All That Is Bitter and Sweet_ A Memoir - Ashley Judd [74]
By now Moyra had joined me on this painful, glorious adventure. I was deeply grateful for her company, and I’m amazed at how we love so many of the same things. As we drove through the countryside, both of us gaped out the window at the cheer the Malagasy put into their tiny clay huts, at the beauty of wild roses, St. John’s lilies, rushing rivers, waterfalls, graceful, inventive orchids, and ridges of green as far as the eye could see.
But after this brief, restorative visit, it was on to the teeming capital, Antananarivo, and the challenges of a once isolated people now being slammed headlong into the twenty-first century. I quickly began to see beyond the physical grandeur of Madagascar and into its extraordinary poverty. Even though the land seems abundant, 88 percent of rural Malagasy do not have safe drinking water, and they suffer the consequences of that with the usual tragedies, all of which are preventable, including unacceptably high maternal and child mortality. The land produces fruit, but it earns them little money, as 60 percent of it rots before it can be exported; farmers cannot afford to pay to transport it. The once magnificent forests are being razed for timber and firewood and by slash-and-burn agricultural practices. And while it seems lovely that there is no litter on the ground, it is because there are no goods to throw away. Only half the children are vaccinated, and half the children are malnourished and stunted. The rural infrastructure is extremely minimal, and our mission of delivering lifesaving messages and goods, such as clean water treatment (which costs only 1 franc per liter), insecticide-treated mosquito nets, maternal and child health education and products, and, of course, HIV/AIDS prevention, has been confronted with a whole new galaxy of challenging puzzles. Fortunately, we do have some good funding here from both USAID and the Global Fund, money I was seeing in action in terms of both ideas and programs and the motivated, dynamic local personnel who implement them.
Although AIDS had been slow in coming to Madagascar, in 2005 it was waiting like a ticking time bomb to explode into the general population. Madagascar’s remoteness, coupled with an isolationist, Socialist government, helped protect its people from the AIDS pandemic that swept the mainland during the 1980s and 1990s. But in recent years, a new leadership had thrown open the doors to private investment, travel, and tourism—and with it, HIV.
At the time of our visit, between only 1 and 2 percent of the population of nineteen million was HIV-positive. That was the good news. The frightening news was that what little the Malagasy people knew about HIV was mostly rumor and misinformation. It reminded me of the United States in the early 1980s, when there was so much fear and such a terrible stigma attached to the virus that HIV carriers were afraid to be tested. But with the Malagasy government’s support, PSI was unleashing a massive social marketing campaign to educate the people about HIV/AIDS and how to prevent it.
Part of my job here was to use my high profile to crack open the social taboos surrounding HIV/AIDS and to find at least one HIV-positive Malagasy to go on television with me to put a human face on the epidemic for the first time. It took Tim Hobgood, PSI’s young country director, most of the week to track down a willing subject. The woman who had agreed to meet me wanted to back