All That Is Bitter and Sweet

by Ashley Judd

  The minister, Dr. Ntawukuliryayo, a long, lanky, hyperenergetic man, would not be lingering long at any of our stops. We continued on our tour of rural clinics in a convoy of government, USAID, UN, WHO, and PSI cars. Lurching and heaving over rutted roads, small black faces joyfully yelling, “Mzungu!” wherever we went, we arrived at an open-sided building where rows and rows of locals were sitting on wooden benches on a poured-concrete floor under a corrugated tin roof. They were waiting patiently for medical services, and by the look of it, they would need that patience—it was very crowded.

  The wards were bare cement rooms with simple aluminum cots lining the walls. The beds were all filled, mostly with mothers nursing their newborns. The minister and I stopped at each bed to talk about how undeveloped children’s immune systems are and why sleeping with mosquito nets is essential. I was able to hold a sleeping two-day-old baby, tiny and probably premature. Low birth weight is a very common consequence of both malaria during pregnancy and other maternal health issues, such as lack of adequate spacing between births. Rwandan women average 6.3 babies each. That means if I were a Rwandan, I would have nearly seven kids and I would be almost dead; life expectancy for women here is forty-four years. I contemplated this for a while, but not for long … the minister was off to the prenatal ward.

  Although we were there to teach the ABCs of malaria prevention and treatment, the minister never missed an opportunity to reinforce other key health messages. At this clinic and everywhere we went, the indefatigable minister also discussed family planning and water purification. He even inspected the outdoor toilets and gave spontaneous talks to observers about sanitation and hygiene.

  The sad fact is that 60 percent of rural and 40 percent of urban Rwandans do not have access to safe water. Even the 2.5 percent with piped water cannot know if that water is safe. Unsafe water makes millions sick and kills 2.2 million worldwide every year. The UN clearly states that disinfection of water at the point of use is consistently the most cost-effective way to save lives. To that end, PSI markets our miracle powder, Sur’Eau, in Rwanda to disinfect and purify polluted water. It comes in a small plastic bottle that provides safe water for a family of six for one month for a total cost of 55 cents!

  After an exhausting day of running around the countryside, our convoy returned to the pasture where the helicopter was waiting. Hundreds, if not thousands, of people had gathered and were lining the field in the most orderly fashion. They were tiered, littlest sitting to tallest standing in the back, staring silently at the big machine. I dove into the crowd and plopped myself down in their midst. I was immediately surrounded by an epic mural of shining black faces, seemingly from grass to sky.

  I noticed a boy in a ragged shirt holding a bundle of old plastic bags that he had compacted and tied up with string to make a precious football. I gestured to him and the ball, stood up, and we were off. In one of the most memorable moments of my life, the kids and I began to stream joyously all over acres of green grass, passing the “football,” shrieking with glee. I was in a state of grace, and I knew it. It felt as though it lasted forever, the running, lungs heaving, laughing, and seeing their unmitigated joy, the color of their skin so black with my own little white body nestled in the herd. I kicked off my flip-flops and ran barefoot hither and yon. I happened to have on my favorite secondhand dress, an old calico print, and I connected easily with the mountain girl in me. I am sure that was what they connected with, too, and why we fit so well together in spite of all our “differences.” When the illusion of differences is rendered obsolete, this, I believe, is heaven.

  At last the helicopter people started to shepherd us off the grass, and the minister, who was ready to go, gave me the stink eye. But it was good while it lasted.

  On the last Saturday of each month, every citizen of Rwanda sets aside three hours to participate in community building. This old cultural practice of helping one another, called umaganda, is absolutely glorious—I would love to start the practice in my hometown in Tennessee. Today’s umaganda project, led by our tireless minister of health, was building homes for genocide widows. (And of course, as there was a throng, he never stopped reinforcing the government’s health messages: “A small family is a healthy family! Use soap! Treat your drinking water!”) As suggested, we all wore get-dirty clothes, and some of us engaged in tough physical labor. It was an enormous turnout. Laboring together has been influential in healing from the genocide; Rwandans now want to be known as just that, Rwandans, and not Tutsis or Hutus. They help one another without reservation, no questions asked. They manage to live side by side; one may literally live beside a neighbor who tortured or murdered members of one’s family and village. It’s remarkable.

