Sunday, February 18, 2007

Day 9: Long Trek Across the Pond

Saturday, February 17, 2007

I left Kigali on Friday morning and 31 hours later via Bujumbura, Jo'berg, Dakar, I made it to Washington, D.C. Re-entry was challenging as always as my kids were all vying for my undivided attention, and my body was crashing.

I'm so glad that so many people have enjoyed reading my blog. It was hard work trying to capture the key highlights from my experience. I will be adding my photographs later in the week and will keep responding to comments if you have any perspectives that you want to share.

Please feel free to email me directly at pzeitz@globalaidsalliance.org

Thursday, February 15, 2007

Day 8: Real Programs Boldly Enhancing the Lives of the Rwandan People

Day 8: Thursday, February 15, 2007

I must admit to you that I’m getting a bit of “blog fatigue”, but I’m hearing that there are some folks reading this. Please send comments and questions so that I know you are alive and interested out there!!

Tears are flowed spontaneously several times today as I’m continuing to read Dallaire’s day-by-day horrific account of the genocide, while simultaneously observing it’s persistent impact today. I feel like my soul is being sheared open in order to more fully feel the suffering which in turn is fueling the wellsprings of compassion and righteousness that drives all of energy to strive for global justice, now! I've also learned that some Rwandans don't like Dallaire's book, as they think he is just defending his failures and he really should have done more. One colleague recommended a book called Death, Despair, and Defiance published by African Rights. I'm trying to track that one down.

Today I had the great opportunity to visit the WE-ACTx programs in Kigali. WE-ACTx began working in Rwanda in early 2004 to provide HIV care to genocide rape survivors, in active partnership with the Rwandan government and five local NGO partners. They are working with 20 women’s association and focusing on empowering HIV-postive women and girls to take charge of their lives and become leaders in the fight against AIDS. For more detailed information check out http://www.we-actx.org/

WE-ACTx has three clinic sites in and around Kigali that has enrolled over 2000 people in HIV/AIDS care and support services, with nearly 1200 women and children on lifesaving anti-retroviral HIV/AIDS treatment. The largest We-ACTx site is called Icyuzuzo, which is supported by a community-based Widow’s Association headed by Judith Nukagakwaya. The clinic was bursting with women coming for HIV-testing, counseling, and their medications. I also observed a large group of 30 community-based mobilizers getting trained by WE-ACTx that support clients and identify new people that need services. This program is mainly supported by Keep A Child Alive (www.keepachildalive.org) which raises money directly from the public and directly supports fast-moving action on behalf of those in the most desperate need.

WE-ACTx has one of the strongest and most extensive psychological support programs for genocide survivors in Rwanda—although they believe that they are only reaching the tip of the iceberg. They have one clinical psychologist, 4 trauma counselors, and 6 family advocates who provide group and individual support and therapy to as many clients as possible. I was told that nearly all of the women enrolled in these programs are suffering from chronic post-traumatic stress disorder which results in bouts of depression, anxiety, and psychoses. Many of the women are experiencing ongoing sexual and physical abuse in dysfunctional relationships. I was told that many of the women reluctantly choose “co-habitation” relationships as they offer some benefits like shelter and food for their children, and the violence is something that comes with the package. This program urgently needs financial support, so please consider contributing if you can.

One of the staff members of WE-ACTx is a dynamic woman by the name of Felicite Rwemalika who is the Project Coordinator of the Rwandan Women Inter-Association Study & Assessment. It turns out that she is a famous lady who has introduced women’s soccer throughout the country. In 1998 she first brought the idea to the country and fought the cultural barriers for 2 years until she was allowed to start the first team. Now there is a National Women’s Football (soccer) Federation with 16 teams that compete around the nation. Felicite has found that football reduces stress, builds self-esteem, and gives women a new lease on life. Check out and consider supporting her Association of Kigali Women Footballers (AKWOF): http://www.globalgiving.com/pfil/1618/projdoc.doc

Finally, I had the opportunity to visit with the Professor Josh Ruxin who directs the Millenium Village – Rwanda Mayange Initiative: http://www.earthinstitute.columbia.edu/mvp/locations/mayange/index.html Keep your eye on this very exciting model for achieving the Millennium Development Goals. Hopefully this type of comprehensive development model will be replicated throughout Rwanda in the very near future.

