Category Archives: HIV/AIDS

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Twitterview with Bisi Alimi – Living Positively with HIV for 10 Years

Via Elnathan John

Transcript of a Twitter interview conducted by Elnathan John on May 7, 2014 with Bisi Alimi.

Bisi Alimi, a human rights campaigner and health advocate who rose to notoriety when he first came out as gay on NTA. He started his advocacy work at the height of the HIV epidemic within the Nigerian MSM community in the late 1990s. In 2004, Bisi’s open declaration of his sexuality, caused a turning point in the discussion on sex and sexuality in Nigeria. In July 2012, he was invited to the White House by President Obama for his work with black gay men in Europe. On May 7, 2004, Bisi was diagnosed with HIV. He continues to passionately do his advocacy work from his base in the UK. This interview marks 10 years of Bisi living ‘positively’.

I first interviewed Bisi in November 2012

Bisi Alimi

EJ: My first question Bisi, what was your first reaction when you got the test results saying you were positive?

 

BA: Honestly, considering the number of friends I had lost before then, I was sure it was going to be positive. Still, I was shocked and upset when I was told I was HIV positive. It was like a big cloud of a broken dream.

 

EJ: Were you in Nigeria at the time?

 

BA: Yes I was in Nigeria. Actually I was tested at the National AIDS Conference in Abuja in 2004.

 

EJ: What was the climate like at the time with regard to access to HIV care? Where did you first receive treatment?

 

BA: You see prior to that time, I didn’t even know much about treatment at all in Nigeria. I was so naïve. Also because of the fear, shame and guilt, I didn’t even tell anyone about my status apart from people present. I was waiting to die. I had seen friends dying, so I was like, well it’s a matter of months until I am gone.

 

EJ: Many people link HIV to homosexuality. However health sources cite over 80% of HIV transmission from heterosexual sex. How, in your experience does ignorance about HIV affect stigma?

 

BA: You see the conversation that HIV is homosexual disease is right and wrong and I will try to explain. HIV as we now know it was first discovered among gay men in America in the late 1970s to early 1980s. So it was kind of okay to link the virus to that community, however further digging around found that it is not so true. Scientists had found out that a similar virus had wiped out a community in the Congo around the late 1960s to early 1970s. So then the global interest started. However depending on who is telling the story the answer is different. The good thing about ownership of the virus by the gay community is that it brings the right sentiment. I guess you can only face one stigma at a time. So they [gay people] wanted to remove the HIV stigma as a pathway. But in the context of Africa, it is a different story. Heterosexual couples are driving the virus. [About ignorance and stigma], this is multilayered. First there is the image of HIV you see on TV. You know the skull and the two bones – it is scary. Then there is the religiosity or morality around the whole sex thing. HIV is seen as being a punishment.

Continue on Elnathan John

Sexual Rights in Zimbabwe

The Sexual Rights Centre is a human rights advocacy organisation based in Bulawayo. They work directly with sex workers and members of the  LGBTI community. They are unapologetic about their commitment to human rights for every Zimbabwean and their conviction that sexual rights are integral to affirming all human rights.
Every two weeks they organise a “creative space”. The idea behind the “creative space” is for people to have fun, and express themselves through various forms of expression. These works were inspired by a desire to have people mark their space. The prevailing theme was ‘Who Am I?’ and people worked in small groups to paint who they were.
As an organisation the Sexual Rights Centre believes in diversity and inclusivity.  Therefore they encourage people to use as many different forms of expression as possible to celebrate themselves. These paintings will remain on the walls of the Sexual Rights Centre as a testimony to the power of sex workers and the importance of their voices.

Continue reading on HOLAAFRICA

Sex workers in Bulawayo challenge the discriminatory legislation that makes it difficult for them to work.

Sex workers in Bulawayo challenge the discriminatory legislation that makes it difficult for them to work.

Sex Work Is Work

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A Veil of Silence [Video]

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The Veil of Silence produced by the TIER and directed by Habeeb Lawal documents the experience of sexual minorities in Nigeria and discusses issues of sexual citizenship, violence and stigma.

On the brink of an impending law that could re-write their destinies, young groups of sexual minorities in Nigeria defy all odds in the pursuit of happiness. In the midst of all, their strength, resilience, vulnerability are brought to fore in this informative and mind-blowing documentary.

A few of the many men and women who appear in the documentary as themselves, sharing their personal experiences and opinions on the subject, include Ayo Sogunro, Ifeanyi Orazuike, Dorothy Aken’ova, Abayomi Aka, and Valentine Crown Tunbi.

Homosexuals sacrificed for political ambition in Uganda: A Statement from Freedom and Roam Uganda [FARUG]

KAMPALA: Freedom and Roam Uganda (FARUG) with dismay and regret condemns the Anti Homosexuality Act accented to by the president of Uganda on Monday 24th, February 2014. The Act contravenes the fundamental national and international human rights standards and the constitution of Uganda which calls for the protection of the right to privacy, equality and non-discrimination. The law also denies Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) persons the rights to freedom of association and peaceful assembly.

While assenting the Bill, the President said that the country can’t be forced to do something “fundamentally wrong.”

The (AHB) which was infamously known as the Kill The Gays Bill was first introduced to parliament by Ndorwa west Member of Parliament; Hon. David Bahati in 2009 with the objective of establishing a comprehensive and consolidated legislation to protect the traditional family by prohibiting any forms of sexual relations between persons of the same sex. “The people of Uganda should know that they have been duped for political ambition. The debate surrounding the Act has been a diverse measure to divert attention from real issues of national concern. This bill will never solve Uganda’s real problems like lack of drugs in hospitals, poor education services, bad roads or corruption. The Act will not change how we feel or who we love. It will make life extremely difficult for us but will change nothing” Said Junic Wambya, the Executive Director of Freedom and Roam Uganda.

This law deals a major blow to public health access and information for LGBTI persons in Uganda especially in regards to HIV prevention and care. Criminalizing the funding and sponsoring of health related activities and policies will not only affect homosexuals but Uganda as a whole. “It is very sickening to listen to the head of the State degrading the people he is supposed to protect. He has distorted the medical reports from around the world to justify his hold on to power in quest for votes from locals at the expense of lives of homosexuals. It’s really a pity that now more than ever we have to watch our backs; but maybe this is a blessing

in disguise. I see that it has now made us move faster to the much anticipated decriminalization since now we shall be heading to the constitutional court which will dismantle even the penal code. That’s my consolation from this madness.” Said Kasha Jacqueline; The founder of FARUG.

Legal implications of the Law

All laws should have a commencement date but the Anti Homosexuality Act doesn’t have a designated commencement date. That means it can only be operational after it has been gazetted which could be

anytime from the date of assent. Before that, no person can be charged under this Law. The Law cannot be used to penalize any person who committed the crimes therein before the Bill was

signed into Law. The Bill was amended to take out the death penalty for acts of aggravated homosexuality but life imprisonment for acts of homosexuality and aggravated homosexuality still stands. The law imposes a sentence of seven years for attempted homosexuality, aiding and abetting homosexuality and recruitment of minors into homosexuality. Any organization found promoting homosexuality stands to serve a sentence of 5 years imprisonment or pay a fine of UGX100million or both.

Call to action

In coming days many LGBTI persons will be assaulted, arrested and detained. As of yesterday, 25th February; a gay couple was attacked and one of them killed while the other is in critical condition in hospital. Many have been thrown out of their houses by landlords and yet others will continue to lose their jobs. In the midst of all this we request the general public to desist from radical and irrational acts of violence towards suspected LGBTI persons. We demand that security agencies including the police and prisons endeavor to investigate any cases of violence perpetrated against LGBT persons and refrain from making arrests based on meagre hearsay and or suspicion. Uganda during the Universal Periodic Review in 2012 in Geneva committed to:

  • ? Investigate and prosecute intimidation and attacks on LGBTI community members and activists.
  • ? Investigate thoroughly and sanction accordingly violence against LGBTI persons including gay rights activist.
  • ? Take immediate and concrete steps to stop discrimination and assault against LGBTI persons. Media organizations should also refrain from sensational reporting which is fuelling hatred and attacks on persons suspected to be homosexuals.

We demand that donors channel funds to Civil Society Organizations carrying out, Social, Economic and human rights work rather than to a corrupt institution that has no remorse in not protecting its citizens. It is very unfortunate that we have to make such a call but Uganda should be isolated to prevent this passing of laws with impunity from spreading across the continent. This is very crucial to protect other countries in Africa. Finally we urge the international community to continue supporting the LBTI community, morally, financial and technically in response to security treats and human rights violations. To contribute to FARUG security fund please donate through our PayPal on our website: http://www.faruganda.org/paypal.html .

For more information contact:

Kasha Jacqueline: 0772463161

Jay Abang: 0782628611

For more on the medical report:

http://www.patheos.com/blogs/warrenthrockmorton/2014/02/23/exclusive-changes-made-in-final-report-of-the-ministry-of-health-committee-on-homosexuality/

Museveni’s speech at signing of Bill

http://www.monitor.co.ug/News/National/Museveni-s-Anti-Homosexuality-speech/-/688334/2219956/-/item/0/-/6t248n/-/index.html

https://pdfzen.com/c12275be8591a372.

FREEDOM AND ROAM UGANDA [FARUG], IS A MEMBER OF THE COALITION OF AFRICAN LESBIAN

African groups call for the African Union to urgently respond to gender and sexuality rights violations in Africa, and particularly to anti-gay laws recently passed in Uganda and Nigeria

African groups call for the African Union to urgently respond to gender and sexuality rights violations in Africa, and
particularly to anti-gay laws recently passed in Uganda and Nigeria

As African civil society organisations whose members live and work to improve the lives of all Africans, we condemn in the strongest terms, the disturbing increase in sexuality and gender-related rights violations and abuses, especially those aimed at women and gender non-conforming people, and people in same sex relations including lesbian, gay, bisexual and trans-identifying African people.

Specifically, we condemn the signing of the Nigerian Same-Sex Marriage [Prohibition] Act and the Ugandan Anti-Homosexuality Act, both of which were passed into law this year by Presidents Goodluck Jonathan of Nigeria and Yoweri Museveni of Uganda, respectively. We also strongly condemn the Anti-Pornography Law, which was passed in Uganda last year.

In defence of African people whom these laws target, we seek recourse through the African Union (AU) and its organs.

We also call on the AU Chairperson, Nkosazana Dlamini-Zuma, to make a public statement condemning both the Nigerian and Ugandan laws, and providing African citizens with a roadmap for how the AU Commission plans to address laws that violate gender and sexuality-related rights amongst member states.

EXTREME VIOLATIONS
Uganda’s Anti-Homosexuality Act criminalises homosexuality—defining it as “same sex or gender sexual acts”—with punishment ranging from seven years to life imprisonment. Those who are found guilty of “aiding and abetting homosexuality” also face up to seven years in prison. Uganda’s Anti-Pornography Act places limitations on ‘appropriate’ dress code for women, specifically banning miniskirts and any other clothing deemed to “cause sexual excitement”.

The Nigerian Same-Sex Marriage [Prohibition] Act goes further than its stated purpose by criminalizing the registration of ‘gay clubs, societies and organisations and banning the public show of a same sex ‘amorous’ relationship either directly or indirectly, carrying a ten year prison sentence for such acts.

These laws have already forced people from their schools, work and homes out of fear and due to their safety being threatened. The levels of violence, threats, and abusive and hate speech have escalated dramatically as homophobic laws have been put in place. We note with alarm that in both Uganda and Nigeria,  the passage of these laws have been accompanied by acts of murder, rape, assault, arbitrary arrest and detention and other forms of persecution of persons on the basis of their imputed or real sexual orientation and gender identity. The climate of fear and hate was further escalated in Uganda by the publication of a list of “200 Top Homosexuals” in Red Pepper Newspaper, with the headline “Exposed”, immediately following President Museveni’s signing of the Anti-Homosexuality Act. This constitutes a gross violation of media ethics and of human rights, both of which, we argue, are punishable under Ugandan law.

States have an obligation to protect the rights of all citizens, regardless of gender or sexuality. States have a responsibility to protect the rights of all who live in their borders. States should not be creating the conditions in which violence by non-state actors are justified or encouraged. Nor should the state set itself up as a threat to its own citizens and block them from living with basic levels of freedom as both Uganda and Nigeria have done.

We reject arguments made by the heads of state of both Uganda and Nigeria, that consensual same-sex relations are “unAfrican”, and we condemn in the strongest terms the comments of political, religious and cultural leaders who have used similar rhetoric to incite hatred against persons perceived to be homosexual.

We celebrate and echo the strong voices of African leaders who have rejected these claims and who continue to condemn discrimination, violence and human rights violations based on real or perceived sexual orientation and gender identity. We align ourselves with all Africans who have spoken out in the face of these unjust laws and who have continued to call for respect for diversity and for all Africans to embrace the African idea of Ubuntu –our shared humanity.

The United Nations High Commissioner for Human Rights, Navi Pillay, stated in respect of the Nigerian law, “Rarely have I seen a piece of legislation that in so few paragraphs directly violates so many basic, universal human rights.” Former President of Mozambique, Joaqium Chissano, in an open letter to African leaders said, “I encourage leaders to take a strong stand for fundamental human rights, and advance the trajectory for basic freedoms…This simply means granting every one the freedom and the means to make informed decisions about very basic aspects of one’s life – one’s sexuality, health, and if, when and with whom to have relationships, marry or have children – without any form of discrimination, coercion or violence.”

Given its mandate as the human rights organ of the African Union, we call upon the African Union Commission, as well as the African Commission on Human and Peoples’ Rights, to condemn all homophobic and anti-gay laws that have either been passed, or are being proposed, throughout Africa, and further respond urgently to the increasingly violent acts that precede and follow these laws.
– Statement by African civil society organisations listed below.

Contact:
Lucinda van den Heever, Sonke Gender Justice : (+27) 72 994 3138
Kene Esom, African Men for Sexual Health and Rights : (+27) 11 242 6801
Sheena Magenya, Coalition of African Lesbians : (+27) 11 403 0004/7

List of signing organisations:
African Men for Sexual Health and Rights (AMSHER)
Africa Regional Civil Society Platform on Health
AIDS Accountability International
Coalition of African Lesbians (CAL)
Gay and Lesbian Memory in Action (GALA)
Gay and Lesbian Network (Pietermaritzburg)
Gender DynamiX
HOPEM (Men For Change) Mozambique
Signing organisations (continued):
International HIV/AIDS Alliance
MenEngage Namibia
MenEngage Zimbabwe
MenEngage Zambia
MenEngage Kenya
Out in Africa
SANAC Women’s Sector
Sonke Gender Justice
South African Council of Churches Youth Forum
Triangle Project
World AIDS Campaign
Women’s Global Network for Reproductive Rights
Background for Editors
Provision of the laws
While there are close to 40 African countries that criminalise consensual sexual conducts between persons of the same sex, the new laws enacted by Nigeria and Uganda goes further by criminalising peoples’ sexual orientation and identities regardless of sexual conduct. They also include such egregious provisions.

