Today is World AIDS Day

I'm sure at some point today you'll hear the stats (there are over 40 million people living with AIDS, most of them women, most of them in developing countries, most of them poor) and you'll think that's awful and move on with your life and not think about it too much. The numbers seem so huge you can't put a face on it and you probably think it can't happen to me.

I just spent about 6 months researching and writing about AIDS. A long the way I met Grace, a woman with eight children lying in a hospital ward in rural Tanzania. She told me her story in bits and pieces, her voice a whisper and stopping often, in obvious pain. She had come to the hospital a couple of years earlier for an operation on her stomach which had never healed. Grace had many children and was poor; she couldn't afford to come back to the hospital so suffered at home for a long time by herself. Finally her pain became so bad she had returned a few weeks earlier. She only ate when one of her children brought food as the hospital can't afford to feed the patients. Although she had been given drugs for her sores they hadn't healed and she felt the same as when she arrived. The doctors told me she had AIDS but didn't know: they hadn't told her and didn't seem to be in a hurry to do so. There was no way to treat her, so why tell her she was doomed to die?

I know a lot of you are thinking "but that's in Tanzania, it doesn't happen here," but actually, it does. HIV/AIDS happens everywhere, and the numbers affected are only increasing. Washington, DC has a higher HIV rate than Tanzania: the highest HIV rate in the US. 1 in 20 people in DC are HIV positive. It also has one of the worst records on treatment, and the highest AIDS mortality rate in the US. AIDS is the leading cause of death among young black women in DC.

Please take a moment today to think about the enormous impact the disease is having all over the world. Think of Grace, who will slowly get sicker and die, suffering needlessly because any drugs that could help her are scarce. Think of her eight children, who will watch their mother die slowly, then most likely their father. Think of the older girls, who will drop out of school (if they haven't already) to look after their siblings. Sex work may be the only way they can support the younger ones, increasing the chances they too will become sick and die. The family, already poor, will become destitute.

AIDS can happen to anyone at anytime. One of the reasons the disease is spreading so fast (and it is spreading all over the world) is because women are biologically, socially and economically at greater risk of HIV/AIDS. Traditional prevention efforts have ignored women's vulnerabilities and focused on techniques that require men's compliance, it's no wonder they have had little discernible effect.

Without treatment, millions of familes around the world will crumble, just like Grace's. Without treatment, there is no hope. Without hope there is no reason to be tested. Without getting tested, there is no way to prevent the spread of HIV/AIDS.

Debt relief, more effective aid, and fair trade will give developing countries funds to invest in HIV/AIDS interventions and fight poverty. Comprehensive and efficient health systems are vital for the poor to access treatment in developed countries. Governments will only support these measures if we, the average citizens, demand that they do so. Through protest, media and civil society action we must force our politicians to fully support effective prevention and treatment options for all, not just those that can afford to pay, and an end to the root cause of the spread of HIV/AIDS: poverty. We have the opportunity to stop the spread of AIDS: we must not let it slip away through inaction.

Please write to your legislators, your newspapers, or talk to your friends about what you can do to help. Think globally and locally: demand more AIDS funding, support local services and protect yourself. You can find some ideas to get you started here (US) and here (UK).

Torture, part 2

I've just received an email from Amnesty International on the new torture legislation being negotiated between the US Senate and White House. The legislation allows sexual abuse such as forcing prisoners to strip and dance naked as part of interrogations and redefines rape and sexual abuse:

the new bill could make prosecution for rape and sexual assault more difficult by requiring proof of specific intent to commit the crime, something generally hard to prove in cases of rape or sexual assault

I know that governments have secretly sanctioned all sorts of horrible things in the past (and present) but that doesn't make it right. I find it terrifying that the wealthiest most powerful country in the world is taking away the shame that would have previously been associated with torturing prisoners. How can we claim to be 'fighting the war on terror' when we are instilling it?

Torture

This morning I found an op-ed against torture by my favourite author, Edwidge Danticat, in the Post. As she writes in the column, it's really difficult to comprehend that the 'world's superpower' is openly discussing which methods of torture are ok. As if any method is. Although I realise this post is a bit off topic, I think it's worth quoting in entirety:

Does It Work?
By Edwidge Danticat

Sunday, September 24, 2006;
Page B01

MIAMI A few years ago, as I worked on a documentary film about torture survivors in exile from my native Haiti, I met a young woman who under questioning by a military officer was slapped until she became deaf in one ear, was forced to chew and swallow a campaign poster, and was kicked so hard in the stomach by booted feet that she kept slipping in and out of consciousness in a pool of her own urine and blood. Another woman had an arm chopped off and her tongue sliced in two before she was dumped in a mass grave, miles from her home.

When I met these women, some time had passed since their ordeals. But they could still feel the hammering of the blows and hear the menacing voices, threatening to drown them, dismember them and set them on fire. The younger woman, Marie Carmel, remembers thinking about her mother. Manman will surely die if I'm killed, she thought. I have to stay alive for her. Alerte, whose arm and tongue were severed, kept thinking about her children as she climbed out of the corpse-filled pit and crawled to the side of the road where she found help. Both had no idea how much pain they could endure until then. They wanted to live, they remembered, to defy their torturers, to tell their stories.

"There is no need for torture," wrote Jean-Paul Sartre. "Hell is the other." Those women saw hell and came back. However, neither one told their torturers what they wanted to know. Marie Carmel did not reveal the names of her fellow pro-democracy activists. Alerte did not divulge the whereabouts of her husband, who was the real object of her captors' search.

