Book Review:  28 Stories of AIDS in Africa

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Siphiwe, Tigist, Mohammed, Prisca, Regine, Lydia, Noe, Christine, Manuel, Cynthia, Mfanimpela, Andualem, Alice, Zackie, Lefa, Pontiano, Winstone, Agnes, Mpho, Anne, Gideon, Ida, Anita, Morolake, Moleen, Ibrahim, Nelson, and Thokozani.  Twenty-eight names.  Twenty-eight lives.  Twenty-eight stories to represent the twenty-eight million people currently infected with HIV in Africa.  Stephanie Nolen is one of the four journalists whose whole career is focused on the HIV pandemic in Africa.  She writes 28 to attempt to bridge the intellectual gap between knowing there is a crisis affecting many millions of people and actually feeling the personal burden suffered by each and every one of those millions.  From prostitutes and truck drivers to medical activists and former presidents, the twenty-eight people displayed in this book have one thing in common; their lives have been unalterably changed due to HIV.

            One major theme throughout 28 is the devastating effect of HIV, not only physically, but also socially.  Within the body, HIV progresses at different speeds in different people.  For some, their immune system will disappear quickly, within a year or two of exposure, while others may make it as long as 8-10 years before immune collapse.  Once the immune system is down, many secondary infections that the body would normally fight off take control, causing many symptoms including weight loss, flu-like symptoms, lesions, and eventually lead to death.  One of the twenty-eight, Moleen, was a fully adult woman who weighed around 70 pounds at the time she was interviewed.  Her husband, Benjamin, was trying to take care of her full time and make enough money to purchase chicken feet for a meal, the only protein within their price range.  Using a variety of medications, Moleen would be able to have a full recovery, but they unfortunately would cost Benjamin and Moleen $18 a month, which is equal to Benjamin’s full salary.  As she wastes away, Benjamin is able to work less and less, earning less and less money for food, and he himself begins to see his health fade.  Moleen passed away one month after the interview.  The author poses another question, “who is left to take care of Benjamin when his health fades?”

            Socially, HIV also can radically alter a person’s life.  The interview with Prisca, a middle-aged woman from Zimbabwe, begins with her recounting her multitude of scars, not from HIV, but from her own family’s attacks.  When she admitted to them that her husband passed from AIDS, instead of the support she hoped for, her family beat her.  They believed it was her fault, for to them only prostitutes carried the disease.  In a sad twist of events, Prisca outlived her entire family, who all lost their lives to the same illness that they beat her for.  Many others in the book lost their jobs or friends due to admitting they had the disease.  Many people in Africa stereotype HIV as a disease you get purely through inappropriate behavior, so it’s your own fault. Yet the highest growing demographic of new HIV cases are married women, whose husbands bring it home from their visits with the sex trade or other wives.  Anita, as an example, is one woman of many who, after being diagnosed with HIV, was disowned by her family, taken away from her children, and forced out of her home for being a whore, despite the fact that the only man she has ever had sex with is her husband, and only once they were married.  The author was unable to find Anita at the time of publishing to report on her health or if she was still living.       

            Another large theme is the affect of stereotypes on the response to the HIV crisis, both initially and in a large effort to reverse these stereotypes.  Many people know of the initial problems with HIV being labeled a disease for homosexuals and prostitutes, but what they may not know is the level to which that hindered a response to treat HIV in Africa.  When a particular disease reaches 1% of a population, it is labeled as an epidemic, requiring massive response.  As an example of a typical response, swine flu (H1N1) never even came close to effecting 1% of any population.  In the late 80’s and early 90’s, HIV had infected 5-15% of many countries in Africa, but the governments refused to place funding into distribution or education due to the “immoral behavior” by which these people had received the disease.  There was also a lack of pharmaceutical interest due to the understanding that the disease was targeting poor populations, and therefore not marketable. 

            One point that Nolen makes is that the overreaction to this stereotypes has had as much of a negative effect on our response.  Once it was pointed out to governments that they were somewhat foolish to consider HIV a “gay disease for prostitutes” they enacted campaigns to the complete opposite.  While this seems like a good idea, to right the misconceptions, in actuality, Nolen writes that we need to understand that the sex trade and infidelity in Africa is still by far the number one vector of transition of the virus.  What she means by vectors are that people involved in these activities are not the high infection rates, they are already infected and the primary route for the disease to infect those who are staying away from these areas.  Many of the recent responses have been so far away from the stereotype that they don’t focus on or reach out to those in the sex trade.  Teaching women and children abstinence only education has its benefits, yet it does nothing to protect them from husbands who are not faithful, and has no effect on helping the second largest growing demographic of HIV infected individuals in Africa, infants who are infected during birth.

            I was deeply impacted by this book.  I agree with the author that one of the most important things we can do is find a way to place a human face, or 28 million, on the HIV pandemic.  The author writes with a mix of personal story and statistics.  The chapter telling the story of a woman who has been in prostitution for 30 years, for example, is full of statistics and history of the sex trade on the movement of HIV across the continent.  For the most part, my ideas were reinforced, but were personalized.  I already knew the HIV crisis was important and terrible, but was less able to wrap my mind around the idea that each of the 28 million people has a story of a life turned upside down by the virus before I read the book.  I was also very challenged in my ideas of what it means to fight stereotypes.  I struggle with the idea that to entirely disregard them can be destructive.  I think the idea that I left with was that we need to be willing to leave our preconceived notions about people at the door, and yet face the issues head on, not neglecting any group of people in order to have the appearance of  being “enlightened and open-minded.”  It is terribly wrong to even begin to think that because someone has HIV they have immoral lives consistent in the sex trade, and yet it is a terrible injustice not to address and help those immersed in the sex trade in order to protect our image.  The one overall weakness of the book was that while it left me with a greater understanding and desire to do something, it never gave me any tangible ways to do so.  I feel left with a great burden, and no direction.  That being said, perhaps just living with a new found awareness is a great step in the right direction.

            Reading 28 as a future educator, I believe it is an incredibly powerful resource to educate teachers on the AIDS epidemic from a human rights perspective. Nolen skillfully brings a voice not just to twenty-eight, but to twenty-eight million individuals living with HIV, while also educating the reader on the history of HIV, the biological challenges, and other social issues in various African countries. While I would not recommend reading this book to young students due to some of the graphic and depressing descriptions of some individuals’ lives, I do think it can inform teachers who are preparing to teaching on AIDS or anticipate any questions about AIDS during a unit on Africa. Nolen’s attempt to personalize a global issue is a concept that is crucial to incorporate into any social studies unit. When teaching towards social justice, presenting mere facts will only scratch the surface of the students’ potential awareness of the issue. However, helping students connect information to real lives will make their learning more relevant and prepare them to become citizens of action. After reading this book, I have a new perspective on addressing stereotypes in the classroom. The stereotype itself is not something to be tolerated, but there is often a driving issue beneath the surface of the stereotype that may or may not need actual evaluation and social action. With that said, in teaching my unit on stereotypes of Africa, it is essential to communicate to the students the need to be critical thinkers of the issues that they are exposed to, instead of casually dismissing stereotypes as inconsequential.

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