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  When I asked Felix what the older people in the community would think about the day’s events, he responded, “They are very happy about it. You’re going to see them at the hall. They are all watching. They know that these problems are here, but they don’t know how to tackle it. That’s the problem. You see, when young people begin to do things themselves, the older people now come in. I have been able to sample their opinion, and I know that they are very much interested here. They like what is happening.”

  Indeed, when the youth march returned, the newly painted hall was filled with adults, who sat in the dimness fanning themselves. They were either unaware of or chose not to comment on the fact that the balloons dangling from the ceiling above them were actually inflated condoms. As each marcher entered the meeting hall, he or she dripped a bit of wax onto a concrete platform a single step off the ground, which served as a stage, then fixed his or her candle to the ground to the right of the platform until they had formed a large blazing AIDS ribbon. Then once reassembled onstage, they broke into religious praise songs. Even the elders clapped and lent their voices.

  Suddenly a young man with a black Kangol cap turned backward and stepped toward the audience as the chorus behind him hushed down to a resonating hum. With an exaggerated strut, he approached a girl standing in the corner with close-cropped hair and prominent dimples on her nervous, smiling face. He peacocked around her, made sweet overtures, and stroked her cheeks, but she offered a forceful resistance. The audience chuckled knowingly as they gave the couple their full attention.

  “I no want die. I no want catch AIDS!” the girl said loudly. “So make we wait until marriage or use condom.”

  The audience clapped while mm-hmm-ing and aha-ing at this message of responsibility appended to a plea for abstinence. Abstinence is, after all, the best way to prevent the spread of HIV and certainly an appreciated message in so religious a country as Nigeria. The skit also highlighted the complexities of messaging in communities that extol traditional values. In order to be effective, the conversation can push the limits only so far. As a messaging expert from the Society for Family Health explained to me, Nigerians are easily offended. As a country and within our separate cultural groups, we are still not ready to have explicit discussions about sex, as is done in the West. This is slowly changing, however, as new technologies allow a younger population access to a wider range of experiences and attitudes as well as more direct ways of communicating with one another.

  In the darkness outside, thunder rumbled in the distance when the keynote speaker finally took the stage. He was a slight man with light brown skin, a pencil-thin mustache above his upper lip, and sweat soaking his clothes from the exertion of clapping and shouting in affirmation. His forehead was a glistening arc in the hall’s dim light. For a moment before he spoke, the room was completely still. The chorus had stopped humming and stood silently behind him, next to the flickering candle AIDS ribbon. He wasn’t from the village, and no one had seen him before. The way his white garment caught the candlelight, how his face shone, and the intensity of his gaze in that sliver of a moment before he opened his mouth made me feel that I had stumbled into a séance. In a sense, he was a seer because he was HIV positive, he said. The room hushed because none of us had known. You would never have been able to tell by looking at him.

  “AIDS!” he shouted. “AIDS! Am I Doing Something? AIDS means ask yourself, Am I Doing Something?’”

  Nigerians have a talent for inventing alternative meanings for acronyms. NEPA, the old Nigerian Electric Power Association, quickly became Never Expect Power Again and when renamed the Power Holding Corporation of Nigeria (PHCN) was popularly called Problem Has Changed Name. Despite the heat and the late hour, which had drawn the sound of tree frogs and crickets from the surrounding foliage, the audience perked up. “Am I doing something? Should I be doing something?” their newfound attention asked. “What can I do?”

  The speaker stalked back and forth from one side of the stage to the other, fluidly switching between English and Igbo, tossing long strings of one language out to the audience along an accusatory finger and then punctuating them with short syllables from another, his “Yes oh!” and “Enh enh” mirrored in stereo sound by the villagers in front and the youthful chorus behind.

  “AIDS. Am I Doing Something?” the speaker asked again.

  “Am I Doing Something!” the audience responded for the last time before the speaker released them, putting an end to the night. The villagers filed away into the night, chattering about what they had just seen and experienced.

  Felix and I hung around after the last of the villagers had departed. I helped him take down the balloons.

  “I didn’t actually know they were condoms,” he said, laughing. “Can you imagine these youths?”

  We finished by scraping the expended wax bits from the candlelight ribbon off the floor. Outside it was raining heavily. We stood at the door, watching the large drops batter the car windows and turn the red earth into a shifting mass.

  I asked Felix what it means to “do something,” and he said, “I often tell people, ‘You know, you don’t really need money to do the little things that you think are not really making some impact in people’s lives.’ But by the time you now do it a hundred times, two hundred times, and you put them together …” He trailed off. “All I know is that I’m actually doing this thing with my whole heart. I like what I’m doing. It’s giving me joy. The little money that is going into my pocket, I am satisfied with. My salary is five thousand naira. There’s a lot of my mates that are going home with one hundred thousand naira, working in better places. There’s a lot of my mates that work for one business or another making their millions, but I think this is what my heart appreciates. I have a calling. Maybe I could say that this is a calling because I think my mind, my whole spirit, is appeased with what I’m doing. I feel I am impacting on somebody’s life. I feel I am doing good. I’m in love with it.”

