Stories of AIDS in Africa
by Stephanie Nolen
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edition:Paperback
publisher: Knopf Canada
imprint: Vintage Canada
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From one of our most widely read, award-winning journalists – comes the powerful, unputdownable story of the very human cost of a global pandemic of staggering scope and scale. It is essential reading for our times.
In 28, Stephanie Nolen, the Globe and Mail's Africa Bureau Chief, puts a human face to the crisis created by HIV-AIDS in Africa. She has achieved, in this amazing book, something extraordinary: she writes with a power, understanding and simplicity that makes us listen, makes us understand and care. Through riveting anecdotal stories – one for each of the million people living with HIV-AIDS in Africa – Nolen explores the effects of an epidemic that well exceeds the Black Plague in magnitude. It is a calamity that is unfolding just a 747-flight away, and one that will take the lives of these 28 million without the help of massive, immediate intervention on an unprecedented scale. 28 is a timely, transformative, thoroughly accessible book that shows us definitively why we continue to ignore the growth of HIV-AIDS in Africa only at our peril and at an intolerable moral cost.
28's stories are much more than a record of the suffering and loss in 28 emblematic lives. Here we meet women and men fighting vigorously on the frontlines of disease: Tigist Haile Michael, a smart, shy 14-year-old Ethiopian orphan fending for herself and her baby brother on the slum streets of Addis Ababa; Alice Kadzanja, an HIV-positive nurse in Malawi, where one in six adults has the virus, and where the average adult's life expectancy is 36; and Zackie Achmat, the hero of South Africa's politically fragmented battle against HIV-AIDS.
28 also tells us how the virus works, spreads and, ultimately, kills. It explains the connection of HIV-AIDS to conflict, famine and the collapse of states; shows us how easily treatment works for those lucky enough to get it and details the struggles of those who fight to stay alive with little support. It makes vivid the strong, desperate people doing all they can, and maintaining courage, dignity and hope against insurmountable odds. It is – in its humanity, beauty and sorrow – a call to action for all who read it.
Why28
I looked at AIDS in Africa for a long time before I understood what I was seeing. That moment came on the shady porch of a small mud-brick house in a village called Nkhotakota in Malawi, early in 2002. The house belonged to Lillian Chandawili. She was thirty-five years old, and I met her through the local AIDS organization. We sat in the softening heat of the late afternoon and she told me how she was raising her five children on her own–her husband was gone. She confided that she was plagued by diarrhea and a racking cough; some days she barely had the strength to lift a hoe, but her little plot of land was the only source of food for her family.
While we talked, Lillian's children ventured up to sit near us, and neighbours and relatives stopped by, polite and eager to greet a visitor. There were a great many children. Lillian explained that in addition to her five she was raising two of her late sister's children and two orphaned cousins. She laid one gentle hand on their heads as they crept in close–"This one has it," she said. "And this one, I think he's infected." When the neighbours moved on, she gestured with a lift of her chin at one or another–"She is infected. He is positive. Her husband is dying. He lost his wife."
And as I listened, I suddenly understood that it wasn't just Lillian and the dozen people in her support group in Nkhotakota who had AIDS. On paper, it was one in six adults in Malawi. But in this village, it was hundreds of people. If they weren't sick themselves, they were caring for the sick. They were sheltering their sisters' orphans, their dead brother's young wife and baby. One way or another, everyone had the disease. And it meant that they earned less, that they grew less food, that fewer children went to school, that no one had any savings. Lillian talked of all the people who had "passed," and I had a sense of a community quietly evaporating around me.
A few days later, in the Malawian capital, Lilongwe, I set out early one morning for the main hospital, where the lone doctor in charge had agreed to speak to me about the country's HIV epidemic. When I got to the hospital, however, no one was quite sure where he was, and people suggested I try one ward or another, check this corridor or that office. I wandered the halls in a state of growing horror. I had by that point seen many basic and overcrowded African hospitals, but never anything like this. There were people everywhere: three to a bed, lying head to foot to head; under the beds, lying on grass mats in the stairwells and in the verandas off the wards. They were bone thin and covered in lesions and abscesses. As I stepped gingerly among them, they shifted their heads slightly to look up at me through eyes grown huge in sunken faces. I could not find the doctor; I did find a nurse–perhaps the only nurse–who was stout and slovenly and clearly drunk, her hairpiece of copper curls askew. Looking around the ward, I couldn't blame her: it was barely 8 a.m., but I felt in desperate need of a stiff drink myself.
