Circling ‘The Scourge’

Lucy Barimbui is resolved to meet with the HIV-infected teachers—even when it means returning about 30 miles along a stretch of bone-shaking road that she has already traveled twice in three days.

Barimbui, who coordinates anti-AIDS education activities for the Kenya National Union of Teachers, plied her cellphone for hours trying to convene the meeting here. But as she jounced along in the union’s white van, losing phone service as often as finding it on the river-gouged foothills of Mount Kenya, about four hours north of Nairobi, she learned that while transportation cost is a problem for the teachers, fear is a bigger one.

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True, they had taken the unusual step of publicly identifying themselves with the human immunodeficiency virus that causes AIDS, for which there is no immunization or cure. But they were not ready to be seen in Meru, the regional market town where more of them are known, let alone use the Meru offices of the union’s local branch.

So the meeting is set for a cliff-top cafe in smaller Chuka, with the expenses of lunch and jitney fare paid by visitors from the Kenyan capital, who include, besides Barimbui, a teachers’ union official from the United States and a journalist.

Five members of the recently formed Kenya Network of Positive Teachers, known as Kenepote, show up—fewer than the local organizer expected, but then, Muihuri Raiji admits, “many of us are not comfortable” being open.

Amid the soft drink bottles they have emptied, the teachers—all in their 30s and early 40s—describe living with HIV. One reports the deaths of his wife and two young children from “the scourge,” as Kenyans often call the AIDS pandemic in their musical English, the language used for much of schooling here. Another tells of his three suicide attempts, the last of which left him using a cane. A woman mentions that her boyfriend walked out on her rather than get tested for the virus.

The teachers sound inspirational themes, too, of family support and Christian rebirth in the face of despair.

Their professional reality is more shaded, though. Some bosses and colleagues are wary; a few are helpful. The silence around their personal experience with HIV or AIDS, which have been officially part of the national curriculum in Kenya since 2002, often causes the most pain.

“I wanted to let the students know my status, to know from me rather than anyone else,” says Raiji, who teaches geography in a secondary school in the Meru area. The principal refused, but Raiji believes the students know anyway because of the questions they ask him about how the virus is transmitted.

The teachers’ travails do not shock the 39-year-old Barimbui, who reached adulthood and began her teaching career just as the pandemic was beginning to spread its shadow over every aspect of Kenyan life. Still, nothing prepares the soul for misery heightened by ignorance. And since Barimbui left off teaching and took the AIDS-related post in Nairobi less than two years ago, that mix has become her daily fare.

A woman with a heart-shaped face and a ready laugh, given, in the Kenyan way, to wearing formal clothing—a two-piece suit and pumps—Barimbui addresses her work hopefully. The hope, though, is tempered by reality.

Her job exists because of a partnership between the KNUT, the Kenyan teachers’ union, and the American Federation of Teachers. Active for decades on the international labor scene and mindful that Africa suffers from the world’s worst poverty, the 1.3-million member AFT has sought to collaborate with independent sub-Saharan teachers’ unions on problems of their choosing.

In Africa, south of the Sahara desert, no education crisis looms larger than AIDS, which as a killer of young people threatens both the teachers and the taught.

Seventy percent of those infected with HIV worldwide live in sub-Saharan Africa, where the disease has been spread mostly by sex between men and women. The infection rates are highest in the nations of southern and eastern Africa, reflecting the origins of the disease in the area west of Lake Victoria.

The pandemic has complicated every need in education—which many see as the best means of reducing poverty over the long haul—from planning how many teachers should be trained to engaging sick or grief-stricken children in learning.

In Kenya alone, where the infection rate is estimated to have reached 13 percent of the population, 27,000 teachers will die and more than 2 million children will lose one or both parents to AIDS in the next five years, by one projection. Even if those figures for the nation of 32 million prove to be high, as a result of an increase in the number of people taking antiviral drugs and a drop in the infection rate, the pandemic will not peak for at least another few years because of the years-long lag between infection and illness.

The AFT has raised some $170,000 from its members for its Africa campaign and used that money to leverage $3.8 million more from the President’s Emergency Program for AIDS Relief, or PEPFAR, a fund launched by President Bush in 2003. With AFT help, unions in Zimbabwe, South Africa, Swaziland, and Kenya are mounting responses to the pandemic.

Following a model the AFT helped craft in Zimbabwe, the Kenyan project uses “study circles,” in which teachers learn together about HIV, script new sexual behaviors for themselves, and figure how better to care for those infected or affected by the disease. As teachers come to grips with AIDS in their own lives, which union officials in both countries view as the project’s first priority, the leaders believe that educators will then be better prepared to help their students, their schools, and their communities.

What’s more, the project’s leaders say they are struck by the drive of many teachers to translate their education and their stature into help for their neighbors.

More than 700 schools across Kenya are expected to convene circles in the next two years, each drafting a list of resources for those affected by HIV and AIDS, and 60 teachers are to be trained as counselors. The program also calls for an awareness and advocacy campaign to help transform schools into places where everyone feels safe from the prejudice and harassment those with the disease often encounter.