I just came back from an amazing first-ever Rwandanese cuisine dinner with cassava bread, fried bananas, and fresh tilapia with my friend Joseph Hakizimana, Country Clinical Coordinator for WE-ACTx. Phew! I’m spent!

Day 8: Visit to Partners in Health-Rwanda/Inshuti Mu Buzima

Day 8: Wednesday, February 14, 2007

Kigali is an amazingly beautiful city of rolling hills with lots of housing and farming. It is the rainy season now, so each day usually begins as bright and sunny until the afternoon when it clouds up and then intense lightening-filled thunderstorms rage the sky. Following the rains there is a misty fog that brings in the dusk and fills the air with a sweet and refreshing smell.

My journey through exploring the Rwandan genocide continues. I’m halfway through Dallaire’s book, Shake Hands with the Devil….it is rattling my soul….and it is challenging my awareness and my thinking about life….I’m crying a lot too. I’ve learned more about the society is trying to cope with this relatively recent crisis. For example, they’ve removed history from the primary school curriculum, as they are developing a new curriculum that focuses on unity and reconciliation. After students complete high school, they attend a “solidarity” camp where they get intensive training and education on being a Rwandan first. Some people feel that the government is being too heavy handed in trying to eliminate the notion of tribal identity, rather than trying to say that it is ok that there are different tribes that can live happily together. If you ask someone what there tribe is they won’t answer, except by saying that they are Rwandan. This seems smart to me!

I left Kigali and traveled for about two hours west towards Tanzania on well-paved road to visit Rwinkwavu Hospital which is being rehabilitated by the amazing Dr. Paul Farmer (also a GAA Board member) and his team from Partners in Health (PIH) or Inshuti Mu Buzima (in the Rwandan national language of Kinyarwanda). On our way out of town, we stopped at the airport to pick up a medical student from Boston who was coming to do a rotation. I was pleasantly surprised to meet Vanessa Kerry, the daughter of Senator John Kerry. We had a great chat and I was left incredibly impressed by her intellect, commitment, and passion for global health justice…I have the sense that she is becoming an important leader in our movement.

PIH began operating in Rhinkwavu Hospital and it’s 6 referring health centers in May of 2005. The Ministry of Health assigned them the two most underserved districts in the whole country. Here is a link to get all the details: http://www.pih.org/where/Rwanda/Rwanda.html. It was amazing to learn that in such a short time, PIH has trained over 700 paid community based accompagnateurs (community health workers) who are supporting over 2000 people (including nearly 200 children under 15 months of age) on lifesaving antiretroviral medicines with an adherence rate of over 95%. In classic PIH fashion, a new gold standard of comprehensive health services is steadily being developed to support the nearly 400,000 people in these districts. Already, some of the groundbreaking training approaches and electronic medical records systems are being picked up by the Ministry of Health for national replication. The excellent financial support from the Global Fund to Fight AIDS, TB, & Malaria, UNICEF, and the Clinton HIV/AIDS Initiative is making this possible.

PIH is supporting HIV/AIDS patients by giving them food and nutritional support and job opportunities. They are empowering people to earn a wage by becoming artists, welders, seamstresses, and furniture makers in nearby buildings. One of the major challenges that PIH is facing is the lack of well-trained health care workers. They have recruited and supported some great Rwandan nurses and doctors, but they also have a steady group of expatriates supporting is important program such Dr. Sara Stulac, Melissa, Christian and others. Being committed to finding structural solutions to problems, PIH was recently awarded a small grant from the Bill and Melinda Gates Foundation to construct a new national health worker training center on the hill above Rhinkwavu--scheduled to open later this year. Soon health workers across Rwanda will be able to access world class training.

The powerful hand-to-hand partnerships between the Rwandans and PIH is one of the most powerful demonstrations that I’ve ever seen of the how the African Renaissance is actually underway! and in our time!! now if only we can help it to succeed!!!