I had realized, long before that day, that AIDS was a unique and savage phenomenon in Africa. Back in 1998, in a rural hospital in Tanzania, the chief medical officer had led me on a tour of the wards. In one, we passed rows of antique but tidy beds lined up under billowy mosquito nets. Then we came to three men off by themselves, lying in a row on a thin mat on the floor. Their legs were like twigs, and their breathing was audible from the other side of the room. I was puzzled at first, and stopped in front of them. Then realized what this must be.
"Do they have AIDS?" I asked.
The doctor and his assistants whipped around. A nurse seized my arm and began to pull me out of the ward.
"Shh, shh, shh," she scolded. "You can't just say that word."
The sight of those men stayed with me. Over the next few years, I kept going back to Africa, drawn to what I began to believe was the biggest story in the world. Not the wars or the refugee crises that occasionally–very occasionally–made the evening news back home, but the slow, almost incalculable devastation that HIV/AIDS was wreaking in country after country I visited.
I know something about what makes news. In the fifteen years I have worked as a journalist, I have reported on some of the biggest stories in the world. I watched Yasser Arafat and the Palestine Liberation Organization move into the West Bank after making peace with Israel in the early 1990s. I saw tentative women venture out of their homes for the first time in five years as the Taliban lost their hold on Afghanistan. I watched Saddam Hussein's army flee Baghdad in the face of an onslaught of U.S. Marines. There is an undeniable thrill that comes with being in the centre of the big story.
But nothing I was sent to cover anywhere in the world compared to what I saw AIDS doing in sub-Saharan Africa. And yet this story never made the news at all.
In 2003, I persuaded my editors at The Globe and Mail that we were missing something important. They did not yet share my conviction about the urgency of the story, but they were willing to let me try to tell it. I moved to Johannesburg and began what would turn out to be years of travel through the heart of the epidemic: the Swazi villages, the slums outside Durban, the highlands of Lesotho, the urban hospitals of Botswana. I found hundreds and hundreds of communities like Nkhotakota on the verge of disappearing. I knew people in North America who had been living with HIV for years, taking antiretroviral medication that does not cure AIDS but will keep a person with HIV healthy for decades. But no one in Africa had the drugs. No one was even talking about getting them the drugs. AIDS was a fully preventable illness at home. But in Africa, it was a plague, and people like Lillian Chandawili could do little but sit and watch its inexorable progression. And I began to wonder how this could be happening–how we could be letting this happen–almost entirely unremarked.
Contributor notes
Stephanie Nolen is the Globe and Mail's Africa Bureau Chief. She is the winner of the National Newspaper Award, the Amnesty International Award for Human Rights Reporting and the Markwell Award of the International Society of Political Psychology. She is also the author of Shakespeare's Face and Promised the Moon: The Untold Story of the First Women in the Space Race. She lives in Johannesburg, South Africa.
Major acclaim for Stephanie Nolen's bestseller 28: Stories of AIDS in Africa
(a bestseller on the Maclean's, the Globe and Mail and the Toronto Star lists)
"Stephanie Nolen looks behind the facts and stats to talk to 28 people across the continent affected by the virus. Through them, she builds up a larger narrative: of mass social stigma and ignorance; corrupt governments; exploitative drug companies; and a dispassionate and largely disinterested West. A welcome dispatch from an epic disaster we ignore at our peril."
—Metro (London)
"In 28, Nolen marshals the reporting and storytelling skills that have made her, after UN special envoy Stephen Lewis, this country's most compelling and vigorous voice for action on the grim parasite worming its way across Africa. In clear, insightful prose and vivid, though never lurid, detail, she allows her characters—one for every million people—to tell tales of despair and remarkable courage, willful ignorance and improbable triumph."
—The Gazette (Montreal)
"Nolen is a gifted listener and storyteller . . . Her collection . . . pays loving tribute to the people of Africa . . . Although history and science are woven lightly in and around the anecdotes and photographic portraits of the 28, this is a book about human life and human nature."
"Nolen puts a very human face on HIV/AIDS in Africa. . . . Nolen sees beneath the surfaces of these individuals, estranged and all but destroyed by governmental ineptitude and denial, and evinces their loves and hopes and family ties, their humanness, with which all others can identify."
