Our Kind of People Page 2

  There was a man from the country who went to work in the city. He slept with a prostitute and contracted HIV. When he returned home, he slept with his wife. Then she died. Then he died. Now their children are orphans.

  Tragedy occurs without bounds and death piles upon death. Numbers feature prominently while the characters remain faceless. These stories exist, but they are not the only stories Africa has to tell about its experience with HIV/AIDS.

  It would be too easy to write a polemic against past and even present depictions of Africans and our relationship to HIV and AIDS. There are too many instances in which egregiously racist beliefs and subtle prejudices have colored both descriptions of Africa’s HIV/AIDS epidemic and the responses to it. There are too many examples of how sensationalism—even when well-meaning—has impeded our understanding of this disease and the people it affects, creating distance where none need exist, making a terrible fantasy of something very real.

  As I sat in that auditorium surrounded by a sea of well-meaning white Western colleagues and luminaries in the field of international health swooning in the presence of this powerful speaker, I suddenly felt very aware of and protective of my African-ness. I began to wonder if there was a way to consider the hard truths of the HIV/AIDS epidemic in Africa and to impress upon people the urgent need for action in a way that was fundamentally humanizing and empowering for those living in the epicenter of this crisis. I thought I might be able to develop a better understanding of what HIV/AIDS means and how we can deal with it by spending time in Nigeria, in a country that is home to one fifth of sub-Saharan Africa’s population and the third-largest population of HIV-positive people in the world. I hoped that this would give me an indication of the epidemic’s impact on the whole region. I thought I could find answers to my questions in a few months, but my exploration turned into a four-year journey, with multiple trips between Nigeria and the United States, that has changed my understanding of the HIV virus, its epidemic, and the real people it affects. I had no idea what I was about to discover.

  AIDS IS REAL

  AIDS is real,” the driver said, pondering the notion for a moment while gnawing the end of a bleached wood chewing stick. He spat a gob of wet pulp out the car window before turning back to me. He was probably the driver for one madam living in the same Victoria Garden City neighborhood of Lagos where my family has a house. Now that he had dropped his employer at work, he had the time for a leisurely kindness otherwise unknown to constantly grinding Lagosians. I had never met him before, and I probably shouldn’t have accepted. In Lagos you don’t get into just anybody’s car. All the same, I was appreciative when he offered me a ride after seeing me walking from our house to the Lekki Expressway where I could catch a taxi. I fidgeted in the passenger seat of the air-conditioned SUV.

  In the distance, the mini-skyscrapers of Victoria Island and down at the city center near the marina shimmered against an embankment of low clouds, and I remembered an uncle’s sarcastic statement that from afar, Lagos actually looks like a wonderful city. Like New York, Lagos is a city of islands. From the air, you can see the massive lagoon that separates the sections of the city on the mainland from the two large islands in the Atlantic Ocean, and the city’s latticework of paved highways, occasional red-earth side streets, and tin roofs looks deceptively peaceful. In truth, this megalopolis, though impressive in scale, is frustrating beyond belief; it simmered around us as we sat in the famous Lagos go-slow (traffic jam). Cars and trucks stretched for miles ahead of us toward the city center and miles behind us toward its outskirts, where developers couldn’t build houses fast enough for an exponentially growing population. Street hawkers roamed among idling vehicles and thrust everything from chilled soft drinks in perspiring bottles to steering wheel covers up against car windows. Lagos, the joke goes, is the one city in the world where, because of the traffic, you can accomplish all of your shopping on the way to the market. That morning the only forward movement came from the okadas (motorbike taxis), which buzzed through tight spaces between cars, leaving behind a trail of suffocating black exhaust as they passed.

  I was on my way to see Rolake Odetoyinbo, the head of Positive Action for Treatment Access (PATA), an advocacy group for causes related to HIV/AIDS. I was going to be late, even by Nigerian standards. PATA’s offices were in the Ikeja section of Lagos on the mainland. Though I had budgeted two hours for what should be a half-hour drive, an accident on the road blocked movement. As the car idled in traffic, the driver and I had struck up a conversation about HIV/AIDS.

