AFRO-NETS> Amazing man, wrenching article

[Leela McCullough <leela@usa.healthnet.org>]

Amazing man, wrenching article
------------------------------

The Globe and Mail
PRINT EDITION

Stephen Lewis has one word for us: Help. He is part of a Canadian 
political dynasty, one of our most eminently reasonable men. But 
since he was appointed UN Special Envoy on HIV/AIDS in Africa, he 
says, his job has left him 'emotionally unhinged' - exhausted, en-
raged, heartbroken. If this crisis is enough to break Stephen Lewis, 
asks STEPHANIE NOLEN, shouldn't it be more troubling to the rest of 
us? 

By STEPHANIE NOLEN
Saturday, January 4, 2003  Page F1 

CHIRUNDU, ZAMBIA -- In a noisy truckers' bar on Zambia's border with 
Zimbabwe, Stephen Lewis is being cruised. A luscious young prostitute 
named Neeka, clad in a backless snakeskin top and skin tight black 
Capri pants, presses close to his side. She pushes a beer into his 
hands, grinning as she evaluates the prospects he presents.

There are a lot of idle long-haul truckers in the bar tonight, drink-
ing away the hours until the border reopens. But Mr. Lewis -- the 
quintessential Canadian, dressed in a plaid collared shirt and chinos 
-- is the only white man, a startling presence whose pale skin 
screams money.

Though he rarely drinks, Mr. Lewis accepts her beer. Over the thump-
ing bass of the music, he shouts questions: What does she know about 
AIDS? Does she use condoms? How many partners does she have?

Mr. Lewis is not shopping. Like Neeka, late on a humid Zambian eve-
ning, he is working. The United Nations Secretary-General's Special 
Envoy for HIV/AIDS in Africa settles in at a picnic table to watch 
the business conducted in the bar. Neeka realizes that she will not 
earn anything here, but she leans on the wall nearby and obligingly 
answers his questions about the mechanics of the sex trade in Chi-
rundu.

Mr. Lewis is in the twilight of a distinguished career. He is a for-
mer leader of Her Majesty's Loyal Opposition in Ontario. A former 
deputy executive director of Unicef. A former Canadian ambassador to 
the United Nations. Now, at 65, he has been named a rare U.N. special 
envoy. But this post is no plum. It may, in fact, be the worst job 
going -- to bear witness on behalf of a disinterested world to the 
disintegration of a continent.

He has reached the bar after a slow, chilling walk through the pitch-
dark border town. A group of outreach workers from a World Vision 
AIDS education project led him past a snaking line of massive trans-
port trucks, parked on both sides of the road, where small groups of 
women moved from truck to truck. Sex workers here have an average of 
five clients an evening; they earn 20,000 kwacha [US$ 7] for a "full-
service" trip into the truck cab, but 10,000 more for "live" sex, 
without a condom.

An estimated 80 per cent of these women have HIV or AIDS. The truck-
ers, almost without exception, have wives back home -- wives with 
whom they will have sex tomorrow or next week.

This is ground zero in the AIDS pandemic. It is a textbook example of 
the reason that one in five adults here has HIV/AIDS. Of why Zambia's 
life expectancy has fallen from 58 years to 37 in the past decade-
and-a-half. Why the hospital wards are crammed with stick-thin pa-
tients drowning in the fluid in their lungs, their agony unrelieved 
by even Tylenol. Why there is one teacher left alive in rural schools 
with 250 students. Why there are gangs of feral street children in 
Lusaka. Why there is a national coffin shortage.

All his life, as a socialist politician, Stephen Lewis has championed 
unpopular causes. This is something different. He can see what is 
happening to Zambia in all its vivid apocalyptic reality. He tells 
people, and no one disputes his words -- presidents, prime ministers, 
some his life-long ideological opponents, all acknowledge the truth 
in what he says -- that Zambia and a dozen other countries in sub-
Saharan Africa are disintegrating in real time. That AIDS is wreaking 
a destruction in Africa nearly unknown in human history.

