Excerpts from Helen Epstein's The Invisible Cure

In The Invisible Cure, Helen Epstein writes about Uganda’s newfound born-again Christian fervor, and how it interacts dangerously with a pressing concern: AIDS prevention. In the 1980s the HIV infection rate was high in Uganda. But it dropped dramatically in the early 90s. The reasons are not completely clear, but Epstein argues convincingly that it was because of the Ugandan Health Ministry’s innovative Zero Grazing program, which encouraged Ugandans – through various grassroots community programs – to stick to one partner. The Zero Grazing program recognized and understood the nature of Ugandan polygamous relationships and addressed the problem of HIV directly and in realistic fashion. The community rallied together: AIDS patients were not stigmatized, but cared for. There was recognition that everyone was susceptible to AIDS. This homegrown, tailored-to-the-context effort was startlingly effective; something like it - frank and compassionate - was needed in other parts of Africa too.

But things have changed since. The evangelical Christianity now sweeping Uganda – supported in turn by the evangelical organizations in the US – is now involved in a push very different from Zero Grazing. The mantra now: Abstinence Only. Abstinence Only initiatives are funded by President Bush’s billion dollar program for AIDS prevention. Many missionary organizations have taken up the mantle. But it is unclear whether such a message on abstaining from sex until marriage is realistic.

Let me present two different excerpts from Helen Epstein’s book – both from a chapter that can be found here. The first is a humorous vignette from Makerere University in Kampala, which illustrates neatly some of the issues Uganda is up against:

“I arrived in Uganda in September 2004 ... As I usually do I stayed in Makerere University in Kampala. It was the beginning of the school year and students were arriving from all over the country. The freshmen dressed in the formal way of the 1940s American college men and women, in long skirts or slacks buttoned-up white shirts with collars. Each year, upperclassmen at Lumumba Hall, a men’s dormitory, welcome the freshmen by displaying their dorm mascot on the grass in front of the building. The mascot is a life-sized sculpture of a man, made from scrap metal, with a large drainpipe for a phallus. In order to educate their peers about HIV, the students dress the phallus in a new condom every day, and box of fresh condoms – free for the taking is placed at its feet. “He symbolizes the culture of our hall of residence,” one of the students explained to me. “He has girlfriends, but he always uses a condom.” One afternoon shortly after I arrived, a pastor from a nearby church marched up to the statue, removed its condom, set a match to the box of free condoms, and then prayed over the fire: “I burn these condoms in the name of Jesus!” he boomed, and then promised each student a free Bible.”

And the second is Epstein’s final philosophical paragraph from the chapter, which expresses very well humanity’s confusion about sexuality and its link to HIV:

Sexuality truly does belong to the world of magic and unreason. It is impossible to plan and control it totally. We were made that way. If sex were an entirely rational process, the species would probably have died out long ago. But the delirious, illogical nature of sex makes setting a realistic HIV prevention policy difficult. Cheerful, sexy condom ads that fail to address the real dangers of AIDS may promote a fatal carelessness; but an exclusive emphasis on abstinence until marriage may well lead to an even more dangerous hysterical recidivism. The genius of the Zero Grazing campaign was that it recognized both the universal power of sexuality and the specific sexual culture in this part of Africa, and gave people advice they could realistically follow.”