  “AIDS is real,” he said again after he removed the chewing stick from his mouth. His eyes flashed with a knowing excitement before he spoke again. “It has been here for generations with our forefathers,” he said in the blasé tone of someone for whom besiegement is ordinary. “We have a word for it. Atogbe,” he mouthed the Yoruba word slowly.

  “Atogbe,” I repeated and then wrote it down. He sighed appreciatively.

  “Yes. Atogbe, someone who urinate until he die. And until when the death comes, he has six or seven sickness at the same time. We have known this thing since the olden days, but now the whites, them come call it AIDS.”

  The first reported case of AIDS in Nigeria was diagnosed in 1985 and presented at the second International AIDS Conference in Paris the following year. According to the case reports, the patient in question was a thirteen-year-old female street hawker from Lagos. I could find out little about this girl or how she contracted the virus that causes AIDS—which at that time was called HTLV-III (human T-lymphotrophic virus III) or LAV (lymphadenopathy-associated virus), depending on whether you followed the American or the French researchers. I could determine only that it was in Lagos that HIV supposedly first appeared in Nigeria and, as far as some are concerned, from this city that HIV spread to the rest of the country.

  “It is from those in the coasts, the towns like Lagos, Port Harcourt. Big cities with the white men, the seamen, those who work with the ships, or soldiers—police, too,” an old retired civil servant said to me as we sat on his veranda sipping bottles of Coke. We had met in a small town in eastern Nigeria. “At first, when this thing was noted in this country, our people, they discountenanced it. They said, ‘What is that? What is AID? Oh! Nah—sickness for the whites and those up there.’ Some, in order to enjoy themselves how they want, they say there is nothing like AIDS.”

  When it first appeared in Nigeria, AIDS was rejected as a nonissue by the successive military governments, as well as by the general public. At less than ten thousand dollars, the original budget for the first AIDS-related government body in Nigeria, the National Expert Advisory Committee on AIDS (NEACA), was laughable. The military dictators took a stance similar to that of other African leaders at the time: AIDS is not a problem here. In popular thought up until the late 1990s, AIDS was also considered a nonissue, sometimes referred to as the American Invention to Discourage Sex, if referred to at all.

  It wasn’t until the late 1990s that Nigeria—indeed, most of Africa—began to wake up to the crisis brewing in our midst. I remember the summer of 1997, when the great Afro-beat musician Fela Kuti died and over a million people marched his coffin down the streets of Lagos. I was fifteen then and remember watching the procession on television with my family in my uncle’s living room. There was total silence. “Fela,” said Olikoye Ransome-Kuti, his brother and the former minister of health, “had died of AIDS.” People couldn’t believe it. For weeks afterward, there were whispers: “How can a great man like Fela die of AIDS? It’s not possible!”

  But the revelation that Fela had lived with and ultimately died from HIV/AIDS did spark some change. Also important was Nigeria’s return to democracy and the election of Olusegun Obasanjo, who was very concerned about HIV/AIDS as president. I remember when billboards with public service announcements about it (now ubiquitous throughout the country) first appeared on buildings and by highways. They displayed slogans like AIDS NO DEY SHOW FOR FACE next to the smiling face of musici
an Femi Kuti, Fela’s famous son, or KNOW YOUR STATUS next to images of happy couples in traditional dress. Newly elected President Obasanjo spoke openly of the “HIV/AIDS pandemic that continues to bring havoc, misery and hopelessness on humanity, especially in Africa where the pandemic is threatening to wipe out entire generations.” He made public appeals to the citizens and members of the military and police to get tested. Something, however small, in the country’s attitude toward HIV/AIDS was changing.

  I could hear it in the discussions about HIV on the radio or in the comments my cousins in college made about safe sex. Once, during a visit home the summer after I graduated from college, I overheard two gentlemen pondering the process of HIV transmission in a Lagos nightclub: “If a man get am and a woman get am, then any child they get must surely catch am.” His companion offered a laughing rebuke. “No. No. No. It neva pass like that.”

