All That Is Bitter and Sweet

by Ashley Judd

  For the rest of my time in Rwanda, as we drove through the now clean and orderly capital, as we drank in the lovely countryside, my mind would occasionally run an automatic slide show, imposing the detritus of genocide on what I was seeing. It really was incomprehensible that such protracted filthy evil transpired ever, anywhere, but especially in a place this pretty and seemingly serene.

  This country is close to the very bottom of impoverished nations, ranking 159th out of 177. Yet our hotel was terrific, with a sparkling azure pool surrounded by palms. I had a little suite, and as part of my meditation each morning, I stood at my window drinking tea, watching a woman with a handmade broom sweep the street below. This had to be the cleanest country in Africa, if not the world: All the lavatories in Kigali were clean, and there was toilet paper available in public places everywhere. The streets and fields were free of litter; those ubiquitous plastic bags clogging gutters everywhere on earth were banned in Rwanda. And this was also the safest country in Africa, Papa Jack had assured me.

  The government keeps a tight rein on its people to enforce a national identity without ethnic divisions. The downside of this extreme vigilance is an authoritarian streak in the government and a restriction of free expression, particularly among political opponents of the ruling party, that is easy for a Westerner to perceive as over the top. One PSI staffer was jailed for rolling his eyes at a traffic jam caused by the discovery of a genocide victim’s remains. As a foreign visitor, I was told to expect that my telephone and emails would be monitored at the hotel. But President Kagame himself told me that when we have lived through their many genocides (1994 was actually but one in a long series), we will have the experience and the right to judge their genocide prevention policies. I really can’t come up with an adequate counterargument to that.

  Looking at the extreme nature of what transpired, the government reckoned that extreme solutions were necessary, and the positive result is one of the most dynamic governments in the entire world. President Kagame and his cabinet seem to spend every waking hour looking for innovative ways to modernize Rwanda and improve the lives of all its people. They rely heavily on international aid but have a can-do attitude about rebuilding their country themselves. The government partners directly with all NGOs and encourages local participation. For instance, of the 150 people PSI employs here, only 4 are non-Rwandan.

  After my wrenching morning at the genocide memorial, I was looking forward to meeting those staff members and absorbing their positive energy. The offices were housed in a two-story brick building set into a small hillside. There was a rondel of cosmos growing by the PSI sign and a small fleet of tidy white trucks parked in front. I met with our country director, Staci Leuschner, and the staff for a briefing about our mission here. The challenges are massive and all too familiar: lack of infrastructure, lack of health care providers, an explosive birth rate and high infant mortality, endemic malaria, lack of safe water (only 2.5 percent of Rwandans have piped water), and the prevalence of STIs, HIV/AIDS, and other preventable diseases and issues that keep the entire population subsisting on less than a dollar a day.

  What is quite special about Rwanda is that the Ministry of Health is attacking these problems in a holistic manner, creating a health care system from the grass roots up, with an emphasis on prevention and primary care delivered by community health workers through a network of local clinics and district hospitals. (They even have a basic national insurance plan with 97 percent enrollment!) What NGOs do here, as in poor countries everywhere, is fill critical gaps in services, education, and product delivery where the government and private sectors are lacking. Governments often have little if any infrastructure, yet magically those fizzy soda pop drinks are ubiquitous, as are mobile phones. Hence, PSI focuses on markets—those consumer goods prove they exist—employing private sector techniques to make markets actually work for poor people. The same networks that make cigarettes available in every corner of the earth can be leveraged and grown to make healthy products and behavior-change communication accessible to hundreds of millions of people. In this way, positive development contributions are made to local economies, increasing employability by adding to job experience. Plus, the initiatives and campaigns appeal to local folks, because they are generated by locals.

  Below the PSI office building is a garage/warehouse for our medical products, many of which bear the proud stamp of USAID, and it is from here we begin to distribute them to clinics and pharmacies and sometimes directly to the poor people who need them. The warehouse staff here, as in most of the sixty-five countries where we have programs, include formerly prostituted women whom we have been able to reach via peer education. As a result, many have been able to exit from prostitution altogether. I visited women who have created a co-op in which they pool their money to buy supplies in bulk, bringing down their individual costs. They make wonderful crafts to sell, and the two sources of income have allowed them to improve their lives substantially, progressing them along the continuum from exploited, informal work to more dignified, formal work with a measure of security and social protections. Plus, they increase their business savvy, allowing them to identify further entrepreneurial opportunities for income generation. There are many reasons to marvel at the “ingenuity of the poor.” It is fascinating to see poverty reduction solutions in action and how one good action opens the way for yet another.

  By late afternoon, I was ready to crash in my hotel room. A familiar crispy, burning fatigue had set in, the kind that feels like grit in my eyes and an aching in my joints, the end product of jet lag and grief. To my surprise, because I am an experienced “rester” but not necessarily a talented “napper,” I fell asleep as soon as my head hit the pillow.

