An HIV-Free Generation in Africa: Can an Education-Reimagination Get Us There?

AidChild Leadership Institute (ALI) is an NGO based in Entebbe Uganda doing remarkable work throughout the country. Here the founder, Dr. Nathaniel Dunigan, shares his dream for an HIV-free generation.

On Friday evening, I was seated in an American friend’s large and tasteful home in Kampala, Uganda. Earlier in the day, I had traveled from my own home in Entebbe. She has lived here for 20 years, and I have been here for 18. Our reunions always begin with a discussion of traffic. Uganda’s enormous population boom and the emergence of a middle class mean that roadways are always very congested.

My friend has a personal driver for her daily commute of more than an hour—and that’s just traveling across town. “As you know, I spend a lot of time in traffic and observing,” she started. “So, get this: there’s a new guy who has emerged at one intersection, selling grated cabbage and carrots car-window to car-window—along with all the many other street vendors. He has a dish basin strapped at stomach level—hanging from his neck—and he grates the veggies into the basin. But what I can’t figure out,” she continued, “is why on earth anyone would want to buy that, and how does he give it to them? I never see any plastic bags or containers. It’s the strangest thing.”

The next day, I shared the story with one of my Ugandan colleagues, and he said, “You’re kidding, right? I mean, you know what’s happening there, don’t you?”

“No, I really don’t,” I said.

“The man is selling graters, and he’s using the cabbage and carrots to demonstrate how they work,” he said.

I share this story in our context of global education leadership for the following reasons:

  • In our global society, no matter how seasoned or thoughtful we may be, outside our own culture, we will occasionally (perhaps frequently) miss the obvious. Our success as global education leaders will forever be linked to community and relationships—to partnerships that foster inclusion and voice from a variety of individuals who will see (and express) the obvious when we miss it. This is true not just in the context of Americans living in Uganda, but also for New Yorkers in L.A., Iranians in Tokyo, Canadians in Brazil, etc.
  • Africa is booming. Despite the fact that Uganda has more road fatalities than most any other nation in the world (URSSI 2018) as well as poverty and a host of public health challenges, the population continues to grow at a tremendous rate. While Uganda is relatively small in terms of geographic size (the 82nd largest in the world), the country currently ranks at number 32 in terms of population size, and is projected to be number 18 by 2050 (Worldmeters) (CIA) .
  • Technology—of every kind—is changing everything from cabbage and carrots to politics and education, bringing both progress and risk.

On Thursday, the day before my visit to my friend in Kampala, the local electric company came to install a pay-as-you-go meter on my kitchen wall. We are among the last in our neighborhood to get this. A printed monthly bill will no longer be delivered to our gate. Instead, we will purchase units of power in advance—using our cellphones. As my son purchased our first allotment, and then entered the code into the keypad on the wall—and as the house sprang to life and light—I said to him, “Never, ever, ever could I have imagined this 18 years ago. I couldn’t even fathom a life here that included consistent power back then, let alone the mobile and satellite technology that just made our transactions possible.”

It all seemed perfectly normal to my son.

Gone are the days of traveling to a phonebooth in town to (hopefully) make a successful call. Now, while only 22% of Uganda’s population have power as I do, more than 52% have a cellphone—and often more than one (mobile phone usage in Uganda: USAID and the Daily Monitor.

It’s time to re-fathom, to reimagine what is possible, what we need to be doing now in order for the next generation to see as “normal” what we see as “impossible.”

For me, that is the goal of an HIV-free generation. In late 2000, I founded AidChild, an NGO serving orphans living with AIDS. Access to life-saving medication was impossible at that time, meaning we were a hospice facility. In 2002, we became the first in Uganda (and among the first in the world) to offer free antiretroviral therapy to children (thanks to a partnership with the AIDS Healthcare foundation). We were quickly selected as a model of pediatric HIV-AIDS care for the continent—by USAID, the CDC, and the Uganda Ministry of Health.

In May of 2017, my colleagues and I knew that it was time to reimagine yet again. We opened a Leadership Institute in Entebbe where we are creating a new model of leadership development—with

this goal of an HIV-free generation. Members of the original cohort of drug recipients in 2002 are the institute’s inaugural interns. No longer “orphans and vulnerable children,” our interns are young professionals and changemakers in training, volunteering in the community, developing their own social capital, hosting public events, engaging with our 2,000 book-library, connecting to a global community, and creating a new human development center to serve the academic and wellness needs of the generation that follows them.

So, what ingredients are needed to achieve an HIV-free generation? The reality must come from our interns’ generation. For years, the global community has rightly focused on access to water, food, medication and education in the region. Now it’s time to reimagine what that “education” must look like as we focus on the root of this wondrous possibility, which—as with so many other things—is power. I offer that an education-reimagination—in addition to academic rigor—might be driven by the following convictions:

  • Young women and men must be afforded—and then be able to understand and embrace—personal power. Herein, we as people are able to make stronger choices about sexual behavior, family planning, partner choice, etc. This power is constructed (or deconstructed) through our personal milieus, including our senses of security and of being loved.
  • All stakeholders must be offered an understanding of the distinction between our higher and lower natures. This is only possible in a life that allows and offers cognitive space beyond survival alone. Wellness and wholeness are not even abstract constructs when one doesn’t know where their next meal will come from. The above discussions show how much progress we have had here—but more must be done.
  • Marginalized communities must be normalized. Frank and open conversations about stigmatized groups—as well as engagement with them—are what foster tolerance in a generation that follows one of intolerance.
  • The capacity and desire to think beyond the here-and-now must be nurtured. In my book “We Are Not Mahogany,” I explore the dangers of a full-focus on the moment—due to a misguided conviction that one just isn’t going to live very long.

It is important to add that excellent and accessible prenatal care must also be made available throughout the region. Without this and other medical interventions and offerings, this goal truly is impossible.

It must also be said that a blogpost cannot get anywhere close to a fair unpacking of the many components of this enormous goal, but as with all reimaginations, their lives are conceived by giving them voice.

And I welcome your voice as well. Please offer your pushback and feedback below.

Meet Dr. Dunigan

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