It is 2008 and changing the behavior of a population continues to be the primary tool applied by
Uganda in its battle to stop the spread of HIV/AIDS. For more than 20 years - nearly two generations of people here in this society- the message has remained the same - abstain from sex until married,
be faithful to your spouse during marriage and use a condom if there is a chance you might become infected.
The current campaign is directed at stopping the "Sugar Daddy" phenomenon where a college girl or young woman links up with a successful older man who takes her to restaurants and clubs and gives her stuff - clothes, a phone, air time, bling bling, in exchange for sex. In her 2005 article, Helen Epstein relates: One of the
women's dorms on Makerere campus has a reputation. "Go there
some Saturday night," said a professor I knew. "That's when the men in
their big cars come and pick up the girls and take them out. Sometimes
you just see men sitting in front of the entrance, waiting. They call
it ‘benching.'"
Epstein says she tried to find the phenomenon but did not. Instead, she wandered over to where Pastor Martin Ssempa was playing to an overflow crowd at the University Swimming Pool - pushing abstinence as he does every Saturday night - driving the point home.
Billboards installed throughout the country in multiple languages are designed to both build the self-esteem of young women and also inflict a sense of shame on the Sugar Daddies themselves. Check out these two examples seen in Kampala in December, 2008. Is it working? Apparently so. Interviews by Uganda TV talk show hosts with young women were full of revelation: "I didn't know I had a choice about it but since I do, I choose to take care of myself," one said. "I've seen a lot fewer old guys in cars on campus," said another. There were no interviews with Sugar Daddies.
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.
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.
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.
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 researcherRand 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.”
“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.
“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.
“The ironic thing
about this curse is that the major transmission is through sexual relationship
which is the passage of life for us. Why
would it attack there? You really need
to know Satan is playing a very serious role here, striking at the very temple
of making life and turning it into a vehicle for death.” – Archbishop Henry
Orombi
If one
should ever wonder about the role faith can play in beating back the AIDS
epidemic, one need only go to Uganda to see the results firsthand. There are few
documented examples; Google the subject and you will not find much. Helen Epstein in her book God and The Fight Against AIDS acknowledges the presence of faith but misses its
depth. She reported in 2005 that the
country is “in the throes of a Born-Again Revival” without understanding that
it has been doing so constantly since the East Africa Revival of 1931.
“Faith-based organizations (FBOs) have a really important
role to play in stopping the spread of AIDS and they’ve been sidelined,” said
Edward C. Green, a social researcher at Harvard University
and author of Rethinking AIDS prevention. FBOs have been have been working for behavior change –
pushing AB, abstinence and being faithful, since before Uganda’s official AIDS
initiative began. They have been working
with orphans and the sick and the dying and the bereaved but they haven’t been
funded to work in AIDS prevention. Ignoring this very important factor of public health policy has no doubt
cost millions of lives.”
President Museveni told me that mobilizing churches to
broadcast the “Zero Grazing” and “AIDS Kills” messages was “the fastest way to
reach the greatest number of people in all the corners of the nation.”
I spoke with Rev. Fr. Dr. Joseph Obunga, the Secretary
General of the Roman Catholic Secretariat at his offices in Kampala. “The Catholic church has been
actively involved with fighting this disease since
1989 with our first pamphlet
called “The AIDS Epidemic.” Later, we
started a program called Save the Youth from AIDS. It is still a common topic in schools. These
days we regularly organize field trips from one parish to another called
‘exposure trips’ so people can learn from one another. This is what the church is supposed to do –
it is people loving their neighbors as themselves.”
Working alongside Fr. Obunga at the Uganda Catholic
Secretariat is Ron Kamara, who chairs the HIV/AIDS committee for the Inter-religious
Council. This organization acts
vigorously to be a common point of information gathering and dissemination for
all the religious entities in Uganda – Catholic, Evangelical, Muslim and any other interested parties. “The AIDS environment changes almost on a
daily basis,” Kamara said.
Anglican Archbishop Henry Orombi told me, “The Church of
Uganda is clear in its theology of passion. Nationwide we speak to young people especially those 13-25 years to let
them know their sexuality is God’s gift to them. We want them to make a decision to work with
God’s will and to realize that AIDS is not a disease but an attack on faith. We teach that condoms give artificial
permission for people to take relationships beyond what God wants. We also show people how to have compassion
for those who are infected and for them to be accepted by society. The more we can show them compassion, the
longer they will live. But the essence
of our AIDS education is it will get you
if you are not diligent.”
