Sister Mary

Last week, we had the privilege of meeting with Sister Mary, who since Father D’Agostino’s death last year has taken over as the director of Nyumbani.

I have been told that I missed out by not getting to meet the founder of Nyumbani, Father D’Agostino, but I considered myself lucky for getting to meet Sister Mary. I was so impressed by her poise, dedication, vast knowledge and enormous compassion for others.


Sister Mary came to Kenya in 1969 from Ireland as a missionary from the Institute of the Blessed Virgin Mary, popularly known as the Loreto Sisters. After arriving in Kenya, she served as the principal of one of the country’s public schools before undergoing training as a psychologist. Once she became accredited with the British Association for Counseling and Psychotherapy, she partnered with Father D’Agostino, who at the time was a psychiatrist and Jesuit priest in Kenya.

Together, they founded Nyumbani in 1992, which was the first hospice center for HIV-positive children in Kenya. In those days, the children who came to Nyumbani would only live to about 10 years old so the approach was mainly palliative care. Father D’Agnostino and Sister Mary organized special occasions for the children such as an airplane tour around Nairobi and a visit to Masai Mara because they wanted to give the children extraordinary treats.

But now Nyumbani’s approach is very different because of the arrival of antiretroviral drugs. Thankfully with these drugs, there’s no known limit to a HIV-positive child’s lifespan.

Nyumbani began administering antiretroviral drugs (ARVs) in 1999 to one girl, and in 2000, more children were put on the drugs. But at the time, the drugs were incredibly expensive and Nyumbani relied on private donors to fund the much-needed drugs. In 2005, the President’s Emergency Plan for AIDS Relief (PEPFAR), which President Bush started, began supplying ARVs to Nyumbani for free, which has allowed for even more children to go on the drugs.

Sister Mary said the Nyumbani staff had to have an attitude change in order to properly care for these children who were now on life-saving drugs. Instead of looking at them as terminally ill or sick children, they had to look at them as children who have a life and can dream into the future.

But in order to have a future, the children needed education and getting that message across to the children was difficult and at times continues to be difficult. The children had this idea embedded in their minds that they weren’t going to live long so why bother studying hard or having high goals to reach. Therefore, Nyumbani’s main focus became education because in every country in the world—particularly a developing country—education is the gateway to self-reliance.

Sister Mary explained to the children earlier this year that Nyumbani—like any parent—can feed them, clothe them, provide shelter for them, look after them medically, and send them to school. But Nyumbani cannot learn for them. Only they can do that.

Currently, Nyumbani has 78 children enrolled in primary school, 9 enrolled in high school, and 1 enrolled in college and living independently on his own.

Unfortunately, the Nyumbani children still face a lot of discrimination. In the developing world and particularly Kenya, there is a strong taboo around sex. And since HIV is linked with sex here, there is a large stigma surrounding HIV. As a result of the stigma and discrimination, HIV-positive individuals carry an enormous amount of shame—so much so that parents often times will not bring their children to get tested for fear of a positive result. According to Sister Mary, most of the deaths in Nyumbani’s community-outreach Lea Toto program are newly enrolled children because their mothers brought them too late because they were too ashamed to come forward earlier. A child is just too malnourished or their CD4 count is too low and there’s nothing more the Nyumbani staff can do.

I told Sister Mary I was keeping a blog during my visit in Kenya, and I asked her what would be her message for the people back in the states reading my blog.


Her first message was that HIV is simply a medical condition, like diabetes or epilepsy or some orthopedic challenge. That’s it. It’s simply a medical challenge. It is her hope (and mine) that people can become more educated about HIV and realize that HIV-positive individuals are just like any other human beings. That way, the stigmas surrounding HIV/AIDS and the discrimination HIV-positive people face can be greatly reduced or even eliminated.

Her second message was to encourage others to have compassion for the orphans of our world. But not a compassion that just simply feels bad for these orphans but a compassion that is practical such as donations or adoptions. In Kenya alone, there are 1.6 million orphans, and by 2010 there is expected to be 30 million orphans in sub-Sahara Africa.