The Nigerian Same-Sex Marriage [Prohibition] Act [A1] includes:
•             a provision for a 14-year prison term for anyone who enters into a same sex union,
•             a ten-year prison term for anyone who ‘administers, witnesses, abets or aids’ a same sex marriage or civil union ceremony.
•             The law states that ‘a person or group of persons who … supports the registration, operation and sustenance of gay clubs, societies, organizations, processions or meetings in Nigeria commits an offence and is liable on conviction to a term of 10 years imprisonment.’

The Uganda Anti-Homosexuality Act: [A2]
•             introduces a series of crimes listed as “aggravated homosexuality” – including sex with a minor or while HIV positive;
•             criminalises lesbianism for the first time;
•             makes it a crime to help individuals engage in homosexual acts;
•             makes homosexual acts punishable with life in prison.

Africa LGBTIQ – aid conditionality & LGBT Rights

From Paper Bird by Scott Long   -  “Resources for the unbelievers on aid conditionality and Africa LGBT Rights

I’ve been working desultorily (a beautiful word: say it slowly: it seems to capture being lazy but just alive enough to claim you’re still doing something) on an article on aid conditionality and LGBT rights.

This all comes, of course, from the controversy launched last fall by David Cameron’s declaring his government would cut development assistance to governments that committed violations based on sexual orientation and gender identity. This statement was idiotic in the pure, Greek sense: Cameron was, in essence, talking to himself. It came without any prior consulting with activists in the countries in question, and was an ill-planned effort to get domestic voices in the UK to shut up and stop pressuring the PM.(They did, obediently.) The ensuing backlash, across Africa and elsewhere, proved exceedingly discouraging about the idea. However, Hillary Clinton’s announcement that LGBT rights were a new US global priority gave new life to the project, and US advocates have urged the Obama administration to enlist American foreign aid money in the cause.

Northern governments have ben conditioning development aid on other issues for a while, especially in the last 30 years– usually affixing economic strings (hire our consultants! buy our goods! privatize your hospitals, if you want our aid!), less often political or rights-related ones.  I’ll raise specific questions in my article about whether something around sexuality- and gender-related abuses makes them peculiarly resistant to being stopped by such linkages. There are also legitimate concerns, though, about whether such linkages ever work the way they’re meant to, or are ever justified. I’m skeptical they do, or are. I’d like to get some discussion going as I finish the article, and so I’ll share some resources here for others who are skeptical, or in favor, or undecided, in hopes you’ll argue or respond. Respond! Use the comments section, or write me directly.

1) First off: here’s an interview with Radhika Balakrishnan, of the Center for Women’s Global Leadership, that lays out some of the concerns with conditionality clearly.

2) The October 2011 statement by dozens of African activists opposing aid conditionality in the LGBT rights sphere is here. Hakima Abbas’s “Aid, Resistance, and Queer Power” expands on its points; her essay can be found in this booklet from Sexuality Policy Watch (pp. 16-19) along with “Aid conditionality and respect for LGBT people’s rights” by Luis Abolafia Anguita (pp. 9-15).

3) An especially important paper you should examine is this report by AWID (the Association of Women in Development), succinctly called Conditionalities Undermine the Right to Development. It sets out a wide range of facts and arguments on the issue. Because it’s 128 pages long, I’ll try in the following points to summarize some of the background with which it deals.

4) A lot of people (including many of those pushing for aid conditionality) don’t know about the political negotiations in the last 10 years over the issue of how aid works, or doesn’t. By “political” I mean: Northern and Southern governments have actually discussed the subject, sometimes with each other! In 2005, a major ministerial-level meeting produced the Paris Declaration on Aid Effectiveness, responding to a wide perception that aid wasn’t being … well, effective. Over 100 countries joined to affirm five pillars of meaningful assistance: Ownership, Harmonisation, Alignment, Results and Mutual Accountability. (OHARMA?)  OK, enough buzzwords. The key commitment under “Ownership” was that conditions on aid, if any, should be jointly owned. Donors should

draw conditions, whenever possible, from a partner’s national development strategy … Other conditions would be included only when a sound justification exists and would be undertaken transparently and in close consultation with other donors and stake holders.

Pragmatically, this recognized that conditions imposed from outside simply weren’t being met. Three years later, another high-level forum in Ghana produced the Accra Agenda for Action (AAA, a way better acronym). This proclaimed, “We will continue to change the nature of conditionality to support ownership” by developing countries. It mandated donors to “work with developing countries to agree on a limited set of mutually agreed conditions based on national development strategies,” and to “document and disseminate good practices on conditionality.”

Both these documents can be found here, and straightforward summaries are here and here. It’s important to see that the emphasis on joint commitments, as opposed to taking aid hostage, severely limits how far donor governments should use aid to enforce rights goals that aren’t fully shared (or aren’t integrated into development strategies). Do we want LGBT rights to be the basis for backtracking on these principles?

Anti-Debt Coalition activists protest an Asian Development Bank (ADB) meeting, Jakarta, 2009 (Reuters)

5) Civil societies and social movements engaged intensely in the lead-up to the Paris and Accra meetings, as well as a further gathering in Busan, Korea, in 2011. And while you might suppose that women’s movements, for example, would want aid more conditioned on rights policies — since they were urging women’s rights and gender equality as core components of development planning – almost exclusively they called for less conditionality. Part of their reasoning involved the possible devastating effect of slashes in aid. They also saw that conditions foreign governments imposed actually prevented civil society in developing countries from being part of the rights discussion: everything turned into an argument between the donor and recipient governments, with domestic voices ignored. A broad coalition of feminist and gender-equality groups in 2011, for instance, called on donors to

[m]ove away from policy conditionalities towards consistent application of concepts of multiple responsibility, accountability and transparency among both donor and developing countries. This could be advanced, for example, by supporting democratic scrutiny of development goals, policies and results. Policy conditionalities can have negative impacts on people, particularly on women and girls. They undermine the principle of ownership and contradict the right to development and self-determination.

Similar criticisms can be found here.

6) The Paris and Accra documents have come under considerable fire for not going far enough. This (briefer) briefing paper from AWID summarizes some of the critiques. And this analysis by the UK-based Overseas Development Institute looks at the debate over aid effectiveness “through the recipient lens,” by talking to officials in governments that get aid. One criticism is that the Paris-based language doesn’t put sufficient stress on “predictability” of aid — states and societies need to know that money isn’t going to go away when the givers shift their whims. Conditionality is a prime generator of unpredictability in aid. The fact that many Northern donor governments don’t have a cross-party consensus on LGBT rights worsens the prospects in this particular sphere. What happens if Obama imposes conditions on development aid based on getting rid of sodomy laws; then Romney defeats him, and suddenly sodomy laws are OK; then Hillary Clinton gets elected in four years, and abruptly the conditions are back on again? Manic roller-coaster swoops and swerves in the terms of assistance don’t just leave governments confused; they mean that anti-poverty, health or infrastructural programs in country after country can’t plan on future funding, or their own existence. That’s a heavy responsibility for LGBT rights to bear.

7) When advocates talk about “conditionality,” often they mean the set of economic — or combined economic and political — strings that donor governments started attaching to aid in the 1980s and 1990s. International lenders, the World Bank and IMF, were even more radical and reviled movers in this. But surely human rights conditions are a different, friendlier thing altogether?

never in history have so many owed so much to so little money from so few

No. What’s happened for 30 years is that donors tie human rights into a bundle with something called “economic freedom,” or maybe “good governance,” conceived as governing the economy with a particular set of virtues that will make particular classes rich. After all, they’re all “freedoms,” right? Rights thus get bound up with the infamous “Washington Consensus”: Privatize everything!  Shrink the state! Down with protection, up with free trade! Deregulate!  This neoliberal “reform” brings wealth to people who are plugged into global flows of capital. It impoverishes pretty much everyone else — women, minorities, unpopular groups even more than others. When human rights get wrapped up with its strictures, they lose their popularity as well. LGBT rights are already seen, in many places, as imports from the insidious Outside. If wedded to imposed neoliberal policies, their street cred likely shrinks to zero.

A fine example is a United States concoction called the “Millennium Challenge Corporation (MCC)” This strange being, set up by the Bush presidency in 2004, reveals how fake-friendly you can make aid conditionality appear, with the right rhetoric. It’s a foreign aid agency with a ton of US money, and a mandate to give it out only based on supposedly clear standards and criteria. If LGBT rights are going to be integrated into US giving, the MCC is one place it will start — and advocates are already targeting it to establish LGBT benchmarks for giving.

The MCC grades developing countries on 17 indicators; they must exceed a median score on a number of them to be eligible to apply for money. One set of indicators is called “Ruling Justly,” and includes “civil liberties” and “political liberties.”  This is the human-rightsy side. Another is called “Economic Freedom,” and includes “trade policy,” “inflation rate,” and “fiscal policy.”  This is the telling part. The “trade policy” benchmarks, for instance, come directly, explicitly, from the Heritage Foundation: a right-wing Washington think tank whose mission – self-described – “is to formulate and promote conservative public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values, and a strong national defense.”

MCC is all about eliminating trade barriers and denuding countries of defenses against foreign purchase and foreign sales. This means ending protective, import-substitution policies for building strong domestic industries: policies that have been the main means, in the last hundred years, for poor countries to develop. It means prying markets open to invasions of US goods, while eviscerating local producers. (The US government’s cabinet-level Trade Representative, statutorily responsible for doing the prying, sits on the MCC’s board.)  It’s striking, too, that one of the absolute rather than relative indicators the MCC demands is “inflation rate,” where it insists on a strict maximum of 15%. This restricts countries’ power to devalue their currencies and stimulate their economies. It locks the receipients of MCC aid into the same austerity trap that Eurozone nations are writhing against today.

A: Because of all the gay cruise ships that will visit

Even the most humane of the MCC’s indicators — the “Investing in People” silo, evaluating public spending on things like health and education — tends toward the lowest standards (and doesn’t pay even lip service to the concept of economic and social rights). The MCC is mainly a brass-knuckle enforcer of neoliberalism, with some salving concessions to human rights in the form of “Ruling Justly” (a bizarre phrase in itself).   Despite its cheerful visage, it’s a sinister strategy. Some serious caution is called for before letting LGBT rights be part of its package. To tie them to a project likely to inflict penury on subject populations could well be disastrous.

I’m not the only one who says this. For some detailed critiques of the Millennium Challenge Corporation, check out the three articles — by Maurizio Carbone, Emma Mawdsley, and Susanne Soederberg – here. (Because these texts are Rapunzelled in behind academic firewalls, I’ve uploaded them and let down their hair so you can read them. If the authors object, fine, but then they’re bad leftists.) And if you want to find out about your own country’s relations with the MCC, that information (the agency is at least transparent!) is here. My advice: Watch out.

But the difficulty transcends the MCC.  The donors most likely to give a friendly hearing to LGBT-rights conditionality are donors already practicing conditionality based on “economic liberalization or “open markets”: conditions that, steeped in neoliberalism, are abhorrent to most peoples of the global South. 

“Symptoms of Neoliberalism”: Cartoon from Mexico, by El Fisgón

8) My real problem with the arguments for aid conditionality goes deeper. It’s that the advocates stay confined within a tightly limited and lopped version of human rights, very different from the one most people in the world believe in.

Proponents speak as if, on one side, there were human rights lined up neatly: free expression, freedom from torture, freedom from sodomy laws, and so on. Then on the other, there’s development money. The only relation between the two sides is that, if a country respects the rights, it should get its development money. If it doesn’t, it shouldn’t get any. Or not as much.

You would never imagine, hearing these folks promote this vision, that development is itself a human right. The UN General Assembly adopted its “Declaration on the Right to Development” in 1986, stating:

The right to development is an inalienable human right by virtue of which every human person and all peoples are entitled to participate in, contribute to, and enjoy economic, social, cultural and political development, in which all human rights and fundamental freedoms can be fully realized.

The Declaration and Programme of Action of the 1993 Vienna World Conference on Human Rights also dealt with the issue extensively: “Democracy, development and respect for human rights and fundamental freedoms are interdependent and mutually reinforcing,” it affirmed. And:

States should cooperate with each other in ensuring development and eliminating obstacles to development. The international community should promote an effective international cooperation for the realization of the right to development and the elimination of obstacles to development.

Imagining that human rights are largely unconnected to development, except to legitimate restricting it, fits with a certain Anglo-American perspective in which economic and social rights don’t exist. But if you do believe development is a right, then to endorse conditionality as part of the standard human rights toolkit is, needlessly and destructively, to pit human rights against each other.

The “Quezon City Declaration on AID” — a 2007 manifesto by a coalition of Asian movements and NGOs — states that

The kind of aid we want must be premised primarily on a recognition of the history of colonization of countries across Asia, a history that persists in the continued exploitation by the North of the South, particularly the peoples of Asia and the region’s biodiversity. From this lens, aid becomes a matter of global redistributive justice, a just righting of historical wrongs.

In this light — and from the perspective of development as a human right —  it’s notable that, in 1970, donor countries pledged to devote 0.7% of their GDP to overseas development assistance. Almost none of them do so. In 2010 only five OECD countries met that mark; the US stood mired at less than a third. Surely the first priority of US and European advocates, including LGBT rights advocates, should be to increase their countries’ overall giving to meet their human rights commitments. They shouldn’t use LGBT rights as an excuse for governments to fail their pledges and give less.

It’s only by understanding development as a right that you can see how the Quezon City statement can both call on states to reject conditionalities, and

enjoin both donors and national governments to adopt a rights-based approach to aid giving, which means ensuring that human rights standards and social development principles guide all development cooperation and programming in all sectors and in all phases of the programming process. Right-holders and their supporters such as human right NGOs should be included in decision-making processes relating to aid money and allocation. Attention must especially be given to those whose voices are at risk of being silenced or marginalized vis-à-vis aid: women, children, and adolescents, or non-citizens such as in/formal migrant workers, indigenous peoples, small farmers and fishers, etc.

A “rights-based approach to aid giving” means not using rights to justify cutbacks, but using aid actively and creatively to promote rights, including funding decision-making and participation by the most marginalized communities. The mounting calls for aid conditionality in the LGBT sphere suggest a failure of imagination, an unwillingness to think through creative ways that aid can further rights, not curtail development. We can do better than that.

What is this protest about?

