|John L. Allen Jr.
Without "serious efforts at poverty eradication," the AIDS crisis will continue. For one thing, people with empty stomachs can't absorb the toxicity of the anti-retroviral medication, and hence either vomit it up or don't take it. For another, deciding who gets ARVs, and monitoring their use, requires complex laboratory work-ups that Kenya's medical infrastructure, badly depleted in the 1980s by World Bank-mandated structural adjustment programs, can no longer manage.
Dr. Margaret Ogola,
a pediatrician who heads the Commission for Health and Family Life for the Kenyan bishops' conference
"I don't know what your idea of liberation theology is. Every theology is liberative. … You cannot preach the gospel to an empty stomach."
Msgr. Joseph Obunga,
secretary general of the Ugandan bishops' conference.
A journey to Africa: confronting AIDS, relations among religions, and the challenges of poverty
By JOHN L. ALLEN JR.
One of the occupational hazards of covering the Vatican is the tendency to assume that the real work of the Catholic church is done behind desks in the Apostolic Palace and the Palazzo delle Congregazioni. Seven days in Kenya and Uganda, Sept. 8-14, were more than enough to cure me of that illusion.
I was in Africa, in part working on my forthcoming book on Opus Dei, in part trying to learn something about the continent and about the church there. After just a week, I can't pretend to expertise in anything other than the legendary mal d'Africa -- the burning desire to go back to Africa once you've experienced it. The place does have a way of getting into your bones.
* * *
Western journalists are often accused of reporting only bad news about Africa, and the frustration is understandable. Certainly Africans do not need us to point out their problems. On the other hand, it would be self-delusional to talk about the beautiful landscapes and the warm, good-hearted people -- both of which are very real -- without also acknowledging the poverty, war, disease and corruption that together spell tragedy for millions of Africans.
Even an observer unwilling to turn a blind eye, however, can still find grounds for hope. Case in point: the Nyumbani Children of God Relief Institute in Nairobi, Kenya. The stark, and staggering, truth is that 94 HIV-positive Kenyan children are alive today, and will probably be alive next month and next year, solely because the Nyumbani orphanage exists.
Nyumbani was founded by an American Jesuit in Kenya named Fr. Angelo D'Agostino, and has no ties to any other organization or movement.
I visited the orphanage Sept 12. I first heard of it when the Vatican announced that proceeds from the pope's Christmas stamp last year would go to the orphanage. On principle, I was already impressed with their commitment to giving HIV-positive orphans care, both medical and psycho-social. Nothing prepared me, however, for the warmth and joy of the place, and the beauty of the children who call it home. ("Nyumbani" actually means "home" in Swahili).
Nyumbani was D'Agostino's brainchild, but the loving environment comes largely from Nyumbani's women -- the religious sisters who administer the orphanage (five Indians from the Adoration Sisters of Kerala, plus an Irish Sister of Loreto named Mary Owens), as well as the African women who serve as "mothers" and "aunts."
My wife Shannon and I arrived on Sunday morning before Mass, and we were greeted like beloved relatives. Within seconds, we had a new friend -- a small Kenyan girl named Awino, who took great pride in writing out her name in my reporter's notebook. (She also took a shine to Shannon's cell phone, punching its keys with gusto).
The Nyumbani compound has five duplexes divided into two cottages each, and each bears the name of a patron saint. The cottage has a sitting room, kitchen, two bedrooms with four bunk beds, and its own "mom" -- a Kenyan woman who lives there and cares for the children. The moms administer the daily doses of anti-retroviral medication that mean the difference between life and death. The moms work four days a week, and on the other three days another woman takes over who's called an "auntie," in the African tradition of child care by the extended family.
I asked Ann Wangeci, the beaming, bustling mom of 17 children from ages 2 to 12 in St. James cottage, where she gets the strength. She looked at me as if she didn't understand the question, and then replied: "We have to do it."
The center of the compound is a colorful outdoor play area, and behind it lies a small building used for Mass and other activities. Last week, it hosted the First Lady of Kenya, Lucy Kibaki, and hundreds of other guests who had come to celebrate Nyumbani's 12th anniversary.
