Monday, April 20, 2009

The Fight for Sarah Obama's Soul

I'm no partisan. Heck I don't even vote. But I can tell you that traveling in Kenya over the past couple of weeks, it has been a delight to see how delighted Kenyans are about Barack Obama. Out in Luoland in Western Kenya, there are signs pointing to his family's ancestral home. After interviewing a Luo elder, one of his wives who works as a seamstress brought me some Obama cloth and shirts featuring his face on a traditional African pattern. At a hip party in Nairobi yesterday, where the menu include plenty of Smirnoff vodka and a bit of goat-head soup, one of the guests was wearing an Obama t-shirt that featured a solemn image of the president and the words "Making history." As I travel around, faces light up whenever I mention I'm an American.

I never sensed much anti-Americanism during my years kicking around the continent for the Washington Post, but I often got the sense that Africans didn't regard the U.S. government as consistently on their side. The main exception was in the petro-state of Nigeria, where George W. Bush's Texas oilman style went down well.

Obama's election has changed the emotional/political chemisty to an amazing extent. The Kenyan papers are trying to outdo each other in trying to get the scoop on a possible Obama presidential visit. And the fascination with all things Obama extends even to the soul of his sort-of grandmother, Sarah Hussein Obama, a Muslim who almost, but not quite, converted to Christianity over the weekend.

Sarah Obama is the third wife of Obama's grandfather, making her, in the family tree of the Luo ethnic group, a "grandmother," even if not Obama's exact, direct grandmother (who was, instead, the second wife of his grandfather. Got that?) Being a dutiful son of Kenya, President Obama calls Sarah Obama "Granny Sarah," as he should. (She is second from the right, bottom row, in the picture, looking resplendent in this image of Barack Obama's Kenyan family.)

The story, as told by Kenya's Nation newspaper, is that the Seventh Day Adentist church, which has sunk deep roots in Luoland over a century of energetic missionary work, managed to convince Sarah Obama to renounce Islam in favor of Jesus Christ. Her Kenyan relatives, however, stepped in before the baptism could take place. The Council of Imams and Preachers of Kenya endorsed her family's blocking maneuver in a statement yesterday: “Mama Sarah should not be forced by anybody to join Christianity since she is a Muslim. Conversion must take place in a voluntary manner,” a group spokesman said.

Seems reasonable enough to me, but I have a feeling this saga may not yet be over...

Sunday, April 19, 2009

Canadians vs Somali Pirates: Who's Winning?

Hard to tell really. If you watch this video that a Canadian Navy public affairs team posted after a pirate encounter couple of weeks ago, you'll see Canadians with big guns and silly hats bravely capture Somali pirates, disarm them and make them walk the plank.

No, no, sorry. They don't walk the plank. They go free. The Canadians don't even confiscate the skiffs the pirates are using to terrorize international shipping. The Canadian Navy did much the same thing after an attack today.

No doubt there is some good reason for all this pirate coddling. But it's hard to fathom what it might be. Even Johnny Depp got spent a little time in jail when British naval authorities caught up with him at various places in the Caribbean, or was that Disney World? The Somalis, on the other hand, are free to keep it up until, apparently, they make the mistake of taking a handsome American captain hostage. All I can say is "Argh!"

Friday, April 10, 2009

A Must-Read Book: "Tulia"

One of the most-satisfying things about writing a book is that you have to read a lot of books, and think about them, along the way. I'm just now finishing the best book I've read in a long time: "Tulia: Race, Cocaine and Corruption in a Small Texas Town."
No doubt the better-read followers of this blog already have worked their way through this masterpiece, which was both a New York Times Notable Book of the Year and winner of the J. Anthony Lucas Book Prize. But I was overseas when it first came out in 2005 and had missed it. I can only say, "Wow!"
A book editor friend of mine recommended this, even though it has nothing to do with my normal preoccupations with AIDS or Africa. But it dives right to the heart of America's terrible racial history and its punishing present-day legacy in so much of the United States.
Author Nate Blakeslee chronicles the arrests of more than 40 supposed drug dealers, which amounted to a massive swath of the marginalized black community of a town of just 5,000 people. The evidence from an undercover narcotics officer was unusually thin and uncorroborated, but that didn't keep West Texas juries from doling out dozens--in one case, hundreds!--of years to these defendants.
Of course it all falls apart as the undercover cop turns out to be shady himself, and apparently a habitual liar. The most chilling part of the book, of course, is that most cases in our so-called drug war don't get anywhere near this much publicity, or scrutiny. It took a high-powered team of attorneys, and the pardon of an embarrassed governor, to eventually undo these blatant injustices. But how many injustices pass without notice beyond the routine reach of public scrutiny and good defense attorneys?

Thursday, April 9, 2009

The Uganda Miracle That Was

The world has hailed Uganda's success on AIDS for so long that few have noticed that the glory days happened long, long ago. But Ugandans know. A chilling report on the epidemiology in Uganda, by Fred Wabwire-Mangen, stated bluntly last year (Here's a Powerpoint Version)that the declines in new HIV infections are over.

" 1. The previously heralded precipitous decline in HIV prevalence and incidence in Uganda stopped in 2002. HIV prevalence and incidence are now on the increase in Uganda

2. HIV-related sexual behaviours have deteriorated especially for men. There is evidence of: a rise in the number of life-time sexual partners and concurrent sexual partnerships; an increase in sex with non-regular partners, and a decline in condom use both for any sex and in the context of higher-risk sex."