For many who remember -- just as these women do, and my own parents do -- what it means to live under a dictatorial regime, a regime in which citizens must leave work or school to witness public executions, torture is not just an individual affliction but a communal one. And now, when political leaders in the United States are asking as as a society to consider not only the legal and moral ramifications of torture but its effectiveness, we are brought closer to these regimes than we may think. If we are part of all that has touched us, as Alfred Tennyson wrote, then we are all endorsers of torture when it is done in our name.

Torture aims for a single goal -- obtaining information -- but it achieves a slew of others. For one thing, it martyrizes the tortured. Think of the old Christlike images of Che Guevara's corpse in Bolivia -- or even of Christ himself.

While working on the documentary and researching the novel it eventually inspired, I interviewed torturers as well as their victims. I realized that torture diminishes us all by numbing us to human distress; the level of callousness in the society rises, with once unimaginable acts suddenly charted and rationalized.

"This is why we have this proverb," one repentant torturer told me, " bay kou bliye pote mak sonje ." The one who strikes the blow might easily forget, but the one who wears the scars must remember.

When seemingly noble ideals -- after all, what can be nobler than wanting to save lives? -- lead us to torture, the path to the torture chamber can find its way to our front door, just as it did for Marie Carmel, Alerte and countless others before them.

"The people who kill and torture and tell lies in the name of their sacred causes . . . " wrote Aldous Huxley, "these are never the publicans and the sinners. No, they're the virtuous, respectable men, who have the finest feelings, the best brains, the noblest ideals."

As a child growing up in a dictatorial state, I always dreaded the pounding I heard at some of my neighbors' doors at night, when many were yanked from their beds never to be seen again. The lucky ones returned from a pit that was as much a physical place as a darkness that would always surround them. They were missing an eye or some teeth; they showed swelling that would take weeks to go down or shaking that worsened over time. These markers of torment first drew me to people such as Marie Carmel and Alerte, women who could have been my mother or myself.

When I first encounter men and women who've been tortured, I notice their dramatic and disfiguring scars. But eventually I recognize their hardened core and, more often than not, their reinforced defiance and renewed commitment to that for which they were abused.

When I meet former torturers, they don't proudly stand up and say, "Here I am, a torturer." Unless they're infamous, they have sought to compartmentalize their lives. At a lively game of dominoes or across a family dinner table, they can distance themselves from their past in a way that their victims can never even attempt. Occasionally, though, they are unwittingly exposed by a child who might say, "Papa was in the military and worked in such-and-such prison at such-and-such time." The torturers squirm and change the subject, knowing they've been unmasked.

Rare is the opportunity, as we seem to have now, for the torturer to plot out methods in advance and in public. Should a person be strapped to a board and have water poured down his nose? Should she be forced to stand for long periods of time in the cold without being allowed to sleep? Should he be slapped in the chest, face or belly? These are almost novelistic questions with no more rational answers than some haywire plot or dark verse.

After first reading it as a young girl newly escaped from Jean-Claude Duvalier's dictatorship in Haiti, I recently rediscovered a poem called "The Colonel" by Carolyn Forché. The narrator describes dining with a dictator who, after the luxurious meal, empties a bag full of human ears on the table.

"I am tired of fooling around," he tells his visitor. "As for the rights of anyone, tell your people they can go [expletive] themselves."

He lifts his glass of wine, and with one sweep of his arm, brushes the ears to the floor.

When the ears hit the ground -- like those of all my disappeared neighbors, I imagine -- the narrator notices that some of them are pressed to the floor while others are catching "this scrap of his voice." My fear is that when it is most needed, none of our ears will bother to catch any voices at all. Then will the tortured see any reason to live on? And if they live, whom will they tell?

Haiti1791@aol.com

Edwidge Danticat, a Haitian American writer, is the author of "The Dew Breaker" (Knopf).

Mandatory testing

I'm in the middle of a mad bout of work and apologise for not posting frequently... can't imagine it changing for the next month or so but I will try to write if I need a bit of distraction.

I was just scanning the Washington Post online and noticed the CDC Recommends HIV Tests for All Americans 13-64. My initial reaction was that's great, maybe regular testing will both normalise the disease and send the message home that anyone can get HIV. Then I saw this:

Patients wouldn't get tested every year: Repeated, annual testing would only be recommended only for those at high-risk.

There would be no consent form specifically for the HIV test; it would be covered in a clinic or hospital's standard care consent form. Patients would be allowed to decline the testing.

and my heart sank. If only people that are 'high risk' are getting tested every year, then it reinforces the notion that you have to be sexually deviant to contract the virus. It also seems really sneaky to include consent in the standard consent form but then only test the people you are suspicious of. Wouldn't it be much better just to test everyone annually?

Msichana

The reason I had my heart set on going back to Mwanza this year was to see Sabina, an incredibly bright and vivacious little girl I taught last year at Hisani. She was one of the community children that came every day for lessons, though I'm sure she taught me far more than I managed to impart to her. During one of the weeks I was teaching, I switched from doing mornings to afternoons so I could fit in some interviews for my research project and Sabina stopped coming to school because I wasn't there. I can assure you I didn't miss teaching any morning classes after that!

I went back this year to see how she was doing and find a way to pay for her school fees once she got to secondary school. Only primary school is free in Tanzania, though uniforms and supplies are compulsory and must be supplied by the students. Many can't afford to buy them and therefore can't attend school. Only about 10% of the population completes primary school and go on to secondary school. Sabina was really smart and a quick learner, I wanted to help her achieve as much as possible.