Perhaps the most haunting corner of the grounds is the small cemetery, where the graves of 15 children are marked by simple white crosses. Prior to the advent of anti-retroviral treatment, Nyumbani used to lose two to three children every month. Most, however, are not buried here, since when African children die their families usually arrive to claim them. Only the most abandoned remain.
Since the late 1990s, Nyumbani has been able to supply ARV treatment, thanks in part to a grant from the Brazilian government that funds one of the three elements in the drug cocktail. The last child to die at Nyumbani was in 2002. The orphanage also runs a network of community outreach programs, however, called Lea Toto, for which similar funds are not available, and seven to ten children in that program still die every month for lack of access to medication.
"That's the injustice of our world," Owens said. "There's medicine available and we can't get it."
Kenya has been among the countries hardest hit by the AIDS crisis, with 2.3 million HIV/AIDS cases between the ages of 15 and 49, according to United Nations statistics, out of a total population of 30 million. More than 1.5 million Kenyan children have been orphaned due to AIDS, and some 300,000 orphans are themselves HIV-positive.
HIV-positive orphans are often abandoned by their families, and many have watched their own parents die from AIDS. They wind up being cared for by extended relatives or on the streets, dropped off at parishes or police stations, and often arrive at state-run orphanages that are unequipped to deal with their problems.
These statistics take on flesh and blood at Nyumbani.
I met John Mwangi, for example, an articulate 14-year-old who recently was selected to represent all of Nairobi at a national conference on child abuse and drug abuse. He described the questions he had put to government ministers at the conference with the practiced eloquence of a courtroom attorney. He dreams of going into public affairs, and one could easily imagine him president of Kenya someday. Smiling and joking with Mwangi, one could almost forget that without Nyumbani, this promising young man would quite probably be dead.
Nyumbani does more, however, than simply keep kids alive. They promote their development, as witnessed by a landmark court case launched by the orphanage last year to force public schools in Kenya to accept HIV-positive children. The cause eventually succeeded, and today all the children attend school.
One can be overwhelmed by the magnitude of the HIV/AIDS crisis in Africa, seeing Nyumbani as a drop in the bucket measured against the need. But that would be to miss the point: 94 stigmatized, forgotten children, with every right to bitterness, are happy instead. They feel safe, loved, and reasonably optimistic about the future. One struggles to imagine a better embodiment of what John Paul II calls the "culture of life" than this.
* * *
D'Agostino has another dream. He would like to construct a model village for Kenya's street children, matching them with another frequently marginalized group -- the elderly. The idea is to build a village for roughly 300 elderly Kenyans who need housing, plus 1,000 orphans who need someone to look after them.
"In Africa, there is no social security," D'Agostino said. "When their children die of AIDS, elderly people, often destitute themselves, inherit responsibility for 15 to 20 grandchildren. It's an overwhelming burden."
D'Agostino said he'll launch the project "whenever we can get 1,000 acres of land."
* * *
In addition to its staff, Nyumbani depends upon between 15 to 20 volunteers who devote three months to a year working here.
On my visit I met Esther Francisco, 22, a graduate of Columbia University, who had arrived at Nyumbani just three days earlier. She's contemplating a religious vocation, and thought some time doing missionary work might clarify things. She found Nyumbani through the Catholic Medical Missionary Board, which suggested that her science background would come in handy, since Nyumbani has one of the best AIDS labs in East Africa.
"The kids are great," Francisco told me. "They're so open and welcoming. They have no inhibitions."
Ted Neill, 26, a Georgetown graduate, has served as the volunteer coordinator at Nyumbani since 2002. He intends to go back to America to finish his graduate work, then return to East Africa to work on HIV/AIDS issues.
"It's a lot happier than you'd expect it to be," Neill said of Nyumbani. "It's not the pathos you'd anticipate."
Neill said he was proud to be part of a transition at Nyumbani, from a focus on end-of-life care to planning for their futures.
"Four years ago, the future was funeral arrangements," he said. "Now we're talking about schools and life skills."
For more information about Nyumbani, consult the web site: www.nyumbani.org.
