Uganda Perspective

Back in Action after Data Disaster

Sorry, y'all, have been off the air for awhile dealing with a hard drive crash.  Data surgeons successfully dissected the drive and recovered all files, however and new backup systems are in place.  Duh, why didn't I think of that before?

The posts are backing with much to report.  I will be in UG from 12/8 to 12/22 & will report from there.  More later. 

Missionaries Find Muslim Neighbors Changed by Love

When Matt and Crystal, two young American Christian missionaries working with Juna Amagara Ministries, decided to build their home in Mbarara, they knew the neighbors were Muslim.  They assumed life would be a challenge.  They were not disappointed.

Matt worked alongside the Ugandan construction crew laying bricks, hoisting rafters, oiling the wood, roofing the house.  All the while, the neighbors peeked at them from around corners, scowling.  Matt adopted a yellow dog - the one breed in town, known as the African Retriever.  The dog appointed himself security chief for the Children's Home where Matt worked and kept strangers at bay.  But when the dog strayed into the neighbors' yards, they would beat him with sticks.  When Matt tried to arrange for electricity to be brought to his house, he discovered it was very expensive.  He needed to get his neighbors to participate.  But they would not.

Matt and Crystal prayed for their neighbors.  Crystal gave birth to a baby boy.  Prayer fellowships were held for ministry kids in their home.  The neighbors stole fruit from the missionaries' garden.  During one long dry spell, the neighbors ran out of water.  Matt said, "Please, help yourself to the water in my tank.  I have plenty.  He had caught rain from his roof in a large tank, plenty for bathing, washing and drinking.  The neighbors humbly accepted his offer.  It has taken more than three years, but the neighbors are coming around.  One woman approached Crystal during the day when no one was around... "Tell me about this Jesus of yours," she said.  The neighbors have now chipped in on the electricity and on Christmas eve 2008, in an Edison moment, the lights began to glow.

When Matt and Crystal adopted an abandoned infant infected with HIV/AIDS, something one can do only if they have lived in Uganda for more than two years, the neighbors began to go out of their way to interact in a positive way.  They no longer stole fruit.  They no longer beat the dog.  Matt says it's because of the love of Jesus.  Crystal says it's because she and Matt clearly aren't going anywhere.

Ugandans Gaga Over Obama

I began receiving excited emails from Ugandans about Barack Obama weeks before Americans went to the polls.  People were engaged, hopeful, energized at even the possibility that a Blackman [sic] could be chosen for the most powerful job on earth.  Now, a week after the election, the gushing about Obama in the East African media with its giddy sense of hope continues unabated. 

Calling Obama's election the "Triumph of Humanity," Jerry Okungu seemed amazed that a blackman [sic] could win the American seat of power.  'For the first time," he wrote, "America proved to the world that their system really works..."  As if America hasn't worked for more than 200 years to become the most powerful nation on earth.  Jerry used Obama's rhetoric and McCain's concession speech as examples of how people of differing opinions can get along - unlike many tribal factions in East Africa.  And he quoted the popular U.S. TV evangelist T.D. Jakes who quipped: "Now I can die, knowing my children will be fine," revealing the smoldering sense of resentment apparently felt and fueled by blacks worldwide.  Echoing this sentiment was Rebekah Heacock on 11/5/08, a white blogger in Kampala whose page simply featured the word "Yes" and a high school photo of B.O.

A New Vision writer likened Obama's eloquence to Winston Churchill and Martin Luther King and lauded America's overcoming its racial divide - interesting because apparently the world sees the U.S. as racially divided.  The writer also lauded the Obama campaign for its "grass roots support" much like Museveni's National Resistance Movement (NRM).  The lessons of opportunity - that any person could be elected to such an office were voiced over and over.

Within days, we saw hopeful stories about "AIDS funding to be expanded with Obama" - where the George Bush PEPFAR program would be extended and expanded only this time, "without restrictions to ideology (abstinence and being faithful)."  The article reprinted Obama's speech made on World Aids Day 12/1/06.  Author Charles Wendo played up the hope and expectation but did insert all is possible "if the U.S. gets its economy working." 

To all those who are euphoric about our new President-elect, I must advise take a "wait and see" attitude.  This man is not a messiah; he is a Chicago politician.  Half the voters in America did NOT vote for him.  If he enacts all of his economic reforms and social programs, there will be few dollars left to send abroad, maybe some change.  I have lived in Chicago all my life.  I have seen too many good-looking, smooth-talking, big ego politicians of all races promise things they cannot deliver just to occupy the seat of power.  I pray to God Obama is not another one.  