Sabina and me, June 2005

It was too late. Though I tried to find her in the small village the family had moved away. I heard from former neighbours Sabina had stopped going to school to stay home and help the family.

At both of the orphanages I've been to, boys far out number girls. It's much harder for girls to leave a bad home; no matter how bad the home life, the situation on the streets can be much tougher. Joseph told me that when a girl is on the streets she may be a "good girl" for a night or two, but eventually she will have to turn to prostitution to support herself.

The few girls I've come across are much shyer, much more timid. I talked to a friend of mine yesterday who's just come back from a couple of months in Mexico. We agreed that we found it really frustrating how difficult it was to interact with women and girls in the places we've been travelling to. My friend commented that it's so easy to forget how effective conditioning is: when you grow up thinking you are worth less you start to believe it.

All over the developing world, girls drop out of school to stay home and help the family at higher rates than boys. Their chances of working their way out of poverty, of gaining independence, are over before they begin. With education comes empowerment, knowledge and choices. The more educated a girl is, the less likely she is to contract HIV.

...a recent Post article quotes Stephen Lewis, the U.N. special envoy for AIDS in Africa, as coming out strongly against the descrimination of women at the Global AIDS conference in Toronto last week:

Lewis...said another undeniable fact in the battle against AIDS is the inequality of women and how that puts them at high risk of becoming infected.

Women account for nearly half of all HIV-infected adults worldwide and for 59 percent in sub-Saharan Africa.

"It is the one area of HIV and AIDS which leads me feeling most helpless and most enraged," he said. "It's a ghastly, deadly business, this untrammeled oppression of women in so many countries on the planet."

Reflections

Although my post isn't about the film, I thought the following quote from today's Post was quite apt:

[Heading South] doesn't make the mistake that so many Westerners-in-World-3 make, where they concentrate so fully on the horror of the posh observers, they pass on the horror of the exploited. What happens is horrible, and perhaps its biggest horror is how helpful it is to Westerners. It's a metaphor for the ways we look but don't feel a whole lot about what happens in the world's gutters.

Almost a month on, I'm still processing all that I saw and felt in East Africa. I'm trying to reconcile my experiences with those of of the people I came into contact with. I always feel a deep sense of shame; shame that I am so afluent, shame that I am so impotent. I can't help but cringe when I see other muzungos interact with 'locals' in a condescending, patronising way and then I think - I must be like that too. For the most part, 'we' (Westerners) are 1) ridiculously afraid of being in Africa and 2) completely blind to most of what's going on around us.

It is so easy to come away and have selective memory. To remember the bad things and not the overwhelming generosity. Do you remember the guy that pulled you to the side at the border crossing and tried to scam you, or the one that came up to you quietly and warned you the first one was a scammer? Do you remember the man that grabbed your throat and tried to rob you, or the mob that stuck up for you and chased after him?

There are streetkids in every city I've been to in Africa, there are probably streetkids in most cities in the world, but with such huge numbers of orphans and enormous poverty it seems to be far more overwhelming in the places I've been to in Africa. Even though I've lived and worked with muzungus who care about children, the streetkids seem invisible to most. I think the problem is so overwhelming most people can't think about it. How can you justify having a 6 year old sleep on the streets and beg for food? How do you justify walking by a 6 year old kid that has no food or home? You say to yourself they'll sniff glue if I give them anything and keep walking.

One day I was in Nairobi walking down the street and a little boy came up to me and said (all this was in Swahili) how are you, where are you from, I'm hungry. I asked him how old he was (he said 9 but looked about 4 or 5), what his name was and where his parents were, and chatted to him for a bit as we walked down the street. The other people I'd been walking with hadn't seen him when he walked up to us. I bought the little boy some food and watched him walk off smiling with a bag almost as big as he was, thinking how futile it was. Someone would probably snatch it from him but even if he kept it, how long would it last? Then I remembered walking by a homeless man in Bristol and giving him some change, he thanked me saying "sometimes I think I don't exist anymore, people walk by me without seeing me every day." At least the little boy had been seen.

I know this post seems a bit all over the place, but it does have a message - please see the people around you are just that: people.

This homeless guy asked me for money the other day.
I was about to give it to him and then I thought he was going to use it on drugs or alcohol.
And then I thought, that's what I'm going to use it on.
Why am I judging this poor bastard.
People love to judge homeless guys.
Like if you give them money they're just going to waste it.
Well, he lives in a box, what do you want him to do?
Save it up and buy a wall unit?
Take a little run to the store for a throw rug and a CD rack?
He's homeless.
I walked behind this guy the other day.
A homeless guy asked him for money.
He looks right at the homeless guy and says why don't you go get a job you bum.
People always say that to homeless guys like it is so easy.
This homeless guy was wearing his underwear outside his pants.
Outside his pants.
I'm guessing his resume isn't all up to date.
I'm predicting some problems during the interview process.
I'm pretty sure even McDonalds has a "underwear goes inside the pants" policy.
Not that they enforce it really strictly, but technically I'm sure it is on the books.

-Lazyboy

The last few days

I'm back safe and sound in England.

So now that's three trips to Africa, no cases of malaria, no other strange tropical diseases or infections (except for the itchy bumps that look like mozzie bites), no muggings, no physical injuries that weren't self inflicted (accidently), no upset stomach, no other 'bad' things... the 'dark continent' is not nearly as dark as people fear.