Via @muparutsazim
Via @muparutsazim – from Free Gender
02 Mar 14

President Yoweri Museveni has done it. Against widespread expectation raised by his earlier pledge, the Ugandan leader turned around this week and signed into law the contentious Anti-Homosexuality Bill passed last December by a parliament his ruling party, the National Resistance Movement (NRM), controls. The bill had been opposed locally and internationally for a record four years, since its introduction to the legislature in 2009. It is a remarkable coincidence that Museveni’s executive action came in the week Pambazuka News has devoted to a special issue on the lesbian, gay, bi-sexual, transgender and intersex (LBGTI) struggles in Africa. Our decision to dedicate a special issue to this subject was informed by the alarming reality that throughout Africa, colonial era laws that criminalised ‘unnatural acts’ are now being reinforced by independent governments, pushed by powerful lobbies, under the pretext that homosexuality is ‘un-African’ and harmful: this despite the fact that the existence of LGBTI persons in Africa since time immemorial is well documented. Colonial legislators would have had no reason to criminalise homosexuality if it is the Europeans who introduced it to the continent. Beyond repression through harsh laws, there is fierce LGBTI intolerance throughout Africa. Even in countries where the constitution proclaims non-discrimination on whatever grounds, politicians, the priestly class and other self-styled moral police are undeterred in inciting their followers against gays. Homosexual persons have been attacked and killed or injured. Many have been forced into hiding, ostracised by their families, denied employment, have been unable to rent a house, etc. In South Africa the horrific phenomenon of ‘corrective rape’ before killing has been perpetrated by men against lesbians as an alleged ‘cure’ of their sexual orientation. It is impossible to remain silent in the face of this epidemic of hate and violence against innocent people.

01 Mar 14

A dangerous new imperialism is on the rise in Africa and the Caribbean. It comes wearing a rainbow flag and dressed in pink. The recent wave of anti-gay laws on the African Continent and a two month visit to Jamaica where LGBT activists and homosexuals are in a battle for self-definition have helped to crystalize this suspicion. To be clear I am a Black, gay Jamaican male who has loved and lived for over 30 years in America. I identify myself thusly so you can understand that this is not a conclusion I come to easily. It comes from observing keenly the struggle for Gay Rights in America, Africa and the Caribbean for the past 30 years.

24 Feb 14

Coming out will not be easy or even an option for everyone, but if you do decide to come out, I wish you luck! Visibility definitely matters. The truth is, I never wanted to have a conversation about who I have sex with, but because the government and the population is having that conversation, I too am forced to. The simple fact at the end of the day is: I am human. I am Nigerian. I am gay. Now my social experiment may or may not work. What I do know is that I must try. I will attempt to change minds, tackle homophobia and let Nigerians see a real life gay person: one introduction at a time.

Bisi Alimi - http://www.ynaija.com/watch-gay-rights-activist-bisi-alimi-speaks-to-amanpour-on-cnn/
Bisi Alimi – http://www.ynaija.com/watch-gay-rights-activist-bisi-alimi-speaks-to-amanpour-on-cnn/

Nigerian gay rights activist, Bisi Alimi, who had to leave the country in 2007 out of fear for his life, spoke to CNN’s Christiane Amanpour on his feelings about the law and the fate of the Nigerian LGBT community.

18 Jan 14

24 Feb 14

Kill them. This sentiment has been expressed about homosexuals in Nigeria, both in the streets and in the media, especially since the Same Sex Marriage (Prohibition) Act came into operation on January 7, 2014 – again, and again. And again.

24 Feb 14

Yet Smith fails to articulate the self-determination demonstrated on the part of LGBTQI Africans as proof against an imagined Africa where all people think negatively about queer and trans people. Even in Uganda, on the very day of the passing of the anti-homosexuality bill, queer and trans Ugandans, and their allies, are asserting their disapproval through a global media campaign aptly titled, #IAmGoingNowhere, according to Hakima Abbas, co-editor (along with Sokari Ekine) of the Queer African Reader.  That there are those placing their lives on the line, today, should be ample enough proof that not all Africans are homophobic. It should also remind us to resist the urge to cast our critical gaze upon other geographical spaces before we cast it upon ourselves.

Via @HOLAAFrica
Via @HOLAAFrica
01 Mar 14

If Kenya is not Uganda or Nigeria, why are we at the brink of legislating laws that further criminalise same sex sexualities?  Kenya will soon follow Uganda and Nigeria in enacting new anti-gay laws, my crystal ball predicts. And it might be sooner than you expect. According to several media reports on radio and TV, several lobby groups, politicians and religious associations, have come out publicly to call for stricter – read, extreme – laws against homosexuality in the country. Unfortunately, 90% of Kenyans support their decision if a Pew Research on attitudes towards homosexuality in Kenya is anything to go by. In December 2013, I highlighted 10 African countries that were going the Nigeria and Uganda way in proposing, debating, enacting and assenting new laws that targeted same sex sexualities among men and women.

Via @ShailjaPatel
Via @ShailjaPatel

Follow @holaafrica @bisialimi @denisnkioka @keguro_macharia @blacklooks

HIV in the Time of Cholera

images

Long before 9/11 and the subsequent incarceration of hundreds of so called “terror suspects” in Guantanamo Bay, thousands of Haitian refugees fleeing the military junta in the early 1990s, were detained on the US base. Many of those were detained because they were suspected of being HIV Positive [+].

The marking of Haitians as carriers of AIDS goes back to the early 1980s when the Center for Disease Control [CDC], identified four high-risk groups, known pejoratively as the 4-H club — “homosexuals, haemophiliacs, heroin users and Haitians”.  This was the first time a disease was tied to a nationality but not the first time black bodies have been tied to racist notions of deviance and contagion and of being a threat to whiteness.  [1]

The first documented case of HIV in Haiti was from the Clinique Bon Sauveur in the Central Plateau in 1986. Within two years the clinic had introduced a programme of free testing, counselling, condoms, HIV education and prevention.  By the early 1990s 25% of admissions were related to HIV and by 1995 this had risen to 40%. Two other medical centres have been at the forefront of HIV/AIDs and TB in Haiti; the GHESKIO Centre in Port-au-Prince, a global pioneer in HIV/AIDS research and treatment, and Partners in Health, which has run an extensive preventative and treatment programme for the past 25 years.  Both must take considerable credit for the massive decrease in the HIV+ rate from 9.4% in 1993 to 1.8% in 2011, an estimated 51% of whom are women and 12% children.  Even with the disruption to treatment caused by the January 2010 earthquake the infection rate continued to decrease.

The underlying and most significant contributory factor to both the spread and death from HIV/AIDS and TB in Haiti is not lack of awareness or failure to follow medication regimes as policy officials tend to argue, but life-shortening conditions, that is the material conditions and structural violence under which people become infected.  Paul Farmer writing on Haiti describes structural violence as
……..one way of describing social arrangements that put individuals and populations in harm’s way… The arrangements are structural because they are embedded in the political and economic organization of our social world; they are violent because they cause injury to people … neither culture nor pure individual will is at fault; rather, historically given (and often economically driven) processes and forces conspire to constrain individual agency. Structural violence is visited upon all those whose social status denies them access to the fruits of scientific and social progress.[2]

After talking to dozens of patients, nurses, doctors and health officials over the past six months, I am very much aware of the violence of poverty which impacts on people in multiple ways.    Gustave and Emile and their families are just three of millions.

IMG_0524

Gustav Renaud was born in Port de Paix in the north, not too far from Cap Haitian. He is 30 years old and came to PAP six months ago after falling ill. He lives with his mother, sister, brother-in-law and their three children in Camp Acra at Delmas 33. His mother, Gustave Taliette, was the first to move to PAP two years ago to look for work and was followed a few months later by her son-in-law, Jonas, and then his family; altogether they are seven. The family was given the tent by someone who moved out from the camp. This was better for them as there is no rent to pay. Since arriving Jonas has only managed to find a few weeks’ work here and there and much of the burden for feeding the family has fallen on Mdm Taliette, who occasionally finds work washing clothes in the city.

Like the dust in the camp, hunger is ever present in their lives. There is nothing to do except to sit and sit some more as the day passes into night. The day I first met Gustave he was sitting in front of his tent with his mother and some neighbours. On the ground in front of Gustave’s tent are a few very old dusty shoes and bags laid out for sale on a piece of equally old plastic. They reminded me of a piece of still-life art moulded into the ground.

We were meeting to talk about his TB. However, during the nearly two hours we sat outside his tent, he hardly coughed, although he was visibly very ill. His hair was thinned out, and he was covered in dried sores. He complained of feeling dizzy with headaches, diarrhoea, vomiting and pains in his legs. Gustav said he left his wife and two children in Port-de-Paix because she threw him out when he became sick. I found myself wondering if he was really HIV+ and possibly the TB story was a cover. Since arriving he had been to two hospitals, Petit St Luke in Tabarre and Kings Hospital in Delmas33, but he said he did not know what was wrong with him. Although the consultations were free, patients have to pay for the test results and since he had no money he could not get the results. I asked him why he thought he had TB? “Because I am coughing and I am tired, also my chest hurts.” He had been given some medication but he didn’t know what it was and anyway it was finished and this was months ago. It was difficult to really assess what was happening. I explained to him that in Haiti everyone who has TB is also tested for HIV and asked if he had had either test. He said no, he did not think so.

As we sat and talked neighbours passed by along the narrow path between the tents. Some kept walking, others stopped to listen until asked to please move on. At one point, Mdm Taliette got up and began walking away. A while later I noticed her return with a bucket of water. She then sat down on a bench in front of the adjoining tent and proceeded to undress to her underpants and bathe herself. I watched briefly as she stared straight ahead and despite the circumstances of bathing in the public glare, there remained a dignity and a defiance in her actions. I looked at the others; no one was watching. There is no privacy in the camp. No privacy to speak, not even for a 50-year-old woman to bathe. She must do so in front of her grown son, her son-in-law, neighbours and strangers like me.

Later, Mdm Tailette returned from bathing with a smile and a photo of Gustave taken about a year ago. In the photo he is a tall, 6ft. 5in heavy-set young man, far removed from the wafer-thin, balding, aged person sitting next to me.

I was concerned that Gustave might be HIV+. I asked Gustave, his mother and brother-in-law what they were going to do as clearly he needed to see a doctor quickly. They said they wanted to go to a doctor but they had no money so they had no choice but to sit and wait. No need to wait, I thought, there is Dr Coffee!

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A few weeks earlier I had gone to meet Dr Megan Coffee, an American infectious disease specialist and a truly amazing woman. She had come to Haiti a few months after the earthquake and stayed. Dr Coffee runs a TB clinic in the grounds of the Hopital l’Universite d’Etat d’Haïti [General Hospital] in downtown PAP. Her clinic consists of three permanent tents laid out on concrete under the glaring 95° degree heat. The first tent is for in-patients, who are extremely sick and near dying of TB and/or HIV+. The middle tent, which is the smallest, is a meagre office consisting of a desk with an assortment of drugs, papers, masks etc; a second desk with more assorted bits and medical files; a camp bed behind a curtain and a wardrobe. There was also a group of four Haitian nurses who are paid by the General Hospital to assist in her clinic.  She volunteers alongside the infectious disease nurse and they survive on donations, as does the clinic. Food for patients is donated by various charities. The third tent, which is really just a piece of tarpaulin giving shade, is for outpatients and family.

This is the only dedicated TB clinic in PAP. On the day of my first visit I arrived around 11am.  There were six people crowded into the small office tent and the one fan blowing hot air did little to relieve the heat. Dr Coffee hadn’t yet arrived so I took the opportunity to speak to the other volunteer, the infectious disease nurse who had been here for a few months. As we spoke she continued to work, emptying the contents of various capsules into a mortar and mixing away. I was fascinated and wondered if this was what chemists do behind pharmacy doors or was this part of the make-shift world of healthcare in Haiti? The nurse explained she was mixing the cocktail of drugs into individual dose bags to make it easier for the patients to take. The bags were for newly discharged out-patients to take home.

Soon Dr Coffee arrived in her usual outfit of long-sleeved t-shirt, overshirt and broad-rimmed hat to protect her from the glaring sun. Patients immediately surrounded her as she spoke in an impressive accented but fluent Kreyol. Eventually with a few minutes to spare she turned her attention to me and I rushed through my interview, not wanting to take time away from very sick people.

The clinic started with just three patients and now treats 800 annually. At present she has 70 bed-patients, four of whom were near death. I asked Dr Coffee what were her biggest challenges?

“Ensuring the patients take their medication. The patients have their own challenges such as food and surviving so I have to stress the pill is their life… missing it will lead to death.”

TB patients burn excessive calories and they need a great deal of food but at the same time they don’t feel the need to eat. Even when they are eating they are still thin. This is additionally problematic when people are hungry and those coming to Dr Coffee’s free clinic are the very poor. One positive system she has managed to create is a “buddy” system where cured patients give back by returning to support sick patients. This could be by helping to exercise patients, helping to feed them or just keeping up their spirits.

Another problem is due to the poor material conditions under which patients live; they wait until they are really ill before attending the clinic, thereby reducing their chances of full recovery.
The majority of sick people I have met over the past six months have been ill for weeks or months before they went to a clinic and often pregnant women will only attend the hospital after they have gone into labour. Even when hospitals are free people are still reluctant to go for fear of being presented with a bill they cannot pay.

I told Gustave and his family about Dr Coffee. I explained she was a TB specialist and all the treatment would be 100% free. All they had to do was to get to the hospital by 10am and she would see them. I explained that he would have a TB and HIV test and then wait and see what happens. Everyone was happy with the suggestion and we said our goodbyes. The next day I learned that Gustave and Jonas had gone to the clinic but were unable to register. I frantically tweeted direct messages to Dr Coffee who responded saying they must return immediately.

This time I decided to go with them. We all met at the hospital and Gustave registered, saw Dr Coffee and had his tests.  It took a few more visits but finally he received the news that he was HIV+ but did not have TB. Now he has transferred from Dr Coffee’s clinic to the Hopital l’Universite d’Etat d’Haïti as an HIV+ patient. At one point he was going to the hospital a couple of times a week. Attending the hospital has been extremely difficult for Gustave. He is weak from the illness which is exacerbated by food insecurity and poor diet. It takes two buses to get to the hospital which costs 100 gds which is 100 less to spend on food for the family. The choice often becomes either the hospital or food to eat. One day he was so weak he collapsed on the street and Jonas had to carry him by motorcycle taxi. At this point it was hard to persuade Gustave to return to the hospital as he said he no longer cared if he died.

If Gustave was HIV+ then it was very possible his wife was also positive and possibly their three-year-old son. When I asked him whether he had told his wife, he replied she was positive and she had been taking medication even before their son was born, who is also positive.  However, he continued to insist that he did not know he, too, was HIV+.  His wife remains in Port-de-Paix so there is no way for me to follow up on her and the baby’s present health status.

Emile Charles is 16 years old and is HIV+. His whole family have died of AIDS-related illnesses. First his younger sister, then his mother and finally his father. I had seen Emile many times during my visits to the workshop at Delmas 33. He was one of the many young boys and girls who made the shoes and jewellery for the camp shop. I was told he might be HIV + and may also have TB as he was coughing a great deal. He is a thin, intense young man with a soft, gentle, inquisitive face. He doesn’t smile often but when he does, it’s like a burst of light.