As we were finishing up our conversation, Sister Mary told me a story about a girl in Ethiopia who after fainting in school recently, told the teacher “I’m sorry I fainted. It wasn’t my day to eat.”

I haven’t been able to forget that story or get those words “It wasn’t my day to eat” out of mind. I don’t understand how we live in a world that allows a child to only eat every other day. I don’t understand how we can all sit comfortably in our homes and know that there are situations like that in our world. I don’t understand how we can watch the six o’clock news tell us about the Darfur genocide, the millions of children starving in the developing world, and the horrific effects of the HIV pandemic and go back to eating our dinner.

Giving to Nyumbani

If you’d like more information about Nyumbani you can visit their website at http://www.nyumbani.org

If you’d like to contact Nyumbani, you can email them at info@nyumbani.org or angelo@nyumbani.org or call them at (254-20) 882429 or (254-20) 883731. To contact someone in the U.S., call (202) 342-8488.

If you’d like to make a contribution to Nyumbani, you can send a check or a donation to Children of God Relief Institute
P.O. Box 24970-00502 Nairobi, Kenya

Tax-deductible donations in the form of checks or money orders should be sent to:

Children of God Relief Fund, Inc.
c/o Kelley Drye Collier Shannon
3050 K Street, N.W., Suite 400
Washington, DC 20007-5108
USA

If you would like to make a tax deductible donation to Nyumbani with a credit card (Visa, Master Card, and American Express), use their secure server by following this link; https://app.etapestry.com/hosted/ChildrenofGodReliefFund/OnlineDonation.html

You can also support the Nyumbani children through the Combined Federal Campaign of the National Capital Area by designating #47471 on your CFC pledge form (www.cfcnca.org).

You can find Nyumbani’s wish lists for the Children’s Home, the Laboratory, the Lea Toto program and the Nyumbani village at http://www.nyumbani.org/help_donate.htm

It All Started With Father D’Ag

I’ve been writing about Nyumbani for over a month now and have hardly mentioned the man who is responsible for creating all of Nyumbani, the first orphanage and hospice center for HIV-positive abandoned children in Kenya. And that man is Father Angelo D’Agostino.

Father D’Agostino (or Father D’Ag as many like to call him) was a physician, psychiatrist and Jesuit priest who fought tirelessly for HIV-positive children in Kenya. He died on November 20, 2006, of cardiac arrest following surgery after he was hospitalized for abdominal pain from diverticulitis.

Standing at about 5 feet tall, Father D’Ag (shown in several pictures below) was a fearless defender for “his” kids. What he lacked in height, he made up for in persistence, compassion and dedication.


He practiced and taught psychiatry in Washington during the 1970s and 1980s before getting called to Kenya. He witnessed first-hand the needs of HIV-positive abandoned children while serving on the board of governors for a large orphanage in Nairobi in 1991. When the orphanage began receiving large numbers of HIV-positive children, Father D’Ag suggested setting up a facility for them so they would have the needed medical infrastructure to care for them. The board refused, so Father D’Ag at 66 years old said “I’ll do it”.

On September 8, 1992, the doors opened at Nyumbani with three HIV-positive children.

But the challenges weren’t over. It was difficult to raise the needed funds to get off the ground because the general response he received was “they’re going to die anyway so why bother”. But that wasn’t Father D’Ag’s vision or his approach to life. He believed that a human life is precious even if they did die early and when life is there, it’s a life to be treasured.

In the early years of Nyumbani’s existence, the facility was very much a hospice center because the children had no access to antiretroviral drugs. But Father D’Ag, an American who knew how easy it was to get antiretroviral drugs back in his homeland, decided his children didn’t deserve to die anymore just because of national regulations and international drug patents. It wasn’t fair that the drugs had not been made available to the continent where they were most needed. So Father D’Ag decided to do something about it. In 2001, Nyumbani became the first place in Africa to import deeply discounted antiretroviral drugs under an Indian pharmaceutical company’s program to make the drugs more affordable.