Just a short walk from the hospital is a local genocide memorial, which are apparently found commonly throughout the country. There is a small blue and white steel and tall fenced in area that has a small memorial wall in front of a large concrete slab...which means that this was another burial site for thousands. As I stood there, I closed my eyes and tried to absorb the paradox of two realities that humans can create in this one physical place. Just 13 years ago this was a senseless killing field and today it is a vortex of hope in a sea of illness and poverty. I pray that we will all wake up and together make "hope" a new permanent reality.

Happy Valentine's Day to my dear wife who supports me so completely on my journeying!

Day 7: The Friends-Africa Board is Serious

Day 7: Tuesday, February 13, 2007

As a member of the Advisory Board of Friends-Africa, I was able to observe the formal proceedings of the inaugural meeting of the Board of Directors. First Lady Kagame, Former President of Nigeria Gowon, Archbishop of Capetown The Most Rvd Njongonkulu W.H. Ndungane, the former Nigerian Finance Minister Her Excellency Ngozi Okonjo-Iweala, amongst others were very serious and committed to ensuring that Friends-Africa will succeed.

As part of the final session of the meeting, I was on a panel that discussed “Financing for Development, Sustainability and Making the Money Work,” with several other African/Africanist colleagues. It felt good to share my perspectives on the fact that we were actually living the African Renaissance, the critical role of civil society in calling for bolder, smarter, and faster action in the spirit of creating a new world order based on justice, and the opportunities we have to work together in solidarity.

It was an amazing meeting where I networked and learned from dynamic African leaders from grassroots groups, people living with HIV/AIDS groups, governments, and the private sector. I feel that Friends Africa has a unique opportunity to have a big impact. I’m committed to doing whatever I can to support this important effort.

Tuesday, February 13, 2007

Day 6: Friends Africa Inauguration: Pomp, Circumstance, and Substance

Day 6: Monday, February 12, 2007

Today was the ceremonial inauguration of the Board of Directors of a new organization called Friends of the Global Fund in Africa. The theme of the day was,”Africans Taking Responsibility and Ensuring Results.” This was a day full of pomp and circumstance in modern African tradition. Over 200 people, including many dignitaries attended the opening session. The entire leadership of the Rwandan government attended the morning session, which required each speaker to address the list of those present, including Mr. President, Madame First Lady, General Gowon-Former President of Nigeria, Mr. Prime Minister, Mr. Chief Justice…etc, etc the list would go on (and on). Each speaker who then begin their speech by saying, “All protocols are observed.” It was an amazing amount of formality...…obviously, this is not my typical way of spending a Monday morning. Here’s a link to the details of the agenda: www.friends-africa.org

The morning culminated with a great speech by President Paul Kagame. In a quiet steady voice he explained his commitment to the battles against HIV/AIDS, TB & Malaria and he proudly described the efforts of his government to improve the health of the Rwandan people. He is known as the Napolean of Africa since he was the victorious general who liberated Rwanda from the genocide perpetrators. In his speech, Kagame called for a culture change focused on community ownership, the need to build health systems and infrastructure, and capacity building to deal with these crises and also the other health needs of the population. He described his commitment to creating Rwanda as a “knowledge” country. [PLEASE READ COMMENTS TO GET PERSPECTIVES ON KAGAME'S ROLE IN THE GENOCIDE]

At the first coffee break, I had the immense opportunity to meet and talk directly with President Kagame and First Lady Janet Kagame. They are amazing leaders. Mrs. Kagame has a strong personal interest in responding to the crisis facing orphans and vulnerable children. Just last week, she launched a public campaign to combat child sexual abuse. I shared information on GAA’s Zero Tolerance campaign(http://www.globalaidsalliance.org/GAA_Violence_Against_Women_Advocacy_Brief.cfm) and we talked about ways of collaborating. In my brief discussion with President Kagame, I shared information on the new U.S democratic Congress. His laser beam eyes seem eager to absorb any tidbit of information and perspective.