Emile’s family were from Hinche in central Haiti. He is not sure but thinks he was six when his father died and he came to live with his uncle in PAP. His uncle did not allow him to play with his own children and Emile had his own food utensils. In 2008 or 2009 he became very ill and was taken to hospital where he ended up spending a year. As a minor, Emile’s uncle would have been told his status and it would be up to him to inform the child. He did not do this. After he was released from hospital he was given a patient card, medication and an appointment. But his uncle never took him back and soon after that Emile was adopted by a neighbour, Jean-Louis [Elie] Joseph who is now one of the main organisers of the Chanjem Leson movement at Camp Acra.

Elie had complained to the uncle about his treatment of Emile and in the end the uncle told him to take the boy but he did not tell Elie about Emile’s medical history. Soon after Emile moved in with Elie and his wife Esther, the earthquake happened and they all moved to Camp Acra.   Emile was constantly sick and at one point was very ill with what Elie believed was shingles. It seems that everyone involved suspected Emile was HIV+ but no one made a decision to take him for a test, the main concern being cost.
At the time I formally met Emile he had again become ill with fever and night coughs. It was at this point that the uncle, who also lives in the camp, finally told Elie that Emile’s family had all died of AIDS-related illnesses and Emile told us he had spent a year in GHESKIO hospital so it made sense for him to return there and continue his treatment. However the hospital had no record of him ever being a patient.

To understand some of the confusion — how was a six or eight-year-old child supposed to know which hospital he had attended, how long he had stayed or what medication he was given? The uncle, possibly not wanting people to know about his nephew’s status, was not forthcoming with information. Despite the decrease in HIV/AIDS and increase in awareness and prevention, there remains a high level of stigma around the illness. Eventually Emile’s guardians found out he had been in a hospital run by nuns in Delmas 18 but the uncle could not remember the name.

By this time four weeks had passed and Emile’s health was deteriorating rapidly. Soon after I received a text message from my interpreter, Serge Supre, saying he was going to Delmas 18 to try to find out the name of the hospital and to collect Emile’s records so they could treat him again or refer him to the Hopital l’Universite d’Etat d’Haïti. The hospital turned out to be run by the Sisters of Mercy of Mother Teresa fame. But it was not a good ending.

The overall context in which Gustave and Emile are trying to live with their illnesses is compounded by the general insecurity and fear in the camp itself. In April someone claiming to be the owner of the land threatened to burn down the camp unless everyone left. The following day a fire broke out in one section which everyone took as a warning. Camp residents reported the fire and threats to the police who said there was nothing they could [would] do. They then decided to protest against the threats and lack of police action during which two men were arrested and one died in custody. Chanjem Leson activists worked with the family of the deceased and reported the police in question to the Inspector General of Police. Since then they have faced daily phone threats from unknown men, including repeated night visits to their tents.

The whole camp is nervous and fearful of being evicted at any moment. Emile’s adoptive parents, Elie Joseph and Esther Pierre have gone into hiding and he is being cared for by Esther’s cousin Serge Supre. Serge is unemployed except for the little he earns from interpreting, and worries about how he will pay for his 18-year-old daughter to finish high school. Regular evictions have begun to take place around the city and each night people go to sleep wondering if this will be their last. This has also meant disruptions to the small craft and art workshop and the school.

Gustave has started ARVs and although the family is happy with his treatment they want more than anything to return to Port-de-Paix – “if we have to be hungry better to be hungry at home than in PAP!”
For the first few weeks Gustave responded positively to the medication and even planned to find work and try to visit his wife and children. However over the past two weeks he has deteriorated, becoming aggressive, removing his clothes and disappearing for days and worst of all, he has stopped taking his medication. The stress of caring for him has taken its toll on his family especially his mother for whom this is one burden too many.

Statistics tell us the numbers of people living with HIV and dying of AIDS / TB in Haiti has decreased dramatically over the past 10 years due to a policy directed at prevention based on education and increased access to treatment. But there are other realities excluded from official reports and statistics.  Gustav and Emile, and millions like them, are forced to struggle to receive the most basic healthcare. Emile has spent two months trying to get treatment and he’s still waiting. It is hard to say no one cares and even though I have followed him through the repeated hurdles and I know we, his family and his friends care, but without money and without agency people like Emile and his family are regularly treated with disdain. You attend the hospital and people don’t even look you in the face, preferring to watch TV or chat with their colleagues. People treated as “expendable non-persons”!
And Emile is doing badly. The hospital run by the Sisters of Mercy is now in Carrefour but they refused to see Emile because “his uncle gave trouble”. Serge tried to appeal to their “mercy” but in vain…

“They said they will do something for the poor but they cannot help Emile because his uncle brought trouble. I would like to know who are the poor – are we not poor, is Emile not poor and sick and a child? Something must be done for him. He cries at night and I don’t know what to do. On Monday I will return to GHESKIO and hope they will help. If not we have to go back to Dr Coffee.”

Emile didn’t get to GHESKIO. Through a “friend of a friend” he is now waiting for an appointment at Dikini hospital in Kafou where they receive HIV+ patients. I hope he finally gets the treatment he needs.

UPDATE: After visits to numerous hospitals and clinics in PAP, finally with the help of Dr Coffee, Emile finally started on ARVs at the end of September 2013.   He had fallen ill yet again and was in a very poor state and was immediately admitted to Dr Coffee’s TB clinic and placed on medication.  In total it had taken  four months since the initial visit to the hospital for Emile to receive ARVs.  Emile then spent another 4 weeks of almost daily hospital visits waiting for a pediatric and  psychology assessment that would enable him to enter a food and school programme providing him with rice, beans and oil plus school fees and text books.   By the end of October he had begun to put on weight and regain his strength.  Now we all look in awe at the new Emile who is twice the size we all thought he was.  He hopes he will start school in January

1] A. Naomi Paik “Carceral Quarantine at Guantanamo: Legacies of US Imprisonment of Haitian Refugees, 1991-1994”  published in Radical History Review Issue 15 /Winter 2013].
2] Castro, Arachu and Paul Farmer, “Infectious Disease in Haiti” EMBO Reports 2003.
[3] ARDTA – Asosyasyon Respekte Dwa Timoun – Ans Wouj [Association for the Respect for the Rights of Children]
* Not his real name!

 

This article was supported in part by the International Reporting Project.

HIV: A silent relative

by Kopano Sibeko

“It’s amazing how the death of someone can also be a blessing” shares Thembela ‘Terra’ Dick. She walks me on a tale of how her sister, Thembi Ngubane’s memorial service was the day her life really started.
“Thembi” was an AIDS activist who was diagnosed with the Hi-virus at the age of 14, so at her memorial service I was courageous enough to speak out, because she had always motivated me to come out and be open about my sexuality and stop hiding as a “boy” she sighs .

Thembela sounds a bit skeptical I can tell by the tone of her voice, and I quiclky pick up that she doesn’t know whether to be grateful that her sister passed on or that the thought of how her life has shaped up is a bit discomforting considering how far she’s come since then. However shares with me that her speech at the service  where she officially came out about her lesbianism created an interest in Richard Mills and Jo Menel from Street Talk, a media production company that was documenting the memorial that day.

terra in Paris with TFC member_2008

Thembela Dick & Mpilo Cele during Paris visit in 2012

She utters that “they approached me and asked if I could be a Researcher for my sister’s story and they offered me training which also afforded me the chance to learn about the visual media.” She currently  holds a position as a researcher, a filmmaker, a director and she also does some editing. She stresses that she can’t do this on her own but she gets the support from her colleagues.

Terra tells me that she is a very persuasive person and that it is easy for people to trust her, so those are the traits that she uses to communicate with people of different cultures, age groups and races because StreetTalk is about stories in the township and putting people together, “I deal with two types of filming,  those are profiling and group discussions” she said.  Then she explains that in the meantime there are only covering the Western Cape. In the midst of our telephonic interview I also get an awakening that her voice is pretty gentle and akwardly convincing so it makes sense that people could easily warm up to her.

Though her life  might seem picture perfect  with her doing what she’s passionate about, but Terra  tells me that she didn’t complete her matric and she knows that one day that reality will catch up with her “I wanna go back to school, I need to know the basics of these technicalities”. She admits that she has to know how to talk and be knowledgable about what she does “I only see a future in film” she insists.

After a few minutes of silence, I ask her to tell me more about her family and where she comes from, “I was born in Gugulethu township, Cape Town, but I was raised in Queenstown in the Eastern Cape”. She tells me that she is a child of Buyiswa Komeni Mtshakazi and Mbambeleli Mtshakazi, who were not so actively involved in her childhood as she grew up with her siblings and that the absense of her mom in her life made her bitter “I refused to go for almost 3 months to see my mother, I was angry at her and after a while I discovered that she was HIV positive” she confesses.

I could easily sense her discomfortness resurface, though she assures me that she is comfortable and  transparent “it’s time we stopped hiding, we need to be there and support our family members who are HIV positive” she confesses.
Thembela also opens up to me about how the virus has become so much a part of her life “it has become a silent relative” she shares with me that five people in her immediate family are living with the virus and she encourages the society at large that they need to do away with the mentalty of not using a condom .

She tells me that she was lucky to have met Zanele Muholi who has been so supportive “Zanele has been great, though sometimes she doesn’t show how much she cares, but she does and she motivates me” she giggles. She also mentions that she’s an emotional person and all this can be too much for her  to handle at times.

Thembela Dick in F&P 151

Thembela Dick’s portrait in Faces & Phases series by Zanele Muholi (2011)

In the reality of it all it suddenly hits me that Terra featured in Muholi’s Faces & Phases and also in a 4 mins intimacy video. In the latter she was part-taking in unprotected sex, so I asked her if that is not hypocritical of her to preach that people should  use condoms while she is not, her response was “my girlfriend and I have been together for sometime now and we get tested almost every after three months and when we did that video we both knew each others statuses” she explains calmly.

I also voice out the fact that most people that don’t know the beauty of art will say that, that clip is not any different from pornography she says “sex is not a taboo and it’s also not porn especially if you’re doing it with you’re partner.”
She laughs gently as she explains to me that, that video was not even planned. She recalls that it was on Human Rights day in 2012 and Muholi took our intimacy photos for Being series which forms part of lesbian safer sex education. She photographed Terra and her lover Lithakazi Nomngcongo and she explains that they were standing, but later on pose on the mattress which heated the moment.

“I was very close to my girlfriend and it just happened, so I even forgot that Muholi was there” she laughs with excitement. She also adds that Muholi didn’t stop them so  they also didn’t care, because they were focused on what they were doing . However she tells me that Muholi asked if they wouldn’t mind if s/he exhibits their video” I asked my girlfriend, she said she doesn’t mind and I thought why not?”.

“I want to make the best of my life, this is a memory I’ve created” she adds while giggling. She slowly moves away from the topic and tells me that she is learning photography and that she is currently filming two documenataries called ‘Lesbian Love‘ and another one  called ‘Terra the Les’ it’s about her personal life telling the story about her family members who are HIV positive.

 

Haiti: Missing healthcare on the frontline of HIV

Long before 9/11 and the subsequent incarceration of hundreds of so called “terror suspects” in Guantanamo Bay, thousands of Haitian refugees fleeing the military junta in the early 1990s, were detained on the US base. Many of those were detained because they were suspected of being HIV Positive [+].

The marking of Haitians as carriers of AIDS goes back to the early 1980s when the Center for Disease Control [CDC], identified four high-risk groups, known pejoratively as the 4-H club — “homosexuals, haemophiliacs, heroin users and Haitians”.  This was the first time a disease was tied to a nationality but not the first time black bodies have been tied to racist notions of deviance and contagion and of being a threat to whiteness.  [1]

The first documented case of HIV in Haiti was from the Clinique Bon Sauveur in the Central Plateau in 1986. Within two years the clinic had introduced a programme of free testing, counselling, condoms, HIV education and prevention.  By the early 1990s 25% of admissions were related to HIV and by 1995 this had risen to 40%. Two other medical centres have been at the forefront of HIV/AIDs and TB in Haiti; the GHESKIO Centre in Port-au-Prince, a global pioneer in HIV/AIDS research and treatment, and Partners in Health, which has run an extensive preventative and treatment programme for the past 25 years.  Both must take considerable credit for the massive decrease in the HIV+ rate from 9.4% in 1993 to 1.8% in 2011, an estimated 51% of whom are women and 12% children.  Even with the disruption to treatment caused by the January 2010 earthquake the infection rate continued to decrease.

The underlying and most significant contributory factor to both the spread and death from HIV/AIDS and TB in Haiti is not lack of awareness or failure to follow medication regimes as policy officials tend to argue, but life-shortening conditions, that is the material conditions and structural violence under which people become infected.  Paul Farmer writing on Haiti describes structural violence as
……..one way of describing social arrangements that put individuals and populations in harm’s way… The arrangements are structural because they are embedded in the political and economic organization of our social world; they are violent because they cause injury to people … neither culture nor pure individual will is at fault; rather, historically given (and often economically driven) processes and forces conspire to constrain individual agency. Structural violence is visited upon all those whose social status denies them access to the fruits of scientific and social progress.[2]

After talking to dozens of patients, nurses, doctors and health officials over the past six months, I am very much aware of the violence of poverty which impacts on people in multiple ways.   Rosi-Ann, Gustave and Emile and their families are just three of millions.

I met activist and youth worker Maxo Gaspard on 31st May during a protest march against the lack of support for cholera victims and the UN’s refusal to admit responsibility.  Maxo is a former restavec and now runs ARDTA,* an organisation working with restavecs, street children and teenage sex workers. Many young girls are trafficked to the Dominican Republic and part of his work is to try to educate families in rural areas on the dangers of giving their children away, and to find homes for the girls.
One of the girls, Rosi-Ann, is 15 years old and lives in the Nazon district of Port-au-Prince [PAP]. Rosi-Ann is a child.  She is beautiful, shy and at first she feels too full of shame to speak.  We spend hours talking; the conversation is slow at first but eventually it breaks free and is interspersed with smiles and laughter as her confidence grows.

Rosi-Ann was a restavec child originally from a poor family near Les Cayes in the south of the country. When she was four her “godmother” brought her to PAP where she suffered 10 years of physical and sexual abuse. About a year ago, Rosi-Ann met another young girl who was already working the streets after her father had died and her mother threw her out. She told Rosi-Ann she should leave her godmother and join her on the streets. Now she lives in a “Chambre Garson” [room or house of men] with a 19-year-old man. She uses the room to work and gives the man some of her earnings. Rosi-Ann says she always wants to use a condom but sometimes the men are violent and beat and / or rape her. She is not HIV+ but is aware of her extreme vulnerability and the repeated vaginal infections, which are often left to fester before being treated, are a warning of what could happen.

