In Kenya, Equality Now representatives travel from village to village, explaining that the clitoris is an organ with an essential function, just like an eye or a hand, using anatomical models of healthy genitals and ones that have been circumcised. They explain that the early onset of vaginal dryness makes sex unbearably painful. The extraordinary pain and difficulties women have with childbirth are related to the lack of elasticity in all the scar tissue where the genitals have been mutilated, including the removed labia. When they do this education face-to-face with both men and women, the practice changes, but Africa is a big place and it’s slow going. They also appeal directly to the older women who perform the mutilations, essentially trying to persuade them to hang up their rusty knives and razors by reeducating them into a small business of some sort or taking the religious route (you’ll go to hell for hurting all these girls so unmercifully!). They are doing fabulous work, and while it is hard, there is progress. Equality Now has partnered with a grassroots group in Maasailand to implement “alternate rites of passage” for schoolgirls. They have engaged in training police officers in ways to enforce anti-FGM laws and have a presence in the courts to hold judges accountable for upholding the rule of law.
Americans might be shocked to learn that FGM practices have spread to this country along with the African diaspora. A federal law passed in 1996 specifically outlawed female genital mutilation in the United States. Equality Now is at the forefront of the campaign to expand the reach of the law to prevent girls from being shipped across the borders on “vacations” to be mutilated. Sadly, the bipartisan Girls Protection Act did not make it through the House of Representatives in 2010; there are plans to reintroduce the bill in the next session.
By the time Agnes and Faiza said their goodbyes, I was so fired up that it was hard to sleep. I could feel my horizons expanding as I contemplated the network of organizations like Equality Now that I could support. Each was like an instrument in an orchestra that, when played together, made a glorious symphony of hope.
Chapter 10
THE RICE TENTS
Prostituted women testing HIV-negative in Madagascar
There is a crack in everything. That is how the light gets in.
—LEONARD COHEN
fter a week in the sunstruck urban wastelands of Kenya, the lush rain forest of Madagascar was a balm for my eyes and my soul. Kate had arranged a brief respite for us at a lodge on the edge of the Andasibe-Mantadia National Park, deep in the eastern mountains of this exotic island nation in the Indian Ocean. My plain wooden bed was under a mosquito net, and my windows and doors opened out into a place rich and lush in life and noise, a jungle filled with colorful birds calling in the trees, eight-foot-tall hibiscus plants rustling in the breeze.
I desperately needed this communion with life, as Nairobi had taken it out of me. I am not an urban person in the best of circumstances, and I’d never been to such a place before, so hard and dirty and tough and desperate. I’d thought everything in the developing world was either like Phnom Penh, basically a large rural town, or Bangkok, modern and muscular with freeways and skyscrapers. I hadn’t known there was such a drastic place with millions of people trapped in slums, barely getting by every day. I had been fully disabused of my romantic notions of Kenya, born of films, books, and tented safari brochures. The Maasai I saw were herding thin cattle on the sides of cratered highways chugging with cars on the verge of collapse. My naïveté made me feel foolish.
All the domestic animals I’d seen in Africa were very thin, and I said a compassion mantra each time I saw some:
Om mane peme hung
. It was how I could feel somewhat useful in my total uselessness to them, and how I could keep from crying. Our young guide from the lodge had an amber-colored dog named Ginger that he called over to meet me so I could love on her. She was awfully friendly and sweet, and I vowed to provide her some food. Papa Jack told me no matter how much money I gave our guide, the dog would see none of it, so I retrieved my lunch scraps from the bin to feed Ginger and her friends. I got some especially good sugar from a lovely brown male, and it was confirmed yet again: There is nothing like the love of a fine dog.
In the morning, we visited an incredible little animal habitat that had chameleons, lizards, snakes, geckos, and the like. It was fascinating that so many unique species had developed in isolation, 240 miles off the southeast coast of Africa. I ended up wondering: How have these creatures so ingeniously and brilliantly evolved to where even their eyeballs make them blend in safely, and we humans have evolved into an eighteen-year-old girl, eight months pregnant, being bought and sold for sex so she can feed herself?