  By the early part of this century, HIV/AIDS had become part of the national consciousness. Certainly I could see now, as this kind driver and I rolled slowly along the main thoroughfares of a hustling, bustling, choked, and congested city, it had become part of the landscape as well. Billboards and posters lined the highway. I saw the universal awareness symbol, a red ribbon, painted boldly on the backs of transport trucks. AIDS was now real to Nigerians but, as it is to most of the world, in an abstract, “I’ve heard about it and know it’s there” kind of way.

  The demographics of the HIV/AIDS epidemic in Nigeria and worldwide are such that people need not knowingly encounter someone who is HIV positive every day. The most recent data collected by the Nigerian Ministry of Health reveal that about 4 percent of Nigeria’s population is HIV positive. This is a small percentage when compared to the 20 percent of the population that is positive in countries like Botswana or South Africa. However, 4 percent of Nigeria’s 150 million people means approximately 3 million Nigerians are living with HIV, the third-largest population of positive people in the world. With such enormous numbers, it seems inconceivable that someone could not know an HIV-positive person, but Nigeria is a geographically and demographically large country. Likewise, though there are approximately 34 million positive people in the world, this is actually less than half of 1 percent of the total global population. This means that most people in the world today have not and will not knowingly encounter someone living with HIV. Under such circumstances, it is hard to convey the diversity of experiences that constitute the reality of HIV. In my own case, when I started writing this book, despite having a background in health and time spent working on the HIV/AIDS epidemic in Africa, I was not close to anyone of known positive status. I had yet to see what the day-to-day reality of HIV/AIDS in Nigeria was like.

  One of the first conversations I had about HIV/ AIDS in Nigeria when I first started writing was with my good friend Femi Adegoke. At the time, he had just finished a master’s degree in public health at Harvard and returned to Abuja to work for Columbia University’s International Center for AIDS Care and Treatment Programs. He has since moved on to work for a number of HIV/AIDS-focused organizations in Nigeria. Indirectly, he was the reason I ended up getting an appointment with Rolake Odetoyinbo. One night in early 2007 as we sat on the rooftop bar of the British Council, a common hangout for diplomats, expats, and aid workers in Abuja, watching the power flicker across different neighborhoods in the common practice of load sharing, he said to me that in Nigeria, “We don’t see AIDS patients. We need to be faced with this reality to move forward. We need to see these things every day.”

  That same week, there happened to be a very visible HIV/AIDS presence in the capital. Every two years, the major groups involved in HIV/AIDS-related work convene at a conference sponsored by the National Agency for the Control of AIDS (NACA), the government body charged with rationalizing and coordinating Nigeria’s response to the epidemic. With community-based organizations, advocacy groups, NGOs, and state government agencies traveling to Abuja from each of Nigeria’s thirty-six states, as well as a strong representation from international organizations, the conference is anything but a regular affair. It is not designed to represent the daily reality of HIV/AIDS, but to allow those who work on the Nigerian epidemic the chance to come together to share experiences, debate related issues, and ultimately speak with one voice about the direction the country needs to take to improve the lives of people living with HIV/AIDS and prevent more infections from occurring. Femi urged me to attend, saying this would be the best place to gain a broad understanding of HIV in Nigeria and perhaps meet people who might be of good help.

  Later that week, I drove to the Abuja International Conference Centre, where the meetings were already under way. I had been to the massive structure, with its sweeping arc of a roof and immaculate glass facade, a couple of years earlier for the wedding reception of a cousin. Then, the speckled red granite floor of the grand entrance hall had boasted a red carpet and numerous tables covered in white cloths and pink napkins. Bridesmaids in pink danced among the tables, inviting all who were seated to join in the festivities and move to loud music echoing from the wall speakers.