  “You’re in love?” I was taken by his choice of words and the passion in his delivery, his insistence. His face was something different at that moment, his eyes wide, nostrils flared, his lips a thin, thoughtful line.

  “Yes! You know when you are in love with a woman, you can actually do everything for that woman. You give the woman your time. You give the woman your life. You are patient. When you are in love with a woman, you will always want to do everything for the person. That is the way it is with me.”

  “Do you think programs like this actually change things?” I asked.

  “I’m very hopeful,” Felix said after some time. “I believe that the prevalence of it [HIV/AIDS] will still have to come down, but that will be dependent on the level we are taking this work to. We need to get more committed to this work. It has to go beyond rhetoric, just talking about it because you ‘feel.’ People have to be committed to it. People have to start realizing that local action, involving the community members, is what will really work. That’s the only way it can be sustained. For people to really modify their behavior, you need to keep bombarding them with the same information, and as long as this information is coming from members of the same community, it makes a whole lot of sense.”

  The more we Nigerians—indeed, everyone in the world—speak about the disease, the more it weaves its way into everyday life. It begins to exist not just as a topic of discussion planted by public health officials and activists, but also as a genuine driver of and topic in our cultural expression. It appears in the films we watch, in the art we produce, and in the music we make.

  For Femi Kuti, that HIV/AIDS should find its way into his music and artistic expression was part of a natural evolution. I first saw him perform live at a Boston nightclub in 2001, on my nineteenth birthday. Watching him perform with his Positive Force band and dancers is an amazing experience. His set that night was intense, fast paced, with frenetic drums beating the polyrhythms characteristic of Afro-beat and aggressive horns complementing his saxophone and singing. I
t was impossible to remain still. His music filled you up and made your body twitch and gyrate. It made you sweat—especially his song “Stop AIDS”—and only afterward did you realize what you had just been listening to.

  With music designed to move your body in a way that suggests sex and lyrics designed to move your mind by expressing the fear, confusion, and hope associated with that activity in a world with HIV/AIDS, the song seeps into your consciousness in a way that direct messaging never could.

  When I spoke with Femi about the song almost ten years later at his Shrine, he said, “Every night, even to now, I always make sure I play that number. The thing about music is you know that sometimes you don’t have to say anything. You just give it a title. Just give it a title like ‘Stop AIDS.’ Even if I didn’t sing any lyrics, just because of the music, everybody would know that it’s about AIDS. It becomes a slang.”

  “So do you consider yourself an activist?” I asked him.

  “Why are you calling me an activist?” he said. “It doesn’t make sense. If you are concerned about mankind, they say you are a humanitarian. These are just stupid titles people give themselves because they want to be important. ‘Oh, I’m a humanitarian. Oh, I’m an activist.’ If you pick up a gun, you become a rebel or a terrorist. We just like titles. I just did or do what I felt I should do. I don’t think I’m an activist. I’m just human.”

  HIV/AIDS is part of the human experience, part of our cultural experience. AIDS is everywhere. The last time I flew out of the Lagos airport, a friend and I noticed a poster hanging on a wall near the security checkpoint. In bright red letters, it read AIDS! NOW THAT WE HAVE YOUR ATTENTION, HAVE A SAFE FLIGHT AND REMEMBER, PLAY SAFE. It was an interesting display—all the more so because of its total irreverence. The conversation is developing slowly and organically—sometimes in the wrong direction—but always in the direction of more noise. The more noise we make about it, the more real HIV/AIDS becomes. The more real AIDS becomes, the more we consider it an aspect of our existence that we can engage with rather than an evil to run away from. That is the first step in treating the epidemic.

  HEALING

  The first time I visited Doc’s clinic, I was amazed by how little there was inside. The one-story building featured nearly empty room after nearly empty room. In the lobby, our footsteps echoed against walls covered by a few instructional posters—how to breast-feed, how to do oral rehydration therapy—but there wasn’t much else besides a few empty wooden benches that lined the walls. The exam rooms had old tables with rusted legs and foam padding pushing through cracks in their vinyl upholstery. There was a birthing room populated only by a bed frame, no mattress on its sagging springs. A storeroom with a few bottles on otherwise barren shelves served as a pharmacy. Doc said very little as we moved from room to room, pointing only to the items that would identify the purpose of each space—a broken operating table, nonfunctioning surgical lamps, a portable autoclave for sterilizing the few instruments he had at his disposal. When we finished the tour, the cavernous lobby was still empty. The room was quiet. Doc sighed with relief. There were no patients. It was only then that I realized that a number of the clinic’s windows were missing windowpanes.

  “This is where you work,” I said to Doc.

  He laughed the way he usually does when he considers something beyond explanation, and then he ushered me out to the front steps. “It’s cooler out there,” he said.