There are a million thoughts and feelings swirling round my head about everything I've just learned and experienced, but writing about it is proving difficult. Here is a bit of my last days, I will try and coherently express more of what I'm feeling in the coming weeks...

My last week in Africa went really well. I managed to get quite a few interviews at the UN tribunal on my last two days in Arusha through befriending a really nice Nigerian lady - she helped me get my foot in the door more places than I would have on my own! Hearing different departments have completely different responses to my questions made me again question the effectiveness of UN operations, though I think the UN is a good idea, it just needs more legitimacy and (always) more money. For witness support, the UN gives the tribunal a mere $70 per witness per year for medical expenses. In the aftermath of the genocide, giving anti-retrovirals to witnesses is a moral (and logistical) necessity which costs the tribunal $240 per person per month. The massive shortfall is made up through additional fundraising efforts by the already over stretched staff.

Arusha is the launching point for the safari circuit and Mt Kili climbs, not a city you would go to for it's charm. Most travellers spend as little time in the place as possible, so when I returned the hotel staff were really happy to see me. One evening I went out to dinner with Max, a guy that works in the hotel. He had wanted to be a farmer but didn't have the capital, or the land, or the resources to do it and so has worked very hard doing whatever he can. For the past few years he has been working 24 hour shifts at the hotel, earning about $70 a month and spending about half of that on rent.

It seems most of the Tanzanian economy is supported through tourist $$$, yet time and time again I've seen that the more tourists hit an area the more prices are inflated. In Arusha the prices on just about everything are double that of Mwanza, a much larger town with (seemingly) more opportunities for employment but very few tourists. Although I recognise the need for tourism, I can't understand how people who live here manage to survive. The dinner I had that night cost roughly half of my companion's monthly disposable income.

Last Thursday I had a relatively easy bus ride from Arusha to Nairobi and spent the rest of the day becoming increasingly more paranoid as it seemed every shop I went into had an additional locked door and armed guard than the last one. After dark I stayed in the hotel, but feeling rather hungry and not wanting to venture out alone I gave a couple of Congolese men I'd met earlier a call and we went out for dinner. They'd told me some rather impressive stories about their families, which I thought had been rather exaggerated, but when they picked me up in a Jag I had to reconsider.

Nairobi was really cold and a tad frightening. Definitely much nicer than it's made out to be ('the most dangerous city in Africa') but at the same time, it's a bit spooky to be frisked before being able to enter the building where you are changing your flight ticket and walk through two (or more) bolted doors with armed guards to enter shops. I'm not really sure all the security is necessary, but perhaps all the money being spent on security would be better off spent on trying to alleviate poverty so you don't need all that security. The enduring impression I have of the city is that there is quite a lot of wealth (in many respects it seemed a lot like any Western city) and overwhelming poverty just outside. Nairobi has some of the largest slums in the world, instead of trying to help the slum-dwellers, it seems the government's policy is to push the slums back from the city centre and ignore them.

My last night in East Africa was spent with very little sleep. After returning from dinner I overheard the man next door refusing to pay the woman he'd just slept with. She was asking for 500KSh (about $7) for putting her life at risk. The hotel cost about $50 a night, so there's no way he couldn't afford it. My stomach churned as I heard her pleading for her kids and he shoved her out into the hallway. I spent the night thinking about the huge inequalities here: between rich and poor, between tourists and residents, between those that have and those that don't. It's no wonder HIV continues to spread amongst the vulnerable.

Paradise found

I've only got a few days left in Tanzania before I fly home and couldn't think of anything better than escaping the cold and dreariness of Arusha and spending my last weekend in Zanzibar.



I spent a few hours on the beach enjoying the sun and tranquility. The boys collected seaweed, the men built dhows and, amazingly, I was the only tourist in sight!

I stayed in a gorgeous hotel in Shangani, the area of Stonetown that's made up of a million tiny side streets lined with street stalls selling Tingatinga paintings, Indian sari's, Arabic antiques, African wood carvings, Masai beaded jewelry. Just about anything you can imagine (and many things you can't) are for sale, and if you bargain hard enough, at very cheap prices. I went to Stonetown with every intention of leaving with nothing more than I came with but ended up with a painting, a handful of necklaces, a new pair of shoes and a couple of masai masks. So much for resisting temptation.



I spent my evenings wandering around Forodhani gardens, one of the most amazing places I've ever been. There are dozens of artists selling their wares on the blanket covered pavements, beadwork and carving proudly displayed.



and dozens more chefs with tables piled high with delicious food. I managed to eat and drink for less than $1!

ICTR Arusha

Though I've had a lot of fun fitting in as much as possible along the way, the real reason I came back to East Africa is to do some research. I'm looking into the effects of HIV on justice for the Rwandan genocide. While in Rwanda I spoke to people in the International Criminal Tribunal for Rwanda (ICTR) office in Kigali and my last two weeks in Africa I'm working at ICTR Arusha.

The Arusha tribunal is where the trials for the high level instigators of the genocide are taking place. "Lower" level criminals are being tried in Rwandan Gacaca courts in a more traditional way. Being here is pretty awful. On Wednesday and Thursday I watched the former prime minister Kambanda testify. He's already been convicted and sentenced to life imprisonment but was a witness in another trial. Watching the clips of him inciting slaughter and then seeing him be as obstructive as possible (when he has nothing left to lose) was sickening.

