Today, after a round of our usual kitchen garden monitoring
and evaluation, we asked the Tujitolee support group if they had any questions
for us. As we sat in the cool breeze of our shaded area, the group briefly
discussed in Kiswahili. Then a woman named Genevieve slowly turned to us and
softly asked us if there are people in the United States living positively with
HIV/AIDS. She said, “In your country are there people living like us? Are they
open; are they talking about it like us? We thought this was only an African
disease. It will encourage us living positively in Kenya to share our stories
and know we have counterparts across continents living like us.” I am always a
little surprised when I hear that people think HIV is a burden unique to
Africa. If only they could realize that this is a global epidemic and have a
sense of solidarity with those living positively in developing and developed
countries alike. Genevieve’s powerful and inspiring words immediately brought
to mind another quote that I had just recently read. As if to address questions
like Genevieve’s, in her book The Coming
Plague, Laurie Garrett puts it
this way:
Rapid globalization of human niches requires
that human beings everywhere on the planet go beyond viewing their
neighborhoods, provinces, countries, or hemispheres as the sum total of their
personal ecospheres. Microbes, and their vectors, recognize none of the
artificial boundaries erected by human beings. Theirs is a world of natural
limitations: temperature, pH, ultraviolet light, the presence of vulnerable
hosts, and mobile vectors.
Like most things in the natural world, bacteria and viruses
pay no heed to lines drawn on a map. They do not care if you’re white or black,
wealthy or poor, Catholic or agnostic. These disparities are but social
fabrications with biological manifestations. What I mean by this is that Mycobacterium tuberculosis, for example,
does not choose its victim based on skin color or religion. Instead, factors
like race, socioeconomics, and drug or alcohol abuse create inequalities that
drastically increase the likelihood of infection. In short, these social
disparities provide environments in which diseases like tuberculosis are able
to flourish. HIV/AIDS can be found anywhere and no matter where you are, it is
certainly devastating. But depending on where you are, certain inequalities—like
access to treatment and nutrition—make HIV a very different experience. When
assessing basic healthcare inequalities around the world, we are not only
looking at the availability of efficient care and treatment, but we must also
take into account the opportunities available for education and economic
empowerment.
WOPLAH has provided an amazing opportunity for us to learn
these lessons firsthand. We did not have to fly twenty hours to study and work
with people suffering from HIV/AIDS; we would have barely needed to drive
twenty minutes from our cozy Colorado campus. We came to Kenya to study the
complex interplay between certain social factors unique to Africa and HIV/AIDS.
For example, at one of the very first support groups we visited as a GROW team
we posed a difficult question: “When you were first diagnosed HIV-positive, did
you face any backlash within your own family?” One woman, who was involved in a
polygamist marriage, said that she is the only wife living positively and is therefore
ostracized within her own family. This example
of stigmatization within a tribal marriage is not something we would find back
home.
Thinking about health and social justice in a Kenyan setting has challenged us to keep in mind that infectious
diseases are what Paul Farmer calls a “biosocial phenomenon.” We are systematically learning that there are many more
factors at play than biological factors like CD4 count.
WOPLAH’s three main objectives, youth empowerment, health and
reproductive education, and income generation, provide a wonderful template for
addressing both the biological and social aspects of HIV/AIDS. One WOPLAH
project that immediately comes to mind when thinking about this complex
relationship is the jiggers campaign. When we visit infected children and
adults, the biological ramifications of these parasites are awfully apparent in
the form of very swollen and malformed feet. When we begin to talk to these
unlucky individuals, we find out that because of jiggers, kids are staying home
from school and falling behind with their education, and parents are not as
able to support their families. This example demonstrates both the social and
biological aspects of infectious disease.
The GROW team is currently struggling with ideas on how the
jiggers campaign can expand and become more sustainable in the future. In 2014,
WOPLAH will cease purchasing shoes for beneficiaries, believing that families will
begin to buy their own after having witnessed firsthand the positive effects of
wearing shoes. I wonder though, since every
person we have talked to thus far has listed school fees and food as their
primary financial difficulties, whether they would actually allocate the money
for shoes when there appears to be other priorities. The dilemma here is
figuring out how to prioritize certain repercussions of poverty. Jiggers are a
visibly heart-wrenching and serious issue these families face, but if they are
still struggling to feed themselves, can we expect them to prioritize shoes
over food?
-Alexis
 |
| Genevieve |
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