The wisest comments I found were written by Paul Busharizi who said, "As a continent, we need to ask not what Obama can do for us, but what we can do for Obama, so he can help us.  Whether Africa reaps a dividend from Obama’s presidency is really up to us. "
(Hat tip to NewVision/ Rastoon for the graphic.)

The Reality of AIDS - Part 15 - Uganda Model Fails Elsewhere

Wouldn’t it make sense that if one country had figured out a way to decrease the new incidence of AIDS from 36% to 6% that other countries wouldn’t adopt the same strategy? Unfortunately, and maddeningly, this has not yet happened. I wanted to know why, so I asked people who had tried to make it happen.

Oliniye Darimola, born in Nigeria, is the African Regional Director for Scripture Union based in Nairobi, Kenya. Sitting on the tree-shaded shaded terrace at the Namirembe Guest House over tea, I asked the Director this question. “Uganda has several things going for it that are simply not present elsewhere,” he said. “First, the presence of AIDS was highlighted here early; the leadership did not hide from it. There is a strong faith community – Scripture Union is strong here with a school system where preachers and evangelists are welcome to visit and enlighten children. Where Scripture Union has a presence –Nigeria, South Africa, Botswana, Malawi – we teach the same message – abstinence and being faithful, but in these places, faith issues do not make the moral message as strong as in Uganda.  Also in these places, there is not the strong leadership as was here in Uganda. And AIDS rages on.

With the strength of the Catholic Church in Africa and its emphasis on experience sharing through regional conferences, I asked Fr. Obunga in 2005 how he thought the Uganda Model could be spread to the rest of Africa. He said, “We had an Africa-wide conference in South Africa in 1999. By then, the disease had killed millions of people. Many of the representatives there thought the Americans were going to come in and solve the problem medically. They are still waiting. And people are still dying. I guess I don’t have a good answer to the question except to keep meeting and keep talking.” 

In September of 2007, Bishop Hugh Slattery of the South African Diocese of Tzaneen spoke about the current state of AIDS prevention through pro-life Population Research Institute’s Weekly Briefing. He related that a program called Education for Life developed by a Ugandan nun in the early 1980s really started the public awareness process there educating people about the dangers of promiscuous sex and its deadly consequences.  “The adult HIV rate in South Africa was 18.8% at the end of 2005, or about what it was in Uganda 15 years ago,” he said.  “Finally, the Education for Life program has now been introduced in this diocese and is spreading throughout South Africa.”

Church of Uganda Archbishop Henry Orombi said, “Not all of the countries in Africa were very serious to begin with. In Malawi, it was not easy for churches to speak out. Other places like South Africa did not accept that AIDS should be something to talk about because culturally, there are a lot of taboos associated with sex. Kenya didn’t want rumors of disease to hurt its tourist trade. Our position was not embraced by everybody but people are beginning to realize that where we are standing is about the safest way we can address AIDS as a church.

“In the context of the continent, I think in the last few years, we have not begun to speak about AIDS per se but in 2000 I was in Cape Town and the church there was asking me if they could come to Uganda and learn from what we have learned. I said Yeah, Man. Give us an opportunity and we can show you. That was recognition of needing some help. I never heard what happened.”

The sad reality is, without strong national leadership voicing the belief that AB can slow the disease – supported by the church with its moral compass - as demonstrated in Uganda, entire populations throughout Africa must depend on condoms to slow the spread of the disease and on ARVs to keep infected people alive. In this scenario, the cycle of death will never end. 

The Reality of AIDS - Part 14 - Selling Condoms

Interestingly enough, teaching people to use condoms requires changing behavior, something the anti-abstinence people argue cannot be done. One of my favorite stories came from the Roman Catholic Secretariat. It involves a team of “condom trainers,” social engineers traveling on motorcycles, sent to an outlying village to teach people how to use the prophylactic devices in order to not only protect themselves from AIDS but also to prevent unwanted pregnancy. When news of the training was announced in the village, many women became excited about the possibility of preventing pregnancies.

Standing in front of the village, the trainers used bananas to illustrate the proper way to apply a condom, all the while extolling the virtues of latex and its ability to protect both the wearer and his partner. They told the people if they used these devices, they would not die from AIDS and they would have fewer babies. After demonstrating the technique, the villagers were encouraged to practice with the condoms on bananas until they felt comfortable with with the process. The training ended. A large box of condoms was left behind and the trainers went on to the next village.