"Never sentimental, Nolen lets the people and their experiences speak for themselves. The result is both an informative and a powerful read, which will help Western readers connect personally with a crisis that too often seems remote. . . . A unique, valuable contribution to the literature on this important topic."
"A kind of continental survey of the impact of the AIDS pandemic on Africa, in stories that are frequently both tragically sad and just as often hugely inspiring."
"28 searing portraits of Africans affected by the deadly virus. . . . With a seasoned journalist's finesse, Nolen effortlessly weaves technical information—health statistics, disease data, NGO reports—into these deeply intimate glimpses of people often overlooked in the flood of contemporary media. Nolen's book packs a real emotional wallop."
"In 28: Stories of AIDS in Africa, Nolen takes the reader on an emotional journey through the continent as she tells the stories of 28 people fighting HIV/AIDS . . . The stories are powerful, heartfelt and deeply human."
—Kingston Whig-Standard
"She is an evocative and empathetic writer."
"[A] powerful, yet restrained, book. . . . Nolen's book is . . . a journalist's honest attempt to tell a powerful story using human interest, anecdotes and poignant quotes in 28 profiles."
"Nolen gives the epidemic a human face – more precisely, 28 human faces, one for each million Africans estimated to be infected with HIV. Ill healthcare workers and activists are portrayed along with ordinary Africans whose lives have been forever changed by AIDS. Nolen tells their stories simply and elegantly, blending their personal experiences with relevant background information about the epidemic. Never sentimental, she lets the people and their experiences speak for themselves. The result is both an informative and a powerful read, which will help Western readers connect personally with a crisis that too often seems remote." –Library Journal
"28 searing portraits of Africans affected by the deadly virus. . . . With a seasoned journalist's finesse, Nolen effortlessly weaves technical information – health statistics, disease data, NGO reports – into these deeply intimate glimpses of people often overlooked in the flood of contemporary media. Nolen's book packs a real emotional wallop."
"Magnificent, inspiring, informative. Nolen opens the essential door to the brave, suffering, human reality of the African AIDS crisis."
"This is a formidable book of record . . . from the tiny virus, via 28 individual human stories, to an entire continent. The stories will tear you apart before putting you back together, fully-armed and ready to go to war with a virus more dangerous than any W.M.D."
"This book is magnificent. It's probably the best book ever written about AIDS, certainly the best I've ever read. I wept when I finished, not just because it's beautifully written, not just because the last chapter tears the heart out, not just because it's a work of such force and feeling and power, not just because it's so intensely and astonishingly human, not just because it covers the entire landscape of the virus, but because its impact could shape public opinion as never before."
–Stephen Lewis, former UN Special Envoy HIV/AIDS in Africa
"A book of quiet yet overwhelming power, delivering a message of devastating moral authority. Moving, heartrending and uplifting, Stephanie Nolen's book bears impeccable witness to the 'unique and savage' phenomenon of AIDS in Africa."
–William Boyd, author of Restless and Brazzaville Beach
"If a war had killed 20 million soldiers, and left 28 million more dying of wounds, we'd call it the worst such tragedy since World War II. This is the scale of AIDS in Africa. Stephanie Nolen brings this story to life in a moving, deeply human way. Through these portraits – shrewdly chosen, varied, and sometimes startlingly unexpected–she artfully puts a series of human faces on the greatest health crisis of our time."
–Adam Hochschild, author of King Leopold's Ghost and Bury the Chains
"28 can soon be 48, 98 and more. And not just in Africa. And it does not have to be. Nolen shows that the struggle of one to live with dignity must be the struggle of all. Read. Weep. Rage. And above all else – like those people described in this brilliant book–find the courage to do."
–Dr. James Orbinski, recipient of the Nobel Peace Prize on behalf of Médecins Sans Frontières
"AIDS in Africa is an enigma. The more it spreads, the less we see it. It is deadly yet deniable. It hides in full view of everyone. What this moving book does is to catch it by the tail and show us its face – it is our own."
–Christopher Hope, author of My Mother's Lovers
"Essential reading in the Age of AIDS, it is never earnest, and, whilst often painful, full of humane and painstakingly researched detail."
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Stephanie Nolen
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