The hope is that Maxo can first find a family to care for her and then take her back to her village to search for her family. She knows she has two older sisters but does not know if her mother is still alive as she hasn’t seen her for 10 years. Maxo had a similar experience: he was rescued by someone who came to visit the woman he was working for and ended his misery. Now he wants to do the same for Rosi-Ann. But there are thousands of young girls on the streets of Haiti’s cities and with no support from the government or NGOS, people like Maxo and his colleague Kethia, become despondent.

It’s like looking at a 10ft wall and wondering how to climb to the other side. After so many jumps no one can blame you for giving up.

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Gustav Renaud was born in Port de Paix in the north, not too far from Cap Haitian. He is 30 years old and came to PAP six months ago after falling ill. He lives with his mother, sister, brother-in-law and their three children in Camp Acra at Delmas 33. His mother, Gustave Taliette, was the first to move to PAP two years ago to look for work and was followed a few months later by her son-in-law, Jonas, and then his family; altogether they are seven. The family was given the tent by someone who moved out from the camp. This was better for them as there is no rent to pay. Since arriving Jonas has only managed to find a few weeks’ work here and there and much of the burden for feeding the family has fallen on Mdm Taliette, who occasionally finds work washing clothes in the city.

Like the dust in the camp, hunger is ever present in their lives. There is nothing to do except to sit and sit some more as the day passes into night. The day I first met Gustave he was sitting in front of his tent with his mother and some neighbours. On the ground in front of Gustave’s tent are a few very old dusty shoes and bags laid out for sale on a piece of equally old plastic. They reminded me of a piece of still-life art moulded into the ground.

We were meeting to talk about his TB. However, during the nearly two hours we sat outside his tent, he hardly coughed, although he was visibly very ill. His hair was thinned out, and he was covered in dried sores. He complained of feeling dizzy with headaches, diarrhoea, vomiting and pains in his legs. Gustav said he left his wife and two children in Port-de-Paix because she threw him out when he became sick. I found myself wondering if he was really HIV+ and possibly the TB story was a cover. Since arriving he had been to two hospitals, Petit St Luke in Tabarre and Kings Hospital in Delmas33, but he said he did not know what was wrong with him. Although the consultations were free, patients have to pay for the test results and since he had no money he could not get the results. I asked him why he thought he had TB? “Because I am coughing and I am tired, also my chest hurts.” He had been given some medication but he didn’t know what it was and anyway it was finished and this was months ago. It was difficult to really assess what was happening. I explained to him that in Haiti everyone who has TB is also tested for HIV and asked if he had had either test. He said no, he did not think so.

As we sat and talked neighbours passed by along the narrow path between the tents. Some kept walking, others stopped to listen until asked to please move on. At one point, Mdm Taliette got up and began walking away. A while later I noticed her return with a bucket of water. She then sat down on a bench in front of the adjoining tent and proceeded to undress to her underpants and bathe herself. I watched briefly as she stared straight ahead and despite the circumstances of bathing in the public glare, there remained a dignity and a defiance in her actions. I looked at the others; no one was watching. There is no privacy in the camp. No privacy to speak, not even for a 50-year-old woman to bathe. She must do so in front of her grown son, her son-in-law, neighbours and strangers like me.

Later, Mdm Tailette returned from bathing with a smile and a photo of Gustave taken about a year ago. In the photo he is a tall, 6ft. 5in heavy-set young man, far removed from the wafer-thin, balding, aged person sitting next to me.

I was concerned that Gustave might be HIV+. I asked Gustave, his mother and brother-in-law what they were going to do as clearly he needed to see a doctor quickly. They said they wanted to go to a doctor but they had no money so they had no choice but to sit and wait. No need to wait, I thought, there is Dr Coffee!

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A few weeks earlier I had gone to meet Dr Megan Coffee, an American infectious disease specialist and a truly amazing woman. She had come to Haiti a few months after the earthquake and stayed. Dr Coffee runs a TB clinic in the grounds of the Hopital l’Universite d’Etat d’Haïti [General Hospital] in downtown PAP. Her clinic consists of three permanent tents laid out on concrete under the glaring 95° degree heat. The first tent is for in-patients, who are extremely sick and near dying of TB and/or HIV+. The middle tent, which is the smallest, is a meagre office consisting of a desk with an assortment of drugs, papers, masks etc; a second desk with more assorted bits and medical files; a camp bed behind a curtain and a wardrobe. There was also a group of four Haitian nurses who are paid by the General Hospital to assist in her clinic.  She volunteers alongside the infectious disease nurse and they survive on donations, as does the clinic. Food for patients is donated by various charities. The third tent, which is really just a piece of tarpaulin giving shade, is for outpatients and family.

This is the only dedicated TB clinic in PAP. On the day of my first visit I arrived around 11am.  There were six people crowded into the small office tent and the one fan blowing hot air did little to relieve the heat. Dr Coffee hadn’t yet arrived so I took the opportunity to speak to the other volunteer, the infectious disease nurse who had been here for a few months. As we spoke she continued to work, emptying the contents of various capsules into a mortar and mixing away. I was fascinated and wondered if this was what chemists do behind pharmacy doors or was this part of the make-shift world of healthcare in Haiti? The nurse explained she was mixing the cocktail of drugs into individual dose bags to make it easier for the patients to take. The bags were for newly discharged out-patients to take home.

Soon Dr Coffee arrived in her usual outfit of long-sleeved t-shirt, overshirt and broad-rimmed hat to protect her from the glaring sun. Patients immediately surrounded her as she spoke in an impressive accented but fluent Kreyol. Eventually with a few minutes to spare she turned her attention to me and I rushed through my interview, not wanting to take time away from very sick people.

The clinic started with just three patients and now treats 800 annually. At present she has 70 bed-patients, four of whom were near death. I asked Dr Coffee what were her biggest challenges?

“Ensuring the patients take their medication. The patients have their own challenges such as food and surviving so I have to stress the pill is their life… missing it will lead to death.”

TB patients burn excessive calories and they need a great deal of food but at the same time they don’t feel the need to eat. Even when they are eating they are still thin. This is additionally problematic when people are hungry and those coming to Dr Coffee’s free clinic are the very poor. One positive system she has managed to create is a “buddy” system where cured patients give back by returning to support sick patients. This could be by helping to exercise patients, helping to feed them or just keeping up their spirits.

Another problem is due to the poor material conditions under which patients live; they wait until they are really ill before attending the clinic, thereby reducing their chances of full recovery.
The majority of sick people I have met over the past six months have been ill for weeks or months before they went to a clinic and often pregnant women will only attend the hospital after they have gone into labour. Even when hospitals are free people are still reluctant to go for fear of being presented with a bill they cannot pay.

I told Gustave and his family about Dr Coffee. I explained she was a TB specialist and all the treatment would be 100% free. All they had to do was to get to the hospital by 10am and she would see them. I explained that he would have a TB and HIV test and then wait and see what happens. Everyone was happy with the suggestion and we said our goodbyes. The next day I learned that Gustave and Jonas had gone to the clinic but were unable to register. I frantically tweeted direct messages to Dr Coffee who responded saying they must return immediately.

This time I decided to go with them. We all met at the hospital and Gustave registered, saw Dr Coffee and had his tests.  It took a few more visits but finally he received the news that he was HIV+ but did not have TB. Now he has transferred from Dr Coffee’s clinic to the Hopital l’Universite d’Etat d’Haïti as an HIV+ patient. At one point he was going to the hospital a couple of times a week. Attending the hospital has been extremely difficult for Gustave. He is weak from the illness which is exacerbated by food insecurity and poor diet. It takes two buses to get to the hospital which costs 100 gds which is 100 less to spend on food for the family. The choice often becomes either the hospital or food to eat. One day he was so weak he collapsed on the street and Jonas had to carry him by motorcycle taxi. At this point it was hard to persuade Gustave to return to the hospital as he said he no longer cared if he died.

If Gustave was HIV+ then it was very possible his wife was also positive and possibly their three-year-old son. When I asked him whether he had told his wife, he replied she was positive and she had been taking medication even before their son was born, who is also positive.  However, he continued to insist that he did not know he, too, was HIV+.  His wife remains in Port-de-Paix so there is no way for me to follow up on her and the baby’s present health status.

Emile Charles is 16 years old and is HIV+. His whole family have died of AIDS-related illnesses. First his younger sister, then his mother and finally his father. I had seen Emile many times during my visits to the workshop at Delmas 33. He was one of the many young boys and girls who made the shoes and jewellery for the camp shop. I was told he might be HIV + and may also have TB as he was coughing a great deal. He is a thin, intense young man with a soft, gentle, inquisitive face. He doesn’t smile often but when he does, it’s like a burst of light.

Emile’s family were from Hinche in central Haiti. He is not sure but thinks he was six when his father died and he came to live with his uncle in PAP. His uncle did not allow him to play with his own children and Emile had his own food utensils. In 2008 or 2009 he became very ill and was taken to hospital where he ended up spending a year. As a minor, Emile’s uncle would have been told his status and it would be up to him to inform the child. He did not do this. After he was released from hospital he was given a patient card, medication and an appointment. But his uncle never took him back and soon after that Emile was adopted by a neighbour, Jean-Louis [Elie] Joseph who is now one of the main organisers of the Chanjem Leson movement at Camp Acra.

Elie had complained to the uncle about his treatment of Emile and in the end the uncle told him to take the boy but he did not tell Elie about Emile’s medical history. Soon after Emile moved in with Elie and his wife Esther, the earthquake happened and they all moved to Camp Acra.   Emile was constantly sick and at one point was very ill with what Elie believed was shingles. It seems that everyone involved suspected Emile was HIV+ but no one made a decision to take him for a test, the main concern being cost.
At the time I formally met Emile he had again become ill with fever and night coughs. It was at this point that the uncle, who also lives in the camp, finally told Elie that Emile’s family had all died of AIDS-related illnesses and Emile told us he had spent a year in GHESKIO hospital so it made sense for him to return there and continue his treatment. However the hospital had no record of him ever being a patient.

To understand some of the confusion — how was a six or eight-year-old child supposed to know which hospital he had attended, how long he had stayed or what medication he was given? The uncle, possibly not wanting people to know about his nephew’s status, was not forthcoming with information. Despite the decrease in HIV/AIDS and increase in awareness and prevention, there remains a high level of stigma around the illness. Eventually Emile’s guardians found out he had been in a hospital run by nuns in Delmas 18 but the uncle could not remember the name.

By this time four weeks had passed and Emile’s health was deteriorating rapidly. Soon after I received a text message from my interpreter, Serge Supre, saying he was going to Delmas 18 to try to find out the name of the hospital and to collect Emile’s records so they could treat him again or refer him to the Hopital l’Universite d’Etat d’Haïti. The hospital turned out to be run by the Sisters of Mercy of Mother Teresa fame. But it was not a good ending.

The overall context in which Gustave and Emile are trying to live with their illnesses is compounded by the general insecurity and fear in the camp itself. In April someone claiming to be the owner of the land threatened to burn down the camp unless everyone left. The following day a fire broke out in one section which everyone took as a warning. Camp residents reported the fire and threats to the police who said there was nothing they could [would] do. They then decided to protest against the threats and lack of police action during which two men were arrested and one died in custody. Chanjem Leson activists worked with the family of the deceased and reported the police in question to the Inspector General of Police. Since then they have faced daily phone threats from unknown men, including repeated night visits to their tents.

The whole camp is nervous and fearful of being evicted at any moment. Emile’s adoptive parents, Elie Joseph and Esther Pierre have gone into hiding and he is being cared for by Esther’s cousin Serge Supre. Serge is unemployed except for the little he earns from interpreting, and worries about how he will pay for his 18-year-old daughter to finish high school. Regular evictions have begun to take place around the city and each night people go to sleep wondering if this will be their last. This has also meant disruptions to the small craft and art workshop and the school.

Gustave has started ARVs and although the family is happy with his treatment they want more than anything to return to Port-de-Paix – “if we have to be hungry better to be hungry at home than in PAP!”
For the first few weeks Gustave responded positively to the medication and even planned to find work and try to visit his wife and children. However over the past two weeks he has deteriorated, becoming aggressive, removing his clothes and disappearing for days and worst of all, he has stopped taking his medication. The stress of caring for him has taken its toll on his family especially his mother for whom this is one burden too many.

For the past month, Rosi-Ann has stopped working and is being treated for a vaginal infection whilst staying with her youth worker Kethia. The plan is for her to travel to Les Cayes with Kethia and Maxo to begin the search for her family but going home brings with it another set of problems. Recently Maxo returned two teenager sex-workers to their families in Jeremie but their families are extremely poor. Millions of Haitians, especially in rural areas, are without food and adequate shelter and the chances of the young girls staying is in the balance – will they stay and remain hungry or try to return to the city forced again to sell their precious bodies? Altogether there are nine girls waiting to return to their families.

Statistics tell us the numbers of people living with HIV and dying of AIDS / TB in Haiti has decreased dramatically over the past 10 years due to a policy directed at prevention based on education and increased access to treatment. But there are other realities excluded from official reports and statistics. Rosi-Anne, Gustav and Emile, and millions like them, are forced to struggle to receive the most basic healthcare. Emile has spent two months trying to get treatment and he’s still waiting. It is hard to say no one cares and even though I have followed him through the repeated hurdles and I know we, his family and his friends care, but without money and without agency people like Emile and his family are regularly treated with disdain. You attend the hospital and people don’t even look you in the face, preferring to watch TV or chat with their colleagues. People treated as “expendable non-persons”!
And Emile is doing badly. The hospital run by the Sisters of Mercy is now in Carrefour but they refused to see Emile because “his uncle gave trouble”. Serge tried to appeal to their “mercy” but in vain…

“They said they will do something for the poor but they cannot help Emile because his uncle brought trouble. I would like to know who are the poor – are we not poor, is Emile not poor and sick and a child? Something must be done for him. He cries at night and I don’t know what to do. On Monday I will return to GHESKIO and hope they will help. If not we have to go back to Dr Coffee.”

Emile didn’t get to GHESKIO. Through a “friend of a friend” he is now waiting for an appointment at Dikini hospital in Kafou where they receive HIV+ patients. I hope he finally gets the treatment he needs.

UPDATE: After visits to numerous hospitals and clinics in PAP, with the help of Dr Coffee, Emile finally started on ARVs at the end of September 2013. He is still very ill but we are hopeful he will be included in a special programme for orphaned children to receive food, school fees and text books.

1] A. Naomi Paik “Carceral Quarantine at Guantanamo: Legacies of US Imprisonment of Haitian Refugees, 1991-1994”  published in Radical History Review Issue 15 /Winter 2013].
2] Castro, Arachu and Paul Farmer, “Infectious Disease in Haiti” EMBO Reports 2003.
[3] ARDTA – Asosyasyon Respekte Dwa Timoun – Ans Wouj [Association for the Respect for the Rights of Children]
* I have changed the names of Emile and Rosi-Ann because they are minors.