But governments ignore him. Rich nations commit pitiably small funds 
to fight the pandemic. Mr. Lewis pleads for intervention to stave off 
the total destruction of societies. No one listens. And this job, 
this role of latter-day Cassandra for the 21st-century plague, is 
driving him from despair into something approaching madness.

"What is driving me crazy, and making me emotionally unhinged, is 
that we're losing too many people," he says one afternoon, his voice 
raw, slumped in the back seat of a white UN Land Rover ferrying him 
from one scene of devastation in rural Zambia to another. "I can't 
stand it. And I just don't know how to break through. It wouldn't 
take that much. It could be turned around."

He sinks even lower, looks out the window and speaks almost to him-
self. "I'm not getting anywhere. As much as there are a million 
things to be done, the fact is that we can't get anywhere on these 
resources. I wake up regularly in an absolutely incensing rage at not 
being able to break through."

In the orphanages and the hospitals of southern Africa, he is the 
Stephen Lewis with whom Canadians are familiar, engaged and asking 
questions. But in Washington and Geneva, the stolid, prim responses 
of bureaucrats and donors and diplomats drain the life from him. 
Sometimes, when the door closes after these meetings, he rages and he 
rails. Sometimes he can say nothing at all.

This job has robbed him of his sleep, of even a moment's peace. "The 
absolute worst of the job, the part I can just can't handle, is the 
death."

Though his love affair with Africa goes back nearly 50 years, a seedy 
truckers' bar in Zambia is a long way from home for the man who has 
grown from scion to patriarch of one of Canada's few political dynas-
ties.

Mr. Lewis is the son of David Lewis, once leader of the federal New 
Democratic Party, and he inherited the family politics: After drop-
ping out of several university programs, he moved to London to work 
for the Socialist International. There he learned of a World Assembly 
of Youth being organized in Accra, Ghana, and he set off to represent 
Canada. He was meant to stay for a matter of days; instead, he stayed 
for years.

"It got in my blood very early," he says. "The exuberance, the music, 
the vitality, the tremendous capacity of the people. And once Africa 
gets into you, you never get it out."

He came home in 1962 to manage a campaign for his father. A year 
later, working for the party, Mr. Lewis met his wife, journalist 
Michele Landsberg, with whom he would have three children: Jenny, now 
a casting director; Ilana, a lawyer, and the mother of an infant son, 
Zev, on whom he dotes; and broadcast-journalist Avi, who is married 
to the writer Naomi Klein.

Soon, though, Mr. Lewis was pressed into electoral service himself, 
and in April, 1963, was elected as an MPP for York Centre in Toronto. 
By 1970 he became leader of the provincial party, and in 1975, his 
NDP became the official opposition. He was admired in the legisla-
ture, yet when the party's fortunes declined, he blamed himself, and 
left politics in 1978. As a speaker and commentator, though, he be-
came famous -- no matter what one thought of his politics -- as one 
of the country's most eminently reasonable men.

In 1984, Brian Mulroney raised eyebrows by naming Mr. Lewis ambassa-
dor to the United Nations; he had a strong bond with the Tory prime 
minister, in their opposition to South African apartheid. Mr. Lewis 
held the job for four years, then stayed on as a special adviser on 
Africa until 1991; he was deputy executive director of Unicef for 
three years in the late 1990s.

In 1999, in a brief foreshadowing of his current role, Mr. Lewis took 
on the thankless and painful job of chairing the team that investi-
gated the 1994 genocide in Rwanda for the UN. He was blunt in laying 
blame at the doors of France and the United States for standing by 
while 800,000 people were slaughtered.

Little came of that report. But it moved United Nations Secretary-
General Kofi Annan, who tapped Mr. Lewis for the job of special AIDS 
envoy in June 2001 when he felt the need to draw special attention to 
the catastrophe in Africa. "The SG," as Mr. Lewis calls his friend of 
almost 20 years, likely knew what he was getting in this envoy -- one 
who would not restrict his language to diplomatic niceties.