In the afternoon, the Board of Directors and the Advisory Board (of which I am a member) went on a site visit to a nearby health center. The physicians and staff of the center were incredibly impressive. They have about 5000 people on lifesaving antiretrovirals, including about 500 children. A recent survey showed that 93% percent of their patients were adherent with their medications. They have an intensive community buddy system that monitors all patients, nutritional support, and comprehensive health services, including family planning. I also learned that Rwanda has about 30,000 people on treatment, which is approximately 65% coverage of those in medical need, which is an amazing affirmation of what is possible.

Then I attended the inaguaral meeting of the Advisory Board. It turned out to be an intense and productive discussion. This meeting was followed by an Awards dinner which honored the personal accomplishment of Rev. Gideon Byamugisha. Rev Gideon is a reknown a HIV+ Anglican priest from Uganda who was the first religious leader to step forward by breaking the silence to reduce stigma and advocate aggressively for evidence based prevention, including condoms. (http://www.anglican.ca/news/news.php?newsItem=2002-11-29_xx.news) He recently formed a global organization that organizes 1900 hundred HIV+ religious leaders from 15 countries…. He is truly breaking the silence and galvanizing change across the continent. He ended is galvanizing speech with an affirmation of, “WWW: We Will Win!”

Sunday, February 11, 2007

Day 5: Facing the Rwandan Genocide

Day 5: Sunday, February 11, 2007

I woke this morning with a pounding headache. After grabbing a quick breakfast, I felt better, and I spent the rest of the morning continuing to read Dallaire’s account of the Rwandan genocide. Several times I had to put the book down and close my eyes as I felt like I could hear the screams of despair of all those who were murdered and all those who were left behind. I’ve done some meditating and praying to manage all of my emotions.

Many of the Rwandans that I've met so far returned home to Rwanda after the genocide from exile in neighboring countries such as Burundi, Uganda, Democratic Republic of the Congo, etc. I've met a few people in their twenties who lived through the ordeal. I can’t imagine how they see the world? Can you ever really go back to leading a routine life after living through Hell?

I also attended several meetings and held informal discussions with colleagues from around the world who are also attending the Friends of the Global Fund in Africa inauguration. Masaki from Japan, Svetlana from Ukraine, and Francoise from Rwanda were some of the civil-society colleagues with whom I networked. I also met with the staff of the Global Fund secretariat and some of the VIPs, including the Ministers of Health from Rwanda and Ethiopia, and the former President of Nigeria, General Gowon. General Gowon was President of Nigeria during the Biafra Civil War in the late 1960s, which could have divided the country, but he was able to keep the federation together, so he is sort of like Nigeria's Abraham Lincoln.

During the afternoon, I went with Svetlana to visit the Kigali Memorial Centre on the Genocide. The memorial is on the site of the mass graves of 256,000 people who were slaughtered in Kigali, the capital of Rwanda. I was shocked when I walked down past a dozen large concrete burial slabs to find that the last concrete slab was left partially open, so that you can actually see wooden coffins holding thousands of remains. The exhibits inside the memorial were very moving, especially the Children’s Memorial Hall, which included personal histories of about a dozen children who were lost. The memorial also had a large exhibit hall on other modern genocides, including the European holocaust, the Cambodian massacre, and the Bosnian crisis.

The most horrific thing I learned was that many victims of the Rwandan genocide had run into their churches for sanctuary. But even there they were not safe. In Nyange, 2,000 congregants were sheltering in their church when Father Seromba gave the order to bulldoze the church. Countless victims were tortured, raped, and forced to watch their loved ones murdered.

I also learned about the amazing efforts of resistance and how many Rwandans reached across tribal lines to save one other from death. Amidst the horror, there are many stories of grace and salvation as well.

This experience has me questioning and examining my own relationship with spirituality and God. How could people of faith be so abandoned? Could I keep my faith in God if I were faced with this kind of unimaginable horror in my own life?

I was inspired to learn from the Rwandan Minister of State in charge of HIV/AIDS about the innovative efforts under way to manage the post-traumatic stress disorder affecting so many people. He told me that April (the month when the genocide began) is a particularly hard time when many people get severely depressed. The Rwandan government has established a national network of community-based counselors and community-based tribunals called "gacacas" (meaning justice on the grass), where perpetrators are brought to justice and reconciliation and forgiveness can occur.