That afternoon, I clumsily tried to evade Papa Jack for a solo hike and was caught red-handed fetching a map at reception. He was kind enough to go against his own instincts and respect my fanatical need for aloneness, and I gratefully trekked up the rich mountains by myself, where I immediately began to weep. I walked and cried, and nature, as always, was overwhelming enough to absorb my grief and allow me to heal some. After Nairobi, I was starting to feel I could no longer be shocked. I could be touched, I could be moved, I could be distraught, but I couldn’t be shocked—at least not by bad stuff. The worst sights and stories were all different versions of the same tragic tale of poverty, lack of education, gender inequality, disease, exploitation, inhumanity. The variety was in nature and in love, where wonders never cease: the colors of the chameleon, memories of Papaw Judd scrambling my eggs for breakfast, Dario’s humble contrition when he’s wrong and his gentle way of helping me learn when I am, twenty women meeting as strangers at a yoga retreat becoming sisters by the end of the week, a thunderstorm in Big Sur, a flock of thousands of birds gamboling and landing on a loch in the Highlands—I could go on and on. The beauty of the world could break my heart, but its ills could no longer break my spirit. At least not today.
By now Moyra had joined me on this painful, glorious adventure. I was deeply grateful for her company, and I’m amazed at how we love so many of the same things. As we drove through the countryside, both of us gaped out the window at the cheer the Malagasy put into their tiny clay huts, at the beauty of wild roses, St. John’s lilies, rushing rivers, waterfalls, graceful, inventive orchids, and ridges of green as far as the eye could see.
But after this brief, restorative visit, it was on to the teeming capital, Antananarivo, and the challenges of a once isolated people now being slammed headlong into the twenty-first century. I quickly began to see beyond the physical grandeur of Madagascar and into its extraordinary poverty. Even though the land seems abundant, 88 percent of rural Malagasy do not have safe drinking water, and they suffer the consequences of that with the usual tragedies, all of which are preventable, including unacceptably high maternal and child mortality. The land produces fruit, but it earns them little money, as 60 percent of it rots before it can be exported; farmers cannot afford to pay to transport it. The once magnificent forests are being razed for timber and firewood and by slash-and-burn agricultural practices. And while it seems lovely that there is no litter on the ground, it is because there are no goods to throw away. Only half the children are vaccinated, and half the children are malnourished and stunted. The rural infrastructure is extremely minimal, and our mission of delivering lifesaving messages and goods, such as clean water treatment (which costs only 1 franc per liter), insecticide-treated mosquito nets, maternal and child health education and products, and, of course, HIV/AIDS prevention, has been confronted with a whole new galaxy of challenging puzzles. Fortunately, we do have some good funding here from both USAID and the Global Fund, money I was seeing in action in terms of both ideas and programs and the motivated, dynamic local personnel who implement them.
Although AIDS had been slow in coming to Madagascar, in 2005 it was waiting like a ticking time bomb to explode into the general population. Madagascar’s remoteness, coupled with an isolationist, Socialist government, helped protect its people from the AIDS pandemic that swept the mainland during the 1980s and 1990s. But in recent years, a new leadership had thrown open the doors to private investment, travel, and tourism—and with it, HIV.
At the time of our visit, between only 1 and 2 percent of the population of nineteen million was HIV-positive. That was the good news. The frightening news was that what little the Malagasy people knew about HIV was mostly rumor and misinformation. It reminded me of the United States in the early 1980s, when there was so much fear and such a terrible stigma attached to the virus that HIV carriers were afraid to be tested. But with the Malagasy government’s support, PSI was unleashing a massive social marketing campaign to educate the people about HIV/AIDS and how to prevent it.
Part of my job here was to use my high profile to crack open the social taboos surrounding HIV/AIDS and to find at least one HIV-positive Malagasy to go on television with me to put a human face on the epidemic for the first time. It took Tim Hobgood, PSI’s young country director, most of the week to track down a willing subject. The woman who had agreed to meet me wanted to back down, because she was afraid that if her relatives found out about her disease, they would reject her bones upon her death and she wouldn’t be buried with her ancestors. In the culture here, that is the same as being sent to hell for eternity. We had to keep trying to overcome the stigma: If people couldn’t even talk about the virus, how could they be educated about how to prevent it?
While we waited for Tim to work his magic, I had the distinct pleasure of visiting the clinic run by one of the many unsung heroes in the fight against HIV/AIDS, Dr. Rene Randrianga. Dr. Rene is a large man with skin the color of milk chocolate, wide cheekbones, and almond-shaped eyes that reflect the mélange of African and Asian ethnicities that make up the Malagasy people. Toss in the French language inherited from the island’s former colonizers, and the mix is complete. For ten years, Dr. Rene has provided health care and counseling to the capital’s prostituted women in an effort to keep them from contracting and spreading HIV. Two factors complicate the danger here: Many Malagasy consider it perfectly normal to have multiple sex partners, in or out of marriage. And this country has one of the world’s highest rates of sexually transmitted infections such as syphilis, and the open sores from these infections facilitate HIV transmission. The best solution available was education and condoms—and PSI was providing both. Dr. Rene would be our guide into the streets of Antananarivo, where—to make a terrible joke—the rubber literally meets the road.