I had lunch at a place just down the road from the UN buildings and spotted two of the defense attorneys eating. I know there are people tried for crimes they didn't commit and need (and deserve) a good defense, but the question that kept going through my head was, how do you defend someone that commits (and incites others to commit) genocide? I know someone has to do it, but how the hell do you live with yourself after getting someone off the hook for such crimes?

As for the research, it's coming along. I've had some good interviews with key people, and the answer is essentially: HIV is hugely affecting the outcome of the trials. According to the chief prosecutor, usually 1/2 the witnesses have died or are too sick to testify by the time cases go to trial. The genocide will continue until all the people (mostly women) that were infected with HIV as a result of the genocide have died. And all their partners who were subsequently infected have died. And all their children who were born HIV positive have died.

Safari pics

Abby and I just got back from a three day safari on the Masai Mara. I think the pics below probably speak more eloquently than I could...















Today we went to a giraffe sanctuary just outside Nairobi and I was able to feed (and pet) my favourite animals!

1994

I'm writing this a few days late because I needed time to think... I still need time to think. As much as I have read, heard, seen and felt about the Rwandan genocide, it is something I don't think I will ever be able to come to terms with. I can't imagine how those that lived through it can.

The week I spent in Rwanda I couldn't stop thinking about what had happened. The scale of the killings was such that everyone in the tiny country would have been impacted in some way by the genocide: either knowing or being perpetrators, victims, or both. Driving through Rwanda there are signs every few minutes to mark massacres, constant reminders that the beautiful landscape was recently scarred by human slaughter.



On the last day I was in Rwanda, Abby and I went to the Kigali Genocide Memorial. There were displays showing events leading up to the genocide, the genocide itself, and how the country is trying to rebuild. Almost a million people killed by machete in a couple of months is something that is really difficult to comprehend. The numbers are so large and the violence so extreme that the people victimised become unreal to us and the perpetrators inhuman. The memorial did an amazingly good job of showing that the victims were people. Video clips around the memorial of survivors describing friends and family that were killed made the numbers seem real.

For me, the hardest section of the memorial were the quiet rooms on the top floor. Poster sized pictures of children were hung from the ceiling with a plaque describing the child below it. Name. Age. Favourite foods. Disposition. How they were killed.

There's nothing we can do now about the Rwandan genocide. There is something you can do about Darfur.

Kinigi, Rwanda

We were in Kinigi from Friday to Monday at the base of the volcanos, it's at a really high altitude and I felt breathless and tired most of the time I was there. Kinigi is a tiny village and tourist destination for all who trek the gorillas, monkeys and other wildlife on the volcanos. Most stay in Ruhengeri, a much larger town about 16 kilometres down a really bumpy road, and travel to Kinigi only for the time they are trekking. There are two lodges in Kinigi, a fairly pricey international lodge and the Kinigi Guesthouse, run by an NGO that supports women and children survivors of the genocide.



We stayed in the NGO-run lodge for two nights. The guesthouse was really friendly and comfortable, easily the nicest place we have stayed at during our travels. Both nights I was in Kinigi I went out for a walk around the village, something that seemed to be almost a celebrity event for the children! No sooner had I left the gates of the lodge than I was surrounded by a young football team who asked me loads of questions about where I was from, what I was doing, and on the second night why I was staying! There were men in uniform with guns all over the village, the children explained that we were really close to the Congolese border where lots of 'bad guys' were (the exiled Hutu militants) and the RDF soldiers would protect our security. It was an eerie reminder of how recently the genocide occurred, and how few of the perpetrators have been brought to justice.



I ended up spending both evenings watching the children play and taking loads of pictures of them. They were very enthusiastic players and insisted I email them all the pictures I'd taken. As much as I enjoyed seeing the gorillas face to face, the best part of the trip to Kinigi was talking to the children.

Gorillas in the mist

This morning we set off early to the gorilla trekking base camp in Kinigi. After splitting into small groups we piled into a 4-wheel drive and bounced around the horrendous roads as far as could, then got out and walked up the volcano. After only about half an hour, I suddenly felt really faint and ill. My legs turned to jelly, I saw stars, I thought my stomach was going to explode. I thought I was going to have to turn back: I was only at the base of the volcano and already felt ill, we had at least an hour trekking in front of us at a much steeper grade than we had climbed so far. The guide told me to sit down, and after resting a few minutes and splashing cold water on my face and neck I felt much better. I got up again and started walking at the front of the group, much more slowly, with rests every few minutes.




The views from the volcano were incredible - we were surrounded by volcanic peaks and lush, thick vegetation. We climbed carefully, in addition to the altitude the prickly stinging nettles went straight through our clothes. What seemed like a very short time later, we turned a corner and came face to face with an enormous mountain gorilla! We spent an hour with the gorillas scrambling down the volcano through the nettles in a game of cat and mouse with the giant animals. The group we encountered had four babies - a couple of them played games running in circles around us and peeking out from the trees long enough for us to catch up with them before charging downhill again.


one of the babies, peering through the brush at me

Just as we were about to leave, the silverback (or chief) of the family stampeded down the volcano and stopped directly in front of us.

The wheels on the bus...

On Tuesday evening we set off from Mwanza on an overnight ferry to Bokoba, Tanzania. We had been assured that on the other side of Lake Victoria we would find a bus to Kigali, Rwanda. A bus that would wait if the ferry was delayed. This sounded a tad optimistic, but ever hopeful we set off. At about 5 in the morning I woke up to find the ferry docked and people disembarking. I poked a seriously disoriented Abby awake, jumped off the top of the three level bunk beds, scrambled to collect my things and marched off the ferry half asleep. We were just about clear of the dockyard when it occurred to me that not *everyone* was climbing off the boat, and maybe I should check where we were. A few minutes later, Abby and I slunk back into our cabin, much to the amusement of the ladies who had been chattering about the muzungos most of the trip.