* * *
In the last three years, two controversies have marred the public image of Nyumbani. The first came in 2001, when a Kenyan scientist accused two Oxford colleagues of illegally taking blood samples drawn at Nyumbani to the UK, in the process claiming credit for research that was properly his. This past May 23, another story broke, this time involving a visit to Nyumbani by a Cambridge scientist to discuss a proposed research project on nutrition, again allegedly without Kenyan government knowledge.
D'Agostino denies both charges, suggesting that the disgruntled Kenyan scientist has an axe to grind, and that he baited the papers to do the May 23 story. He expects eventual vindication from an action he's launched against the Sunday Nation.
For the sake of clarity, no one has accused Nyumbani of abusing children or failing to meet professional standards of child care.
The Archbishop of Nairobi, Ndingi Mwana a'Nzeki, told NCR Sept. 13 that he has full confidence in Nyumbani.
"If it happened, having blood tests taken outside of the country without permission, it's very unfortunate," Nzeki said. Yet he said that the orphanage "absolutely" enjoys his support.
"From what I can see, they are doing very well," he said.
* * *
I met a number of impressive people in Kenya, and somewhere near the top of the list would be Dr. Margaret Ogola, who heads the Commission for Health and Family Life for the Kenyan bishops' conference. Ogola is a pediatrician, a mother of four, and the medical director of the Cottolengo Hospice in Nairobi for HIV-positive orphans, a center analogous to Nyumbani. In her spare time, she writes prize-winning novels. (Her 1994 novel, The River and the Source, won the 1995 Jomo Kenyatta Prize for Literature and the 1995 Commonwealth Writers' Prize for Best First Book).
I sat down with Ogola, a supernumerary in Opus Dei, on Sept. 14 to discuss the HIV/AIDS crisis.
Kenya has at least 200,000 AIDS sufferers who should be on anti-retroviral treatment, but only 20,000 actually get the medicine. Ogola knows how important ARV therapy can be; at Cottolengo, she's watched it make the difference between life and death. Yet she says there's a sense in which the question Western journalists always ask, why more people aren't on ARVs, misses the point.
"It's futile to think that ARVs will solve the problem of AIDS," Ogola said. For one thing, she said, people with empty stomachs can't absorb the toxicity of the medication, and hence either vomit it up or don't take it. For another, deciding who gets ARVs, and monitoring their use, requires complex laboratory work-ups that Kenya's medical infrastructure, badly depleted in the 1980s by World Bank-mandated structural adjustment programs, can no longer manage.
Without "serious efforts at poverty eradication," she said, the AIDS crisis will continue. Among other things, she said, poverty has broken down traditional African social structures that surrounded sexual promiscuity with taboos.
Ogola said that the best bet for ARVs in the developing world is the Indian pill, which sells for about $7 and comes in single dosages. Yet funding provided by the American government under the Bush AIDS initiative comes with a stipulation that it be spent on the more expensive, and more complex, ARV treatment manufactured by American pharmaceutical companies.
Since Ogola works for the Kenyan bishops, I brought up the inevitable topic of condoms. She wearily expressed frustration that so much good work by the Catholic church on AIDS has been overshadowed by the condoms debate, handing me, for example, a list of 93 Catholic charitable homes and community-based programs in Kenya. She said that when journalists call looking for comment on the condoms issue these days she refuses, unwilling to fan the flames.
Ogola also acknowledged, however, that many African priests quietly counsel married couples in which one partner is infected and the other is not that the use of condoms in such circumstances can be tolerated.
Ogola was clear that she doesn't believe condoms are the solution. Noting that "it's the one gadget in medicine you have to use correctly each and every time," she said only "massive public education" followed by changes in behavior holds real promise.
Ogola said that as a physician one of her main worries about the AIDS crisis is the way it falls disproportionately upon women. Because of social customs such as wife inheritance, in which a husband's oldest brother inherits his widow, women are dependent upon men and thus less able to protect themselves from infection. Because women are considered men's property, it's a rare African woman who can say "no" when her husband demands sex, even if he's infected. Moreover, when children are infected, it is the woman who cares for them.