Yet the UN didn't take the job seriously when he was appointed. It 
took him more than a year to get an office, a part-time salary for an 
assistant, and a phone line at UN headquarters in New York. And he, 
too, did not understand at first what it would mean. "It's the hard-
est thing I've ever done in my life. It's even worse than the Rwanda-
genocide stuff -- because it never ends."

Today, Mr. Lewis is almost troll-like in appearance, with enormous 
unflattering glasses, sketchily cut grey hair, small threads hanging 
off his suit. His face is seamed and jowly, his nails are bitten to 
the quick. He has a dark and deadpan sense of humour, though his 
quips are often lost on the dry diplomats or muffled in the cultural 
translation for African hosts.

He is astoundingly good at his work. He wades into a crowd of HIV-
positive schoolgirls, asks everyone's name, then remembers each one 
15 minutes later (although they are all multisyllabic Bemba names). 
He engages instantly with crowds, any crowd: AIDS orphans, ambassa-
dors, skeptical reporters, old village women.

He is a brilliant extemporaneous speaker, with a freakish grasp of 
the facts on each nation he visits: How many teachers died of AIDS 
last year and how many fewer new ones were trained? How many house-
holds are now headed by children? How much does a course of anti-
retro-viral drugs cost in Malawian kwacha, in Kenyan shillings?

And he never sleeps. "He gets on a night flight to Nairobi, he works 
the whole way, he gets off the plane and goes to a day full of meet-
ings, he goes to a dinner where he finds out he suddenly has to make 
a speech, and you go back to the hotel late at night and he says, 
'I'm just going to do a few emails and make a few calls and do you 
want a wake-up call because I'll be up before 5,' " says his assis-
tant, Paula Donavan, who travels with him. "It's not human."

It is not that Mr. Lewis is one of those people who "doesn't need" 
sleep, she says. It's simply that his sense of urgency keeps oblivion 
out of reach for more than an hour or two. "He's up in the morning, 
but he feels terrible."

In Africa, Mr. Lewis insists on informality, flinching when referred 
to as "Your Excellency," introducing himself only as Stephen. When 
forced to sit through lengthy speeches of welcome by chiefs or minis-
ters, he resigns himself, then sits almost visibly quivering as pre-
cious time is wasted.

He does see some things he can do. It was Mr. Lewis who first pointed 
out that HIV/AIDS merited only a laughable two-line mention in the 
lengthy New Economic Plan for African Development (NEPAD), heralded 
as African leaders' blueprint for a political future. And Mr. Lewis 
was the first major figure to describe the face of the pandemic as 
female, noting that women now are the majority of infected people, 
yet also carry virtually all of the burden of nursing, care-taking 
and additional labour. He was chastised early in his appointment for 
talking in terms of "murder by complacency," but the phrase is now 
commonplace.

He has a vast faith in the United Nations, to which he refers con-
stantly as "the UN family." But he has none of the career diplomat's 
striving love of systems and protocol. He asks disarmingly frank 
questions that startle his Zambian hosts; he tactfully raises so-
cially taboo issues, such as the wildly escalating incidences of sex-
ual abuse of children by parents and guardians whose resources are 
strained past all coping.

His style is something new for the life-long diplomats and aid work-
ers he runs into in the field. In Lusaka, he meets a group of men and 
women in their 20s, only one of whom can afford $50 (U.S.) a month 
for the drugs that would keep them alive. Their anger leaves Mr. 
Lewis near tears.

"He seems to get quite worked up," says one senior UN officer, wrin-
kling her nose in distaste.

The statistics are mind-numbing, and Mr. Lewis can recite them at 
length. Three-quarters of the people in the world with HIV/AIDS live 
in sub-Saharan Africa, and 90 per cent of those do not know they have 
it. Of the 30 million infected people on the continent, only 30,000 
have access to the anti-retroviral drugs (ARVs) that have made it a 
manageable, chronic condition in the first world.

The typical African is dead three years from the time he or she 
learns they have the disease. Some 9,600 people die of AIDS-related 
diseases in Africa every single day. That's the city of Nelson, B.C., 
dead each day.