When we did arrive in Bokoba a few hours later we found, not surprisingly, there was no direct bus to Kigali. We would first have to spend a day travelling to Kampala, Uganda, and then another day travelling down to Kigali. The daily bus to Kampala had already left, so we would have to wait a day in Bukoba before we could get going. Bokoba was a pretty sleepy town: we discovered the very slow internet connections, a New Rose cafe with good Tanzanian grub, and not much else.


scenes from Kampala

We stopped once on the long bus ride to Kampala at the Tanzania-Uganda border. We grabbed the chance to use the loo, and when we returned we asked the border guard which one was our bus. He pointed at it and said "I think it is even having mechanical problems" as if that were a good thing! Sure enough, the bus was having a tire changed, as the bumpy roads had bounced the previous one off.

Kampala was a chance to regroup, though after Tanzania everything seemed much more expensive! In the morning we set off again down to Kigali. The long Uganda-Rwanda border crossing, made even longer by a stupid muzungu who had her iPod stolen after she left it on the bus unattended, made us long for the tire change of the previous day.


the Rwandan countryside

After a full sunrise-sunset day on the bus we finally arrived in the capital of Rwanda and checked into our hotel. Though far more expensive than Tanzania or Uganda, the chance to soak in the bath was well worth it :)

Kwa heri Mwanza

On Tuesday Abby and I took Cha-Cha, Angela and Zainabi to the private hospital because we suspected that their constant coughing was a sign of TB. The doctor ran several tests on them and told us all three of them had malaria, a chest infection and worms but not TB. We were completely amazed that the children were so sick - they hadn't complained and it was only because we heard them coughing we thought they should go to the doctor. Joseph told us that the orphanage staff had suspected they (and several other children) were ill but couldn't focus on health care until they had enough money to feed the children. At the private hospital registration, consultation with the doctor, four lab tests for each child and all their medications (3-5 per child) came to a total of about US$30. It continues to amaze me that so little money can do so much here, and really makes you wonder why those that can afford it aren't doing more to help.



Yesterday was our last day in Mwanza. Abby and I took the horrendous falling apart dalla-dalla to Buswelu just outside of town and when it failed to start after it's first stop we decided to get out and take another one. The fare collector completely ripped us off, but after several minutes of arguing we gave up and let him keep the extra 'muzungu' fare, we were thankful to be away from the decrepit vehicle. We jumped on another and ended up walking from the main road to Hisani (the orphanage I volunteered with last year). Despite taking at least half an hour to get there, we noticed the dalla-dalla we got out of didn't pass us at all - very satisfying to know we made the right choice :)



When we arrived at Hisani all the kids came running out shouting my name - I was so suprised they all remembered me after so long! I handed out photos to the children which they were very happy to receive: most of the kids don't have any pictures of themselves or their families. Hisani now has links with Volunteer Africa and the difference in the orphanage was really amazing: the children had tiled floors, proper beds, loads of room and even a computer with internet connection! It was great to see them all doing so well.


Mwanza, taken on Lake Victoria

After lunch we headed back to Fonelisco and said good bye to all the children - they made us promise we would be back and this year I'm sure I will be!

50 kids go adventuring

Yesterday we all got up really early to head off to Saa Naane island, a small island in the middle of Lake Victoria that acts as a miny zoo and picnic point. We arrived at the orphanage around 7 am just in time to see the kids having breakfast. Most of them were tucking into a rather slimy looking gruel made from the same stuff as ugali: maize powder and water, but some of the boys had decided to collect a little protein to along with it.


When they realised how disgusted the muzungus were with them eating grasshoppers, they insisted on posing with their food and throwing grasshoppers at us to hear us squeal!



While some of the other volunteers studiously made hundreds of samosas as lunch for the children and staff in the morning, I played with Happy and the other children. A new boy, Charlie, had joined the orphanage the night before and had been really shy and sticking to himself a lot. I gave him my camera: he soon mastered the art of photography and made quite a few friends in the process.

After 5 hours or so of cooking and preparations, the dalla dalla arrived to take us all to Saa Naane. There were far too many kids and staff to fit into one dalla dalla, so we had to make two trips to the ferry point. Only ten people could (officially) fit in the tiny boat, so we had five (very packed) journeys back and forth to the island until we all arrived. After all that effort, it wasn't until about 3pm that the entire group reached Saa Naane.



The staff and volunteers were totally exhausted by all this, but the children absolutely loved seeing a lion up close and having a picnic with such amazing views. All that hard work was definitely paid off seeing their smiling faces at the end of the day :)

The places we go

One of the things you learn really fast in Tanzania is that nothing happens quickly: time is a rather flexible concept. Yesterday Joseph asked us if we wanted to take a 'quick walk' in the afternoon to do some home visits. When he can, Joseph arranges for older children to be adopted into the community with their families or other guardians, that way he can take in more children at the orphanage and keep more kids off the streets. The home visits are to check on the children and make sure they are in a safe and good environment, this particular visit was to check on one of the children that had been placed with his grandparents a few years ago.