Six months later the trainers stopped by for a follow-up visit. The chief received them with typically warm Ugandan hospitality, but when they asked, “How’s it going,” the chief shook his head. Sadly, he said, the condoms do not seem to be working. We still have women becoming pregnant and people are still getting sick. “We are doing everything you taught us but it is not working,” he said. On further investigation, the team found the chief had spoken the truth:

Every home had placed in plain view a banana wearing a condom.The villagers never realized the device was meant to be worn by a human being.

 

The Reality of AIDS - Part 13 - Selling Abstinence

Shortly after the turn of the 21st century, when it seemed the condom wars would never end, the AB message received an enormous boost with the onset of the President Bush’s Emergency Plan For AIDS Relief (PEPFAR), based entirely on what is known as “The Uganda Model” for stopping the spread of the virus. 

PEPFAR infuriated the UN-based public health community.  In 2005, Dr. Ruben DelPrado, the Uganda coordinator for UNAIDS was asked to leave the country because of his vociferous objection to a public health policy that reduces an emphasis on condoms and for lobbying for homosexual rights in a nation where homosexuality is illegal.  Speaking from his office in Geneva after leaving the country, Dr. DelPrado told me, “That government is making a huge mistake.  There’s no way an ideology can be used to fight an epidemic.”

“By ideology, you mean marriage?” I asked.

“Yes.  Marriage.  Being faithful.  It is against human nature,” DelPrado stated. “You cannot stop promiscuity in that culture.  The only way to fight the spread of AIDS there is to provide condoms.”

The idea for PEPFAR was introduced in 2003 largely on the results of research undertaken for USAID by Harvard’s Edward C. (Ted) Green, Dr. Rand Stoneburner and Dr. Norman Hearst.  In a presentation before the Medical Institute for Sexual Health in Austin, TX to Ambassador Randall Tobias, the Global AIDS Coordinator and approximately 35 appointees of the Bush Administration from the White House and the Department of Health and Human Services, Green stated that worldwide, 8,000 people die of AIDS every day, the equivalent of 20 fully-loaded Boeing 747s crashing, killing everyone on board, day after day, year after year.  He told how, at the urging of USAID, more than 100 developing countries had completed the formulation of strategic AIDS plans by December, 2002.

Heralded as one of the most objective presentations on dealing with the AIDS pandemic, participants dealt only with statistical fact, openly avoiding issues such as “Is my personal or corporate ideology or time-honored presupposition threatened?  Is my personal or corporate prestige threatened?  Is my person or corporate financial future threatened?  Was a program developed by me or my group of our friends?”  The purpose of the presentation was to answer the question: “Is there one place in the world, shown by scientific study, to have reversed a generalized HIV epidemic for an extended number of years?”  The answer was yes.  Uganda.  As Rand Stoneburner stated: “Uganda is the only country in the world where HIV prevalence in a heterosexual population has undergone such a dramatic and sustained decline (a decrease of HIV prevalence in pregnant women from 30% to less than 6% 1990-2000)

Norman Hearst, Professor of Epidemiology and Biostatistics at the University of California, San Francisco School of Medicine reported: “There is no known example of a country that has turned back a generalized heterosexual epidemic of HIV primary through condom promotion.  Contrary to popular belief, there is little evidence to show that all this condom promotion we’ve been doing all these years in African countries with generalized epidemics has made any difference.

“Fortunately for Uganda, there weren’t a lot of foreign experts then telling them how to do things in the late 1980s and early 1990s,” he added.  “So they did things their own way.  That’s when Museveni was going around with his bullhorn telling people about Zero Grazing and, in the circles I travel (the so-called AIDS experts), everybody thought he was a clown, a buffoon.  Everybody made fun of him.  Well, it turns out he was exactly right and we were all wrong.”

Soon after this conference, President George Bush launched PEPFAR as a $15 billion fund to support an abstinence-first education effort in seven African nations.  The program was ultimately expanded to include many Caribbean countries.  Deemed successful by USAID, the President proposed doubling the size of the program in 2007.  The funding at last gave Uganda and other countries the tools and techniques they needed to present its case in as bold a fashion as the condom providers.

The Reality of AIDS - Part 12 - A Case for Abstinence

Perhaps the most authoritative voice on the subject of abstinence as a tactic for stemming AIDS proliferation comes from Edward C. Green, a research scientist at Harvard University and author of Rethinking AIDS Prevention. In 2003, the US Agency for International Development (USAID) asked the sociologist to study the long-term benefits achieved through the various AIDS prevention methods in Africa. When it was submitted, USAID shelved Green’s report and hired a condom advocate to conduct a further study which it ultimately accepted. Green had concluded the “ABC method – abstinence, being faithful in marriage and Condoms only for high–risk populations – was most effective in the dramatic reduction of AIDS cases in Uganda.