 

This article was supported in part by the International Reporting Project.

A Gay Kenyan’s Gang Rape (Part 1): The Blessing

On the morning of Dec. 11, 2007, Anthony Adero decided to leave his hometown forever and head to the capital, because he wanted to kiss a man for the first time in his life. He packed the few essentials needed for his five-hour trip, little things that carry weight, like family photographs and a prerecorded cellphone message from his baby sister; he felt soothed whenever he heard her giggles. What he could not stuff into his suitcase he packed in his heart. Then he took two reassuring breaths for courage, allowed himself a measured silence, and then headed straight for the central bus station in Kisumu for his final goodbyes. His grandmother cried. The men cried, too, but rural machismo forbids public displays of emotion among men, so they turned their backs to hide their shame. His older brother was envious, while his baby sister was proud. Anthony was hopeful, but everyone else held serious doubts. Kiss, hug… those final moments were so tense that he forgot his ticket before boarding.

One covers 164.85 miles, or 265.3 kilometers, between Kisumu and Nairobi, which would require five hours and three minutes on the well-lit, pothole-free, butter-smooth road that exists in every African’s dreams for his or her country’s future. In reality (wherever reality is), his trip took longer, but linear time, like history, is the Western world’s delusion, and no African on that bus cared how long it took to get to Nairobi as long as they were safe with their possessions intact by journey’s end. With both hands pressed against the window to frame his world, everything familiar got swallowed as the bus inched toward its final destination, which, according to Anthony, wasn’t so much a fixed spot or place but the sweet promise of self-actualization that would come with the freedom to explore his sexuality. Whatever didn’t slip past his eyes as he looked out the bus window burned deep in his mind as painful memories: the semester when six boys were expelled for wearing earrings; the boys beaten to a pulp by their fathers who had sacrificed nearly everything to educate them, counting on their sons for support should they take sick, grow old or become too weak to provide; blood spilling from one boy as he fell to the ground, kneeling as his father pounded him, front teeth knocked clear out of his swollen mouth; searching the dictionary for “homosexuality” to find no word in Kiswahili, though the slang for “faggot,” “cunt” and “bitch boy” lives in multiple incarnations at the tip of every Kenyan’s tongue; televised broadcasts of presidential speeches outlawing gay love; sermons preaching eternal hellfire, demonic possession, perversity; finally telling his girlfriend, “No, sweetheart, I cannot marry you, because I’m gay,” then banking on God’s protection, not hellfire, to pave the way for a planned escape.

As the bus pulled into the depot, Anthony decided that a celebratory drink should precede a phone call home telling his family that he’d arrived safely. The rumored hotspot for gay-positive clubbing was Steps on Tom Mboya Street, where men who have sex with men (MSM) mingled with marginalized folks who could party: tourists, prostitutes and the high-ranking African diplomats who preferred local whores to their well-educated African wives.

Anthony sat at the bar and ordered his drink, but he was reluctant to look around, in case locals mistook him for a wide-eyed, awestruck “rural greenhorn” fresh off the bus. Plus, who could see much of anything, given how dark it was inside? Two men, mostly in shadow, sat beside him. They were tall with deep voices, probably MSM. Prospects to explore his sexuality were abundant. “Maybe that first kiss could double for both lovers,” Anthony thought as the men inched closer, offering to buy his next drink if he cared to stay a little longer and keep them company — pretty boy. Anthony smiled. It was his first mistake. Harmless. His second proved to be disastrous.

* * * * *
They stole my shoes, my bag, my money. I lay stomach-down on a dirt floor, embraced by darkness. Eyes closed, I heard the rush of cars down a nearby road. Where was I? I’d been dumped in a semi-completed, abandoned house without a door, which meant they could come back to rape me again and again. Mosquitoes feasted on blood from my anus. Blood was dripping down my legs. There was blood on the side of my skull, where they’d beaten me with a steel pipe, I guessed. My asshole throbbed with pain. My skull and stomach jerked with pain whenever I moved; even the slightest gesture jolted my suffering to its depths.

But to stay motionless was an invitation for rape, more insecurity in a mysterious world where my survival was nothing but a threat. Alternatively, I could escape this hell. I closed my eyes and pushed my consciousness into a bird. I flew. I soared. I was free. Eyes open, I tried to push my upper body off the dirt floor but failed. My wings were too fragile. In my stillness I could not gather peace, only rushing thoughts from a counternarrative in which they parted my legs and penetrated me, stabbing my sexuality as mosquitoes danced joyfully to the rhythm of each greedy thrust. “No!” I screamed, pushing my upper body off the floor. “No!” I screamed as I came to my knees. “No! No! No!”

I stood naked in the dark, a baby bird on the verge of flight, at the edge of a steep cliff, facing takeoff. My first wobbly step took me toward heaven, the open door a threshold to eternity. Then I realized that I had to cover my nakedness if I wanted to reclaim my damaged body to the world outside. I felt around for plastic sheeting left over from construction work. I found it. My broken heart danced. I put the plastic around my body, careful to cover the blood on my legs as best as I could. I worried that I smelled of spunk, blood, sweat, anus. When I reached the door, I took one deep breath, then my first step. How to describe it, that moment of initial self-rescue? A million birds taking flight from my heart, thanks to release by an inner warrior. The spirit regaining “yes” language with each step as affirmation. God of a thousand hands stretching to lift the mountain off my back. Fire dragons plunging headfirst into the ocean, emerging as butterfly love. I was flying. I was soaring. Yes, freedom.

At the end of the road, I came across a woman, old, tired, overworked, poor. I looked for scorn in her eyes. She gave me directions. She walked me to the matatu bus stop, step after step, then slowly reached into her bra and brought out 90 Kenyan shillings for my fare back to Nairobi. “Take,” my angel said. She promised to pray for my protection. During the ride back, passengers refused to sit near me. They called me “monster” with volume to accentuate their disgust. In Nairobi I telephoned my rich relatives, who came to pick me up. They said I looked miserable. They said Nairobi was a cosmopolitan city for sophisticated people, a place where someone as dirt-poor and as rural as I could not survive beyond a week at best. They said I smelled bad and spoke like a stupid, uneducated farmhand. I kept silent, in pain. They said curse words. “Idiot, ugly, filth, trash,” they said. They sai– Stop! A voice in my head interrupted their dirty, abusive sermon with warrior language for my broken spirit:

“Anthony Adero, this is not who you are.”

“Who am I?”

Then came the epiphany:

“I. Am. Blessed.”

* * * * *
Anthony Adero had contracted HIV.

 
© Nick Mwaluko and Anthony Adero

Personal herstories Lihles story

First part – Inkanyiso

My name is Lihle, (not real name). I chose not to use my real name for this story because I was scared of being victimized. Even though I’m not ashamed of the fact that I’m living with the virus. I’m not ready for the stares, and some people will over do the caring things to show that they do not have a problem with me being HIV positive.

I am a 28 year old lesbian woman, mother of an 8 year old boy who brings joy in my life every day.
I live in Khayelitsha with my brothers, I do technical support for a private company, and I studied information technology. I love writing, organizing event and just helping young kids to achieve their dreams.

At the moment I’m registering my project to teach young people from my community about different things like beading and talking about my experiences through life. With my partner’s help we managed to get some material, we also teach fine arts and hopefully in the long run we will be able to teach ceramics as well. However, the material is too expensive for us at the moment.

I’m very passionate about activism, I love happiness and I hate laziness.

I have overcome my fears about the virus and I made a decision that I will not die until my son is old enough to fend for himself and I hope to see my grandchildren. I am one of the luckiest people alive to have a partner that loves and supports me in all I do. She is one of the best things that ever happened to me. I can safely say she is the partner I’ve been looking for, she is compassionate and I love her to bits not just for being there for me but I love her for my heart, she is good for my soul.
If I believed in destiny I would say “she is my destiny” or “the one”. I sometimes feel like I have no right to have sex with her since she is negative, however, that’s something my counsellor and I are working on, but my biggest fear is what if something goes wrong with the protection we are using and I end up infecting her.

I am involved in a lot of activities which keep me going, and my family has been great. The thing that keeps me going is the decision I make every morning to forgive and be happy. So I have to make sure I smile and at least make the one person that keeps me going smiling.

Second part

Choosing to live has been a real challenging choice for me. Living has been really fruitful to say the least.

Growing up had its own challenges especially if one is a breadwinner at home. I applied for a life insurance policy. That I thought was a Gift to my son, my brothers and to my unemployed father, little did I know that I would be receiving a gift myself.

The process and thing I needed to do in order to get the policy were explained to me, which included taking several medical tests to confirm my health state. However, there was one test I had to do before the application was approved. I had to take an HIV/AIDS test.

People usually get scared when they have to test, but I wasn’t because I was so sure that this too will come out negative, so you can imagine my surprise when I was told otherwise.

Let me take you through my day.

I had tested the day before so I was going there to just get my results and go to court, well that was my plan anyway. When I got to the doctor’s office, the doctor asked me to sit down. I could see it in her face that she was the bearer of bad news.

She kept asking questions like:
“If you are HIV positive how would you take it?
Who would you tell? Is there a person you can talk to?”

For me that was stupid because I’ve been given bad news almost all my life and I already knew the results, so I asked her nicely to stop asking me stupid questions and just give me the results.

When she said that she is sorry but I was indeed HIV positive, it sounded different from what I thought it would sound like. I was not prepared for her to say it. Even though I knew what the result were.

She ripped my heart into pieces.

My world fell apart.

I wanted to drain all the blood from my body.

By the time I got home it was already late. In the morning there were no tears, but I began to think about who could have infected me. The blame game had begun in my head. The problem is I didn’t know who to blame from the people I was in an accident with, to people I’ve slept with. I wanted someone to account to this unfortunate incident. I sank in thoughts until my head started spinning.

Even though I wanted to cry as the pain was too much, there were no tears. I decided to buy a bottle of vodka and drank half of it and by that time tears and sobs came non-stop. I cried until I fell asleep. When I woke up, my friends were there, preparing food for me.

I was diagnosed with HIV last year  (2012 June/July). I am not sure about the month now. I then disclosed my status to my father, not that I required any assistance or support from him as he is not staying with me, I just felt like telling him.

No one judged me for my behavior. They were there for me because they cared and because of that I made a choice to live with the virus and that’s all. It is a virus that is in my blood nothing else; it does not define who I am not who I sleep with.

This is how I disclosed to my friends:

I sent an sms to one of my close friend, so I know what I told her. The others I think I told them during my drinking spree. Some I sent WhatsApp messages and even though some acted like they accepted me. I later realized that was not the case. My friends and I used to call and visit each other often but this time it was different, even if I was the one who did the visiting, they suddenly didn’t have time or they would just ignore me blatantly.

To all the lesbians out there who are living with the virus and feel there is no one to talk to because you’re scared of how your fellow lesbians will take your HIV status, you are not alone.
The key is to live a positive lifestyle.

My Girlfriend and I

I have just reconciled with my girlfriend, I wanted to be honest with her so that she can decide if she wants to stay with me or not. After telling her, she was very supportive and caring still, even though we encountered some challenges sexually, because I was scared to make love to her due to my status.

We had to go through the process together, learning more about HIV and our sex life, we went to Triangle Project (an LGBTI organization in Cape Town) and there we learned ways to protect each from contracting STI’s including protecting her from HIV.

We now have a healthy sex life. We’ve worked through our problems and honesty the open communication in our relationship has worked so far.

My Fears

If my CD4 count went down and I start taking medication what will happen?
However, I have plenty of time before I cross that bridge.

My attitude towards my status has really helped me and the people around me including my brothers help me not to give up.  Disclosing my status gave me strength to face the virus head on and for that I thank God for giving me such wonderful people in my life, people who halved my load. Thus far I haven’t faced any real challenges that I can’t deal with.

__________________________

*** Please note that the name of the author is reserved to protect her identity and privacy.

Remembering Busi

Busi died on the 12th March 2007.  One of the few poems she published on her blog “My Realities”  was “Remember Me When I Am Gone” – This year I forgot the day but not Busi.  I think of her often as she was.

 

In November 2006 she wrote “No one can take it away from me”

The beautiful soul that i am
The creative genius that i am
The artist i was born to be
The good writer that i doubted
The storyteller and the original educator
Born to change the world, yes, i was
Born to relate my own happenings and mishaps
Given by GOD Almighty Himself
Its’s true i say “no one can take that awy from me”
The reviver of dead minds
The bearer of good news
The true master mind but, not a proud one.because
I only live to make myself and my GOD proud.
As for the people who are gossiping,muttering words and calling me names behind my back
Fuck them I say!
I was born like this
I was born to tell my tales
I give love to the people, my people
Black women of the continent of Africa
I shall be free one day
Free from the negative,stereotyped,crowded fucked up situations we live in.
A home we should call it.Well, its not for some of us
Its three roomed housed containers with walls closed up and closing up people’s minds
Because they believe, yes they believe
A man needs to work which is why every end of the month
He drowns himself in a beer drum & fights with the rest of the street and his family
He calls her names and tells her she’s a bitch
Because he buys her food, she dont see nothing wrong
Well, i refuse to tolerate such animals
Because i am a true and original Blessed queen
A woman full of love
A Goddess born to change their mindests
It is with me that they will realise
She was born for a reason
She was created for love, by love, for a woman
The woman within a woman
No one can take that away from me
I am who I am!!!

 

Busi along with Buhle Msibi who both died at the age of 25 will be remembered on 6th April 2013

Cholera and Healthcare in Haiti

It is impossible to talk about health care in Haiti without mentioning the 2010 earthquake and the subsequent cholera epidemic which so far has affected 630,000 people and taken the lives of 7,500.  It would be easy to believe that cholera was a direct result of the devastation of the earthquake and the heavy rains of June, July and August.  In fact the media spent much of 2010 speculating on the possibility of a medical epidemic.  2 million people were forced into overcrowded internally displaced camps [IDPs] where living conditions were  appalling. People were traumatized and fearful of further earthquakes and even to mourn the dead was hard as the struggle to live became harder as months passed.

Pediatric Clinic Cite Soleil

Many women and girls in the tent camps especially, were raped and lived with the fear of physical and sexual violence; food and clean water were scarce; latrines dangerously inadequate; and sewers overflowed. So why were so many health care providers and humanitarian aid agencies caught off guard when in October, the first cases of cholera began to appear and not in the IDP as might have been expected? The answer to this question and others, such as why did it spread so rapidly,  who was responsible and what has been the response all serve as an excellent lens from which to examine healthcare and the socioeconomic realities of the UN/US occupation of Haiti.