We asked a few times how long the walk would be when we diembarked from the dalla-dalla, and Joseph assured us it would only be about 15 minutes. A very scenic and rigorous hour later we arrived at a tiny mudhut and met the family. A very elderly couple welcomed us warmly, and struggled to find places for us all to sit. They borrowed wooden chairs from neighbours and eventually brought their 'bed' - a very used and thin sack stuff with straw - out for us to sit on so we would be comfortable. It was really painful to watch them trying to comfort us as much as possible when they clearly had nothing. You might think from my description of seats that not many people lived in the hut, but the couple were looking after four grandchildren from their own children who had died, and another four grandchildren and wife of their son who had run off.


the family with Joseph (2nd from the left)


The husband had been a business man but had long since retired and now had to make sisal ropes in order to support the family. He showed us the 'machine' he used to shred the plants - a mere scrap of metal - and demonstrated how long it took to carefully twist the strands together. We could see that it would take him at least half an hour of twisting to make a rope that could fetch about 300 TSh (30 cents) at market, and he was supporting 11 people by doing this. The boy we had come to visit wasn't there, as the family had absolutely nothing and the children had gone to town to beg for dinner. Joseph told us that the situation was common and that was why he had to monitor the families children were placed with often to make sure the children weren't starving to death. He told us it was likely the boy would have to return to the orphanage as it was clear the family was unable to support him.

Mwanza revisited

Yesterday Abby and I arrived in Mwanza and were extremely warmly welcomed by Joseph and all the children in Fonelisco. The children at the orphanage (and the staff) put on a wonderful performance singing and dancing for us. At the end Abby and I were forced to get up and join everyone - so it was a good thing we got some rest in Nairobi otherwise we would have been knackered!


the staff performing a local dance

Last year while I was here I took a group of streetkids out to dinner at the local pizzeria that's run by another orphanage in mwanza. Yesterday when I walked into Fonelisco I saw Jimmy straight away, one of the streetkids I had told to go to Joseph's orphanage a year ago. I couldn't believe that he had taken my advice and it was so nice to see that he was healthy, happy and safe :)


abby and jimmy

hakuna matata

Abby and I arrived in Nairobi first thing this morning and it seemed very likely to turn into one of those days where everything goes wrong. We'd heard the stories about 'Nairobbery' so had planned to go straight to Mwanza to catch up on sleep and explore Nairobi on the tail end of the journey. The flight wasn't until 3pm so we would have had 6 hours at the airport waiting to fly but we couldn't fly today because seats to Mwanza were fully booked. We checked into a backpacker dive and have spent the day resting, seeing a bit of the city, and discovered that our phone was broken so managed to get it fixed, something that would be really unlikely anywhere else we are travelling to! The city is much nicer than I imagined and it's the first time I've been anywhere in Africa and totally ignored - after all the stories you hear about the place it has been a wonderful first day and it is fantastic to be back :)


this is Mt Kilimajaro by air on the way to Mwanza

Truancy, as usual

I've noticed that a lot of people are finding me through looking for info on volunteering in Tanzania, if that's the stuff you're after you can find it here and here.

Sorry I haven't been posting very regularly recently, I've got loads of work to finish before heading back to East Africa in June. I'm taking Abby (my little sister) with me this summer... will be far more travelling than I did last summer - we plan to do a loop of Lake Victoria but I'm not sure if we can stomach the grueling day long bus journey from Mwanza to Kigali - so it might involve a bit of backtracking though Uganda. I'm going to spend a week in Mwanza and can't wait to see the kids again and catch up with the wonderful people I met there :) Then Abby and I are going of to gorrilla trek in Rwanda. Abby wants to be a primatologist so I'm hoping it'll be some inspiration for her! We will be darting around like mad - look forward to some real (and hopefully interesting) posts starting the end of next month.

Please don't tell me you're surprised

Today the Post's Shankar Vedantam reports that the pharmaceutical company which sponsors a drug trial is most likely to find their own drug works 'best'. Comparison of Schizophrenia Drugs Often Favors Firm Funding Study goes onto say:

...when psychiatrist John Davis analyzed every publicly available trial funded by the pharmaceutical industry pitting five new antipsychotic drugs against one another, nine in 10 showed that the best drug was the one made by the company funding the study."On the basis of these contrasting findings in head-to-head trials, it appears that whichever company sponsors the trial produces the better antipsychotic drug," Davis and others wrote in the American Journal of Psychiatry.

Such studies make up the bulk of the evidence that American doctors rely on to prescribe $10 billion worth of antipsychotic medications each year. Davis pointed out the potential biases in design and interpretation that produced such contradictory results. Other experts note that industry studies invariably seek to boost the image of expensive drugs that are still under patent. Moreover, they say, the trials are relatively brief and test drugs on patients with simpler problems than doctors typically encounter in daily practice.

By contrast, when the federal government recently compared a broader range of drugs in typical schizophrenia patients in a lengthy trial, two medications that stood out were cheaper drugs not under patent. The medication that worked best for patients with severe, intractable schizophrenia was clozapine, whose sales lag well behind every other drug in its class. And an earlier leg of the study found that the largely unused drug perphenazine had about the same risks and benefits as far more expensive competitors that are widely assumed to be safer.

US govt policy at work

AIDS prevention efforts are being undermined by spending restrictions in US foreign aid the Washington Post reports today. Despite years of evidence showing that tied aid is less effective than untied aid (Sachs, 2005), Bush's PEPFAR plan requires that a significant proportion of US funding must be spent on abstinence only prevention efforts. This means that in many cases struggling health systems have had to cut spending to more necessary areas in order to fulfill US demands.

