Recently, this editorial appeared in the Washington Post:

Condom Sense
Pope Benedict XVI is wrong.
Washington Post Editorial, Thursday, March 19, 2009; Page A14

THE LATE New York senator Daniel Patrick Moynihan once said, “Everyone is entitled to his own opinion but not his own facts.” This holds true even for the pope.

While on a flight to Cameroon on Tuesday to begin a weeklong journey through Africa, Pope Benedict XVI said, “You can’t resolve [the AIDS epidemic] with the distribution of condoms. On the contrary, it increases the problem.” In a perfect world, people would abstain from having sex until they were married or would be monogamous in committed relationships. But the world isn’t perfect — and neither is Pope Benedict’s pronouncement on the effectiveness of condoms in the battle against HIV/AIDS. The evidence says so.
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Obviously, that is just a short piece of it, and you can read the rest of the article here:
http://www.washingtonpost.com/wp-dyn/content/article/2009/03/18/AR2009031803136.html

Why do I bother to mention this?  Because I totally agree with the Pope on this one.  Condoms are not the answer to the AIDS epidemic in Africa.  In other places, perhaps they are, and in certain populations in Africa, like truck drivers and the prostitutes they frequent, they are the answer.  But in the vast majority of cases, condoms are not going to solve the problem.

I’ll tell you more about that in a minute.  But first, I wanted to explain something that is not commonly known among people in the West.  Before I came out to Mozambique, my cousin and I were having a discussion about WHY there is such an AIDS epidemic in Africa and why it hasn’t spread so rapidly in America.  Certainly there are lots of people having unprotected sex in America, but the epidemic really has been limited to high-risk populations for the most part, and education and condom use has really slowed the infection rate.  Why has it taken off like a rocket here? Was malaria weakening the immune system of people so that they were more likely to contract HIV?  That was one theory, but didn’t account for its spread in areas where there is little malaria.  Poverty certainly has its role to play in weakening people, or giving women few sexual rights.  All those are factors, certainly. But in talking to our mission AIDS coordinator, who has a lot of on-the-ground experience with this, and with people here, especially missionaries who have been here a long time, I found that the answer is that many, many people have multiple sexual partners.  In America, people tend to be serial monogamists.  They have one parter for a number of months or years, then have another (Then there are those who abstain or who have only one long-term partner).

Here, one person will have several partners during the same time period, and each of those people have several.  This spreads the virus much more rapidly.  Women have few sexual rights, and this makes the problem much worse. It was hard for me to believe that this was going on at first, but unfortunately it is true.

So, why won’t condoms solve this problem?  Just pass them out to enough people, make them available for purchase, educate people about the risks, and the incidence will fall, right?  Experience and research has shown that this is not the case.

Here’s an excerpt from an interview was done by Christianity Today:
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Condoms, HIV, and Pope Benedict

Leading HIV researcher Edward C. Green says criticism of the pope ‘unfair.’

Interview by Timothy C. Morgan | posted 3/20/2009 04:27PM

Edward C. Green is one of the world’s leading field researchers on the spread of HIV and public health interventions. He’s the director of the Harvard AIDS Prevention Research Project, and is a leading advocate for evidence-based interventions. He has been sharply criticized by some public health experts for supporting sexual partner reduction programs and for endorsing the so-called ABC method (“Abstain, Be faithful, or use a Condom”) for fighting the transmission of HIV. After Pope Benedict’s comments earlier this week, Green agreed to answer Christianity Today deputy managing editor Tim Morgan’s questions by e-mail.

(Here is one question that he answered)
CT:Is there any country in Africa with a high HIV infection rate that has implemented new programs and seen infection rates fall? If so, what strategies are being followed?