  I roused a couple of hours later to meet Zainab Salbi, founder and director of Women for Women International (WFWI), who was visiting Rwanda for a conference on gender-based violence. I had a pot of green tea ready when she arrived at my door, resplendent with chic cropped hair, black silk shirtwaist dress, and fabulous enormous beaded necklace. I’ve been a longtime supporter, and I was eager to meet the elegant and dynamic Zainab. She is a survivor of Saddam Hussein’s Iraq and a human rights activist who founded Women for Women out of the ruins of the rape camps in Bosnia in 1993. Since then, the group has helped some 250,000 women rebuild their lives during and in the aftermath of war. The organization offers immediate food and medical support for women in conflict zones, then lifts them up with counseling, jobs, civic participation and empowerment training, literacy education, and microcredit loans and savings to create leaders out of victims. They work in the toughest places, from Afghanistan to Darfur. The strong women-to-women alliances that emerge during the course of a woman’s one-year program participation is one of the greatest assets a woman gains.

  Zainab is an intense and rapid talker, and I was content to sip my tea and let her school me in the recent history of the region and hear about the group’s work in Rwanda and across the border in the Democratic Republic of the Congo.

  “Rape is contagious,” she said. “And where it has become an epidemic, it has to be treated like a disease.” In the eastern DRC, she said, punctuating her points with jabs of her finger, literally hundreds of thousands of women had been raped since the mid-1990s, and the practice has become ingrained in the culture. The epidemic began during the Rwandan genocide and spilled across the border with the fleeing Hutu fanatics. Before long, the militias regrouped as a rebel army, which began terrorizing the Congolese and using refugee camps to stage raids into Rwanda. In 1996, Paul Kagame’s army invaded the eastern Congo to flush out the Hutu militants, while backing a rebel Congolese force to oust that country’s dictator, Mobutu Sese Seko. It’s a long and complex story, but the invasion touched off what is known as “Africa’s world war,” with several far-flung nations sending troops to join the fight over control of the DRC. Much of the DRC is fairly peaceful now, but the war rages on in the easternmost provinces between various armed militias and go
vernment troops. Along the way, an estimated five million people have died in a conflict that few Westerners were even aware was happening. Zainab explained that this war, like all wars, has become about the economy and land and exploiting natural resources. And rape, as a weapon to terrorize and coerce civilian populations, has become a daily occurrence.

  Zainab told me that WFWI, which has an extensive program to help the women of Rwanda, arrived in the DRC in 2004 to launch a multitiered program of direct aid and emotional support, rights awareness and leadership education, vocational skills training and income-generation support. So far it has helped eight thousand women in the conflict zone. But Zainab realized that any gains for women would be short-lived without reeducating men. So WFWI has started up leadership schools to change the behavior of Congolese men, to train them how to respect women’s rights, and to educate them in the value of women’s work in the development of communities and nations.

  “It’s fascinating, Ashley!” said Zainab in her British-inflected English. “You must see our programs there.”

  I decided on the spot that I had to check this out for myself—how cool would that be, after having been a WFWI sponsor to my sisters in Nigeria for three years? I called Kate and Marshall and told them I would no longer be joining them on a trek to visit the famous mountain gorillas in the Parc National des Volcans. Instead I wanted to slip across the border to the town of Goma to visit Zainab’s projects, along with some PSI partner programs. Dario was not amused when I told him, but I assured him that Papa Jack and Marshall would be with me and that Goma was said to be stable these days, with a large UN presence. The gorillas, much as I love them, would have to wait.

  Downstairs at what would be healing dinner, rich with new friendships, Zainab introduced me first to the great Rwandan senator Aloisea Inyumba, who hugged me warmly. President Kagame’s legislature and ministerial posts are loaded with capable women, the highest female participation anywhere in the world, but Aloisea is a standout. In 1994, after he stopped the genocide, Kagame made her Minister of Family, Gender, and Social Affairs. Her job was to oversee the burial of the dead, resettlement of refugees, and placement in homes for the country’s five hundred thousand orphans. Her solution: Everyone must take in a child, and that meant Hutus raising Tutsi children (Gandhi would heartily agree). It was a first step toward reconciliation. Later, she was put in charge of one of the biggest challenges of all: finding a just punishment for the perpetrators of genocide living in Rwanda. Rather than seeking revenge, the Tutsis in charge of the country wanted to find a way for everyone to live together again in peace. When she took the job as head of the Unity and Reconciliation Commission in 2000, the fragile prison system was clogged with low-level génocidaires awaiting trial. (The ringleaders are still being tried in an international court in Tanzania.) Inyumba decided to bring back traditional gacacas, literally meaning “patch of grass” courts, to try the accused right in their districts. Since then, more than 1.5 million accused have passed through the gacaca system. Defendants were offered shorter sentences for confessing and apologizing to the families of their victims and the whole community. It has been a tough, tough process, but a vital step toward healing the trauma and moving ahead as a unified nation.

  I spoke for a while with this amazing, special woman (who has since become a close friend and collaborator), and then, when the moment was right, she took me over to meet the First Lady of Rwanda. Jeannette Kagame is a physically imposing presence and somewhat stoic, perhaps even dour. We exchanged a few polite words, but I couldn’t really pay attention because I was having an attack of static cling, and my silk dress was naughtily climbing ever upward! I know this because the First Lady’s aide-de-camp was on her knees behind me, pulling my dress down and off my backside. Hmmm … was it to protect my modesty or the decorum of the entire event? After all, I was smack dab at the front of the room, back turned to the crowd, a movie star chatting with the First Lady. What a lousy time for a bad case of hungry bum!