“We have in our possession a social vaccine,” Green said, referring to a point made by fellow AIDS researcher Rand Stoneburner, MD, MPH. “The biomedical vaccines we talk about for AIDS have been 10 years away for 20 years. They’re still far away and no one is expecting such a vaccine to be more than about 35 to 40 percent effective when and if we get one. In fact, a new, more aggressive strain of the AIDS virus has just recently emerged. But, as Stoneburner has been saying, we already have a social vaccine promoting partner reductions, fidelity, monogamy, abstinence.”

Green at first focused on the facts in Uganda in 1993 when he was a social engineer and self-avowed condom advocate. He says he was stunned to see infection rates were falling because of something other than condoms. “Nobody believed that the rates were coming down and nobody believed that it had anything to do with abstinence and faithfulness,” he said. I said to USAID in a report that’s published in my book ‘Ah! Look, they’re doing something different and it’s working. My recommendation was to put more resources into abstinence and faithfulness.’ Those recommendations were ignored until Green’s findings caused George Bush to issue the President’s Emergency Plan For AIDS Relief (PEPFAR) in 2002, a program designed to push abstinence.

Green cites a parallel situation: “You would advise young people not to start smoking and say to others: If you already smoke, consider giving it up or at least have fewer cigarettes per day,” he said. “But for the last 20 plus years we have not been able to say that about sexual behavior. We haven’t been able to talk about sexual behavior like, ‘If you’re young, don’t start until you’re married and, if you’ve already started, stick to one partner. Don’t have dozens or scores or hundreds of partners.’ In any infectious disease, you want to limit your number of contacts. How do you limit your contacts when it comes to something that’s sexually transmitted except with fidelity and abstinence?”

“There is a trend in Africa toward abstinence and fidelity despite lack of funding for that sort of promotion,” Green said. “Though faith-based organizations have been the major voices for abstinence in Uganda, they have been sidelined. Almost none of them have been funded by major donors, or major organizations that fund AIDS programs. We found that if you ask people in those countries why they’re choosing those methods, it’s typically because some religious group told them they have to do it or they’ll die. Such blatant truth-telling is stemming the tide of the AIDS epidemic in some African nations.”

Such recognition is even happening in the U.S. The on-line fact sheet on condoms issued by the Centers for Disease Control and Prevention used to begin with this statement: “Condoms are effective in preventing HIV and other STDs.” The fact sheet was removed from this website site in 2002 and was later replaced with one that states: “The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse or be in a long-term monogamous relationship with someone whom you know is not infected.”

Reality of AIDS - Part 11: "Virginity is Cool"

“Every time I walk into a singles bar, I can hear Mom's words: Don't pick that up; you don't know where it's been.” - Jeff Foxworthy

It is Saturday night on Munongo Road in the heart of Kampala and there is sex in the air. Young men and women are hanging out. The girls, poetry in tight jeans and tube tops, with pouty looks, knowing smiles and eyes that say “available” greet the boys, strutting in their best shirts, their hair just right, smelling good and only too willing to oblige. They sway to the throbbing music from a dozen loud speakers. Billboards promise popularity and success with a Nile Lager. Open-air bars and discos filled with people ripple with too-loud laughter. A tender touch, a whispered word, a slow dance and the night is young. Western rap echoes tribal drums that touch the ancient souls of the young, and for this generation, the effect is the same as it was for their ancestors. Undulating hips, the heat of the night, a Waragi for the lady, a moist sheen on the skin, the throb of a drum, a taste just to feel good, and the evening wouldn’t be complete without…

Two miles away, the roar of a crowd swells over Makerere University. Some 1,200 students fill the bleachers at the swimming complex to sing, laugh, shout and pray with Pastor Martin Ssempa, who has only one message: sex is a precious gift from God. Ssempa, an evangelical pastor and social activist talks about family – the goal of life, often including his wife Theresa and their children on stage. He invites visiting missionaries and colleagues to talk about their families and their walks with God. “If you want to live a long life pleasing to you and pleasing to God,” he says softly into the microphone, “You will keep this gift, this treasure of self, hidden away until you present it to your lover on your wedding night.”

Tonight, he speaks to the crowd as he has for more than a decade, as if each person were sitting with him privately in a little office. “Isn’t it interesting,” he says, “that Satan, the tempter and destroyer, would show up with death right at that place where we are meant to create and cherish life? You can choose life or you can choose death. God wants you to choose life. Go ahead. Choose life.”

