We Never Have Enough Coffins

“Alas” reader Samantha emailed me this speech by Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa, which he delivered in Pennsylvania last week. The entire speech, about women, HIV, and Africa, deserves your reading time, but here’s a few samples.

I’ve been in the Envoy role for four years. Things are changing in an incremental, if painfully glacial way. It’s now possible to feel merely catastrophic rather than apocalyptic. Initiatives on treatment, resources, training, capacity, infrastructure and prevention are underway. But one factor is largely impervious to change: the situation of women. On the ground, where it counts, where the wily words confront reality, the lives of women are as mercilessly desperate as they have always been in the last twenty plus years of the pandemic.

Just a few weeks ago, I was in Zambia, visiting a district well outside of Lusaka. We were taken to a rural village to see an “income generating project” run by a group of Women Living With AIDS. They were gathered under a large banner proclaiming their identity, some fifteen or twenty women, all living with the virus, all looking after orphans. They were standing proudly beside the income generating project … a bountiful cabbage patch. After they had spoken volubly and eloquently about their needs and the needs of their children (as always, hunger led the litany), I asked about the cabbages. I assumed it supplemented their diet? Yes, they chorused. And you sell the surplus at market? An energetic nodding of heads. And I take it you make a profit? Yes again. What do you do with the profit? And this time there was an almost quizzical response as if to say what kind of ridiculous question is that … surely you knew the answer before you asked: “We buy coffins of course; we never have enough coffins”.

I was listening to the presentations at the dinner last night, and thinking to myself, when in heaven’s name does it end? Obstetric fistula causes such awful misery, and isn’t it symptomatic that one of the largest — perhaps the largest — contributions to addressing this appalling condition has come not from a government but from Oprah Winfrey?

I was noting, just in the last 48 hours, that Save the Children in the UK has released a report pointing out that fully half of the three hundred thousand child soldiers in the world are girls. And if that isn’t a maiming of health — in this case emotional and psychological health — then I don’t know what is. And perhaps you notice the rancid irony: women have achieved parity on the receiving end of conflict and AIDS, but nowhere else.

Although they don’t make for easy out-of-context quoting, Lewis also suggests some concrete steps that institutions (governments, the UN, and large universities) should be taking.