Of the 15 "focus countries" -- 12 African countries, plus Haiti, Guyana and Vietnam -- nine reduced the amount of money for programs to prevent mother-to-child transmission of HIV in their 2006 budgets to meet the spending target for abstinence promotion.

In one, mother-to-child funding was cut from $1.4 million to $1 million, and in another it was reduced by $300,000, said GAO's David Gootnick, who oversaw the report.

In perhaps the largest adjustment, one country cut from $8 million to $4 million its spending on prevention services for couples in which one person has HIV infection and the other does not -- an extremely high-risk group -- as well as on sexually active youths and sex workers.

I graduated!

My aunt Meriel, my gran, me and my mum celebrating my MSc graduation :)

Last day in the Gambia

Maz and I with our wonderful taxi driver Pappe Jazz

Crossing the Gambia & Senegal

Sunrise on the Gambian River

Leaving the ferry on the farside of the river

Sunburned but smiling

We packed so much into the past few days that it's gone by in a total blur. On Sunday we walked round the Abuko nature reserve - before we walked in our taxi driver asked if we wanted him to drive round to the exit to pick us up or if we wanted to walk back to the entrance - we foolishly told him we were perfectly capapble fo walking back and set off. Gambia is really famous for the variety of birds here, and we saw some really beautiful ones, but were much more impressed by the massive crocodiles along the banks. At about the 33rd marker I started to feel a bit tired and asked our guide how much further the walk was - he laughed and said there were 107 markers till the end! We kept going and at about the 1/2 way point stopped at the animal rehab house, had a drink and snapped a few pics of the alarmingly close hyena family. The last 1/2 I walked fast to reach the end as soon as possible, and have never been so happy as to see our taxi driver waiting patiently for us. Maz and I jumped in and were happy to be off when we were told the Nigerian president was about to pass and we couldn't leave until he had done so... about 20 minutes later a parade of cars filed past and we were finally on our way.

We met up with the Gambian family of one of Maz'z coworkers on Sunday evening and they have been taking brilliant care of us - guiding us to places we never would have found on our own, explaining the country from a locals point of view and even feeding us a wonderful Gambian dinner of fish, plassus and rice last night. They live so far away from where we are staying on the coast that it took a couple of hours by gellah-gellah to get back last night, but it was a much more relaxing trip than the dalla-dallas of Tanzania (for a start everyone had their own seat!).

Today I decided to take a break from all the hectic site-seeing to spend some time on the beach and am decidedly pink as a result!

Future football stars

Children in the Gambia

The family that made us feel welcome in the Gambia

Just as close as they appear

Gambia Maybe Time

Hello from hot and sunny Kotu Beach, the Gambia. Maz and I left the absolutely freezing streets of London yesterday morning thinking it wouldn't be possible to survive in temperatures any colder and spent the evening walking a long the beach barefoot. The cold that I had when I left England has almost dissappeared with the warm weather.

We had heard quite a lot about sex tourism here before we came (as has just about everyone it seems!), though watching the middle age women with boys 1/2 their age is a sight that can only really be seen to be believed. Thanks to this wonderful practice, we've found it completely impossible to walk anywhere unaccompanied by 'bumsters' who seem harmless but are rather irritating. This morning we went to the markets in Serrekundu (the largest city in the Gambia) and spent an hour or so walking round with a constant companion telling us "relax and take it easy, I'm not hassling you," If that is so, I dread to think what hassling is!

Now that we've missed the peak sun hours, we'll spent the afternoon lounging on the beach and relaxing :)

The Western Sahara by air

Some good news in the new year?

Today Justin Gillis wrote that a Once-a-Day AIDS Pill Could Be Ready Soon in the Washington Post. This is, ofcourse, good news. Having to take only one pill a day means treatment regimens are easier to maintain, patients won't get as sick and drug resistant strains are less likely to develop. Though "[t]he pill won't be ideal for women of child-bearing age, since it may cause birth defects." The group most affected by HIV/AIDS worldwide, won't be able to use this new drug. The eternal cynic in me noticed this sentence:

"With nearly two dozen AIDS drugs on the market, with many more on the way, and with the patients taking them expecting to live out normal life spans, companies say devising convenient regimens has become a make-or-break problem."

and it made me wonder: isn't this the perfect market for drug companies? I know it's been said before, but an ever-increasing population forced to maintain drug regimens for their entire natural life, it all seems too perfect. What incentive do pharmaceutical companies have to develop a cure for AIDS? No matter how hard we try to treat the rapidly multiplying numbers of people affected by HIV/AIDS in developing countries, until there is a cure the poorest will continue to have far higher HIV infection and AIDS mortality rates.

The Post also reports that the NIH Halts International AIDS Study testing whether breaks from anti-retroviral drugs had an effect on drug effectiveness. Unsurprisingly, the trial "showed that patients had twice the risk of dying or developing clinical AIDS if they took breaks from the drug cocktails, called highly active antiretroviral therapy." This has major implications for donor agencies funding treatment in developing countries. While there are now several programmes offering developing countries assistance for ART (anti-retroviral treatment) that are expected to increase their investment in the coming years, it is crucial that these programmes don't, as all too often happens, have their funding cut in future budgets. Pressure must be kept up to ensure that the Global Fund, the WHO's 3*5, and other AIDS treatment programmes are maintained as even short breaks in treatment can increase the development of drug resistant HIV strains, cause earlier AIDS onset and more illness for those with HIV/AIDS.