A Picture is Worth a Thousand Words

In 2008 we were fortunate to have Zambian AIDS activist Winstone Zulu as a speaker for the Give a Day campaign. Winstone was one of the first Africans to live publicly with HIV, and he spoke out courageously and persistently to get the global community to take action on HIV/AIDS and TB. In November of 2008 it was my privilege to accompany Winstone as he visited many of the Toronto law firms that champion the Give a Day campaign. In his quiet but very strong voice, Winstone patiently educated all of us and stressed how crucial it is for us to lend both our voices, and our resources, to ending the pandemic. After living with HIV for 20 years, Winstone passed away last week from AIDS.

This past weekend, journalist Stephanie Nolen wrote a tribute to Winstone Zulu in the Globe and Mail that captures his spirit beautifully. In it she tells the story of a gathering that happened in the offices of the Stephen Lewis Foundation in 2008, which I had the great good fortune to be present for. When he arrived that afternoon, Winstone had a large brown envelope in his hands. When Stephen Lewis came to greet Winstone, I watched as Winstone handed him the envelope, which held two photographs. One photograph had been taken six months earlier when he had been through a period of AIDS-related infections and looked thin and ill. The second had been taken recently, after living in Canada for six months and receiving medical care here. He looked healthy, strong and happy, ready to take on the world again. And if you spent any time with Winstone, you knew that he had the energy and drive to do just that.

Since I heard the news of Winstone’s death I haven’t been able to get thoughts of those photos out of my mind. It was one of the most tangible illustrations I’ve ever seen of the inequities between health care that is available in Canada, and what is available to those who need it in Africa. It is also an illustration of the difference good health can make to a family, allowing parents to raise their children, go to work to support their families and contribute to their communities. I won’t ever forget those photographs, just as I won’t forget Winstone.

Strength and Hope – The Grandmothers of Africa

Dr. Lorna Adams, Give a Day supporter writes…There is no doubt.  The grannies of sub-Saharan Africa are holding the continent up on their shoulders.  I have met so many grannies, and they are the glue that is keeping what is left of the families of this continent together.  They are making new families.  They incorporate the children of their next door neighbour into their new family group, and the children of their deceased sister’s friend’s daughter, and the children of their grandchildren’s teacher, into their family unit.  And then they look in on the children in the home down the street, where there is a 13 year old, raising her brothers and sisters.  They are utterly exhausted, at times, with the demands that they have accepted for themselves.  But they continue, because, who else will do it?  They know there are too many deaths; there is a coffin maker in every town, even if there are not many other businesses.  There is always need of a coffin during this pandemic that is HIV and AIDS in sub-Saharan Africa.  And the grannies continue on, caring, loving, doing as best as they can, in a situation that does, at times feel overwhelming.

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Grandmother Grace with her grandson, Emmanuel


But, there is HOPE.  A recent report, prepared by the WHO with UNICEF and UNAIDS, states that there has been significant progress in care of people living with HIV since the beginning of this decade. This report states that 42% of people in the developing world who are infected, and should be on ARV medication are now on medication.  Just a few years ago, there was still debate among AIDS experts about the safety of offering a difficult treatment program to people in areas of the world most affected.  Dignitas International has proven that it is safe, feasible, affordable and completely doable.  As Jane Philpott has said, “AIDS is outrageous….and solvable”.  I’m not sure I entirely agreed with Jane before I went to work in Africa with Dignitas International, but I sure do now.

News from Malawi- HIV/AIDS is “Coming Out”

Dr. Lorna Adams, Give a Day supporter writes…It is becoming clear to me, as I spend more time in Malawi working in the HIV/AIDS Clinic run by Dignitas International, that HIV and AIDS are  coming ‘out’ in Malawi.  There are posters everywhere, encouraging people to “know your status”.  Signs in stores and offices ask people to reduce transmission of the virus by using condoms, and there are education programs in schools about how the virus is transmitted.   Posters encourage people to be tested, and there is a significant attempt to reduce the ‘stigma’ of being diagnosed HIV positive. 

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In the nursing school that is associated with the Zomba Central Hospital and the Tisungane Clinic, I walked by a sign showing two young people, gazing into each other’s eyes, with the caption  “AIDS/HIV….if you don’t have it, don’t get it.  If you have it, don’t pass it on”.  It was quite clear and to the point. 

I worked with Alice Kadzanja in Malawi, a nurse who was portrayed in Stephanie Nolen’s remarkable book, “28  Stories of AIDS in africa”.  Alice is HIV positive, and supports people in their decision to consider being tested, using herself as an example of someone who was sick, and is now well because of treatment.  Alice played volleyball on the Clinic Sports Day, proudly wearing her T shirt which declared “ARV’s are essential drugs for people with AIDS”. 