Cholera is an acute dehydrating bacterial infection spread through contaminated water and food.  The source of the contamination is human feces and the illness is exacerbated by poor sanitation, limited clean water, heavy rains and associated poor hygiene such as failure to wash hands after going to the toilet.   Symptoms can be mild or severe with leg cramps, white watery dirreahea and profuse vomiting. They can appear within hours or over a period of days.  However once severe symptoms appear, those most vulnerable such as children, the elderly, pregnant women and those already malnourished and or suffering from chronic illness, rapid dehydration can lead to death in just a few hours.  Treatment for most people is a surprisingly simple:  oral rehydration treatment [ORT] and in severe cases, an intravenous rehydration with antibiotics.

I visited Haiti in November 2010 and by then cholera was already embedded in Haitian lives.  Banners and posters announcing the dangers and prevention of cholera hung from streets and decorated what walls were left standing.  Radio and TV jingles blared out similar messages whilst schools, camp committees and women’s organisations reinforced all these messages whilst trying their best to create hygienic environments and most important provide clean water.   SOPUDEP school did not escape cholera as many parents and students were taken ill.  Their priority was to provide clean water through a mix of water treatment tablets and clorox as well as to reinforce basic hygiene regimes – with 700 children it was not an easy task and there were constant school closures as children or their parents were taken ill.  Nonetheless they were able to avoid a local epidemic.

In the early hours of one morning, a diabetic friend was rushed to the Médecins Sans Frontières [MSF] hospital in  Martissant 26 which at the time was one of their cholera treatment centers [CTCs].  I arrived in the evening just as dusk was falling to visit my friend.  As I waited outside, I watched as cholera patients came and were directed to the side entrance.  Some walked, some were carried, frantic parents with a baby wrapped in a bundle but visible enough to know she or he would die very soon;  an elderly woman in a wheelbarrow, shrunken and surely at the point of death.  In  Martissant 26 Cholera was everywhere.  It was unavoidable as vendors and customers vied with mountains of rotting refuse and pools of stagnant water lying amidst rubble and buildings destroyed by the earthquake.

Prior to October 2010  there had been no cases of cholera in Haiti for nearly a century.  The first hospitalizied case was on the 17th October in Mirebalais, in the region of Haiti’s longest river, the Artibonite. By October 22nd cholera was confirmed and the outbreak in the costal areas of St Marc was established.    The disease was able to spread rapidly due to initial misdiagnosis, lack of Oral Rehydration Treatment [ORT]  and an already overstretched medical infrastructure. Cholera was not the epidemic in waiting. The first responders to both the earthquake and the cholera outbreak, were the largely ignored by western media,  Cuban brigade, who had been in Haiti since 1998, along with the well established MSF also in Haiti for many years.   At the start of 2013 these are the only two sizable medical teams left from those first 12 to 18 months.  From an initial 72 CTCs in 2010/11, MSF which now accepts all cholera referrals as well as walk in patients,  has just four CTCs,  in Leogane [40 beds] Delmas 33 [80 beds],  Carrefour  [275 beds] and Cite Soleil/Drouillard [100 beds].

In order to place Haiti’s health challenges in a global south context I asked  Oliver Schulz,  the head of the MSF mission in Haiti  how the country compares to African countries. He gave the example of the eastern Congo, where in general, there is a structure and willingness by the Ministry of Health to get involved. So within six months of starting a MSF cholera project  the ministry is ready to take over.  However in Haiti, because the disease is new and because there is neither the capacity nor the necessary health infrastructure, the government has been unable to take over.   However as Oliver Schulz, program director for MSF, pointed out, the situation in Haiti is far more complex than simply pointing a finger at the government as they simply do not have the resources.   In particular, Schulz was critical of the WHO and UN whose role should be to support the government in developing a comprehensive health care infrastructure yet despite years of talking little has actually happened.

even with cholera some of the things we discussed two years ago are still being discussed. I do not know how much they are involved in activities like plans etc but it seems to me that by now we should have a national health plan and it seems to me normally the WHO supports the government in making such plans as thats what they do in other countries.”

The problem with healthcare in Haiti is there is no system, no structures, no plan – at least not one that has been implemented. What healthcare facilities exist are wholly inadequate – insufficient medical staff, support staff, equipment and treatment, and left to medical NGOs such as MSF, the Cuban Brigade and a few faith based and charity clinics.  For example there is one MSF hospital in  Carrefour with 275 beds serving about 400,000 people.  In Cite Soleil the figures are similar. In addition to MSF hospital there is public hospital, St Catherine’s  which like most government hospitals is staffed by excellent Haitian doctors but is  rundown and under equipped.

The Charity Mission runs a small hospice for HIV/AIDs patients and a few other small clinics serve at least 250,000 people.   Finally there is the Centre de Nutrition et Sante Rosalie Rendu which has a pediatric clinic and sees up to 300 under 5s a day, many mothers traveling across the city to reach the clinic.   The round trip from for example, Delmas to Cite Soleil can take up to 4 hours and three tap taps at a cost of about $2 – a long and costly journey.  But the Haitian and American doctor are excellent and the clinic includes a nutrition center for malnourished children who attend everyday for six months or until their weight and overall condition has improved.

The public hospitals including the country’s main teaching hospital and clinical and trauma referral center, L’Hôpital Université d’Etat d’Haïti (Haitian State University Hospital or HUEH), are in terrible condition and have effectively been abandoned by all those involved in running the country – the government, the UN, the USAID and other country donors, and the NGOs.  HUEH was partially damaged in the earthquake -  150 nursing students were killed and two thirds of the buildings destroyed.    Even before the earthquake, it wasn’t in great shape and the rebuilding  of HUEH was supposed to be a priority as shown in this  2010 proposal by Partners In Health [PIH].

Significant, strategic, and ongoing improvements to the comprehensive infrastructure, staffing, training, operations, and clinical practice of this central public health facility are investments in the future of all public health throughout Haiti. ………..More immediately, HUEH is in a state of emergency. If conditions at the hospital are not improved in a matter of months, it will become the site of a second round of catastrophic deaths due to disease outbreak or total health system collapse. There has been a vision articulated by the Haitian leadership of the hospital, but they cannot implement it alone. Please join the effort to build Haiti back better by first investing in the health of Haiti’s people

One medical improvement to HUEH and which is exemplary of how things happen in Haiti, is the TB clinic set up in 2010 by an American volunteer, Dr Coffee and a group of Haitian nurses.  The clinic initially operated under tents is now housed in a building and has cared for over 1000 patients TB since 2010.

Since 2004, when the Medical School of UNIFA (the University of the Aristide Foundation] was forcibly closed,  HUEH has been the sole medical training center in Haiti.  UNIFA was founded by President Jean-Bertrand Aristide in 1996 in order to ‘amply the voices of Haitian people’ by creating an inclusive educational space from adult literacy to training doctors and nurses.   In August 2011 the much needed medical school reopened with 63 men and 63 women.  In the politics of US imperialism in Haiti, the contribution of UNIFA and the Cuban brigade doctors,  to the health infrastructure have been ignored by western media. I doubt this is by accident given the election of puppet and Duvalierst, Michel Martelly, and the resurgent post earthquake neo-liberal agenda driven by the US, it’s allies and NGOs.

Although the rebuilding of the HUEH and other public health clinics have not taken place the new Paul Farmer led, PIH, state of the art, University Hospital of Mirebalais [HUM] has now opened.    I asked a number of  NGO personnel, doctors and Haitian activists why the HUEH has been abandoned yet the PIH NGO hospital has flourished.  The response was always the same – “we ask the same question”.  No one would question the importance of HUM to Haiti’s health infrastructure.  It is the largest post-earthquake project in the country and has taken three years to build.  HUM has 300 beds, plus primary and secondary health care for up to 500 people a day. As a teaching hospital HUM along with UNIFA will provide doctors and nurses for Haiti.  However questions remain as to the location and who will have access to the hospital.

There is no doubt that both the earthquake and cholera epidemic played a leading role in the funding and realization of the PIH project.  One of the uses of founder, Paul Farmer is that he is able to raise funds especially since he became a spokesperson for ‘the machine that drives Haiti”.   When questioned by journalist Ansel Herz about the stalling of a wage increase from $3 to $5, Farmer, the new voice of the occupiers, also stalled as he seemed to have forgotten his own treatise on ‘pathologies of power’.

The inadequate provision of healthcare for the poor in Haiti and elsewhere, as Farmer himself has written over and over, is due in large part to structural violence and a pathology of greed which has left over 2 million people food insecure, forces women into relationships which are detrimental and often abusive; results in people dying needlessly of cholera or because they couldn’t  access simple surgery as was the case for Elie Joseph.

In February 2012, Elie Joseph was diagnosed with a heart murmur which is a common congenital heart defect called ventricular septal defect [VSD] where the blood flows the wrong way, putting stress on the heart and lungs which can lead to infections. The charity Haitian Hearts, which sends children suffering from heart related illnesses to the Dominican Republic or the US, arranged for Elie to travel to the Dominican Republic for the 15 minute procedure which would fix his heart.  Elie received his travel documents but not his mother so he was unable to undertake the operation which would have taken some 4 hours plus the follow up treatment.  In December 2012 Elie Joseph died from pneumonia in the tent at Aviation camp where his parents are forced to continue to live three years after the quake.  VSD is not an illness to die of and Elie is one child out of thousands who have died needlessly as a result of structural violence.

The violence of poverty is multifaceted so that even when healthcare is accessible there are still other obstacles to overcome.  Gladis* lives with her three children aged 6 months, 4 and 9 years in a camp in Delmas 33.    She is fortunate because the camp is not too far from both the MSF cholera treatment center in Delmas 33  and the La Paz clinic run by Cuban doctors.    Gladis came to Acra camp a few days after the earthquake with her two children.   Her home in Tabarre was destroyed in front of her eyes and she wandered the streets for three days disorientated , traumatized, sleeping and walking with the children till eventually she came to Acra.  At that time there were no tents and people were sleeping in the open or under whatever makeshift covering they could find.  It was about three months before the people at Acra were able to secure tents by searching out various NGOs themselves.

It was a dangerous time for women in particular as sexual violence was rampant,  the only food and water was being handed out by NGOS and you had to queue for hours.   Three years later, Gladis is hardly coping with her life and its possible that only the support of her neighbours and the camp committee which has kept her going.   In October 2011 when she was about 6 months pregnant, Gladis caught cholera.   It started in the morning and within a few hours she was unable to walk.  Her neighbours gave her water with the RHT salts but these did not help.   She had two problems – she would have to leave her children with neighbors and luckily hers were trustworthy. Secondly she had to get to the MSF treatment center.  She was in no condition to travel by Tap Tap or motorbike and besides she did not have the money. The only way was by car. Again Gladis was lucky as one of the camp leaders saw she was ill and suspected cholera. He had an old truck that just about ran and its with this that Gladis, near death, was taken to the hospital where she spent 15 days.

“I didnt know what was happening until after some days.  I saw they had put me in the last room where many people were dying and I thought I would die too.  So many people died, I don’t know how many but every day they were dying……When I started to get better, I was able to eat.  They gave us food sometimes three times a day.“

Although Gladis was released after 15 days she was still ill suffering from headaches and with a fever. But for the MSF her cholera had been treated and they needed the beds as new patients were arriving all the time.   Gladis survived but she remains unwell, fearful and hardly able to breast feed her baby. Again this is one story.  Although I have heard many complaints from women on the public hospital and clinics, I have only ever heard good things about both the Cuban doctors, MSF the pediatricians at Sante Rosalie Lendu.

The cholera epidemic is not over by far and once the rains start the numbers are expected to rise again.   The estimates for 2013 are are 118,000 cases.  To put these numbers in a global context,  there were 160,000 cases in the whole of Africa in 2010, thats nearly 1 billion people compared to the 10 million population in Haiti.  I asked Oliver Schulz of MSF his thoughts on the year ahead.

 “My personal fear is that things will get worse before they get better.  The structures are weaker today than in 2011/2012.   Every year the structures deteriorate.  There is no plan for cholera and without a WHO supported comprehensive national health care plan with clear directives, clear action plans and milestones then it will not get better. Also many of the big agencies have left and there are too many unknown NGOs, charities and faith groups”

Within weeks suggestions began to appear that the origins of cholera lay with the UN and specifically a Nepalese contingent based near the  Artibonite river and spread through the base toilets.  Initially the UN denied being responsible however there has been  mounting evidence of  the UN being the source.  By October 2012, two years after the outbreak,  the evidence against the UN was irrefutable

“We can now say,” Dr Lantagne said, “that the most likely source of the introduction of cholera into Haiti was someone infected with the Nepal strain of cholera and associated with the United Nations Mirabalais camp.”

In the hope of obtaining justice and reparations for the thousands of cholera victims, the Bureau des Avo­cats Inter­na­tionaux [BAI] and Institute for Justice and Democracy in Haiti [IJDH] filed a groundbreaking suit against the UN on behalf of 5,000 cholera victims.  In addition to insisting on accountability the suit  demands that the UN

  •  Install a national water and sanitation system that will control the epidemic;
  • Compensate for individual victims of cholera for their losses; and
  • Issue a public apology from the United Nations for its wrongful acts.

The UN role in  introducing cholera is one more abuse in a long list of  violent acts  against the Haitian people with no accountability.  From sexual abuse, rape, cholera to the  killing of innocent civilians.  UN appointed special Envoy of Occupation,  Paul Farmer suggested as early as December 2010,  a vaccination programme as part of a 5 point intervention to halt the epidemic. However Haitians had little reason to trust a UN led initiative even if it was supported by a world renowned physician.   Three years later the only evidence of improvement in the healthcare is the teaching hospital at Mirebalais.  More than anything Haiti needs clean water, not just for cholera but for a range of illnesses and because everyone has a right to clean water.  Provision of clean water however does not make money for pharmaceutical companies – being well does not make money for pharmaceutical companies. But a cholera vaccine every three years is highly profitable disaster capitalism at work.    Rashid Haider explains the case against vaccination..

The vaccines Shanchol and Dukoral contain large amounts of killed cholera bacteria, the latter having an additional component known as the recombinant B subunit of cholera toxin (rCTB). Both vaccines are two-dose oral vaccines that are taken with an interval of two weeks, and are meant to cause development of protection against cholera one week after the second dose.

Harmon’s assumption that these vaccines are 60 to 90 percent protective for a period of two to three years does not concur with facts. The Shanchol that is intended for field testing soon in Haiti had offered a poor protection of 45 percent during the first year of surveillance in a large-scale field trial in India in 2006. Dismal results were obtained in a large-scale field trial in Peru in 1994 when the two-dose vaccine Dukoral was tested.

The alternative argument for a national water and sanitation system is a far more sustainable and realistic solution to ending the epidemic and preventing new outbreaks.  It is long term, benefits everyone and responds to a range of preventable illness and improves the overall quality of lives.

UPDATE

A March 2013 report by MSF speaks to the deplorable condition of cholera patients in Haiti.