The AFT grant for the joint work underwrites Barimbui’s salary, which, including benefits, comes to about $12,000 U.S. a year. The job brings with it a big office in the KNUT’s Nairobi headquarters and a single, shared Internet connection—minus her own computer.

The human side of the work can require a combination of boldness and delicacy that is not easily compensated, even in developed nations.

After the gathering of Kenepote teachers breaks up, for instance, Raiji, the leader, stops Barimbui to talk about his family. He and his wife, who has tested negative for HIV, have two young children, who are also negative.

Barimbui, though yearning at that moment to visit the hairdresser, responds as if she had no other concern but the teachers’ and not a second to lose. In fact, as a wife, a daughter, the mother of 9- and 12-year-old sons and the highest-ranking female on the union’s staff, she has a host of responsibilities, which she is the first to say she is learning to balance.

“Are you practicing safe sex?” she gently demands.

Raiji says that after praying over his choices, he has decided to refrain from intercourse, because using condoms is taking a chance. He adds that his wife, who is at home with an infant and a 5-year-old, is unhappy with the decision.

Barimbui thinks she knows why. “You are out and about, doing this and that, going around,” she points out. “She is lonely, perhaps, and bored.”

Maybe, Barimbui is saying in so many words, the decision should be rethought.

When Barimbui takes the American visitors through the sagging gates at Egoji Teacher Training College near Meru, it’s a homecoming. The holder of a four-year degree in secondary education, she taught aspiring primary school teachers at Egoji, one of 26 such two-year institutions in the country, before being tapped for the job with the teachers’ union.

At the time, she was wrestling with government policy for teachers at all grade levels to “integrate and infuse” discussion of HIV and AIDS into lessons. Rather than dismiss the jargon and stick to teaching English, Barimbui resolved to find ways to bring the continuing health crisis to the classroom and beyond. She and others organized a club for students, who performed songs and skits with anti-AIDS themes in public places. A Methodist who had taught at a secondary school in a nearby district, Barimbui was in high demand to speak in area churches of her denomination.

Meanwhile, the disease was exacting a personal toll. Two members of her department died, presumably of AIDS, although no no one said so. Then the woman who ran the school store confided in Barimbui: She was sick; her husband had died with the same ailment; it was witchcraft. In other Kenyan social circles, the cause might be ascribed to sin, AIDS-infected condoms, or even failing to eat enough fresh fish, while the cure might be having sex with a virgin.

Often, the woman came to Barimbui’s house and wanted to talk. “The greatest challenge of my life was how to handle that,” Barimbui recalls as the KNUT van rattles over the red-dirt hills, past a lushness of banana and mango trees, of coffee bushes and emerald-green tea seedlings. The book she is reading, Morality for Beautiful Girls, lays unminded on the seat beside her. Later, she will devour a book on personal time management.

The deaths magnified Barimbui’s thoughts on what needed to be done: prevention education and counseling, support for infected students and staff, an end to the secrecy and the shame.

She merely glimpsed those changes three years ago, when her energy led Joe Davis, the AFT’s point person for Africa, to suggest that she be invited to join a group of otherwise all-male KNUT leaders and government officials studying anti-AIDS efforts in the United States.

Now, as part of the national project that Barimbui coordinates, former colleagues at the college have organized a half-dozen study circles among staff and students.

In one such circle for college staff on this particular warm January afternoon, 10 women and six men are talking about which bodily fluids can transmit the immunodeficiency virus and which bodily orifices lend themselves to transmission. In a society where the worlds of the sexes are more sharply delineated than in the United States, and the value put on sexual modesty is reflected in the long skirts that most women wear, it’s not an everyday discussion.

“What about deep kissing?” asks Paul Kirema, the veteran science teacher or “tutor” who is leading today’s session. He coaches the group to consider whether the word “saliva” should be moved from the “definitely infectious” to the “possibly infectious” column, both created by means of handwritten signs taped to the pale-yellow wall.

“Pre-ejaculate” has already been moved the other way—from “possibly” to “definitely infectious.” The word, defined in a businesslike way by Kirema as “the clear liquid that forms on the tip of a man’s penis before ejaculation,” eventually settles in the “possibly” column. “Saliva” is moved again to “not infectious.”

Kirema notes that it is easier for women to get infected during condomless sexual intercourse than for men, a point not lost on a group that knows women now make up a majority of those infected in Kenya and elsewhere in sub-Saharan Africa.

In another study circle across the way, Joe Davis recalls later, the discussion centers on the sexual expectations men have of women. Wives should be sexually passive, though available anytime, according to the men. Prostitutes, on the other hand, ideally initiate sex and show pleasure, some of the men believe.

A wife who is uninterested in sex, the reasoning goes, will not seek pleasure outside the marriage, a threat that many African tribal groups have addressed by cutting female genitalia. That practice is slowly waning in the face of government and aid-donor opposition, though it is estimated that about half of local women, members of the Meru and Embu tribes, have undergone the procedure.

For reasons like those, many experts and the KNUT training manual argue that the pandemic cannot be arrested without a shift in power relations between the sexes, with women gaining new control over their lives.