I’ve been told by many people who knew him here in Kenya that he was someone you just couldn’t say no to because the things he asked of you were the things that would keep you awake at night if you said no—giving a dying child their last wish, putting a child on antiretroviral drugs, or giving a child enough to eat.


I’ve also been told he would back down to no one and when someone told him they wouldn’t help his children, he would not take no as an answer whether that be a U.S. congressman, wealthy international donors or even the Kenyan government. In 2004, he sued the Kenyan government for their policy on banning HIV-positive children from the free primary education system. After bringing all of “his” children to court in order to put a face with the children who were being denied an education, he won the suit allowing for more than 100,000 children throughout Kenya to finally be able to go to school.


The Jesuit priest also created one of the most advanced blood diagnostic laboratories in Kenya at Nyumbani so his children’s health could be monitored. Children with HIV need routine checkups so their CD4 count and viral loads can be taken. A child’s specific dose of antiretroviral drugs changes frequently during their childhood years because the drug make-up is based on their height and weight.

In addition to the orphanage which houses around 100 children at one time, Father D’Ag created in 1998 the Lea Toto program, which is a community-outreach program that provides services to HIV-positive children and their families in several of Kenya’s largest slums. Unable to cope with the increasing number of referrals for admission to his orphanage, he realized how great the need was for proper medical care for children with HIV in these slums. Today, about 2,000 HIV-positive children are enrolled in the Lea Toto program, which provides testing, counseling, nutritional support, antiretroviral drugs, medical care and proper training for caregivers.


And seven months before Father D’Ag died at 80 years old, he opened the Nyumbani Village, which is a self-sustaining community to serve the orphans and elderly left behind by the “lost generation” of the AIDS pandemic.

Aren’t impressed yet?

Father D’Ag, one of six children born to Italian immigrants in Providence, RI, received his undergraduate degree in chemistry and philosophy from St. Michael’s College in 1945, his medical degree from Tufts University in 1949, and a master of science degree in surgery from Tufts in 1953.

He served in the Air Force as chief of urology at Bolling Air Force Base from 1953 to 1955. He completed a psychiatric residency at Georgetown from 1959 to 1965 and received more extensive training at the Washington Psychoanalytic Institute from 1962 to 1967.

Father D’Ag decided to enter the priesthood in 1954 and was later ordained in 1966. He taught psychiatry at Georgetown University and George Washington University and from 1983 to 1987 he worked in his private practice in the nation’s capital. Combining his two passions he founded the Center for Religion and Psychiatry at the Washington Theological Union.

Before permanently moving to Kenya, he helped manage refugee camps in Thailand and East Africa in the 1980s. But it was Kenya’s HIV-positive children that he was called to spend the rest of his life fighting for.


Susan Gold, the Fulbright scholar at Nyumbani who I’ve come to know very well, told me she feels sorry for people who didn’t get a chance to meet Father D’Ag.

I certainly wish I had.

"When A Crocodile Eats The Sun"

I found this memoir a few weeks ago and decided to share it with you all. Not only is the writing beautiful, but it speaks the truth. The children that I've seen at Nyumbani Children's Home and in Kibera do live in constant proximity to death every day. The younger children don't necessarily understand what they have or why they're sick, but they do understand death. They understand that their friend who was with them last week, is now buried under the ground. But the older children understand the disease. They understand that unless they take their antiretroviral drugs every day, there's a big chance they will die some day. They understand that their parents and possibly their siblings died as a result of this virus and they could be next. So you can understand why maintaining the illusion of control is difficult in a world where children don't know if they'll have a tomorrow. They don't know if they'll have a future.

Would you feel in control of if you didn't know you were going to have a tomorrow or if you didn't have a future?