Mr. Lewis is in Zambia as part of a fact-finding mission to four 
countries on the relationship between AIDS and the growing famine in 
southern Africa. The epidemic has cut sharply into the work force 
that grows the food in what are still largely subsistence societies; 
AIDS has left households with more orphaned mouths to feed and placed 
a huge burden on women, who must do the farm work even as they nurse 
the dying.

In theory, Mr. Lewis will assess the problem and return to New York 
to advise the Secretary-General. But it is obvious that Mr. Lewis is 
also eager to Do Things. Of presidents, of local groups of people 
living with AIDS, he asks over and over, "What can I do? What do you 
need that I can help with?" His itinerary in each country has been 
planned exhaustively by the resident UN mission, but within hours 
he's packing more in.

Government and NGO figures who had expected one more dry diplomatic 
exchange are moved by his urgency, by his offers: to get the govern-
ment moving on drug access, or to call the Global Fund for AIDS, TB 
and Malaria and find out why it has not sent Zambia the first instal-
ment of a promised $98-million (U.S.) grant to make those drugs 
available.

This is how Mr. Lewis has reshaped the nebulous job of envoy -- tak-
ing its literal meaning, "messenger." The AIDS patients can't get an-
swers from the government on drug access, so Mr. Lewis will get the 
answers for them. He promises Western donors that he will tell senior 
government ministers of their concerns about a lack of political 
leadership on AIDS. He will find out why a starving village has had 
no shipments of food aid.

Two days into his visit, he arranged another meeting to tell the peo-
ple with AIDS what he learned. The group was clearly shocked he did 
it. "No one ever reports back to these people," he raged later. "It's 
the most degrading thing in the world, to be dying and to make a 
plea, and no one responds."

So Mr. Lewis is also a conscience, sometimes unable to temper his 
scorn. At the start of a cocktail gathering with ambassadors and do-
nors, he asks if someone can explain why there is not a single Zam-
bian with HIV/AIDS in their large "theme" working group. No one re-
sponds, so Mr. Lewis concludes the 90-minute conversation like this: 
"Nobody here addressed my question of the people living with AIDS in 
the theme group. So maybe you can talk about that as you sip your 
wine."

On his travels through Africa, Mr. Lewis is asked for money, for 
staff, for drugs, for support, for training. Sometimes the pleas come 
from stubborn or frightened governments with limited plans to tackle 
the issues. And sometimes, far worse, they come from people with all 
the skills and knowledge they need, but no money.

"Do you feel you're drowning sometimes?" he asks Andrew Mutenga, Zam-
bia's Minister of Education. "That it's too much? I can't imagine 
what the future will hold unless you're able to start a recovery 
process immediately."

The next day, Mr. Lewis and his UN escorts are back in the Land 
Rover, driving across the country to the home of Chief Hanjalika, in 
the southern district of Mazabuka.

Religious leaders in Zambia, as in so many other countries in sub-
Saharan Africa, have put up huge resistance to promoting the use of 
condoms, despite the fact that transmission in heterosexual sex is 
the source of virtually all HIV infection in the country. Chief Han-
jalika, alone of the traditional and religious leaders, has embraced 
the fight against AIDS.

In his region, an estimated one in four adults are infected with HIV. 
In the last few years, the chief has managed to end the practice of 
ritual sexual "cleansing" of widows, and eradicated the taboo of 
talking to young people about sex. This morning he has assembled a 
thousand of his subjects. With a bemused and delighted Mr. Lewis 
looking on, the chief begins his proselytizing.

"It is my duty to come and educate you, my subjects, about this dis-
ease -- it has come to stay, and you must be very careful," he says 
in booming Tonga. The chief proceeds to his safer-sex demonstration, 
brandishing a condom in one hand and a round-tipped nightstick in an-
other. The crowd begins to giggle.

Mr. Lewis steps forward obligingly to hold the nightstick while the 
chief rolls down the condom. Then the chief mimes the way in which a 
woman should keep hold of a sheathed penis. By now, his subjects are 
convulsed with embarrassed laughter.