Ogola rejected the image frequently floated in the West that Africa is a hyper-sexual culture. She offered the example of a security guard in Nairobi who comes from the bush. He may work in the city for a year in order to accumulate savings to take home, and could well be faithful to his wife for almost all of that time, perhaps visiting a prostitute just once. During the one week his boss gives him to go home over Christmas, he might have relations with his wife just once. Two infections, the husband and wife, might well result from those two sexual acts. That, Ogola said, and not some mythical African promiscuity, is the normal way AIDS spreads.
Finally, Ogola acknowledged that some Africans, and even a few politicians and bishops, believe that the HIV virus was deliberately manufactured in the West as a sinister means of limiting population in the developing world. She said she finds that hard to believe, since letting loose such a lethal virus would be an act of the highest madness. We groped for a term to describe it, eventually settling on "omnicide." In any event, she said, the virus is here, and no matter how it arrived, the point is what one does about it.
* * *
I spoke with Archbishop Ndingi Mwana a'Nzeki after a lovely dinner at his Nairobi residence on Sunday evening, Sept. 12. Nzeki has the distinguished bearing of an African elder. Although he's listed in the Vatican Annuario as 73, he really doesn't know how old he is; there were no birth certificates issued in the bush, but when he was baptized the parish clerk said he looked about 14, and that's how it went into the books.
Over coffee and ice cream after dinner, Nzeki and I had a wide-ranging interview, the full text of which can be found here: Nzeki Interview and in the Special Documents section of NCRonline.org. The following are excerpts.
What do you make of the so-called "sects," small independent Protestant movements, that are growing rapidly in Africa.
They come out forcefully, but they don't seem to keep their stamina. They seem to burn out quickly. … There is too much dancing and emotion, usually without a moment of reflection. Whereas traditionally, like in the area where I was born, when we met for worship there was a moment for talking, for chatting, and then a moment came when no one talked until the leader does this business around the tree, pouring water or oil or what have you, and then he sits down and starts talking. Even the children would keep quiet at that moment. This is traditional African religion. In the Catholic church, we have the moment when the priest prays, the consecration, when nobody else talks, so it's familiar to Africans.
What is the relationship with Islam?
We worked together until a debate arose over the new constitution. The Muslims wanted Islamic religious practices inserted, and there we differed. They wanted their Islamic legal system, the shariah, their courts, to not only be recognized but financially supported. We wanted a clause that would recognize all religions and their rules, for example canon law, provided that religious law does not work in conflict with the national constitution. They walked out of the meeting, but we are trying to get them to come back. … Really, apart from areas where there is a heavy Muslim population, in Kenya we have no fight.
Some say that the Catholic church has stood in the way of solving the AIDS question because of its opposition to condoms.
For me, a condom is not the answer. In fact, in this country I would say without fear that the use of condoms has been the greatest means of increasing the cases of AIDS. … In this country, to provide a young person, a young Kenyan, with a condom is a license. It's like saying, "my son or daughter, you are free." And they do it.
Many have talked about the idea of an African pope. Is the African church ready to produce a pope?
It's possible, if there is one who could be elected by the cardinals. Why not? Whoever thought there would be a pope from Poland?
* * *
I visited Kampala, Uganda, on Saturday, Sept. 11. Uganda is one of Catholicism's strongholds in Africa, representing 45 percent of the country's 22.8 million people. With 10.4 million Catholics, Uganda is the fourth largest Catholic country in the world in which English is a dominant language (after the United States, India and Canada).
I had wanted to see the famous shrine of the Ugandan martyrs, one of the main pilgrimage sites in all of East Africa. Pope Paul VI visited on Aug. 2, 1969, and John Paul II in 1993. An annual procession draws hundreds of thousands of Ugandans and Africans from neighboring countries.
I had lunch with a priest before heading out to the shrine, and he told me the story. His version was based on the book African Holocaust: The Story of the Ugandan Martyrs, published in the early 1960s by Mill Hill Fr. J.F. Faupel. In it, the author alleges that the martyrdom of 22 young Catholics in 1886, most of them pages in the court of King Mwanga, happened in part because they spurned the homosexual advances of the king, who Faupel also says was addicted to smoking hemp. Further, Faupel wrote that King Mwanga was "converted" to homosexuality by Arab Muslim traders who had arrived in his Buganda kingdom in the mid-19th century.
