Margaret Musambi (credit: Dominic Chavez)

MUMIAS, Kenya — Margaret Musambi is one of those rare people who likes to expand her job responsibilities to have a greater impact on people’s lives. She is an extension agent for Kenya’s Ministry of Agriculture, based here in the western part of the country.

Musambi’s passion in the last few years has been to teach farmers the multiple uses of soybeans, emphasizing their nutritional benefits. She has shown farmers how to make soy milk, soy yogurt, soy cakes, soy sausages, even soy meatballs.

“Soy is wonderful,” she said one day recently, sitting with a group of farmers.

But one of her more creative projects has been to introduce soy to a group of people infected with HIV, the virus that causes AIDS. In Mumias, a town of about 30,000 people, she has begun to work with 50 members belonging to an HIV/AIDS support group.

Helped by a small grant from the US Agency for International Development, the group purchased 50-kilogram bags of soybeans. She told the group members, most of whom are taking anti-retroviral drugs to fight AIDS, that they should incorporate more soy into their diets. She also taught them how to make soy products, which the members now sell in local markets.

“These people are becoming so healthy,” Musambi said. “Their drugs are helping them, and the soybeans are as well. It’s true. You eat soy and it will cheer you up.”

Kenya Cows (credit: Dominic Chavez)

NAIROBI – The pace of life here is as it always has been–lots of traffic jams, crowded downtown sidewalks, tens of thousands of people selling things by the roadside. Tourists also have returned in high numbers this summer. It is easy to forget that just seven months ago the waves of post-election violence raised serious questions about the country’s future.

But the impacts linger, just out of view. This morning, I was interviewing Machira Gichohi, managing director of the Kenya Dairy Board, and he brought up how the violence affected the dairy industry.

Much of the violence, he noted, was concentrated in the Rift Valley, which produces roughly half of the country’s milk. During the month-long upheaval, “farmers’ animals were stolen, infrastructure was destroyed, and people just scattered.”

In December 2007, just before the violent outbreak, the country was producing 1.2 million liters of milk per day. But during the violence–January and February–output dropped by half, to 600,000 liters per day. Now, Gichohi said, it had rebounded to 850,000 liters daily.

It is the cold season here, and dairy cows are producing less milk than during warmer times. So it seemed that the dairy industry was making a fairly swift rebound, and that in a few months it was conceivable to approach the pre-violence numbers.

But Gichohi said it wouldn’t be so easy.

“It will take us one to two years to get back to where it was,” he said. “As our prime minister said in London, ‘Kenyans have gone to hell and we don’t want to go back.’ That’s how we feel. We hope those crazy days don’t come back.”

Mariam Yussif (credit: John Donnelly)

ACCRA, Ghana – Over the last decade, support groups for HIV-positive people have flourished around Africa. The best of these groups offer so much: a safe place to talk about the range of issues they face; endless empathy; even connections that can lead to jobs. But rarely have I seen such a need for a group as during a recent visit here, with the Yaddah Dah Allah Muslim Women Association, whose members are HIV positive.

The 35 women share a secret — their HIV status — almost entirely just among themselves. Husbands don’t know. Families haven’t heard. Friends haven’t been told. The reason is simple: Many fear that if they revealed their status, husbands and members of the extended family would kick them out of their homes or worse — even though in almost all cases husbands infected them.

“In the Muslim community, we don’t want to disclose our status to each other,” said Mariam Yussif, the founder of the group. “People would rather kill themselves than bring it out.”

So their escape valve opens only when they meet — the third Thursday of every month. Mariam leads them. She has had a tragic past — her husband and three of her five children have died from AIDS-related causes, she said.

And yet, on a visit recently with a small group of African health journalists attending a Kaiser Family Foundation-sponsored workshop in Accra, Mariam didn’t evoke feelings of sympathy. Instead, we were dazzled by her — she spoke freely and expressed herself with heartfelt precision.