  The day of the conference was an altogether more serious affair. The entrance hall still sparkled but remained unfurnished. Instead it bustled with people in dark suits or traditional Nigerian prints, attaché cases or files of documents in hand or under arm. The attendees were mostly domestic. They stood in clusters, locked in serious conversations. They folded their arms across their chests or cupped their chins in the space between thumb and index finger. Occasionally greetings would break up the exchanges as smiles and laughter erupted when people working on similar issues in different parts of the country made their annual reconnections and collided into hugs and handshakes.

  Femi had told me about the conference after the completion of registration, so I attended without accreditation. I slunk around the conference hall from table to table, picking up literature, pocketing brochures, and engaging in casual conversation with the representatives of various NGOs and SACAs (state AIDS control agencies) who had arranged their tables and booths to emphasize the strengths or needs of their various organizations. All of Nigeria’s thirty-six states were represented. At the Kogi State table, tended by a wiry man with tinted lenses in his metal frames, the emphasis was on counseling and testing programs for sex workers. Kogi borders Abuja, and its capital, Lokoja, sits near the confluence of the Niger and Benue Rivers. Any truck heading toward the southwest must pass through this city. Where there are long-haul truck drivers, the conventional wisdom goes, there are sex workers, and in these places, there tends to be a higher rate of HIV transmission. The Plateau State booth boasted a whole set of educational materials for primary schools, with a group of young women hardly enthusiastic to explain the process of creating them. They told me they were members of the National Youth Service Corps, recent university graduates completing a mandatory year of national service. Mass communication, not HIV/AIDS, was their specialty. They looked more disoriented than I was.

  After an hour of wandering from table to table, I stumbled from the main hall back into the lobby with an armful of brochures and a pocketful of business cards. I had met a few interesting people, some of whom I intended to contact immediately, but for the most part, I was tired and confused. I recognized that there was a certain absurdity about not wanting to sensationalize the HIV/AIDS epidemic while desperately searching for some charismatic HIV-positive figure to introduce me to its reality. I had no idea where to begin. This overload of voices, colored brochures, screaming posters, and videos was not helping.

  I made my way toward a set of stairs that led to an over-air-conditioned cafeteria. As I ascended, I briefly locked eyes with a young man with uncombed curls of hair, dressed in a dashiki and descending the staircase.

  “Do I know you?” he asked.

  “I don’t think so,” I stammered, concerned that he was a conference organizer who would realize that I had no right to be around and promptly usher me out.

  “Dapo,�
�� he introduced himself, extending a hand. “I work with PATA.” He noticed my blank look and added, “Positive Action for Treatment Access. We’re based in Lagos. Who are you with?”

  “Oh, I’m not really with anyone. Just trying to get an idea of what AIDS is really like in this country.”

  He nodded knowingly. “So you’re a journalist.”

  I didn’t answer. I didn’t necessarily want this to be a journalistic endeavor, but journalist seemed more acceptable than “personal crusader” or “interested party.”

  “Well, I work for my sister Rolake, who founded the NGO. If your work brings you to Lagos, be in touch.”

  I had heard about Rolake Odetoyinbo but not her organization. She is a well-known and well-regarded Nigerian AIDS activist who has had no qualms discussing her HIV-positive status on television, radio, and in the regular columns she writes for newspapers and magazines. I was in luck.

  The PATA offices were in a dingy four-story building set back from the noise of Awolowo Way, a busy street in the Ikeja section of Lagos. The noise of the building’s standby generator was relative calm compared to the horns of the traffic-clogged road yards away. It looked sturdy, but the structure had clearly seen better days, a condition that became all the more apparent when I entered a dimly lit staircase with plaster flaking off the walls. But inside the office, the sunlit rooms were a whirl of bright fabrics as women participating in a PATA-run support-group meeting flitted about with plates of food, conversing and laughing loudly over the unrelenting rumble of the generator two stories below. The walls were sparsely decorated with informational posters advertising new HIV medications and encouraging safe sex. Powerful standing fans made the posters flutter against the walls.

  Rolake appeared moderately peeved, if also understanding of my tardiness.

  “Go-slow,” I muttered, invoking the traffic jam as an apology.