Rwandans are so hopeful about the progress they are making, and it is indeed inspiring to see their brilliant minds and bodies working together to repair and rebuild their families and country. But we have to face the fact that genocide is still happening, for example, in Darfur, Sudan. And the potential for genocidal violence in many other places remains all too real. Can we find a way to create a new 21st century humanity where we can truly commit to "never again" allow another genocide? I think we should try!

Day 4: Travel to Kigali, Rwanda

Day 4: Saturday, February 10, 2007

I woke up around 3:30 am to get ready for the three airplane rides to Kigali. As it turned out, all of the flights of the day arrived and departed nearly on time. When I first started traveling in Africa in the early 1990s, I always experienced long delays, canceled flights, and extended gaps between flights,-so things definitely seem to be improving. The 14-hour trek took me from Cape Town to Jo'berg to Nairobi and then finally to Kigali.

The Jomo Kenyatta International Airport in Nairobi is a nostalgic place for me. I've walked its circular halls many many times. I've even slept overnight on the floors of this airport, so it is always fun to be there and remember my younger days. I remember spending one lengthy layover in the late 1990s, complaining to every store and to the airport management that there was no internet cafe in the airport. I argued that this would be a profitable endeavor for whoever led the way. I was thrilled to find that there now at least five internet cafes, all buzzing with customers.

I'm already reading three books that I brought on this trip, but I couldn't help visiting another bookstore. My eyes were immediately drawn to a book titled "Shake Hands with the Devil: The Failure of Humanity in Rwanda" by Lt. General Romeo Dallaire. Dallaire was the head of the UN Mission in Rwanda prior to and during the 1994 genocide that left 800,000 souls slaughtered in 100 days. I've read several books about the genocide, and I intentionally avoided Dallaire's because I found these accounts so disturbing and enraging, and I didn't feel like going through that again. Today, however, I decided to buy the book, and I've read it continuously on the remainder of the journey.

The Rwandan genocide has a painful personal side for me. I was born into a conservative Jewish family, and when I underwent my Jewish education, we were taught, even brainwashed, around the mantra of "Never Again." I could always understand the "never again" concept as this was intuitively obvious to me. I remember, even as a young child, asking myself the question, "But, how could all those people living in that time just sit by and let it happen?" In the spring of 1994, I was riding the Metro to work in Washington, DC. I remember reading in The Washington Post about the ongoing genocide ... and then a loud bell rang off in my head. I was one of those people who was just going on with my daily life while just a short plane ride across the pond (the Atlantic Ocean), a horrific genocide was ensuing. I promised myself that I would not live my whole life that way. When living in Zambia, several years later, and confronting the daily holocaust of death and destruction from HIV/AIDS, the bell rang again, and I experienced a personal tsunami that changed my life. I left the personal comforts of life as a technocrat and become an advocate for global justice ... eventually helping to create the Global AIDS Alliance. "Never again" has a different meaning for me in this phase of my life. It is a guidepost for how I live my life and spend my time!

On arrival to Kigali, dusk was settling, and as I drove from the airport to my hotel, a football match was letting out, and throngs of healthy looking, dynamic Rwandans were walking the streets. Kigali is a crowded city of some 500,000 people situated in the rolling hills of central Rwanda. Our car passed by the Hotel Des Milles Collins, where the film "Hotel Rwanda," which depicts the genocide, actually took place. It was eerie.

The first part of my week in Kigali will be focused on attending the inauguration of the Board of Directors of a new organization called Friends of the Global Fund in Africa, or Friends Africa as it's popularly known. Click here to visit their website!

Rwandan President Paul Kagame will be opening the meeting tomorrow. I'm excited to see him, as he was the general of the Revolutionary Patriotic Front (RPF) that liberated Rwanda from the those conducting the genocide. Friends Africa has adopted the theme of "Taking Responsibility, Ensuring Results!" and I'm honored to serve on their Advisory Council. It is a great joy to see Africans mobilizing themselves to accelerate the battle to combat the epidemics of HIV/AIDS, tuberculosis, and malaria that are ravaging the continent.