A trio of Uganda AIDS experts tried to ring the alarm bells with articles in major Ugandan papers in January (here's a link to a copy of them). But I've sensed little energy around the issue on my visit here to Kampala, the national capital. Ugandans speak often of the AIDS epidemic in the past tense, and AIDS experts here are convinced that widely available treatment has taken the energy out of prevention campaigns. Now there's a dilemma to ponder: Is there any way to have good treatment and aggressive prevention programs at the same time?

Tuesday, April 7, 2009

The Rorschach Test

I'm on my way to Uganda to do some more reporting on the astonishing, and generally misunderstood, story of how this country emerged from devastating civil war in the mid-1980s to craft the most effective AIDS response in African history. It's a subject I've tackled before for The Washington Post. But for the purposes of book writing, I need to dig deeper, as well as feel the African sun on my skin and again marvel at the world's ugliest birds, which fly around Kampala, the capital.
Cynics often describe Uganda as Rorschach Test of AIDS: People see what they want to see. Some attribute the steep drop in new infection that began in 1989 (and ended in 1994) to condoms, others to abstinence. Some say good political leadership was the key, or maybe multi-sectoral approaches. Even Death, sometimes called the "D" of "ABC" prevention efforts, gets credit for the steep drop in AIDS rates.
I don't think much of this has held up to serious scrutiny in the years since scientists Rand Stoneburner and Daniel Low-Beer published their groundbreaking study in Science magazine in 2004. It showed conclusively that the drop in new infections tracked with major shifts in sexual behavior, away from multiple sex partners, casual sex and prostitution. Political, religious and cultural voices spoke together in those years, urging people to be more monogamous, or at least faithful to their spouses if polygamous. The resulting changes saved more than one million lives. And it all happened, and pretty much ended, before the wave of condom promotion that began in the mid-1990s and the abstinence programs that began a few years after that.
In any case, I'm hoping to have more to say in a few days. But my hunch is that Uganda's story is the opposite of a Rorschach Test. It was a moment of remarkable clarity, now lost and gone away. Those stupid blurry ink splotches, however, seem like they will be with us forever.

Thursday, April 2, 2009

The Chinese: Africa's Salvation, or Doom?

This kind of simplistic question dominated about a decade worth of news coverage of rising Chinese influence in Africa. Both answers, of course, are wrong. Chinese incursions, both economic and political, upended the old order but the influence was neither uniformly benign, nor entirely malign. That ship carrying guns and bullets to Zimbabwe's embattled government certainly was a low point, but Chinese money and skill also built plenty of road, port and rail projects. Plus many Africans I interviewed were pleased with the straightforwardness of their dealings with Chinese companies. They were about profit, not about "saving" Africa.... as the West has been trying to do with varying degrees of success for nearly two centuries.
One correspondent who consistently avoided the salvation-vs.-doom trap is Lydia Polgreen, the excellent West Africa correspondent for the New York Times. Her story this week out of Guinea reminds us the Chinese-Africa relationship, like all relationships, is complex.
It also reminds us, as the Post's Karin Brulliard did last week with her dispatch from Zambia, that when things in the world go wrong, Africans generally pay the price--whether or not they had any role in causing the problem.

Wednesday, April 1, 2009

Should African Mothers With HIV Breastfeed?

Amid all the talk about the Pope and condoms the last few weeks, many people overlooked another intriguing development about AIDS in Africa. Health authorities in Mozambique are urging women with HIV to breastfeed their babies. Like many issues in the AIDS world, the logic is totally counter-intuitive. But given the other threats babies face in the poorest parts of Africa, the risk of getting HIV from breast milk is small compared to the risk that babies will die of other maladies that breastfeeding helps prevent.

The most obvious is the danger posed by infant formula itself in places that lack reliable sources of clean water or sterile feeding equipment. A couple of years ago, I wrote a story for The Washington Post about floods in Botswana that caused widespread water contamination, which led to the deaths of more than 500 babies and young children. In some places, two or three died in a single village. What an American team of investigators found was that well-intentioned efforts to provide infant formula to women with HIV had led to widespread abandonment of breastfeeding, even among women who didn't have HIV. A huge percentage of the children and babies who died during the floods were not breastfed. The push for the formula feeding came largely from Western medical authorities working at UNICEF, though the agency later reconsidered as evidence about the dangers of formula mounted.

Breast milk is not only inherently free of the kinds of contaminants that get into drinking water, it also has nearly perfect nutrition for a baby and antibodies that protect a child against all manner of disease. So while women with HIV who have access to reliably clean water, as in the case of some modern cities such as Johannesburg, should use formula, others mothers should abandon breastfeeding only with great caution.

In places where clean water is not available every single day, the best solution for mothers with HIV probably is breastfeeding ONLY for the first six months. Then breastfeeding should stop entirely and be replaced by other foods. Mixing breast milk that contains HIV with other food sources dramatically raises the risk of the HIV infection taking hold in the baby. The reason is that digesting the other food causes tiny intestinal ulcers that HIV can penetrate fairly easily. So let's hear it for the Mozambicans for applying the best available science to a difficult situation.