The people he is reaching at this university of 40,000 students are enthusiastic and inspired. And now, after years of delivering the message, Ssempa looks into the growing number of faces at his overflow Saturday night rallies and says simply, “Yeah. Virginity is cool.”

“You know,” he told me earlier. “When students were dying from the disease – when their friends could see them wasting away – there was fear. It was easy for people to understand the message of abstinence and being faithful then. I myself watched a cousin’s sister die in Masaka in 1986. There was a famous rock singer named Philly Lutaaya who got AIDS and then started to sing about what a tragedy it was for young people. He sang until he died and was a huge influence on a generation. The threat was clear then. Today, it’s not so easy.”

“What do you mean,” I asked. “Aren’t students still getting AIDS?”

“Oh, yes. They still get it,” he replied. “And I fear they are getting it in far greater frequency than they were ten years ago. Philly Lutaaya had his message but tonight there is a popular rock group performing on campus with their message: ‘Slim-U is Dead.’ (Slim was what people in Uganda called the disease before it was called HIV/AIDS.) “The problem is that HIV positive people look normal today,” Ssempa said. “Anti-retroviral drugs, the ARVs now in plentiful supply mask the disease. You don’t see people walking around on campus with big purple sores. The hospitals here are no longer full of people wasting away. People live longer so we don’t graduate people with posthumous degrees much anymore. If you talk to students, they will tell you it is okay to party once again. But it is not. People on ARVs can still spread the disease.

“It all comes back to the basics,” Ssempa said. “The spread of AIDS is a behavior problem. If people want to live a long life and not be the carrier of death for other people, they need to make the conscious decision to abstain from sexual relations until they are married. We are telling young people to base their lives not on whether or not the man has a condom in his pocket. And the message is getting through. There are virginity clubs, virginity rallies, the First Lady holds Abstinence rallies that are hugely popular. Yeah, Virginity is cool.” Another joyous roar erupts from the swimming stadium.

The Reality of AIDS – Part 10: Condom Wars

“When elephants fight, only the grass suffers.” - African proverb

When the magnitude of the AIDS epidemic became known in the late 1980s, the first world sprang to assist the third world in its effort to stop or at least slow the spread of the virus. Uganda had already made significant progress creating awareness about the disease and its causes through its massive information campaign focused on “zero grazing” and “abstinence / being faithful," but the institutions of the West – the U.N., the World Health Organization, USAID and the like discounted the feasibility of such a strategy applied on a worldwide scale. Indeed, the first worlders agreed what was needed was a solution that was simple to provide, easy to understand and obvious in its benefit. Their choice was the condom. 

Of course the UN must take a world view which includes dealing with countries whose leaders denied they had a problem – and some are still denying it to this day. But in Uganda, where the nation’s leadership was already solving the problem, a solution from the outside was not welcome especially when it came with strings attached.

The U.N. brought highly paid social science consultants to Africa, along with their households, families and expensive vehicles, to help implement the “social engineering” necessary for condom acceptance and usage. Interestingly enough, one argument for the condom was that “behavior couldn’t be changed” to accept abstinence. Yet, here were the social engineers whose job it was to change sexual behavior to include the condom.

Condom providers poured millions into billboards and radio advertising. The U.N. agencies offered condomization programs to the government and implied that other aid funds would be cut if they did not accept them. The leadership of Uganda resented the entire effort but they needed the aid funding and so condom programs were set up in “high risk areas” like bars.  Nevertheless, First Lady Janet Museveni was and still is the strongest advocate for abstinence on the continent. Church leaders rejected the very idea of the condom. Anglican Archbishop Henry Orombi says, “Those things give people permission to keep on sinning.” Roman Catholic Secretary Obunga says, “This goes against everything we teach.” Free condoms were given to freshman University students when they came to school. “They encourage young people to have sex – and sentence themselves to death,” Ben said. The passions for and against condoms boiled over one year when Planned Parenthood organized “Send a Condom to Africa” on Valentine's Day.

Uganda President Museveni telephoned the President of PPH, which is not just an advocate group but is also a major manufacturer of condoms, and told her emphatically, “Stop sending condoms to Uganda. You are killing my people.” She, of course, resented the call and ran the program again the next year.

Today, people in Uganda are well aware of condoms. Church leaders have mellowed their opposition with, “The first and best choice is to be abstinent and faithful to your spouse. But for those who cannot control themselves, for the good of the population, we urge those people to use a condom.” The government leaves distribution of the things to private enterprises. There are still free condoms at schools. But in this place it is the practice of abstinence and being faithful that is eradicating the disease.