Mr. Lewis, though, beckons a translator and addresses the crowd ur-
gently: "You have a great chief. I would like to take him all over 
Africa, to talk to all of Africa, the way he has talked to you today. 
I have never heard a chief before speak so honestly and so openly 
about AIDS to his subjects.

"It is a terrible thing that is happening in Zambia today. There is 
hunger and there is AIDS and together they are killing many people. 
When I see the hospitals I see medical wards of men and women dying 
of AIDS. When I go into villages of Africa and into the homes I see 
the fathers and mothers dying of AIDS." Once again, it is almost as 
if he is talking to himself.

And then he remembers where he is, and wraps an arm around the chief. 
"I'm proud to stand beside such a man, because he is giving you such 
leadership." The crowd claps thunderously.

But when Mr. Lewis moves into the crowd to shake some hands before he 
leaves, people begin to mime to him, thumping their rail-thin chests, 
their hollow stomachs, yanking up the shirts of their babies to show 
concave bellies. He does not need to speak Tonga to understand that 
no one here has any food, and no one knows how they will survive.

The chief tells him it has been more than a month since the last 
World Food Programme delivery to his district; a composed and digni-
fied man, Chief Hanjalika begins to weep as he tells Mr. Lewis about 
the old people who come to his house, people who have not eaten in 
five days. Mr. Lewis promises to investigate. As his Land Rover pulls 
away, the energy drains from him and he crumples into his seat. He 
stares grimly out the window, his jaw set, his hands clenched.

When he arrives in Lusaka later that day, to the cocktail party with 
donors, he makes a beeline for the World Food Program representative. 
He wants to know when food was last delivered to Mazabuka. He wants 
to know if it's been a month, and why. The WFP rep listens with her 
eyes widening; she pledges to find an answer. Mr. Lewis says, nicely, 
that he would like it before he leaves Zambia the next day.

Mr. Lewis says he finished this trip with a grimly sharpened under-
standing of the spiral between the AIDS pandemic and the food short-
age. And he has found a dozen small things he can do -- arranging 
contacts between North American hospitals and programs here, and 
calling the Global Fund to find out where Zambia's money is. He sends 
a strong letter to the director, Richard Feachem. "They just don't 
want to be called on it. So they will act."

There are things, though, that he cannot do. In Chirundu, he learned 
from seasoned commercial sex workers that they are angry at the "vil-
lage chickens" -- girls from the villages, desperate from the 
drought, who have turned to sex work at the border posts to get food. 
They are undercutting the standard prices.

"The area is poor and we have hunger all over," Dixon Nkumbuke, a 
peer educator with World Vision, explained. "Girls and mothers come 
to Chirundu to draw water or to try to do some work, and in the eve-
nings they find themselves in bars.... And they find they could have 
sex once, or draw 30 litres of water and make the same amount of 
money, and then they will not be so tired when they have to go home 
and do the farming."

Some of the women are receptive to the idea of using a condom, said 
Edah Ngandwe Syanjobo, an outreach worker from the same project, 
though the drivers remain resistant. Other women say they see little 
point. "It's very difficult when you have no food at home, no mealie 
meal and you are offered 50,000 kwacha without a condom or 20,000 
with a condom," said Ms. Syanjobo. "And anyway, they say, 'We are al-
ready dead.' "

Mr. Lewis sighed, and jammed his hands further in his trouser pock-
ets.

He leaves projects like this and returns to North America, to endless 
rounds of media interviews and speaking engagements. His speeches, 
these days, employ the oratorical skill for which he has long been 
known, underwritten by a new edge of desperation. His tales of the 
apocalypse are received with ovations and a steady stream of invita-
tions.

But the key things don't change: The Global Fund, suggested by Mr. 
Annan as the only way to stop the pandemic and intended to raise $10-
billion (U.S.) a year in new funds, has received pledges of only 
$2.1-billion over five years. Canada's commitment to the Global Fund 
is $150-million (US) over four years; the United States, source of 
one-quarter of global GDP, has pledged only $500-million over the 
next two years.