"I feel too that the gap between my new life in NY and the situation at home in Africa is stretching into a gulf, as Zimbabwe spirals downward into a violent dictatorship. My head bulges with the effort to contain both worlds. When I am back in NY Africa immediately seems fantastical, a wildly plumaged bird as exotic as it is unlikely.
Most of us struggle in life to maintain the illusion of control, but in Africa that illusion is almost impossible to maintain. I always have the sense that there is no equilibrium, that everything perpetually teeters on the brink of some dramatic change, that society constantly stands poised for some spasm, some tsunami in which you can do nothing but hope to bob up to the surface and not be sucked out into a dark and hungry sea. The origin of my permanent sense of unease, my general foreboding, is probably the fact that I have lived through just such change, such a sudden and violent upending of value systems.
In my part of Africa, death is never far away. With most Zimbabweans dying in their early thirties now, mortality has a seat at every table. The urgent, tugging winds themselves seem to whisper the message memento mori, you too shall die. In Africa, you do not view death from the auditorium of life, as a spectator, but from the edge of the stage, waiting only for your cue. You feel perishable, temporary, transient. You feel mortal.
Maybe that is why you seem to live more vividly in Africa. The drama of life there is amplified by its constant proximity to death. That’s what infuses it with tension. It is the essence of its tragedy too. People love harder there. Love is the way that life forgets that it is terminal. Love is life’s alibi in the face of death.
For me the illusion of control is much easier to maintain in England or in America. In this temperate world, I feel more secure, as if change will only happen incrementally, in manageable, finely calibrated, bite size portions. There is a sense of continuity threaded through it all: the anchor of history, the tangible presence of antiquity, of buildings, of institutions. You live in the expectation of reaching old age.
At least you used to."

When A Crocodile Eats The Sun
A Memoir of Africa

Peter Godwin

Ignorance Ignorance Ignorance

On Friday, Michael and I went to the Nyumbani Children’s Home at noon and rode the school bus to two public primary schools in Karen, which is a suburb of Nairobi. The Nyumbani staff brings lunch to the older children who stay for a full-day and pick up the children who only stay for a half-day.

First, we visited St. Mary’s Karen Primary School that had murals covering the outside walls of their school buildings. One read “AIDS KILLS PEOPLE DEAD”. Another read “Avoid Pornography”. And another read “DON’T HAVE SEX WITH A STRANGER.


Next, we visited Karen C Primary School. Painted in red, stripped across the main school building in big capital letters reads, “AIDS HAS NO CURE! AIDS KILLS!”


My jaw literally dropped. I couldn’t believe it. At a primary school where children as young as seven years old are going to school lies the definition of discrimination. A school is supposed to be a place for educating and for the truth. I’ve always thought that ignorance breeds from not being educated. I never thought that a school would breed ignorance.

I couldn’t believe that these children from Nyumbani who are HIV positive go to school everyday with “AIDS HAS NO CURE! AIDS KILLS!” greeting them. It’s horrible. It’s unfair. It’s ignorant. It’s disturbing.

These children have already faced so much stigma and discrimination in the Kenya school system. Before 2004, HIV positive children were not admitted to any public school and most private schools in Kenya. The Nyumbani children all went to an expensive private school in Karen that fortunately enrolled them. When President Kibaki came into power in 2003 in Kenya, primary school became free. However, public schools were still refusing to accept not only Nyumbani children but also all HIV positive children saying they “simply didn’t have any vacancies”. The founder and former director of Nyumbani, Father Angelo D’Agostino decided enough was enough and sued the Kenyan government for their policy on banning HIV positive children from the education system. Father D’Agostino won the case in 2004, which allowed for more than 100,000 children to finally be able to go to school.

But still almost four years later, the children still face an enormous stigma against them.

While AIDS does not have a cure, it doesn’t necessarily always kill anymore. Thanks to antiretroviral drugs, HIV positive individuals can live long, healthy and normal lives. Antiretrovirals (ARVs) are the drugs used to treat HIV/AIDS. They work by stopping HIV from replicating in the CD4 cells, which are the cells that are responsible for helping the body to fight off infections. ARVs reduce the amount of the virus in a patient’s bloodstream, allowing the CD4 cells to be replenished and restores immune function. ARVs have significantly cut down the AIDS death rates in many countries and has dramatically enhanced the quality of life for those lucky enough to be on these life-saving drugs.