EG:I’m glad you asked this. We are seeing HIV decline in eight or nine African countries. In every case, there’s been a decrease in the proportion of men and women reporting multiple sexual partners. Ironically, in the first country where we saw this, Uganda, HIV prevalence decline stopped in about 2004, and infection rates appear to be rising again. This appears to be in part because emphasis on interventions that promote monogamy and fidelity has weakened significantly, and earlier behavior changes have eroded. There has been a steady increase in the very behavior that once accounted for rates declining — namely, having multiple and concurrent sex partners. There is a widespread belief that somehow Uganda had fewer condoms. In fact, foreign donors have persuaded Uganda to put even more emphasis on condoms.
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Here’s the link to the whole article:
http://www.christianitytoday.com/ct/2009/marchweb-only/111-53.0.html

Why won’t condoms solve it? Well, for one thing it doesn’t address the behavior that is causing the problem, but also the vast majority of people simply won’t pay for condoms, and even if given them, quite a few won’t use them.  When people are involved with multiple partners, then condoms are needed every single time, with every single partner, and this is realistically not something that is going to happen in an economically poor society.  And women with little sexual power cannot force their male partners to use them (especially poor rural women whose husbands work in urban areas, returning for visits).  There are all kinds of problems.  This is not to say they should not be available, or not be distributed.

People in the West see the propagation of the “abstinence, monogamy” idea as an imposition of moralistic religious people on the culture of Africa.  They believe that this idea suppresses people’s sexual freedom, and therefore that we should encourage sexual freedom, and try to stem the tide through condom use.  They forget that traditional African culture IS monogamous.  It has been, in major part, the influence of the West that has caused the problems that are now occuring.

I encourage you to read the article in CT and investigate this matter further.  In a later post, I’ll talk about AIDS and our local situation. – Cami

I’ve been delayed in posting this entry about Ben’s birthday party on March 1st.  He had a “bug” party, so we put up pictures of bugs all over, spread out all our plastic bugs, and made a “dirt cake”, which was layers of chocolate cake, pudding, chocolate shavings, gummy bugs, and oreo crumbs.  It sure was good and Ben enjoyed his party very much.  We invited five little friends and their parents, and some other adult friends, and it was a very happy day.  Hard to believe it has been 3 years since Ben made his appearance at the hospital in Portugal and how many places he has been toted since then!  We were counting up his plane travels the other day and they were quite impressive.  Portugal to USA, Florida to LA, Connecticut to Hawaii to Minnesota to Colorado, Florida to Ohio, Connecticut to Florida, New York to Mozambique!  Then quite a few car trips since then.  Ben is a sweet little guy, who is VERY stubborn and quite adventurous.  Everyone comments on his love of climbing on things, and he travels everywhere to his own soundtrack (DUHM Duhm Duhmn) as he hums his “theme music” while he plays.  Often he sings to himself and he loves the Rescue Heroes, Spiderman and Superman.  Last week Kevin urged him to eat his food, ben, and he replied “I not Ben!  Right now I Superman!”  Ok Superman, eat your food.  He keeps us in stitches and we can’t imagine life without him.  -Cami

Sorry about the title, guys!  I know you’ll hate it.  But I wanted to post about some wonderful young people who are trying to make a difference here.  There is a local orphanage, run by a young Mozambican man who is married to an American, and some of the missionary teens periodically try to do things to support them.  Last week, they had a car wash/oil change and asked all the expats to come by and donate in exchange for services.  I couldn’t make it to the location, so they came to my house and whipped out their vacuum cleaner, buckets and sponges, and cleaned up our car in a jif.  I realized, as I watched, that Benjamin doesn’t know what a vacuum cleaner is!  He hasn’t seen one since he was less than a year old.

Anyway, these “fine young people” (really, they are!) did a great job and raised some money to donate to the orphanage.  These same folks lead the worship at the English Fellowship every other Sunday night with overheads, keyboards, drums, guitar, piano and singing, and we feel greatly priviledged to benefit from their talent.  You have no idea how much professionaly-done worship can minister to a tired missionary!