“If we could get the Muslim community to talk about HIV, it would start to do away with the stigma,” she said, standing in front on about a dozen support group members. “Many men have more than two wives, so if he gets infected, it means everyone is infected. And if a Muslim woman is infected in Ghana, she is a prisoner.”

When Mariam finished, Penny Duckham, who is charge of the Kaiser Media Fellowship programs, whispered to me, “She’s a rock star.” Penny was right — Mariam was such an effective speaker that she had the ability to move audiences, and by doing so could greatly help women like herself.

And yet, there wasn’t much else uplifting from our visit. Several Muslim women spoke to us about the troubles in their lives.

“It was so difficult for me to be living with this disease. I need to talk to someone about it, but that wasn’t possible,” said one woman. “So it was such a great joy that I found this group.”

I asked them if they were able to express anger toward their husbands in the group setting. The women all shook their heads. No, they said.

“When we meet, we don’t talk about any anger toward our husbands,” said one. “Instead, we draw strength from each other.”

Rosa, Before (credit: Dominic Chavez)

I have traveled around the developing world since I was barely out of my teens. I’ve been in more places forgotten than remembered. But people often stay with me. Rosa does.

I met her last fall in a rundown quarter of Addis Ababa, Ethiopia. She was 16, with black unruly hair that ran in all directions, and she wore a pout –- partly because a man I was writing about was telling her how disappointed she had made him. The man, Nasir al-Amin, had been spending his vacations for the past five years helping put children through school in Addis. I am in the process of writing a book on how Americans are trying to help children in Africa, and Nasir is a key person in the book.

For Nasir, Rosa was special. He had known her for four years. She had lost both her parents to AIDS. And Nasir was putting Rosa through school, along with 57 other Ethiopian kids. But the other 57 were doing well in school; Rosa was not. She had dropped out of a photography school, and for two days last fall Nasir tried to get her back on track.

Rosa had health problems — an irregular heart beat, and depression, it seemed — and Nasir gave her money to see a doctor and enroll in school. But after seeing her in late September, Rosa never showed for a meeting to give him receipts and a report on how it went. For several months afterward, Nasir thought all was lost. He sent out emissaries to find her, but he heard nothing. Nasir feared she had turned to sex work.

Six months later, I returned to Addis, and went looking for Rosa.

I called a social worker to ask for help. He said he would call around. A few days later, I showed up at his office. An acquaintance of his had found Rosa’s phone number, and had talked to her. Even better, she had agreed to meet me in a few days. But I didn’t have a few days –- I had to meet her that morning. I was flying back to Washington the next day. The social worker said he couldn’t help me right away. I pressed him. He left to speak with his boss; he received permission to go with me.

Rosa had moved to a nearby slum. But when we arrived, she wasn’t there. The social worker called her, and she promised to come immediately. Five minutes passed, and then she called out our names. We rounded a corner, and there was Rosa, older somehow, her hair shorn, bigger, much bigger. I approached and it was obvious: Rosa was pregnant.

She took us to her sister’s house — her sister was a waif, Rosa 20 days from delivery. Her stories poured out. Just the day after we had seen her in the fall, a doctor told her she was pregnant. A day later, her uncle had beat her for going out with boys, beat her so bad that her blood ran down her back and chest. Then the uncle took scissors to her beautiful hair and cut huge clumps indiscriminately. Rosa retreated to her room, and shaved her head. The next morning, her uncle kicked her out of the house with nothing. Rosa moved in with her boyfriend’s family’s home, where she remained still. But her problems hadn’t ended. Her heart was giving her trouble –- racing one minute, causing her to gulp for air another. Two doctors had told her in the past few days that she was in grave danger now, that giving birth put her and her baby at risk.

I sat across from her, wondering what would become of her. She would have a baby in days. She would be caring for her baby, she wouldn’t be going to school. Sixteen-year-old Rosa was a memory. I went looking for her, but she was lost.