Friday, February 9, 2007

Day 3: Activism in Action

Day 3: Friday, February 9, 2007

During this short visit to South Africa, I’ve heard over and over again that many South Africans are feeling that they need to unify and mobilize themselves in the fight against HIV/AIDS in the same way they waged the battle against apartheid.

Today, I was honored and privileged to observe the National Executive Committee meeting of the Treatment Action Campaign. TAC’s leadership, including Sipho Mthathi and Zackie Achmat, met with provincial-level leaders and key partners to develop their 2007 strategy. It was amazing to see the strategy for action being discussed and defined based on front-line challenges identified at the community and clinic levels. Drug shortages, test kit stock-outs, the emergence of extremely drug-resistant tuberculosis (XDR-TB), the crisis of violence, and the shortage of health care workers were among the key issues discussed and debated. TAC combines community mobilization and education with street protests and high-level policy advocacy. They work closely with the AIDS Law Project, which challenges the government, the AIDS denialists, and pharmaceutical companies that block action. The combined impact of the work of these people is truly historic. They are breaking down the walls of silence, indifference, and greed, and they are saving lives!

As the morning wore on, there was a bit of a lull in the meeting, and a young woman from the Eastern Cape province started singing a South African mobilization song. Soon the whole room was singing and dancing in what seemed like a ritual of solidarity for the people needlessly suffering from HIV/AIDS whom TAC serves. My soul shook from their voices as I tried to absorb every note. I learned so much today from the women and men of the Treatment Action Campaign. I am so inspired, it is hard to leave. However, I fly out at 6:00 am tomorrow for a long day's journey to Kigali, Rwanda.

Day 2: Visiting the Front Lines

Day 2: Thursday, February 8, 2007

I slept great and had an early morning breakfast with my colleague, Lisa Schechtman, GAA’s Senior Policy Officer. Lisa arrived in South Africa earlier in the week for an in-depth fact-finding mission on the state of the response to the crisis of violence against women and children. Click here to check out her blog!

After a challenging taxi ride that involved getting lost a couple of times, we finally arrived around 8:30 am for our first meeting at the headquarters of the Treatment Action Campaign (TAC) in Muizenberg, about 30 minutes outside of Cape Town. In case you aren't familiar with TAC, they are one of the world’s leading HIV/AIDS activist organizations. They have led the battle for treatment access in South Africa, and over the past year they have been building an "Access to Justice Campaign," which is focusing on combating violence against women and children. We had a great meeting with Linda Nafu, National Campaign Manager, Rukia Cornelius, National Manager, and Nono Eland, Treatment Literary Coordinator. What an amazing group of dynamic women! Lisa and I learned about the progress and the immense ongoing challenges facing our TAC comrades. Click here to learn more about TAC's campaigns!

South Africa is an incredibly dynamic country that is still birthing its own unique form of democracy. Having been liberated from the apartheid regime in 1994, it is fascinating to see how the people here are now fighting the government bureaucracy and political stagnation for their social and economic rights. The devastating impact of HIV/AIDS on South Africa is also forcing dramatic reforms of the health, education, and social protection sectors. It is clear that groups like TAC are critical in pushing for faster and bolder action and holding government and other stakeholders accountable for saving as many lives as possible. Viva TAC!

I was especially moved as Linda Nafu shared with us in a very open-hearted way her personal experiences with child sexual abuse over a nine-year period. Her story is featured on page 8 of the June 2006 issue of "Equal Treatment," TAC’s magazine. Click here to read it!

It was horrible to hear about the despair Linda experienced as she went to family members, teachers, and neighbors for help, but no one responded. Fortunately, Linda survived that trauma and went through years of therapy, so that she has transformed the pain of her experience into a passion for justice and action to protect her own children and all children who are subjected to sexual violence in South Africa.