So, thanks guys!  And yes, there in the front row is Ian, the young man who was airlifted out near death with malaria just a couple of months ago.  We are all glad to see him back and looking great (no matter how dirty he is).  Praise God!  – Cami

Well, I complained in a previous post about people digging for boogers and God thought He’d have a laugh at my expense.  Me and the boys have been sick this week with croup/cold/flu with fever, wet cough and lots of congestion.  Ben, predictably, has been very boogery and I’ve been too sick to follow him around the house wiping his nose constantly.  So, he’s taken to wiping his nose on the back of his arms, then coming to my bed and wiping it on ME or on my bed.  Ewwwwww! Finally this morning I hit on the idea of giving him a big cloth handkerchief and he seems interested in wiping on that instead.  Here is a photo of him, fast asleep with his head on the kitchen table.  I asked him to take some cough medicine so that he wouldn’t be up all night coughing, and he refused.  When told he would sit there until he took it, he said “ok” and there he sat until he fell asleep.  It is so pathetic! He is such a stubborn little guy, and even an offer of chocolate could not budge him. Toby was always such a sensible little guy, and when told “Here, drink this bad-tasting medicine and I will give you a lollipop.” it went right down the hatch.  Ben would rather die than let it touch his lips.  I managed to get a little into him, but he did indeed cough half the night, keeping both of us up.  Next time:  we sit on him.  Sheesh. – Cami

Things are just different here in Mozambique, and although there are things that don’t phase me at all anymore (like seeing a mentally ill naked person walk down the street – although it is sad) there are some things that make me just shake my head in disbelief.

1.  On a positive note, the generosity of some of the poor continues to overwhelm me.  Kevin will go to preach at a church outside of town, where everybody is hungry or has been living on powdered manioc for months, and will come home with a big bunch of bananas or a bowl of peanuts.  That kind of generosity is astonishing to me.

2.  The callousness of medical professionals toward people here.  The attitude seems to be, “If you don’t pay me something extra, you are not worth my time.”  This week, we went to visit the wife of a pastor in the hospital who had her 4th c-section and she was moaning in pain.  She told us she hadn’t had anything for pain for 24 hours (and this was only 48 hours after the surgery).  When I questioned the nurse, she was irritated that the woman hadn’t told her.  The nurse hadn’t checked on her at all?  Apparently not.  The nurse said they didn’t have any of the injectable pain medicine, the hospital was all out.  I dug some ibuprofen out of my purse and gave it to the poor woman, and the nurse said, “Well, we have THAT”.  But apparently didn’t care to give her any.  You should have seen the sewing job on that massive 8 inch scar that ran vertically.  I could have done better, and I have no medical training.  I am so thankful I have the means of avoiding treatment in that hospital.

3.  Some of the personal habits of people here are somewhat disturbing to me, though none of the locals seem bothered.  The “ick factor” is pretty high when I see someone digging around in their nose for a booger, and on the street this is not uncommon.  People we know don’t do it, though among children it is rampant.

4.  Although I am used to the crazy drivers, pretty frequently I am annoyed and upset at the inconsideration and aggressiveness (not to mention stupidity) of some drivers here.  Yesterday, I was driving behind a minibus taxi, on a very bumpy dirt road.  We were going along at an ok clip, but too slow for the guy behind us.  He pulled up beside me and then, when another car approached from the other direction, tried to run me off the road so he could get in front of me.  Not kidding.  I laid on the horn, and he missed me by inches.  I drove in New York, including the city, for quite a few years, and I don’t mind high-speed, aggressive driving.  But this kind of thing happens all the time, and is just plain dangerous and ugly.  Cars turn suddenly in front of you to do a u-turn, motorcycles weave around you and cut you off, and bicycles laden with charcoal or wood wobble unsteadily down the road, blocking traffic.  Quite a few people drive in ways that are unsafe.

5.  Closely related to that is the large numbers of small children who ride around on motorcycles and bicycles, hanging precariously with no helmet and without being strapped on in any way.  Last week I passed a guy on a bicycle tooling down the road with a baby that couldn’t have been more than 14 months old sitting on the bar in front of him, holding onto the handlebars.  He wasn’t holding the child, but was driving the bike.  He was on a main street, with cars whizzing by.  It made me shudder. Frequently, I pass motorcycles laden with 2 or 3 children positioned around the driver.  These drivers are usually careful (they don’t want their children injured of course) but it seems a recipe for disaster.  Nobody has a helmet in these cases.