Evidence suggests that teachers, though likely better informed on the subject of AIDS than the average Kenyan, do not in any way escape those patterns. Preliminary data from a recent survey conducted by the Washington-based Population Council and the Population Studies and Research Institute of the University of Nairobi show that of the more than 1,200 teachers answering a questionnaire, about 45 percent of the women and a little more than half the men disapproved of a married woman’s suggesting condom use.

Nor are teachers free of the fears or prejudices surrounding the disease, according to the survey results. More than 60 percent reported they were “very concerned” about being infected with HIV at work, and a third said they were “very afraid” of people who are infected. Four out of five teachers surveyed believed that their jobs might not be safe if school managers knew they had tested positive for the AIDS virus.

A few days after the trip to the teachers’ college, Barimbui stops at Nkubu Primary School in the small town of that name south of Meru. The school, built by Roman Catholic missionaries, boasts a pillared portico and concrete lions at its entrance, though it is laid out along the same utterly simple lines and constructed of the same roughly mortared local stone as other public schools in the district.

Headmaster Bartholomew Njogu, a tall, serious man in spectacles, says that, for the most part, he does not know which children in his school are infected. Susan Kagwiria, the teacher who voluntarily functions as a counselor for many of the children affected by AIDS, keeps that information to herself for fear a child will be stigmatized. Disclosure of a student’s HIV status, according to the policy recently approved by national education officials, is to be based on the best interests of the child.

Nonetheless, one boy is known to the headmaster because of the sores on his face. The visitors agree not to single out the orphan, but, somehow, with the buzz in the school about their interest in AIDS, other children laugh at him. The boy, who is about 11, begins crying. He is led to the staff room, where teachers huddle around him. So much for confidentiality, Barimbui recalls thinking in those moments.

When she arrives back in the headmaster’s office, she is visibly agitated. “You must excuse my feelings,” she blurts. “It’s the handling of orphans.”

Barimbui is, in one sense, all too aware of what she herself doesn’t know. She has completed two counseling courses in Nairobi, but she thirsts for more. A standard reference book for therapists, the Diagnostic and Statistical Manual of Mental Disorders, is hard to come by. The library at Egoji Teacher Training College, for instance, does not have one.

Indeed, the library there has few materials on AIDS. Barimbui’s husband, a secondary science teacher who lost a brother to the disease, has coached her on HIV biology, concerned she might suffer embarrassment with high-level officials.

Barimbui is among many teachers who hope for more knowledge of the field. Kagwiria, for example, who teaches the 7th grade at Nkubu Primary and has qualified as a master trainer for the KNUT’s study-circle program, has completed a diploma in HIV management. But she wants a graduate degree in psychology. It would help in her volunteer work as a counselor.

On weekends and after school, Kagwiria goes to children’s homes, where her first mission can be to persuade an often fearful and hard-pressed guardian to allow a child to be tested for the virus. If a child tests positive, the teacher urges drug treatment, which she then helps get and monitor.

The day after the incident that upset Barimbui, the cheery Kagwiria, in a bright-red sweater and a pleated skirt, is visiting one of the students whose treatment she monitors, a 16-year-old boy who has lost his mother to AIDS. He sits as still as a rabbit in his aunt’s low-ceilinged room, his smooth face expressionless as Kagwiria questions him:

“When do you take the medicine, before or after eating?”

“Before eating.”

“You should be taking it after eating,” she reminds him, “with lots of fluids.”

But that’s not the only problem. He has run out of the drugs, though it is two days till his next appointment at the hospital.

Later, she worries that the teenager could be infecting others. After all, he is 16.

That same day, Barimbui visits Raiji, the Kenepote leader. To get to his small peacock-blue, metal-sheathed house, visitors must tromp up a track too muddy for the van, alongside garden plots of corn, past his parents’ own small house. Raiji says his mother and father know of his illness, but they have never mentioned it.

The walk is less than a tenth of Raiji’s hike to Kiangua Secondary School, even on the days when he can pick up a jitney—a matatu—for part of the journey. Then he spends an hour and a half on foot each way.

Sometimes, Raiji says, he feels dizzy. But he is not taking antiviral drugs. They cost 3,500 Kenyan shillings a month, and his salary is 10,000 in the same period.

The teacher is walking with the visitors back toward the van when his wife, Joy—“my Joy,” he says when introducing her—calls to Barimbui. They talk in the askew doorway, under a philodendron vine carefully trained over a few nails.

“My wife needs counseling, and there is none around here,” Raiji explains. “All she gets is from me.”

When Barimbui climbs into the van later, toting a big sack of dried beans given to her by Raiji’s wife, she says the young woman is concerned about her husband’s temporary job status. More than that, communication between wife and husband is faltering.

There is weariness—and a grim determination—in Barimbui’s voice as she recounts the conversation.

Not like the day she meets the teachers in the Chuka cafe. That afternoon, at their request, she closes the gathering with a prayer—of petition, of thanks for fellowship.

Afterward, in a reflective mood, she waits as men repair a flat tire on the van, and other men with nothing better to do watch. When she speaks, she looks past the milling figures, past an unfinished building adorned with two concrete tusks.

“Don’t you think,” she murmurs, “it’s a very bad thing to have happened to mankind?”