That version of events is taken as gospel truth by many, if not most, Ugandan Catholics. I might not have questioned it myself, if not for the fact that while I was conducting interviews my wife went to the tombs of the Bugandan kings, where she saw Mwanga's burial site. Her docent, a Ugandan, coincidentally mentioned Faupel's book and insisted that everything on pages 82 and 86 is lies -- which happen to be the pages where the king's alleged homosexuality and drug use are amply discussed.
In later conversation with Ugandans, I learned that the truth of the matter is probably beyond recovery. What's more interesting is the way each constituency remembers the past, shaped by the pressures of the present. In Kampala, there are three hills associated with religion -- one for the Catholics, one for the Protestants, and one for the Muslims. The topography symbolizes the three-way struggle that's been underway here since the 19th century. In that contest, it served Catholic interests to preserve negative traditions about Muslims and the pagan king. Conversely, modern-day Ugandan nationalism wants to point to a glorious Ugandan past, and unpleasant rumors about the king don't help.
None of this changes the fact that 22 brave young Catholics, along with a larger number of Protestants, met their deaths in and around Namugongo in 1886. Their shrine is built in the style of a holocaust offering, and the painting above the main altar depicts 22 black martyrs in white robes holding palms out to Christ. It is a dramatic reminder of the price that has been paid, in different times and places, for fidelity.
* * *
While in Uganda, I went to see Msgr. Joseph Obunga, the secretary general of the Ugandan bishops' conference. The full text of our interview can be found here: Obunga Interview and in the Special Documents section of NCRonline.org. The following are excerpts.
Why are 'the new Protestant sects' growing?
Because they have got bait, the riches. They say if you come, we shall give you money. They entice the members with free scholarships, clothing. Some people here are very poor.
What is the pastoral strategy of the bishops in Uganda to respond to the sects?
We are printing a book I have written on small Christian communities. … The idea is holistic evangelization for integral development. We want to evangelize the whole person, not only the soul. … For example, the poor families we are aiming at will discuss increasing the family's income. … If we can everywhere instill in church leaders that they are not only spiritual people, but they are for the whole human person, then we will make progress.
This sounds like liberation theology.
I don't know what your idea of liberation theology is. Every theology is liberative. … You cannot preach the gospel to an empty stomach. These sects will find that person, who has the empty stomach, and they will feed him and they will take him. At some stage, we lost sight of the physical needs of the human person. The theology of Trent emphasized prima lex ecclesiae, salus animarum … saving one's soul. They did not put much emphasis on the social needs.
What is the relationship with Islam?
We engage in common programs, especially in AIDS, in bringing about peaceful resolution of conflicts, women's programs, and in poverty eradication. At the same time, there is some kind of crusade of "Islamization." You hear of Muslims saying, "Marry those Christian girls." You see Muslims marrying these girls, so they become Muslims and produce Muslim children. Secondly, they are building schools left and right. At times they are very good, so that many Christians and Catholics take their children to these schools. Now, imagine a child taken at an early age, and he is exposed to the Muslim environment. After he has been there six or eight years, what will he be?
Do you resent African priests serving in America and Europe?
No. But I would like to see more collaboration between the Americans, who have got money, and the Africans, who have got vocations. Many people here cannot obtain the priesthood because they don't have resources. Maybe we could send two or three priests to the States, and half of the remuneration could come back to help the seminaries here. … The church is one, universal, and Catholic, but we need to see those words put into action.
* * *
Last week I wrote about Sant'Egidio's annual inter-religious conference, held this year in Milan, where some strongly critical voices were heard regarding American foreign policy.
By way of illustrating the relativity of perception, within an hour or so of the column being posted reader Jim Roth wrote to congratulate me on exposing the liberal agenda, reader Ed Peitler accused me of fueling the liberal agenda, and reader Brian Benestad complimented me for having no agenda.
For the record, all I was trying to do was report what happened in Milan and to place it in context. Whether that's liberal, conservative or none of the above, I leave to the judgment of others.
The e-mail address for John L. Allen Jr. is
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