6.  Overall I have adjusted to the street boys who harrass me next to my car.  I’ve created ways of entering and leaving my car with my purchases to minimize the risk of theft.  However, at the central market I struggle not to lose my patience.  Only once have I ever paid a boy to carry my purchases (in the two years I’ve been going!) when I was on crutches after knee surgery.  But these kids see my white face and think “Bonanza!” or at least hope for a few pennies anyway.  They follow me through the whole market, repeatedly asking me to buy their plastic bags, or to carry my purchases.  Whenever the vendor weighs out my tomatoes or whatever, they hopefully try to grab the bag to carry it for me.  “No” I repeat over and over and OVER.  As I dig in my bag for money, they edge closer and closer to look in my purse.  Theft is pretty common there, so of course I wonder if they are going to make a grab for it. Frequently, I gently push one of them back from my elbow.  When I bring my kids, they tease and laugh at them, which is upsetting for Toby and Ben.  However, they are kind and help them get up if they fall.  Although I feel very sorry for these kids, I get awfully tired of being harassed.  I guess I do feel kind of like a rock star, with an entourage of toughs following me around like a pack!

7.  The “Great White Hope”.  The Christians here are lovely people, and sincere believers.  Unfortunately, quite a few of the Christians see foreigners as the answer to their prayers.  The answer for financial support for the church, the answer for evangelism and the answer for teaching.  Churches hope to get their own missionary so that someone will pay for their church buildings, transport their pastors and leaders around to conferences (and pay for them), teach the church, and give their group prestige.  There are very good reasons why they feel this way, including grinding poverty, lack of transport, the history of this country and the very real lack of training for pastors and leaders (one reason we are here).  But it is hard to convince some of the believers here that they can do it themselves.  One has to disentangle oneself from requests and expectations, and try to build up the Church by building up the leaders, instead of taking over and running it (what many want you to do).  When you visit a church, you are treated like royalty and although it reflects the hospitality and generosity of the local people, there is also sometimes the attitude that the whites are better than the local people.  It is so upsetting, the low self-esteem of many of the people here and we wish that people felt better about themselves and their ability to run things.

8.  People chatting in the local language in front of me.  Now, I can’t say I blame them, because for everyone here, Portuguese is their second language.  Same as for me. So, when I visit people, often there are side conversations going in Macua, the local tribal language.  Frequently, however, people make comments about me and chat in front of me (while I sit watching) in Macua, which I understand not at all.  It is not considered rude here as far as I know, but I wonder what they are saying about me!  Especially when they laugh.

9.  The inconsistency of services.  Internet goes out suddenly and can be out for days, and no apology is offered.  Water goes off and on, and electricity suddenly cuts out.  The cell phone network goes down for no apparent reason, for a whole day. In general, we have adjusted to this and understand that this is just the way life is.  The water and electricity, especially, we have learned to deal without.  However, we often get frustrated when we can’t contact people or send out information that is needed by others.  This is more a matter of control of one’s attitude and attempting to keep a sense of humor, rather than descend into a bitter anger about “all that is wrong here”, as we see some expats do.

10.  Pregnant ladies everywhere!  I haven’t gotten used to this yet.  I think I have trouble reconciling this in my mind because I see the burden that all these children are on the ladies here.  Children are a blessing, I believe that firmly, and whenever someone tells me (or I see) that they are expecting, I am truly happy for them.  However, I wish that circumstances (misunderstandings about the body, difficulty in getting birth control that works for women, no access to birth control in some circumstances, ignorance, and ridiculous expectations for sexual performance from women) all contribute to almost constant pregnancy for many of the ladies here.  Of course, there are lots of good reasons for this, too.  Babies are lost at a much higher rate here due to hundreds of reasons I don’t need to go into here, and large families are considered a blessing.  But the constant work and struggle of so many of the women to care for and raise all those children is hard for me to see.  I don’t advocate abortion, by any stretch of the imagination, but I do frequently wish that the circumstances of women here could be changed on all fronts.  I believe it will, over time, but it will be a long road.

