Sporting a gauzy melafa, spectacles and carrying a notebook and pen, Fatimata Ball sat among the other health professionals, ostensibly blending into the group. It was an intimate group of 20 – doctors, nurses, sage-femmes, and birth attendants - many of whom already knew each other. But I doubt any questioned her presence. “Probably, a newly assigned nurse or sage-femme,” they thought. That is until the introductions began, and she acknowledged the real reason she was here. In lilting, but calm and confident French, Fatimata introduced herself as both a fellow health professional and nurse as well as “une seropositif” (HIV-positive).
The reaction was muted, a few loaded glances and some shifting in seats. I was worried there would be an audible gasp or someone would walk out of the room, but this was an AIDS Conference, and they were trained health professionals, after all. Though silent at the start, Fatimata's presence was profoundly felt for the remainder of the two-day conference, and, I hope, is still felt by many attendees today. Her story is a powerful one, of conflicting identities and emotions. It is unfortunate, but I know she wouldn’t call her situation a tragedy. Instead, she would embrace her life as a story of trial and triumph, of rebirth and recognition of further purpose. Only she can do her story justice – her strong voice and warm, confidential manner - but in order to understand her impact, one must know her story. I hope you’ll click on the following link to learn more about Fatimata's story.
"Fighting AIDS in Mauritania"
But why was Fatimata's presence necessary in the first place? Plenty of individuals in Africa and, indeed, worldwide can grasp the tragedy of the AIDS epidemic without listening to the personal stories of those affected. A quick examination of the 2007 USAID report reveals more than enough to produce alarm:
- Number of people living with HIV in 2007: 33.2 million
- People newly infected with HIV: 2.5 million
- AIDS deaths in 2007: 2.1 million
These statistics are so horrifying that they almost defy imagination. It’s kind of like looking at the number of deaths that resulted from the Holocaust and the American Civil War; the numbers are so gross that they almost overshadow the events and stories couched within them. Which is precisely the problem. It is dangerous to reduce this disease (and others) to just statistics. To do so blinds us to the shifting realities and social trends that perpetuate diseases’ spread.
In the months leading up to the conference, I discovered through various conversations and observations that this was sadly the case among most of the health professionals and community members in my region of Mauritania. Ignorance, racism, misinterpretation of statistics, and a host of other factors had blinded the very individuals entrusted with the health of the community, to the reality right before their eyes. The epidemic just didn’t seem real. In their minds, AIDS was something that occurred in the rest of the world and among the black African population, not in their belani (white moor) subset. Furthermore, some individuals refused to believe that “good Muslims” could contract HIV. Needless to say, the implications of such a mentality are disastrous; it disarms the proverbial firewall and reduces health workers’ ability to effectively educate, motivate, and counsel the community.
And yet, to some degree, I can understand their conscious and unconscious reticence to acknowledge AIDS presence in their lives. Not only is it terrifying to accept AIDS as a legitimate threat, but the Tagant is a seemingly low-risk region. Centrally located in Mauritania and at the end of one of its primary highways, Tidjikja remains one of the more isolated cities in the country. Unlike higher risk environs, Tidjikja and the other cities of the Tagant region do not share an international border nor are its cities highly trafficked on the Road of Hope. Honestly, I do not doubt that the number of HIV-positive individuals in the Tagant is lower than in other regions; the last study was done in 2001. However, the number of individuals who have contracted the virus since then has undoubtedly grown. Travel in and out of the Tagant region has increased; divorce and remarriage are still common practices; and condoms are under-utilized as a means of birth control and protection. The dearth of HIV/AIDS educational activities and discussion in the community and a lack of motivation among community members to get tested merely compound the problem.
In discussing these factors with Ghallet, a local sage-femme, and with Dr. Moustapha ould El Moctar, the regional chief of health services, we came to the conclusion that the best way to effect the most change was with a conference. While any of us could venture into the community and do an AIDS sensibilization, we understood that those individuals closer to the community, the perceived authorities on health-related issues, would have greater success and exponentially increase our outreach. The primary challenge for us then was to shock these professionals out of their comfort zone and force them to confront this new reality. Enter: Fatimata Ball.
And Fatimata did exactly that. She hammered at their misconceptions and previously constructed walls and conventions. She said, “Look at me. I’m a good Muslim woman. I am a trained health professional. I am a Mauritanian. I am infected. And I’m not the only one!” On the last day of the conference, I sat, watching Fatimata share laughs and trade stories with some of the assembled nurses and birth attendants… Tirelessly working to tear down any remaining mistaken beliefs. As proud as I was and as hopeful as I wanted to be in that moment, I couldn’t help but question whether the attending health worker’s would actually take Fatimata's story to heart and implement the lessons of the conference? I didn’t have to wait long for an answer. The next day, my friend, Selem, called, asking me to accompany her to a brousse town to do an AIDS sensibilization. A week later, Hamoud, a math teacher in Gnimlane, requested AIDS materials and help in planning his village’s own AIDS conference.
I am immeasurably proud of these individuals and the others who have so wholly embraced the message of the conference, but my favorite moment was perhaps this past Saturday during my weekly Club Santé meeting. I was discussing HIV/AIDS and STI’s – still touchy subjects for Muslim students even though they are exposed to them beginning in primary school. Suddenly, in the midst of answering questions on protection and prevention, one student raised his hand and asked, “Teacher, est-ce que nous pouvons faire le depistage?” (Can we take an HIV test?). I was completely blown away. While testing remains free and confidential to all Mauritanians at the regional hospital, few individuals, much less students, know of this service and even fewer take advantage of it because of the stigma attached to it. Instead, the entire class jumped at the proposition! It may sound a bit morbid, but I'm honestly looking forward to next week when I will escort them to the hospital for their first test. Inshallah, all the results will be negative, and the students will feel empowered to encourage others to faire le depistage (get tested).
Two lessons that continue to resonate with me in the wake of these two seminars:
1. We must never become immune to the individual lives caught in the crossfire of disease, violence, and/or other tragedy… even if it does make it easier to digest and cope.
2. Nor must we let these tragedies rule our perspective, forever dampening our outlook. Never lose faith in the ability of individuals to adapt, to change, and to grow.