  We sat on the building’s steps just in front of the ramp that gave ambulances easy access to the triage rooms and lobby. Without patients that day, there wasn’t very much to do but sit and wait for a government official Doc had invited to tour the clinic in hopes of convincing him to provide funds for its upkeep, possibly even an upgrade. He wasn’t holding his breath. He had invited the man a number of times before, waited for hours, and not seen anyone. In fact, Doc had been waiting for four years, and still some of the windows lacked glass panes, the pharmacy was understocked, and the exam rooms were short on supplies. This, he told me, was the nature of health care in a resource-poor setting: you provide whatever care you can with the tools at your disposal. Sometimes he used money from his own salary, roughly four hundred dollars a month, to buy the necessary items for patient care, but that was when the state government remembered to pay him. It was immensely frustrating, he said. When he’d first arrived, he often thought of leaving, but now his random posting here as a young doctor just after he finished his internship had become a mission to bring adequate health care to the thousands of people living in the area. A large part of his work involved tackling the HIV/AIDS epidemic in the community.

  “I started campaigning right through the time I came to serve,” he said as we sipped from the now warm bottles of water I had carried with me from his house just down the road from the clinic. “I used HIV/AIDS awareness as my community development project,” he said, explaining that a project was a requirement for everyone doing the mandated year of national service. He had started by organizing meetings in village squares, where he would educate men and women about its presence in the community and the methods of transmission and prevention, and since then he had added formal workshops for the villagers on HIV/AIDS, as well as a community health worker program to make home visits to people too weak or too remote to access the clinic.

  “I didn’t even know the significance of what I was doing. I didn’t know the HIV incidence was high. I was just doing it out of somebody who had the energy to do something,” he said. “Then I started seeing cases in the hospital. I remember there was a guy that came. He was almost my age. He tested positive, and it was very difficult to tell him because I don’t have the drugs to help them. I don’t have antiretroviral therapy. Assuming there is treatment available, I would say, ‘Ah, don’t worry about it!’ And when I’m saying it, I would say it with full authority. ‘You see this treatment? Once you take it, it’s going to help you.’ But sometimes when there is no help, you can only give supportive therapy and encourage elements of healthy, positive living—nutrition, take care of themselves more, any time they feel any symptoms, they should come to the hospital for treatment of opportunistic infections. If it’s possible, I can also refer them to the government treatment program that is in the city. But most of them cannot afford the transportation cost.”

  He scuffed at a mud stain on the concrete steps with his sandal and rubbed his thighs with his hands.

  “It was actually after that time I intensified. I moved even beyond education. I started doing trade-justice advocacy for access to treatment, because I knew it was crucial if people are going to get the message. It has transformative effects when people see hope, when they know that even if we are infected, we can still live. When people are down with AIDS, if you want to help them, you give them antiretrovirals. That’s the only thing that can change their lives.”

  He rummaged through a folder of papers he carried with him, presumably documents for the visiting official. He produced a pamphlet from Paul Farmer’s Boston-based international health organization, Partners in Health. On the cover were two juxtaposed photographs, one of an emaciated person with body sores, pustules, and a vacant stare, the other of a muscular man with a firm stance, wide smile, and bright eyes. “Can you believe it’s the same patient, same person?” he said, pointing. “This is the magic of antiretroviral drugs.”

  HIV/AIDS is a treatable disease. It does not yet have a cure. It still causes many deaths in sub-Saharan Africa each year. But this does not mean the HIV virus is invincible. The HIV/AIDS epidemic in Africa can be brought under control. For the first time in the history of the African epidemic, the number of new infections most recently recorded has dropped by 20 percent since 1999. The annual number of AIDS-related deaths in sub-Saharan Africa has also decreased by about 20 percent since 2004. In Nigeria, although there has not yet been a decrease in the number of new HIV/AIDS infections or deaths, the numbers are not rising. This progress, however incremental, is the result of the complicated proc
ess of balancing large-scale health initiatives that target the general public with small-scale individualized treatment for people living with HIV/AIDS. One of the main tools in reducing the scope of the epidemic is the antiretroviral medication that Doc mentioned. These drugs can have dramatic effects on the health and quality of life of individuals living with HIV/ AIDS, and in so doing, can also reduce the broader impact of the epidemic.

  Antiretrovirals, commonly known as ARVs (or antiretroviral therapy [ART]), are a class of drugs that can stop the entry of the HIV virus into cells, the successful production of its genetic material once inside cells, and the assembly of the proteins that make up the HIV virus structure. ARVs keep the HIV virus at bay in a person’s body, allowing his or her immune system time to recover and prevent the myriad infections that constitute AIDS. The drugs also reduce the amount of virus in a person’s blood and body fluids, making him or her much less likely to pass the virus on to others. The first ARV, zidovudine, also known as azidothymidine (AZT), was developed in the United States in 1987. Its introduction completely changed the way the Western world dealt with HIV/ AIDS as a disease and an epidemic. The initial treatments with early ARVs like AZT required patients to take large numbers of pills on a complicated schedule, often causing a number of unpleasant side effects, such as persistent nausea, diarrhea, and changes in metabolism and physical appearance. But no longer was HIV/ AIDS considered a death sentence; no longer would it plow through a population unchecked.