– Cami

You may, or may not, have heard of the cholera problems this year in Africa.  Cholera is generally caused by dirty water. Fecal matter infected by the cholera “bug” gets in the water, and people injest it.  That’s why we don’t have it in America anymore (last outbreak was in 1910). When you become ill with cholera, you can generally survive it.  What will kill you is the dehydration, because one of the main symptoms is raging diarrhea and vomiting.  It can literally kill you within hours, since the victim goes into shock from dehydration.  It is particularly dangerous in children.

Unfortunately, this has been a bad year for cholera in this area.  It comes every year, with the rainy season, but this year is worse.  I am not really sure why.  We hear of cases here and there, and many times the person can be saved if IV fluids are introduced quickly.  However, we have heard of deaths.  It isn’t the kind of epidemic that we are right in the midst of and can really report on, but one that we hear of secondhand from Kevin’s students, who have relatives or neighbors dying from it.  There is one town very close to Nampula where has been very bad, apparently.

We aren’t very concerned about getting it ourselves, if you are wondering.  We only drink and cook with filtered water, and wash all our fruits and veggies with bleach.  It is rarely spread from person to person, and if one avoids the contaminated water, your chances of getting it are very low.

There is so much suffering here, so much suffering that is PREVENTABLE.  Malaria, cholera, malnutrition, AIDS.  It is so frustrating.  – Cami

Well, our internet was down for a week, and we had lots of “fun” during that week.  Kevin got really sick last Tuesday, and though a malaria test showed negative we started him on the medication on Wednesday, when I realized that if he got any sicker I’d have to take him to the hospital.  So, he started treatment and within 24 hours showed noticeable improvement.  He couldn’t eat anything without throwing up for 3 days, though, and lost 8 pounds.  He was pleased to be back to the weight he was when we married 17 years ago!  At the same time, he had a nasty infection in his leg from a deep wound sustained during a small motorcycle accident the week before.  I started treating that with a broad-spectrum antibiotic but after 4 days it really was not much better.  A call to a local missionary doctor revealed that it was probably a staph infection, so a new antibiotic was in order.  Today, 2 weeks after the accident, it is much better, though still swollen.  We continue to hope it will improve and not have to be opened up and cleaned out!

Meanwhile, Benjamin had a nasty case of impetigo and had blisters and sores all over his body.  Remember the photo of him with the purple spots?  It got much worse than that.  Started with ringworm and turned into the bacterial infection.  It was itchy and nasty, and he shared it with Toby and I.  Toby’s spots seemed to not be spreading, but then a few days ago a whole new colony broke out in the other armpit and now he is also on antibiotics (which Ben ended up starting last week).

At the same time, Ben and I were locked in battle in the “vegetable wars”.  For two years, he’s refused to eat veggies and finally I’d had enough.  Needless to say, it was ugly but after 2 days of not eating, I won.  He is just as stubborn as I am (Kevin says) but I am wilier.  for now, anyway.  I had a stomach bug all through this and Ben and I continue have upset tummies.  We’ve been a mess!

Here is a photo of Toby and Ben’s playhouse.  Nice, huh?  It was built by one of our guards, Carlos.

Next is our tire swing and water tank.  The tank catches rainwater from the garage roof and is used for all the outside washing and watering.  We could hook it up to the house and use it inside but that would take more work than we are willing to do right now.  Plus the tank isn’t big enough to take care of our needs during the dry season.

This lovely mango spider was in our backyard this morning.  It is as big as my hand.  Ick! However, I am told they don’t bite and Toby spent a lot of time last year with little friends catching them.  Ugh.

I decided to post a few photos of our backyard, which is looking rather more lush these days.  Why no grass, you ask?  It breeds mosquitoes.  I’d rather have just the dirt and have fewer mosquitoes around.  Just with the trees and shrubs, we’ve noticed a lot more mosquitoes this year. We have to keep our bed nets well tucked in at night to keep them out.

We constructed an arbor across the back porch to grow passion fruit vines and shield the porch from sun and from the rain that drives in.  We’ve already got some fruit going and I look forward to making some juice!  In our yard are also papaya trees, banana trees (we’ve been enjoying those lately), an orange tree, mango tree, and guava tree.  Also something called “coracao de boi” or “heart of ox” which I really don’t like at all but Kevin does.