Most of the Nyumbani children are on ARVs and therefore will live long healthy lives. But unfortunately until our world can become more accepting, they will still face enormous discrimination and in the immediate future they will still read “AIDS HAS NO CURE! AIDS KILLS!” everyday.

Plumpynut

Not sure if everyone has heard about Plumpynut yet but I thought it deserved a blog post. My mother sent me this CBS News article last week and I was fascinated. CNN’s Anderson Cooper first reported this on 60 Minutes.

What is Plumpynut? Well, it might just be the thing that saves the millions of children suffering from malnutrition across the world. Created by Doctors Without Borders, Plumpynut is a cheap, ready-to-eat, vitamin-enriched creation.

Malnutrition kills five million children annually, which is one child every six seconds. And malnutrition is most seen throughout the developing world. Children are deprived of the necessary vitamins and minerals because their parents are too poor to purchase milk and nutritious food. And people living on less than $1 a day can’t afford electricity and thus they can’t store anything because there is no refrigeration—not to mention no access to clean water.

However, Plumpynut can get around those hurdles.

Plumpynut is made of peanut butter, powdered milk, powdered sugar, and lots of vitamins and minerals. And the best part—kids love it because it’s sweet and takes like peanut butter.

This life-saving concoction doesn’t need water, cooking or refrigeration. It simply needs to be squeezed out of its container and given to a severe malnourished child. Each serving of Plumpynut is the equivalent of a glass of milk and a multivitamin. And Plumpynut works pretty fast. A severely malnourished child that looks like they are on the brink of death can be cured in about three weeks.

Unfortunately, malnutrition and HIV usually run hand in hand. Malnutrition worsens a child’s HIV while at the same time a child’s HIV worsens their malnutrition. Nutrition is so critical for a child that is HIV positive but for millions of children in the developing world, it’s something that is unattainable or something that comes too late. You see when a child reaches a certain point in their malnutrition, it’s hard to turn back. Even if a child is getting nutritious food, there comes a point where a child will lose the ability to digest food properly because it’s just too late. However, Plumpynut might be the thing that gives these children a second chance.

It could have been the thing that gave Ken or Margaret a second chance.

Ken was abandoned by his family last year in Nairobi’s Kenyatta National Hospital. Ken was not only HIV positive but severely malnourished—so malnourished that he wasn’t able to digest food properly. He was referred to Nyumbani and came to live there in January of this year. As much as the Nyumbani staff did everything possible to rehabilitate him—antiretroviral drugs, nutritious food, love and support—his system had just been too compromised. The effect over the years of malnourishment combined with his HIV positive status killed him. At 12 years old, he was 23 pounds when he died this past September.

Margaret came to Nyumbani sadly to die. She was 11 years old and only weighed 25 pounds. Both of her parents died after battling AIDS, and Margaret was left to be cared for by her two aunts. She lived with one of her aunts and spent the days with her other aunt. The aunt she lived with abused her. While the aunt she spent the days with didn’t abuse her, her uncle would not allow her to live in his house. Since neither of her aunts would commit to administering the antiretroviral drugs for Margaret, she could not go on the life-saving drugs. She came to Nyumbani abused, broken, near death and severely malnourished. Susan Gold, the woman who is a Fulbright scholar at Nyumbani, told me it was difficult for her to find a place on Margaret’s body where an injection could go in because she was mostly just skin and bones. The night before Margaret died, she looked at Susan and said “Everyone has left me”. And that was the last words she ever spoke. She died the next day.

Susan said she was so angry when Margaret died because Margaret's last words had so much truth to them.