 

“Some of the staff at the cholera treatment centers have not been paid for several months,” said Dr. Mamady Traoré, MSF deputy medical coordinator, who participated in the Artibonite assessment in late December 2012. “Infrastructure and equipment are worn out because they haven’t been maintained and there are frequent shortages of medical supplies. As a result, hygiene precautions that are essential to limiting the spread of the disease are no longer enforced. Sometimes patients are left without treatment or must pay to obtain it. That is intolerable.”

Haiti: Occassional Musings – 6

Last week I visited two clinics in Cite Soleil. The first was  a pediatric clinic which is part of a complex run by the Catholic church for the past 37 years. In addition to the clinic which sees pre-natal mothers and children up to 5, there is a free primary school and a women’s training and work center. Despite the media’s representation of Cite Soleil as a dangerous space, I have always found it calm and friendly and have yet to meet anyone who says otherwise.

Like much of the media reports on  Haiti, events are rarely contextualised accurately and Haitians are presented as being undisciplined  and violent or as ‘famous’ US journalist, Amy  Wilentz, described them “poor, needy and desperate” – but this fits well into the victim narrative so thats OK!   Nonetheless Cite Soleil residents have a history of protest against violent repression and more recently from the UN following the 2004 coup against President Aristide as depicted in Kevin Pina’s film “We Must Kill the Bandits“.   And yes there is gang violence and it can be a dangerous place for youths in particular, much as the streets of  cities in the US and Europe  - Miami, Chicago, London and Paris are zones of violence against youth.  But the deeper violence that seeps into everything and that kills people is poverty.

The complex consists of  a large compound with low rise buildings – classrooms for adults, the workshops, dinning halls, playgrounds and the clinic –  set amongst palm trees and flower gardens. There is a sense of tranquility both in the outside areas and in the classrooms and clinic rooms. The clinic along with nearby St Catherine’s Hospital, serves the whole of Cite Soleil and beyond. By far the majority of children who attend the clinic are suffering from poverty related illnessness or illnesses or illnesses aggravated by poverty – dirty and insufficient water, poor or non-existent santitation facilities, and lack of protein diets. Illnesses such as anemia, malnutrition, TB, parasites and diarrhea.  Often illnesses lead to a needless death as in the case of 2 year old  Elie Joseph.   In February 2012, Elie Joseph was diagnosed by Doctor John Carroll, with a heart murmur which he explained as

a common congenital heart defect called ventricular septal defect [VSD] where the blood flows the wrong way, putting stress on the heart and lungs which can lead to infections.

Dr Carroll who runs a charity Haitian Hearts, which sends children suffering from heart related illnesses to the Dominican Republic or the US, arranged for Elie to travel to the Dominican Republic for the 15 minute procedure which would fix his heart.  Elie received his travel documents but not his mother so he was unable to undertake the operation which would have taken some 4 hours plus the follow up treatment.  In December 2012 Elie Joseph died from pneumonia in the tent at Aviation camp where his parents are forced to continue to live three years after the quake.  Elie should not have died.   Aviation camp is like other camps is so crowded you can hardly move between tents, there  are  pools of stagnant water and rotting garbage everywhere.

Sometimes even those who claim to be ‘helping’ do so with paternalistic disdain. Like the person I met at a nearby  mission which includes a hospice for  men and women HIV/AIDS patients.  I can’t say t his view was shared by others who worked there, but it was shocking to hear someone supposedly caring for the dying blaming  their illness on  “Haitians lack of morality”.

It seems to me that no matter the level of health care available without addressing the underlying poverty, any health care is ‘bandaid’ medicine and yes a bandaid is better than nothing but people deserve something more than ‘better than nothing’.    HIV /AIDS patients arrive very sick many on the verge of death. They are treated, fed and made relatively well.  Then they return home back home to the same environment that brought them to the hospice in the first place so its not surprising when they soon die or return once again for a three months break from poverty.

Thousands and thousands of people, maybe even hundreds of thousands, have been disappeared in Haiti over the past 50 years.   The obscenity of the living conditions and  insufficient though often excellent,  health provision largely lies in the fact of $billions of disappeared  monies and the building of monuments to aid workers such as the Clinton Foundation funded,  Hotel Oasis.

 

 

This article was supported in part by the International Reporting Project.

#16Days – Living with HIV

 

From the Daily Maverick [the Maverick just gets better and better] their series on 16 Days of Activism Against Violence Against Women. The last day of the series focuses on the work of South African photographer Leonie Marinovich who has been photographing and speaking with people in rural communities who are living with HIV.

Pretty Blose

Born ’87, November 3

Diagnosed 2005

We were all sleeping down on the floor, in the room with Granny. I was screaming and nobody heard. They were snoring, and sleeping like they’re dead. Yes. I screamed. I said, Somebody!

I even called one girl who has since passed away, my other aunt — her name was Buhle, I said, Buhle, Buhle, is anyone there, anyone can you hear me?

And nobody heard. And the guy had a big knife. He put it on my neck and he

held my mouth when I was screaming. And then he just raped me. I was 10.

And I was wearing that dress my aunt gave me, when she came back from Joburg. And when the guy raped me, the dress didn’t have the blood. The blood was in a white panty that I was wearing, so I took the white panty and I made it look like a balloon.

I was scared to tell my mother the truth. My dad and my mom, they were brought up with the whip. So they decided, that’s the way for me.

I would just get a hiding for nothing.

I was young and very reckless and rebellious, I won’t lie. There was a time when I was very strict with using condoms. I used them, but then I dated this older guy, and we had a long-term relationship and then, because I loved him, and I trusted him, I felt, why should I use protection?

I just became dumb out of nowhere. And then I got infected.

So I gave birth to my son, then, a bunch of doctors came in the morning. They said, Ah, good morning, Pretty. And then they said, Sorry dear, we are so sad to say this, but you are HIV-positive.

And the moment they said that, it’s like, something was going on in my ears; like I was going blank and deaf.

So I’m like, Oh God, God hates me. Did I do something bad to Him or to people that I live with? Did I do any major sin that I don’t know of, and now He is punishing me?

My granny was dating these men. And then all of a sudden she gets sick and she resigns from work. When she goes for her check-ups for blood pressure they discover that she’s HIV-positive. And then I’m like, damn, Granny now, can you believe i?. How can I tell people that my mother is HIV-positive, my dad’s big brother?  And a lot of my relatives that I could count? The list goes on.

And my father’s sleeping around with a lot of young girls. He doesn’t want the older ones; he wants them young and fresh. Holding a Black Label, his beer, his friend, he says: These doctors don’t know what they’re doing. I say, Okay, Dad, ja.

My older sister is also HIV-positive. She’s busy trying to lower her CD4 count because she wants to get a grant. She will die trying to get the fucking grant.

Then I defaulted.

My dad was busy stealing my ARVs. Can you believe it?   Continued on the Daily Maverick

#16Days: AWID Condemns Uganda Anti-Homosexuality Bill

The Association for Women’s Rights in Development (AWID) strongly condemns the repeated efforts, now for the third time, to introduce the Anti-Homosexuality Bill in Uganda’s Parliament. We stand in solidarity with Ugandans who are calling for their government to withdraw this bill, once and for all, and respect the human rights of everyone.

The latest introduction of the bill, on November 21, 2012 could see the bill discussed and passed before the middle of December 2012. If passed, the bill would represent a grave assault on the human rights of all Ugandans, and in particular, would further sanction discrimination against those who are, or who are believed to be lesbian, gay, bisexual, transgender, or intersex (LGBTI). Furthermore, repeated efforts to pass this bill contribute to an environment that heightens stigma, discrimination, and violence targeted towards the LGBTI community, their family, friends, and supporters.

We stand in solidarity with the Ugandan LGBTI community and the tremendous pan-African response against the Anti-Homosexuality Bill, including from African LGBTI organizations, feminist, women’s rights and human rights organizations, the HIV and AIDS sector, and religious leaders. As an international women’s rights organization led by and engaging a majority constituency in the global South, we also note that the struggle for human rights for all including LGBTI people is universal. Countries in the global South such as Brazil, India, and South Africa have all taken leadership in the past two decades in legal and policy reform to support and respect LGBTI people’s rights. We urge the government of Uganda to do the same and take positive action in rejecting this bill and in protecting human rights for all.

The Anti-Homosexuality Bill seeks to introduce draconian provisions reinforcing Uganda’s existing prohibitions on consensual same-sex relations. According to some reports, the Legal and Parliamentary Affairs Committee appears to have removed the death penalty from the original draft of the bill. Not withstanding these or any other changes, we condemn the bill in its entirety, as well as existing measures which seek to criminalise, stigmatise, persecute, and punish people based on their sexual orientation or gender identity.

AWID’s research on religious fundamentalisms clearly demonstrates that across regions and religions, sexual orientation and gender identity are lightning rods for fundamentalist forces. As in the case of Uganda, those who do not fit rigid norms as defined by fundamentalists are seen as threatening the social fabric, notions of ‘morality’ and the ‘family’- discourses that are often deployed by such actors to harness power. Although couched in the discourse of protecting family, children, and traditional values, this bill in fact spreads hatred and violence. Far from being about authentic cultural values, the bill has been strongly influenced by resources and hate-speech by Christian Right groups from the United States.

The Anti-Homosexuality Bill not only violates multiple protections guaranteed by the Constitution of Uganda, but also contravenes the African Charter on Human and People’s Rights, theInternational Covenant on Civil and Political Rights (ICCPR), and other international human rights treaties to which Uganda is a party. The bill also seriously contradicts the strong call made in theJoint Statement to the UN Human Rights Council in March 2011, signed by 84 member states (including Nigeria, the Central African Republic, South Africa, and Rwanda), which called for states to take steps to end acts of violence, criminal sanctions, and related human rights violations against individuals because of their sexual orientation or gender identity.

AWID stands in solidarity with the people of Uganda who are fighting for human rights and justice. We believe that full respect for sexual rights is part of guaranteeing human rights for all, and we therefore call upon the government of Uganda to immediately withdraw the Anti-Homosexuality Bill and uphold the universality of human rights.

For more information and to take action:

A history to remember: “Who says being queer is unAfrican?”

 

In “The frightful development of this vice amongst the Natives”: Who says being queer is unAfrican?” Zackie Achmat traces the role of missionaries and the colonial state in the control and disciple of the African male body. He begins with a brief account of his own imprisonment at the age of 16 where he was first placed in a cell with a group of adult men including murderers and rapists. Expecting unimaginable acts of violence against him, the experience changed his own perception of prison gangs.

I could hardly understand the language they spoke. Two or three words were derived from Afrikaans, but the rest was from a mixture of African languages I could not identify at the time. Cups instructed one of the younger lads to call the other cells: “Ons wil met die Generaal tjaizana.” (“We want to talk to the General.”)

Within minutes all the toilet bowls in the Remand Section were flushed and all the water was removed from the one in our cell. In this way, the sound was carried through the entire sewage system of the block. This system allowed prisoners to communicate with each other illegally, with a diminished threat of punishment and discovery by the warders. When we arrived the 28s had to report to their General — they had to account for the loot gained from the newly arrived prisoners. MaPinda and Cups took turns talking into the “phone.” Basil, known in the cell as “die Moffie,”4 spoke to me in a grave tone: “Hulle discuss nou vir jou. MaPinda en Cups wil altwee vir jou he en nou vra hulle virrie Generaal wat hulle moet maak.” (“They are talking about you now. Both MaPinda and Cups want you, and they are asking for the General’s guidance.”) I had not had sex since my detention and felt deprived, but Mapinda was not my idea of a sex partner. Basil interrupted these thoughts with the verdict: “Die Generaal se die rules moet apply. Cups is jonger en is nie die baas nie, maar hy is MaPinda se luitenant. Mapinda het nourie dag ‘n wyfie gekry wat Cups wil gehad het en nou is dit Cups se kans/’ (“The General says the rules must apply. Cups is younger and is not the cell boss. He is MaPinda’s lieutenant. And, the other day MaPinda took a young wife (boy) Cups wanted so now it is Cups’ turn.”)

The post begins with a review of the film “Apostles of Civilised Vice”: ‘Immoral Practices’and ‘Unnatural Vice’ in South African Prisons and Compounds, 1890-1920 Zackie Achmat (1992) 

For, to one native on whose heart the good seed has fallen, who returns to the kraal in native garb and with the glowing message of an apostle in his heart, there are ten thousand who by their speech and countenance are apostles of civilised vice, who through their bodies spread the diseases of the white man over the face of wild Africa.(1) “Ethelreda Lewis (1934).

Continued. …..

Will the real Same Sex Marriage Prohibition Bill stand up

Since the passing of the Same Sex Marriage Prohibition Bill 2011 [SSMB] by the Nigerian Senate hundreds of online and twitter comments have been made supporting the Bill. By far the majority of these comments have defended the Bill on the basis that it only concerns marriage between two people identifying as the same sex; that as a national law it stands outside of international treaties to which Nigeria is a signature. As I pointed out previously, this is a deceit by the supporters of the Bill in both houses as same-sex relationships are already criminalised and obviously, so is marriage between persons of the same-sex. The two questions we should be asking are: what is the real purpose of this Bill apart from whipping up moral hysteria against a largely invisible 1-3 million Nigerians? and how will it impact on everyone irrespective of their sexual orientation.

In addition to targeting people who identify as lesbians, gays, bisexual, transgender or gender non-conforming, the SSMB will:

Prevent and or call into question two people of the same sex living or staying together, whether lovers, friends, co-workers or acquaintances,.

Will prohibit any display of friendship and or affection between two people of the same sex. Any form of touching, holding hands, embracing, and even looking could very well result in a 10 year prison sentence.
Continue reading

Uganda uses Anti-Homosexuality Bill as a political diversion

The Anti-Homosexuality Bill could be passed in the next 24 hours. After two years of off and on the AHB will be presented at tomorrows parliamentary session. For the past three weeks Uganda has been in the midst of it’s own uprising against the Museveni government – the peaceful “Walk to Work” protests against rising prices and described by blogger Angie Kintu as a protest

about reality, frustration and desperate times. I am buying a litre of Ugandan made and grown cooking oil for sh6,500. I am paying sh3,600 for a litre of fuel. A tomato has gone up to sh300 at the very least.

Led by opposition leader Kissa Besigyne, protestors have been shot, killed and arrested including Besignyne. Whilst the AHB is being used to distract protestors away from violence of poverty both The Anti-Homosexuality Bill and the attacks against the “Walk to Work” protestors are interconnected – both are violations of human rights against Ugandan. There is not a huge amount to say that has not already been said except to say its WRONG WRONG WRONG – more here on Gay Uganda

Two other closely related Bills are also due for discussion tomorrow – the Marriage and Divorce Bill 2009 which also includes a ban against Same Sex Marriages, has a second reading and the HIV and AIDS Prevention and Control Bill 2010 which will criminalise “intentional transmission of AIDS virus, has a third reading. For more explanation on the implications and commentary on the HIV & AIDs Bill see here

Tomorrow will be a shameful day for human rights in Uganda.

There is a petition to try to stop the AHB being passed – see here