suddenly felt very aware of and protective of my African-ness. I began to wonder if there was a way to consider the hard truths of the HIV/AIDS epidemic in Africa and to impress upon people the urgent need for action in a way that was fundamentally humanizing and empowering for those living in the epicenter of this crisis. I thought I might be able to develop a better understanding of what HIV/AIDS means and how we can deal with it by spending time in Nigeria, in a country that is home to one fifth of sub-Saharan Africa’s population and the third-largest population of HIV-positive people in the world. I hoped that this would give me an indication of the epidemic’s impact on the whole region. I thought I could find answers to my questions in a few months, but my exploration turned into a four-year journey, with multiple trips between Nigeria and the United States, that has changed my understanding of the HIV virus, its epidemic, and the real people it affects. I had no idea what I was about to discover.

A
IDS is real,” the driver said, pondering the notion for a moment while gnawing the end of a bleached wood chewing stick. He spat a gob of wet pulp out the car window before turning back to me. He was probably the driver for one madam living in the same Victoria Garden City neighborhood of Lagos where my family has a house. Now that he had dropped his employer at work, he had the time for a leisurely kindness otherwise unknown to constantly grinding Lagosians. I had never met him before, and I probably shouldn’t have accepted. In Lagos you don’t get into just anybody’s car. All the same, I was appreciative when he offered me a ride after seeing me walking from our house to the Lekki Expressway where I could catch a taxi. I fidgeted in the passenger seat of the air-conditioned SUV.

In the distance, the mini-skyscrapers of Victoria Island and down at the city center near the marina shimmered against an embankment of low clouds, and I remembered an uncle’s sarcastic statement that from afar, Lagos actually looks like a wonderful city. Like New York, Lagos is a city of islands. From the air, you can see the massive lagoon that separates the sections of the city on the mainland from the two large islands in the Atlantic Ocean, and the city’s latticework of paved highways, occasional red-earth side streets, and tin roofs looks deceptively peaceful. In truth, this megalopolis, though impressive in scale, is frustrating beyond belief; it simmered around us as we sat in the famous Lagos go-slow (traffic jam). Cars and trucks stretched for miles ahead of us toward the city center and miles behind us toward its outskirts, where developers couldn’t build houses fast enough for an exponentially growing population. Street hawkers roamed among idling vehicles and thrust everything from chilled soft drinks in perspiring bottles to steering wheel covers up against car windows. Lagos, the joke goes, is the one city in the world where, because of the traffic, you can accomplish all of your shopping on the way to the market. That morning the only forward movement came from the
okadas
(motorbike taxis), which buzzed through tight spaces between cars, leaving behind a trail of suffocating black exhaust as they passed.

I was on my way to see Rolake Odetoyinbo, the head of Positive Action for Treatment Access (PATA), an advocacy group for causes related to HIV/AIDS. I was going to be late, even by Nigerian standards. PATA’s offices were in the Ikeja section of Lagos on the mainland. Though I had budgeted two hours for what should be a half-hour drive, an accident on the road blocked movement. As the car idled in traffic, the driver and I had struck up a conversation about HIV/AIDS.

“AIDS is real,” he said again after he removed the chewing stick from his mouth. His eyes flashed with a knowing excitement before he spoke again. “It has been here for generations with our forefathers,” he said in the blasé tone of someone for whom besiegement is ordinary. “We have a word for it.
Atogbe
,” he mouthed the Yoruba word slowly.

“Atogbe,”
I repeated and then wrote it down. He sighed appreciatively.

“Yes.
Atogbe
, someone who urinate until he die. And until when the death comes, he has six or seven sickness at the same time. We have known this thing since the olden days, but now the whites, them come call it AIDS.”

The first reported case of AIDS in Nigeria was diagnosed in 1985 and presented at the second International AIDS Conference in Paris the following year. According to the case reports, the patient in question was a thirteen-year-old female street hawker from Lagos. I could find out little about this girl or how she contracted the virus that causes AIDS—which at that time was called HTLV-III (human T-lymphotrophic virus III) or LAV (lymphadenopathy-associated virus), depending on whether you followed the American or the French researchers. I could determine only that it was in Lagos that HIV supposedly first appeared in Nigeria and, as far as some are concerned, from this city that HIV spread to the rest of the country.

“It is from those in the coasts, the towns like Lagos, Port Harcourt. Big cities with the white men, the seamen, those who work with the ships, or soldiers—police, too,” an old retired civil servant said to me as we sat on his veranda sipping bottles of Coke. We had met in a small town in eastern Nigeria. “At first, when this thing was noted in this country, our people, they discountenanced it. They said, ‘What is that? What is AID? Oh! Nah—sickness for the whites and those up there.’ Some, in order to enjoy themselves how they want, they say there is nothing like AIDS.”

When it first appeared in Nigeria, AIDS was rejected as a nonissue by the successive military governments, as well as by the general public. At less than ten thousand dollars, the original budget for the first AIDS-related government body in Nigeria, the National Expert Advisory Committee on AIDS (NEACA), was laughable. The military dictators took a stance similar to that of other African leaders at the time: AIDS is not a problem here. In popular thought up until the late 1990s, AIDS was also considered a nonissue, sometimes referred to as the American Invention to Discourage Sex, if referred to at all.