  Better events followed. The most extraordinary drumming and dancing began, performed by the Inganzo Cultural Troupe, and I could feel the pain of earlier in the day being vibrated out of my chest. I was absolutely in awe. This is the Africa I believed in, its traditional culture and arts preserved and shining amid educated, empowered people talking smart about gender equality and development with an eye on seven generations ahead. Even though we were in a hotel’s spiffy ballroom, when I closed my eyes I was in the bush, around a fire, the sounds of the wild engulfing me. It was fabulous beyond description. The senator narrated each dance for me: Ah, this is the dance about millet, teaching and celebrating agricultural practices, valuing production to keep everyone fed. Ah, this is the dance for the herd, the grass at the end of their sticks is to dust off the herd. Ahhhh, this is the dance of women, celebrating their beautiful bodies! My gosh, I live for this stuff—it’s what I dreamed of in college!

  That night when I closed my eyes and visions of broken skulls and bloodstained dresses welled up in my thoughts, I let the drums beat them out of my head. I slept pretty well and woke up curious about another day in this lush land.

  At first light, we drove out to the airport and boarded a heifer of a government helicopter, a giant military thing with bench seating lining the length of the cabin. Some old Russian Mi-17, Dario later explained, rather confounded that I’d signed a release saying that a) I would fly in it, and b) neither I nor anyone in my family would be mad if it crashed. I was joining Rwanda’s minister of health, Dr. Jean Damascène Ntawukuliryayo, crisscrossing the small country to celebrate World Malaria Day with a tour of clinics and programs. The people here need them so badly. One in twelve children born here will die before age one, then an additional one child in seven will die before age five (that’s why our child survival program is called Five & Alive). Malaria, preventable and treatable, is cause number one.

  To take this on, PSI socially markets Tuzanet, which is pretreated with the appropriate insecticide and lasts for three years. It is available at a very small price or for free in many areas as well. This blended approach of private sector availability combined with recent free distribution of three million bed nets to caregivers of children under age five, pregnant mothers, and the HIV-positive helped achieve a stunning 60 percent reduction in malaria cases in 2007. This is the greatest reduction of malaria rates in the world, something Kagame’s government can be very proud of doing for its people. There was a lot to celebrate on World Malaria Day 2008.

  From the air, I could see why Rwanda is called the “Land of a Thousand Hills.” Its peaks and valleys undulated below me, green and terraced and graced with lakes. While I admired the landscape I began to register what I had heard, that every square inch of the land is tilled in the effort to feed all ten million people living here. They have already run out of space, and there are predictable environmental consequences: massive deforestation, erosion, loss of biodiversity. I was warned that I would never be alone (something I need at least a little of daily), as even in the most remote parts of the country, people would be … everywhere. And it’s true, they are. No matter how much I hunted for a discreet place to pee, I could never find one. Even unpaved rural roads are lined with folks walking somewhere, perhaps in a blue school uniform or with baskets of goods or a jerrican of water on their heads. There is no way Rwanda and other countries can overcome their problems unless the population growth is reduced.

  We landed in a giant field in the Est Province, greeted by hundreds of onlookers who were curious about the helicopter. Cries of mzungu—“white person”—erupted as my colleagues and I climbed into our cars. We jolted across rough, red dirt roads to visit a community of health workers in action. Our guide, Pierre, was elected by his fellow villagers to become the village’s health worker. Once chosen, he received intensive health services training, which is ongoing. Pierre carries a bag with lifesaving pharmaceuticals, such as antibiotics, family-planning kits, malaria treatment, and first-aid materials. He
is available in his home and goes to those who are too unwell to traverse the mountains. If the case is too difficult for him to handle, Pierre refers the patient to the local clinic. He also follows up and makes sure patients take their medications for AIDS and tuberculosis. It’s a wonderful program that allows primary care to reach the poorest and most remote areas.

  In a small, bare home, we visited a broken woman holding a limp infant. Pierre had diagnosed malaria in the baby and was teaching the mother about her new insecticide-impregnated net and the proper use of Primo, the lifesaving treatment that PSI packages and markets especially for children. When I sat with the woman, she was not easy to engage, she herself was so ill and overwhelmed. I tried to squeeze in a few quiet moments with her, as I am not a breeze in, breeze out, kind of gal. My only real contact with her, however, was that she smelled so rotten I actually had a gag reflex, a first for me in eleven countries of slums, brothels, and hospices. Water is so scarce here, and it is such hard work to fetch it, that one drinks it mostly, then perhaps uses it for cooking. Washing oneself is a very low priority in this country. I felt very sad. I didn’t even learn her name.

  In back of the minuscule house, another woman who rented the bedroom proudly showed us her treated net hanging over her bed. She was wearing a matched lavender outfit, and we sat under her net giggling, unable to understand each other with words but giddily connected somehow, excited just to see each other and hug.