Pharmaceutical companies still stubbornly refuse to allow generic 
production of ARVs in Africa, and Western countries still staunchly 
defend that position in World Trade Organization debates.

Yet Stephen Lewis remains one of the few voices of optimism on 
HIV/AIDS in Africa. He does believe the course of the pandemic could 
be changed, with the right resources. "The pendulum is going to 
swing.... With the mobilization of technical capacity, the resources 
taken together in a master plan, you could turn this thing around in 
five or six years."

He is hugely heartened by the capacity of people he meets in each 
country to address the crisis. The orphanages, the community caregiv-
ers, the sex workers teaching condom use -- he marvels at what they 
achieve with miniscule budgets. He gnashes his teeth thinking what 
they could do with a few thousand dollars. He relies on the credo 
that got him through years of socialist politicking: "If you keep at 
them doggedly, tenaciously, if you never give them a moment's rest, 
you'll make it."

To that end, Mr. Lewis has decided to start a foundation of his own, 
to channel union, church and community group money directly to the 
small projects he sees. His daughter Ilana will direct it; he hopes 
to have it up and running within months.

But it doesn't do much to ease the effects of the endless parade of 
death. On his itinerary in three days in Zambia was a project to 
teach basic life skills to orphaned teenaged girls, a project with 
street kids, and a visit to a hospital ward doing emergency feeding 
of babies -- a half-dozen died while he was there, and he later said, 
"That nearly finished me."

The scale of it overwhelms him. "Very few people understand the proc-
ess of irreversible decline -- we will have failed states. I don't 
think that's avoidable now. But maybe we can save some lives, save 
some of those states." Ultimately, it is the very smallest picture 
that is crippling. "These wonderfully bright, alert young people, and 
they won't be here next year. Those faces haunt you. They have to."

Ms. Donovan, like Mr. Lewis's family, is alarmed by the toll the job 
is taking on him. "But," she says reasonably, "it would be weirder if 
it wasn't affecting him like this. To see all this stuff, all this 
death, and not react like this -- I think that would be crazy."

Mr. Lewis himself acknowledges, "I am fraying at the edges, and so 
sometimes I'm overwhelmed. But I'm strong enough at the core to hold 
it together" -- and then, making a quick crack to leaven the pain in 
his voice -- "having been a democratic socialist in Canada."

But can he go on, with the endless rounds of desperate mothers and 
dying babies -- and then the polite luncheon meetings in New York and 
Geneva? "I've never been clearer about an issue in my life," he says. 
"I'm going to keep doing it. As long as I can."

What you can do?

Stephen Lewis's suggestions for African organizations that are badly 
in need of funds and doing innovative work to fight HIV/AIDS:

- Polyclinic of Hope, A Centre for Women Victims of Violence (women 
raped during the genocide, many of whom are now HIV positive); P.O. 
Box 3517, Kigali, Rwanda. The director is Mary Balikungeri
<balikungeri@yahoo.com> or <rwanet@rwandatel1.rwandal.com> 

- Umoyo Training Centre for Girls; Plot 5779--M, Lusaka West, P.O. 
Box 37559, Lusaka, Zambia. The centre educates and supports teenage 
girls, orphaned by AIDS, who are now heads of households in Lusaka. 
Managed by Mwamba Mutale <kara@zamnet.zm>

- WOFAK (Women Fighting AIDS in Kenya), doing everything from coun-
selling to home-based care; P.O. Box 35168, Alladin House, Haile 
Selassie Avenue, Nairobi, Kenya. Executive director is Dorothy On-
yango <wofak@iconnect.co.ke>

- Lironga Eparu (Learning to Survive), the Association of People Liv-
ing With AIDS in Namibia; Red Cross Society Centre, Katutura, Wind-
hoek, Namibia. Chairperson in David Uirab <uirab@nip.com.na>

© 2003 Bell Globemedia Interactive Inc. All Rights Reserved.

--
Dr. Leela McCullough
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Watertown, MA 02472, USA
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