When His Excellency President Museveni declared the AIDS
crisis in Uganda a behavior problem in 1986, he had no idea he was poking a stick into a very
large hive of bees.
It took some years for the magnitude of the epidemic to
become known to world’s public health institutions and for them to formulate a
workable solution to slowing the spread of the disease. The institutions – the World Health
Organization, the United Nations (ultimately UN-AIDS and The Global Fund), the
Center for Disease Control in the U.S. – and others – were challenged
to come up with a solution that would work worldwide. The Uganda President’s pragmatic solution –
tell the people what causes the disease, tell them to abstain from sexual
relations before marriage, tell them to be faithful exclusively to their spouse
or partner – was simply dismissed as unworkable by Western aid institutions.
They sought a solution that was based not on
ideals but on tangible results. Their
solution was the condom, a device that had been available in Uganda since at least 1980. To the world’s public health community, the
condom was a practical and tangible way to fight AIDS. But selling the population on the device was
not easy and so the field of “social engineering” was born. This approach conflicted directly with the
“social vaccine” of behavior change and in fact also required people to change
behavior.
The President’s initial campaign of abstinence and being
faithful became known as the A-B Method. Not many years later when the condom was interjected, it became much
catchier, the A-B-C method. But there
was vast resistance to condoms by churches (you are giving people a vehicle to
not change behavior), government (you are forcing to do things your way and not
our way), the health department (condoms are not 100% reliable; abstinence is)
and by people themselves (we do not need such things). The tension between abstinence people and
condom people became known as the “Condom Wars,” and will be the subject of
another blog.
The interesting thing about Uganda is, the preachers,
evangelists and youth workers turned A-B-C to their advantage by saying C is
for Christ, not condoms. “You see,” the pastor
says from the pulpit, “If our young people have Christ, they have the love they
need to grow strong – without finding it in the banana patch. If our young people know that keeping
themselves pure until they are married makes Christ smile, they will do
it. And if they cling to Christ to avoid
sinful sexuality, they will live to become productive adults.”
Rev. Ben, who traveled the countryside for 10 years preaching
to young people said, “In this country, we know this message has power because,
among Christian kids, the age of first sexual encounter averages nearly 18
years. That’s astounding for African
society. So, A-B-C: Abstinence, Being
Faithful and Christ, not condoms. That
will kill this disease here.”
When you talk to people in Uganda about AIDS, you get used to
hearing the words, “They died.” I lost
three sisters. They died. The person who was paying my school fees. He died. The people I knew in that town. They died. The man who was her
boyfriend, he died, she died. You hear
it so much, the words lose meaning. Yet
every one of these deaths was preceded by long and painful suffering, a
withering of the body and the spirit into oblivion. The anguish extends to the caregivers and the
relatives, the friends, the villagers, the loved ones not just as a
relationally shared pain for the disease but also for the anxiety of ‘who else
is carrying the virus and am I next?’ For those who have lost multiple family members or multiple neighbors in
a village, the anguish is numbing. Dying
is taken for granted. It is less
tragic. It happens too often. The true tragedy, however, falls on the innocents,
those people left behind, often children who have no means to support
themselves.
On one visit to Uganda, I stayed with Amos and
Mabel Twinamasiko in their home in Mbarara. The house could have been a modest home in suburban Florida, built of concrete-block-and-stucco
painted pastel with a tile roof surrounded by a sedgy lawn and fruit
trees. Dr. Amos is an ophthalmologist in
the local hospital and over breakfast one morning, I asked about his family. “Well,” he began. “I came from a family of 10 of which only
four of us are left. Mabel comes from
family of nine of which only three are left. And for those who died, each left multiple children behind. We just buried a niece who had been recently
married and left four kids.”
“What happens to these children,” I asked
“We try to take care of them,” Dr. Amos said. I had heard this time and time again about Uganda: A million parents dead. A million and a half children cut off from
their only means of food, shelter and care in a nation without a public welfare
system. Some 700,000 of these had been
taken up by family, friends or caring people in the village. Ben had told me of the children he had
supported through University including his nephew Herbert and this on a
miniscule missionary’s income. A woman
known as Aunt Jocelyn, somewhat prosperous with shops and a farm, cares for
multiple children in her home and employs them in her businesses. A prominent local women’s rights consultant
named Jolly Bibarikamu and her husband Erik reported raising and educating some
19 children to date through university level. “We ourselves currently support five kids with school fees,” she told me.
“The number varies, but there are always four.”
“And what of the rest of the children,” I asked over tea.
“The rest,” Dr. Amos said. Mabel turned her head to hide the tear welling in her eye. “The rest we pray for.”