  I was reminded of an image from my visit to the genocide museum on my first morning in Rwanda. Outside the building there are graves where thousands upon thousands of genocide victims were buried en masse. The slabs that cover the graves are fifteen feet wide, twenty feet long, several feet above the ground (the graves are so deep, so deep), and go on for as far as the eye can see. In the poured concrete that is the final resting place for bones hacked by machetes, I saw a white flower, tinier than my pinky fingernail, growing out from within the flat cement of a massive tomb. Rwanda is like this flower, a thing that is blooming out of the detritus and wreckage of the absolute worst humanity has to offer.

  The wheel of time turns: Life, death. Life, death.

  Life.

  Chapter 21

  THE REPUBLIC OF RAPE

  (right to left) Kavira, Kika, Solange, and Stuka, adolescent survivors of gang rape, at a HEAL Africa clinic.

  Quand on disait “plus jamais” apres L’Holocauste, cela concernait-il certaines personnes et pas d’autres?

  (When you said, “never again” after the Holocaust, did you mean that for some people, and not others?)

  —APOLLON KABAHIZI

  Alternative translation:

  When you said, “never again” after the Holocaust, did you mean that just for yourselves? Or us, too?

  Or

  .…. did you mean that for everyone, or just yourselves?

  he border between Rwanda and the Democratic Republic of the Congo resembles nothing more sinister than a gate connecting the pastures on our farm in Tennessee, but what a shocking difference a few feet makes. On the Rwanda side of the crossing, in the city of Gisenyi, the roads are tidy, maintained, lined with tiny, colorful flower gardens. The breezes lapping the shores of Lake Kivu are serene, and the people are friendly and helpful. Passing into the DRC, however … Oh, my God. We were leaving a country with virtually no official corruption to go to a place where bribery and coercion are a way of life. It took me, Marshall, Papa Jack, and our driver an hour to navigate through the immigration and customs routine—which involved Papa Jack reaching into his pocket for a steady presentation of $20 bills. We joked that he should be used to it as the parent of a teenage daughter. As soon as we cleared the border post, all color seemed to drain from the earth, and we entered an urban wasteland of some eight hundred thousand people, most of them displaced by war.

  As soon as we cleared the gate, we were stopped by a group of uniformed “police” carrying heavy weaponry. No traffic violations, just a simple and typical moment of attempted extortion. James, our driver, spoke Lingala and told them we didn’t have anything to give them while I nervously sat on my laptop, suddenly imaging it, and all of my writing, being taken from me.

  The lead extortionist shrugged and waved us through. DRC is essentially a failed state, and government, army, and civil service jobs pay nothing. Some are specifically directed, when they begin their jobs, to “live off the land,” meaning the people they are supposed to be serving and protecting. Crimes, from the petty to those that qualify as war crimes and crimes against humanity, are committed with impunity.

  A few hundred feet later, the road opened up and I saw the notorious city of Goma for the first time: a vast, relentless, dusty slum. There was rubble, garbage
, filth, people covered in muck and grime, buildings that were nothing more than lean- to shanties. The earth was gray, drab, choking with dust and ash, courtesy of a volcano just north of town that had been erupting on and off for several years.

  Our first stop was a clinic run by one of PSI’s partners that specializes in family planning, maternal and child health, and the treatment and prevention of malaria. The clinic’s doctor was waiting in his office in a white stuccoed cinder-block building; his hours were painted in a sweet shade of blue paint, and they did not include Sunday mornings, which was when we arrived. I thanked him for making the special effort and asked him about his job.

  His main work was in obstetrics, but every week he made home visits in the neighborhood to generate interest in modern family planning, birth spacing, and pre- and postnatal care. He told me that twenty to twenty-five new women showed up each month to access the clinic’s services. Although this number sounded small, he said it represented significant cultural change; men here generally want their women to produce as many babies as possible. Seeking to regulate their fertility was big news.

  As he spoke, I tried to keep track of the litany of horrors he encountered in his daily work: The babies he delivered were often premature, and infant mortality here was the highest in the world. He treated women who were victims of sexual violence daily. Rape, including gang rape, has become an appallingly common occurrence in militia populated areas around Goma—meaning everywhere, as militias often roam. A frequent consequence of such rapes is fistula, when the wall between the rectum and vagina, or bladder and vagina, is torn open—and more. The doctor told us he had treated children, little girls as young as three and four, for rape-induced injuries. He also saw a lot of obstetric fistulas, caused when such tearing occurs in childbirth. It often happens because the mother herself is a child and her pelvis is not fully formed to accommodate childbirth, or as a result of other complications that in the United States would not have to cost a woman her health or her life. But when you try to give birth unattended, as 66 percent of African women do, fistula is a very real, life-destroying problem.