“It’s like she's right. Her family left her, her country left her, and the world left her. Everyone left her and she’s an 11 year-old child! I will never understand that—how a world, a country and families will do that to a child. Where is President Kibaki and why is he not saying we don’t do that to our children, we take care of our own, this is not allowed, there is no reason for it. And it’s being done everyday and I will never understand that,” Susan said.

We’ll never know for sure but Plumpynut could have helped Ken and Margaret. Maybe not indefinitely but it may have given them another week, another month or another year.

Sister Mary, the director of Nyumbani, said she recently signed an agreement with Concern International, a non-governmental organization that aims to reduce poverty in the world’s poorest countries. Now, Nyumbani will have access to Plumpynut. Hopefully, it will benefit the many malnourished children the Nyumbani staff come into contact with in their many community-outreach programs in places like Kibera, the second largest slum in Africa.

Doctors Without Borders is asking for more of this type of food so they can save more children's lives. If the U.S. and the EU would spend some of their food aid on this, more companies would start making Plumpynut allowing more children to have access to this life-saving concoction.

To read more about Plumpynut, go to http://www.cbsnews.com/stories/2007/10/19/60minutes/main3386661_page3.shtml

Barbed Wire Fence Is Not Something You Want to Be Pushed Up Against

Since The Nation is hosting me while I’m here in Kenya and giving me a place to work, I’ve spent the last few days working from there. Yesterday (Thursday) I worked until 5 PM and Michael met me outside of The Nation’s building. We’ve been mostly taking city buses and matatus because we can’t afford to take cabs everywhere we need to go all the time. So we walked to the place where we catch the bus back to our apartment. Since it was 5 PM, everyone was on the streets trying to go home. It was insane how many people were maneuvering on the sidewalks to find their matatu or city bus number. Our bus is #46. The first couple 46 buses we came to were full so we started walking down the street towards oncoming traffic with the rest of the crowd searching for an empty bus. We were in a bit of a hurry because we were chasing the sun and had to be home before the sun set. It's not safe for us to be walking outside in the dark.

After some time, we came upon a 46 bus that had some open seats. There were about 10 people in front of us waiting to get on the bus. But since this wasn’t technically a place you get on the bus (traffic just wasn’t moving so conductors were allowing people to get onboard), a policeman made the bus driver move the bus up since traffic had started moving. So instead of turning around and calmly walking the few steps needed to catch up with the bus, the 10 people in front of us trampled me.

Not more than 10 minutes before this, I had taken my backpack off my pack and moved it to my front because since we were in such a huge crowd of people, I didn’t want to take a chance on someone unzipping my backpack without me knowing and stealing something. But if I had known I was going to be pushed into barbed wire, I would have kept my backpack on my back for protection!

As those 10 people were running towards the bus, they pushed me back into the barbed wire fence that conveniently lined the side of the road. The barbed wire tore into my back. I started screaming but it was no use. I continued to be smashed into the barbed wire. Finally once they all made it to the bus, I was released. I totally freaked out, primarily because of the instant extreme pain I was in but also because it was so frightening. I reached to my back and felt a tear in my shirt.

And I didn’t have to see the blood to know that my back was bleeding. I could feel the wetness on my back from the blood trickling down my skin. At that moment, the only place I really wanted to go was home (and not our apartment in Nairobi home but USA home). But I didn’t have that option.

We jumped into a cab and tried to get back to our apartment as quickly as possible but of course traffic was horrible. The stinging on my back and the pain wouldn’t stop. I was so unbelievably angry at those 10 people who trampled me, who heard me screaming, who saw my face, and who couldn’t be bothered to make sure I was okay because they would rather not miss their bus.

Once we got into our apartment and I took off my shirt, I freaked out again at the site of my back. But Michael was nice enough to nurse me up: cleaned the cut, put Neosporin on it and poured me a glass of Coke.

And then to put the icing on the cake, our Internet didn’t work for the rest of the night.

I think I'm going to take cabs from now on when I'm leaving The Nation at rush hour.

Hopefully today will be a better day.