I think I’m the most infrequent blogger on the MSF web site. Sorry-O, as they say in Nigeria. My excuse is that, in the last couple of weeks, I’ve done 5 radio, 4 TV and 3 newspaper interviews, taken on a 2nd job (as interim Project Coordinator for our HIV/AIDS clinic), and participated in 1 public hearing on legislation to criminalise discrimination against people living with HIV/AIDS. And I’m pretty sure there were some drummers drumming in there at some point too.
Yesterday I met Femi Kuti, the son of Fela Kuti, and a famous musician in his own right. He has a music club, The New Africa Shrine, that is regularly used by MSF and Nigeria’s Treatment Action Movement to do public outreach/education about HIV/AIDS, safe sex practices, the importance of knowing your HIV status, empowerment of young people to take responsibility for their own health, and the need to seek and demand appropriate medical treatment from the Nigerian government. The club audience is the most at risk demographic group in Nigeria, and the one with the highest HIV prevalence rate – young people between 15 and 30, so it’s a great venue to reach them with accurate information/messages and to distribute condoms. Lots of people show up very early, long before the concerts start, they’re in a good mood and disposed to listen because Femi Kuti is very outspoken about the realities of HIV/AIDS, in a country where there are still a lot of people who think it’s all one big fiction. So, it’s a great partnership. This type of more public health oriented work is a really important adjunct to the direct medical care that MSF provides and with which most people around the world are more familiar.
The rainy season has started with a vengeance. Lots more mosquitos around, and an increasing number of positive malaria paracheck results amongst our staff and patients, so we’ll have to stay on top of that as the rainy season intensifies…
In the last few days we have been invaded by moths. I counted 63 in the cold chain room this morning, and 17 in the hallway that leads to my bedroom. This morning, as I brushed past a hedge outside our base, I watched the lips of one of my colleagues call out my name in greeting, but heard only the thrumming of hundreds of tiny wings. The moths billowed around me, and I held my breath for fear of inhaling them before I could get back inside.
I’m wondering what’s next in the pageant of plagues to which we are currently being subjected. Our living quarters are infested with cockroaches, mice and rats. One wall of the office that I share with the clinical team has been entirely claimed by at least 3 species of ants. When I work late into the evening, as I routinely do, I also share the office with the half dozen geckos that live, until the sun goes down, in the light fixtures and behind the “Know Your HIV Status!” posters.
Our team has implemented a multi-faceted strategy to deal with the rats, the major thrust of which is humour. Our new Australian doctor informed us that giant, Gambian rats are actually used as landmine detectors as they are highly trainable and, while giant, not heavy enough to detonate the landmines. This is convenient, given the significant investment that is made in capturing, then training them. However, this knowledge is of little practical use to us here as, in spite of the high level of violence and militancy throughout Nigeria, landmines are not one of the security issues that we have to deal with. Besides, I have no interest in developing a professional relationship with the rats, and would prefer that they just hit the road. I am, however, ready to propose marriage to my mosquito net. Although we have very few mosquitoes here (I think they’ve all been eaten by the moths, the cockroaches, the mice and the rats), when tucked around my mattress, it does protect me from the biblical procession of these other species with which I am required to cohabit.
Last night I was sure that the locusts were also finally on their way. However, the giant preying mantis I saw was, in fact, a solitary, wounded traveller, having come into traumatic union with our ceiling fan.
The besieged flavour here was enhanced the last couple of weekends because we could not leave our compound at all, due to insecurity and violence surrounding the state and federal elections. Ordinarily, the attentiveness required to navigate the insane Lagos traffic between our base and our clinic provides a welcome psychological break from the endless insect and rodent encounters. And now a third election has been called for this weekend, because two rounds of resounding condemnation from national and international election observers isn’t enough, and Nigeria is going for a hat trick.
But Pablo Neruda was right – they can cut down all the flowers, but they can not stop the spring
Lagos, where I’m based, is the world’s fastest growing megalopolis. In this place I feel a little like Azaro, the spirit child in Ben Okri’s novels. Part of me resists occupying my physical self, which has to see and hear and smell this city. So while I have been entirely engaged in my work, I don’t yet feel fully present in my own experience. Lagos is a case, and there is most assuredly an element of the centre not holding.
People and their dreams often spiral out of control here. This city is where all bad municipal planners should be forced to spend their retirement, where all former military dictators should do community service until they die, which, in Lagos, would be soon and miserably. For most people it’s a hard place, with its heaving morbidity and mortality, its ever-expanding slums, the mountainous garbage and the perpetual, stinking smog.
The MSF clinic at the General Hospital Lagos is a good thing, a little miracle in a calamitous city. It was the first free HIV/AIDS treatment center in all of Nigeria. And while access to treatment in this country is improving, there’s still a long road to hoe before a Nigerian can enjoy what so many of us take for granted in our universal, publicly funded Canadian health care system.
Photo: Youth Activist at National HIV AIDS Summit
I just returned from Abuja, the purpose built capital of Nigeria which, with its wide boulevards and expensive modern buildings, is a disorienting change from the frenetic pace, claustrophobia-inducing congestion, and general decay of Lagos. I was there for a national summit focused on the mid-point review of the Nigerian National Strategic Framework for HIV/AIDS. MSF is advocating for free, comprehensive care for all people living with HIV/AIDS in Nigeria, but while this country swimming in oil money, the vast majority of its citizens do not benefit from the nation’s resources and wealth. When also burdened with illness, they are often asked to reach into their mostly empty pockets to pay for the privilege of attempting to save their own lives.
I travelled back to Lagos overland, 11.5 dusty, bumpy hours. It was great. I got to see something of this huge country, it’s wonderfully weird rock formations, its hyper-fertile delta region, small town political rallies, roadside rat sellers, and beautiful children giggling and waving and calling out “oyibo” (white person) as we drove by.
Photo : Child Labour, boys selling drinks.
Photo : Child_Labour, Girl Selling Candy
With the state and federal elections days away, tensions have been rising here. Everyone on our team hopes that things will remain calm enough that work at our HIV/AIDS clinic will continue uninterrupted. I guess we’ll know by the time I submit my next blog…
Photo : Funeral procession near Badagry.
Photo : Little girl near Badagry
Mel Sweetnam has a backgound in health policy and is currently working as a Campaigner for MSF in Lagos, Nigeria. Her work focuses on networking with civil society organisations, advocating for the rights of people living with HIV/AIDS, access to essential medicines, and coordinating MSF’s media and other communications activities in Nigeria.