Nurse Alice Kadzanja, Tisungane Clinic, Malawi

Nurse Alice Kadzanja, Tisungane Clinic, Malawi

I met another woman on a bus, who was happy to have me photograph her with her shirt that proclaimed for all to see that she was on therapy.  It is actions like this that reduce the stigma of being diagnosed HIV positive, and encourage people to discuss their risk of infection.  The Dignitas Program has allowed many people in the Zomba area of Malawi to understand that AIDS is a treatable disease.  In a continent where HIV infection knows no age, socioeconomic, educational, gender, political or cultural bias, this is a remarkable and very important step forward in the fight against this pandemic.


Jaja Sylvia’s Story

The Stephen Lewis Foundation writes…This morning we accompanied Angela, St. Francis’ capable young Grandmothers Officer, on a visit to one of the jajas  (grandmothers) in the community.  We drove down Jinja’s bumpy red roads through the village, and came to a house set back from the road. Next door, there was a small barn, which houses chickens and two young calves. In the background, we could hear the bleeting of a goat and the grunting of pigs.

Angela, St. Francis' Grandmothers Officer, on a visit

Angela, St. Francis' Grandmothers Officer, on a visit

On the way to Jaja Sylvia’s house, Angela told us more about St. Francis’ grandmothers programme. Although 120 grannies are currently receiving support – through granny groups, school fees, food parcels, the savings and loan programme, medical care, home visits and more – there are many more grandmothers in the community who would like to take part. One of the hardest things, Angela said, is having to turn grannies away because they don’t have the capacity to take on additional women at this time. There are so many grannies who could use the support.


The grandmothers being supported through St. Francis are either HIV positive themselves, or are caring for HIV-positive grandchildren, or both. On average, Angela said, they are caring for 8 or 9 children at home. I was surprised to learn that so many of the grannies are HIV positive themselves – an estimated 70 out of 120 in the group have the virus. HIV infection among older people is not frequently discussed, particularly in relation to sexuality – it is often seen as a taboo subject.

Jaja Sylvia

Jaja Sylvia

Jaja Sylvia first came to the St. Francis Health Centre in 2006. After caring for her adult children through the final stages of AIDS, she had seen the disease and the toll that it had taken on their lives. When she began to fall ill herself, she went and got tested at the centre, and learned that she was HIV-positive. St. Francis provided counselling, antiretroviral drugs and food parcels for her family, and her health began to improve dramatically. Today, she says, she is strong and feels healthy.


Sylvia was among the first grandmothers to be supported by St. Francis. She has lost four children to AIDS, and is now caring for five of her orphaned grandchildren, ranging from age three to fourteen. All of the grandchildren in her care are attending school – except the youngest, who is not yet old enough – and St. Francis is paying for their school fees. Jaja Sylvia is part of a local granny group and has been taking part in the group’s savings and loan programme. A few months ago, she was able to take out a loan of 100,000 UGS (about $50 CDN) to buy much-needed medicine and supplies for the new calves on her farm. She was able to repay the loan (plus 20% interest) within a month, and is assured future income and sustenance through the milk of the young calves.


"There are so many intelligent children," says Sylvia, "We want them to grow up to be whatever they want to be."

"There are so many intelligent children," says Sylvia, "We want them to grow up to be whatever they want to be."

In August 2006, Jaja Sylvia was one of a few grannies chosen by St. Francis to participate in the Grandmothers’ Gathering in Toronto. She spoke of the excitement of meeting grandmothers from Canada and from across Africa, and to learn that she was not alone. “It was very encouraging to learn that grandmothers across Africa were facing the same challenges,” she said. After returning home to Uganda, Jaja Sylvia helped to set up the grandmothers programme at St. Francis. With funding from the Stephen Lewis Foundation, they began starting groups, giving out loans for income-generation, providing counsellors and paying school fees. As a result, she said, there has been a big change in the community.


Jaja Sylvia asked me to pass on to the grandmothers of Canada that she and her fellow jajas are grateful for their support and solidarity, and that it has made a difference in their lives. She hopes to meet more Canadian grandmothers in the future – perhaps at a future Grandmothers’ Gathering. 

Her hope, like so many other grandmothers in the community, is for her grandchildren to be able to attend secondary school, and university or vocational training. “There are so many intelligent children,” she said. “We want them to grow up to be whatever they want to be. We want them to be good people – educated, disciplined. We want the same as everyone else.”