Our backyard is full of flowers, zinnias.  Right now.  Fernando knows how much I love flowers so he plants them all over the place.  They are great for making a bouquet and taking to a friend.

And lastly, here’s a photo of Fernando, our guard, playing with Ben.  He is really such a nice man and the kids love him.  it is very rare for an adult man to play with children here, but he is good-humored about it when Ben takes his hand and asks him to play.  We go out and save him after a few minutes!  – Cami

Every once in awhile we REALLY need to get away, and the easiest getaway for us is in Nacala, a port town just 2 1/2 hours east of us.  We went off 2 weeks ago and enjoyed two nights and 1 1/2 days there (way too short) visiting friends and snorkeling off the beach.  Toby made his snorkeling debut, after months of paddling around with his mask and fins.  He put on his mask and snorkel, inflatable armbands to make it easier, and his fins, and off we went around the bits of reef. We were more than 30 feet offshore, and he did fantastic!  He was excited to see a lionfish, clownfish, puffer fish, cowfish, sardines leaping out of the water (and whacking him in the head!), and about 10 other types of tropical fish.  Plus anemones, an eel and various kinds of coral.  He is one lucky kid, and adventurous too.  He was totally hooked, and dad and mom took turns taking him out. He can’t wait for our next trip out to the coast. – Cami

A few weeks ago, an Austrian missionary friend of ours taught a seminar in our garage on the uses of Artemesia.  What is Artemesia, you ask?  Well, it is a plant from Asia that has been used there for hundreds (thousands?) of years in the treatment of malaria.  A group called Anamed (Action for Natural Medicine) has been promoting its use in Africa as a natural treatment.  They do this not because they believe herbal is always better (though sometimes it is) but because in many parts of Africa, people either do not have access to medications, or do not have the money to purchase them. The use of the plant has had a great deal of success in treating malaria, especially in rural areas where it is hard to get or afford medications.

Artemesia is not easy to grow here in Africa, where it is not native.  It takes careful cultivation and a lot of attention, and our guard (also who does the gardening) has struggled to get things going in our yard.  However, he has had more success that most, and currently we have a small bit of production going on.  You remove the leaves of the plant, dry them, then put a teaspoonful into a cup of boiling water to make a particularly nasty-tasting tea.  This can be drunk daily to prevent malaria, and Kevin and I have been using this (sporadically) over the last year.  Recently we’ve started using it for the kids, by crushing up the dried leaves and mixing it with chocolate sauce!  For us, this is a good prophylaxis (to prevent malaria).  However, for local people it is used mainly as a treatment, again by making a tea and drinking it over a course of 10 days.

Sigi, our Austrian friend, led a great seminar and about 22 people attended.  Missionaries and local people all showed a lot of interest and purchased dried leaves and creams (it can also be used to treat various skin conditions) and carted away informational books and posters.  Whether or not people will pursue its use remains to be seen.  People here have to be really convinced that something like this can change their lives in order to use it regularly.  We hear that those Mozambicans who drink it weekly see a great decrease in the amount of malaria they have (people here have it regularly), as well as a decrease in other sicknesses. The bitter taste, however, is a real deterrent!  We hope that this seminar will really make a difference in people’s lives and are so thankful to Sigi (who was not feeling well) for really making a big effort to put on such a great seminar. – Cami

Ben came down with some very strange skin lesions this week, and at first we thought it was just a couple of sores from falling down.  But, when we noticed how round they were, and that they were spreading, we realized that it is Ringworm.  Ringworm is actually a fungus, not a worm, and is treated with antifungal cream.  By the time we started him on the cream, he had spots in 4 different places, and despite our efforts they are continuing to spread.  Missionary Susan here in Nampula recommended we try something called Gentian Violet, which dries out the sores and hopefully will keep them from spreading.  So, this morning we told him he was going to be a spotted leopard and painted him up.  “Pah-et yepahd?” He asked.  Yup.  Pah-et yepahd.  Cute, huh?  We’ll hope that this stops him from looking like he has leprosy, though meanwhile he looks like he had an accident with a marker.  – Cami