Saturday, August 12, 2006

Braiding Hair/Visiting Kibera/Do ARVs help spread AIDS?

This morning, Lucy and I both braided (plaited) our hair. All morning. We started at 7:00am and finished about 1:30 pm. It was a bit expensive and took a long time, but it’s fun and I hope it will make my hair easy to manage for a while – not having to wash as much or worry about fixing it. It still looks a little funny to me on my own head, but I don’t see myself that much so I don’t think it really matters. It also feels a little funny – it pulls a little and it’s a little heavy (with the extensions in), but they said I would get used to it. I asked the lady who did it whether I would look like an African or still just a mzungu and she told me (to my disappointment) that I would still just be a mzungu. I did get a lot of compliments on it in town.

This afternoon we went to Kibera to visit two of the students that Courtney’s organization sponsors for high school (Education for the Future Foundation), partly because we needed to visit the students and partly because it gave me the opportunity to visit Kibera. Kibera is the largest slum in Africa and from what I’d heard, I was expected row after row of shacks with garbage everywhere and sewage running and lots of very poor people. What I found was quite different. There are so many very nice, hard working people. The kids were all out playing and having fun (after coming home from school). There are churches, health clinics and lots of shops. It wasn’t at all like I expected. I know that it’s still not an easy place to live, but it was not as bad as I thought it would be. I talked to the mothers of the two students for a while and they told me that it’s easier to earn money living there in town than in the rural area. In the rural area, they can grow food to eat, but it’s very difficult to get cash for school fees and other expenses. The moms make maandazi and chapatis to sell at office buildings in the city centre. They wake up very early in the morning and work so hard. We took pictures with the students and their families, but I didn’t feel comfortable taking pictures outside – like it would be exploitative.

It’s hard to know what to think about it. I feel like I should be overwhelmed and heartbroken after having visited the largest slum in Africa, but I just found people, living life there, just like any other place. I enjoyed my time with the families very much. Their houses are small and there is a lot of garbage around, but, it’s not that much different than other places. A lot of people have electricity and good water. I think if I were to spend more time there and see more of the day to day challenges, it would be different, but my impression today was pretty positive. If anybody has any thoughts on this, I’d be happy to hear them.

The other noteworthy item of the day was the news report we heard from a health conference that took place in Nairobi yesterday. One idea presented was that the use of anti-retroviral drugs (ARVs) actually contributed to the spread of HIV because people look well and so they go on spreading the disease. I’m not sure if the presenter was suggesting that the use of ARVs be discontinued or reduced or not, but I was quite shocked. I’ve also heard that people are more willing to be tested if they know that treatment (i.e. ARVs) is available and that this reduces the spread because people know whether they are positive or negative and can change their behavior accordingly. To me it seems like an issue of understanding and behavior instead of a problem with giving treatment. If people are on ARVs, they obviously know that they are HIV positive. So it seems like they should be the ones, with counseling and education, who can keep from spreading the virus. There is definitely the idea that people who look healthy can’t be HIV positive, but that seems like an issue of education and communication rather than a reason to stop giving treatment to people so that they look sick and other people avoid them. I know there’s a degree to which people want to continue with their old life once they’re being treated for HIV, especially if they are healthy and don’t want other people to know, but I also think that they have the responsibility to do what they can to keep from passing it on to someone else. I know that Kenya is not like America. I know that this could be an issue especially for wives of unfaithful husbands who never know that their husbands are infected and end up with HIV themselves, but still, I just can’t accept that giving ARVs is contributing to the spread of HIV. Well, these are all first impression thoughts and I would love to hear what other people think. Is there anything I’m not seeing or not understanding? Do you have an opinion on this? What should be done to help stop the spread of HIV and who’s responsibility is it? Please share so that we can learn together.


Senor Bozo said...

I agree with you that it's hard to make a connection between ARVs and the spread of AIDS, but I was interested to read just this morning another article that indicated that having the appearance of 'not having AIDS' has a powerful behavioral effect:

On another note, I'll trade you a picture of Molly in braids for a picture of you in braids - I can hardly imagine! (LOL)

Love and blessings, John S.

Mark and Courtney said...

Hi Sarah! It was interesting to hear your experience with the AIDS discussion in Africa, since there was an article on CNN this morning about preventing AIDS. Here's the link:

The Gates' Foundation is doing a lot of work and pouring a lot of money into stopping the spread of HIV.

Hiker Girl said...

I don't know that I can bring an informed opinion to the discussion, but it seems more of a reactive point of view to argue that ARV's are more harmful than helpful. I can understand the premise, but I certainly wouldn't want to throw the baby out with the bath water, either. But, seriously, I guess I don't know enough to make an intelligent argument.

What I am quite knowledgable about, however, is that we miss you very, very much. I pray that you are learning SO VERY much while you are away. I will continue to pray for your loneliness. Thanks so much for keeping us informed. We miss you so much.

Lots of love, Andrea Sherman

Julie said...

As always, I love hearing about your adventures. And about the issues that you face day to day. It brings up things that I wouldn't normally think about.

Megan H said...

Hey Sarah - I haven't heard the argument about ARVs making people more likely to spread the disease, though I have heard of multiple cases of people stopping the ARVs b/c they think they're "cured" since they look/feel healthier (also some instances of pastors telling patients to stop taking them b/c God "healed" them...).

The program in El Doret that IU supports focuses a lot on the idea that an ARV option makes people more willing to get tested - and that makes sense...if you have hope it's not quite as scary to find out you're positive.

And of course there are still the few out there who actually think that ARVs are tools of the west to reduce fertility or to cause HIV in the first place...