Among children younger than 18, official statistics indicate that 1 out of 3 girls and 1 out of 6 boys experience sexual violence. Our TAC friends feel that this data represents a significant under-reporting of what is really happening, which is why they are launching their own national campaign to help stop the violence. I was very excited by TAC's impassioned commitment to tackle this problem in a comprehensive way.

We then visited TAC’s community-based programs in the Khayelistsha district in the Western Cape. Khayelistha is a 30-square-mile shanty town along the South Africa coast. Many of the poor people here live in hand-made wood and tin shacks that look like they'd topple over in a strong wind. There are some signs of progress. The government is building upgraded houses that are home to more and more people. But it was shocking to learn that approximately 60% of the people in this area are completely unemployed.

On Lisa’s blog, she describes our visit to Semalela, a model rape crisis center that brings together counseling, police reporting, medical care, and forensics collection at a single site. There are only six centers like this in all of South Africa.

Next we visited one of longest standing antiretroviral (ARV) treatment programs in Africa, which opened in 2001. We met with Marta Darder from Medicins Sans Frontieres/Doctors Without Borders (MSF), who helps coordinate a large ARV treatment program in Khayelistsha. They now are reaching 60% of those who medically require treatment and are moving toward universal access with prevention of mother-to-child HIV transmission programs. The success of these programs is truly inspiring. Mortality rates are declining, and they are close to eliminating pediatric HIV infection. The biggest problems facing the program are the shortage of health care workers and the lack of second-line drugs for those who develop resistance to first-line drugs. MSF and TAC are working vigorously to combat these challenges.

Our long day culminated with an unexpected visit to Robben Island. We traveled for about 35 minutes across choppy waters to visit the prison where Nelson Mandela and over 3,000 other anti-apartheid activists spent time during their decades of struggle. Mandela himself spent 27 years in prison and detention. For 18 years, he lived in a tiny cell about the size of a small bathroom in Cellblock A on Robben Island, with only a thin mat to sleep on.

The tour was led by a middle-aged man named Modisha (meaning shepherd) who spent five years imprisoned on Robben Island in the late 1970s and early 1980s for his student activism against apartheid. He graphically described the physical and psychological torture he experienced and the "blinding" rage it produced. He recounted his first hug from Mandela, who encouraged him to transform his rage into reconciliation, even while they were in the midst of an imprisoned hell. Modisha preached for South Africans to reject hatred and racism and to embrace forgiveness and tolerance. I’m starting to cry as I write this, as I feel so grateful and awed that a man like Modisha has the strength to heal himself so profoundly that he can stand in front of crowds of strangers each day and teach of all of us how to create a better, more peaceful world. This was one of the most incredible things I have ever experienced.

Day 1: Travel to South Africa

After a frenetic day of packing, finishing work, and saying goodbye to my family, I finally boarded my evening flight from Washington, DC, to Johannesburg (Jo’berg), South Africa. I was excited that it was going to be a non-stop direct flight and thrilled that the seat next to me was empty, so I could stretch my legs a bit.

This is my first trip to Africa this year, and I always get excited as I feel like I’m returning home. Ever since I spent four years living in Zambia (from 1996-2000), I have shifted my sense of home as being with my friends and colleagues in Africa, as well as my personal network. There is something bittersweet in the combination of my fascination with learning about the dynamic and expanding state of the HIV/AIDS response, and my sense of despair that despite the progress, there are still too many lives being lost and our collective response remains totally inadequate.

With a population of 43 million, there are over 5 million South Africans who are HIV-positive, and hundreds of thousands have already died. It is estimated that 1,000 people are tragically dying each day because of the lethargic roll-out of treatment programs, due largely to the failed leadership of President Mbeki and his administration.

The flight to Jo’berg was uneventful, thank God. I always feel a bit disappointed when I fly over Zambia and know that I won’t be going home. I checked out the flight navigation system as we flew over the western province of Zambia and thought about all of my friends and loved ones and sent them greetings and blessings for good health. On arrival to Jo’berg I quickly transfered to a flight to Cape Town, which arrived in Wednesday evening, February 7. After 22 hours of non-stop travel, it was great to crash on a comfortable bed at the St. George’s Hotel in central Cape Town.