  When I asked where this pervasive practice of rape came from, was it embedded in the culture, he said it was not cultural to begin with. He confirmed what I had heard from Zainab Salbi: Raping began here as a weapon of war, a way to dominate the enemy by terrorizing women, regarded as the backbone of the family, and destroying family structure. Now, gang rape was used by various armed groups, often on behalf of government and army officials and their proxies, in the artisanal mining of Congo’s extraordinary mineral wealth. The mass raping allowed groups to access the lucrative elements just under the soil without resistance, clearing out entire villages (hence the massive problem of forcibly displaced persons in eastern DRC). And now there had been violence and instability in this region for so long that war had become a way of life, and rape had become normalized—in the same way that poverty, lack of services, and hardship were the norm. Now, it was all generations knew.

  There’s no way to sugarcoat it: Goma is a shithole. The stench is putrid. There is no sanitation. The water is unsafe. The rooms of the next clinic I visited were stuffed with malaria patients of all ages. They looked dazed and miserable, their bodies sagging, their eyelids heavy.

  I sat on a few beds, making small talk about how to prevent the disease and, in my own hopeful way, introducing the possibility of each individual making a commitment to sleep under a mousquetaire—or mosquito net—at home.

  It was a visiting day, so most patients had family in, grandmothers, other children, and siblings. Someone had brought a transistor radio that squawked out a tinny disco tune. My attention was drawn to one man who was feeding his small son. The boy was lethargic and mute, his nose ran, and an IV PICC line was taped awkwardly to his hand, which it dwarfed. The man fed him black beans from a tin plate, around which gnats flew.

  This man was a hardened person, and our presence in the clinic that day seemed to irritate him. Unprompted, he started raging at the pregnant women who were given nets free of charge when they came to the clinic. The men still had to pay for theirs, although at highly subsidized prices. And the tough guy with the beans thought this was fundamentally wrong.

  “Am I not a man?” he complained. “Should I not be given a net?”

  I decided to engage him and try to lighten the mood with some playful questions. I asked him—in French—if nets were available in the private sector.

  Yes, he said, but he had no money to buy them.

  I scoffed. It is well documented that women in the developing world save and invest every pittance, while men waste money at shocking rates. This man, who was dressed in clean, matching, store-bought clothes, did not seem like a pauper.

  “Oh, come on,” I said. “I bet you have a little money from time to time for a smoke!”

  “No!” he exclaimed.

  “Beer, what about a glass of beer?”

  Again, “No!”

  “Ah, you have so much virtue! Such a clean life!” I said. “But … I bet from time to time you have a little money to spend on a woman!”

  The room erupted into roars of laughter.

  We debated the value of investing in prevention by spending half a franc on a net. “Wouldn’t it be wise,” I said, trying again, “to spend a little money for a net, so as to save all it costs when you’re sick? When the children are sick?” I gestured to the tiny, stifling room loaded with inert bodies. He had no response to that.

  I didn’t think he had anything against buying products for himself. For example, he had a high-end mobile phone with the latest bells and whistles, to which he turned his attention when our conversation ended.

  A lovely little girl sitting near the man’s son was eyeing me cautiously. She began to stare at me more openly, and I thought to take her picture and show her the image. Perhaps it would please her. I took my camera out of its bag and aimed it in her direction. The man leapt up in front of my camera, blocking me from photographing not just his boy, but everyone in the room.

  I put the camera away but explained what I had meant to do and that it was a means of reaching out to a new friend. The man started mocking me. He took out his phone, scrolled through its zillion features, found the camera, and ran all over the room as if taking my picture with it. I hammed it up, posing from each angle to which he darted—voguing in the DRC. Everyone giggled, and the tension was slightly broken.

  Finally it was time to go. I thanked everyone for the visit, wished them a good afternoon, a speedy recovery, and good health. I may have been wrong, but I walked to the car wondering not if but how many women and girls that man had raped.

  Everywhere the car lurched, children with stunted growth stared. Once eye contact was made and a wave offered, their faces would joyously crinkle into smiles. They wore tattered Western clothes. I saw one little girl in a raggedy pink tutu. The sight of her still haunts me, the distorted Goma version of the precious little American girl who discovers ballet and won’t take her tutu off for weeks at a time.

  Our next stop was the HEAL Africa hospital in downtown Goma, a 180-bed hospital that specializes in repairing fistulas and reconstructing the damaged genitals of rape survivors. There is so much demand—there are usually 150 women on the waiting list at any given time—that dozens have taken up residence outside and around the facility. I visited with some women who were squatting in the courtyard, washing their clothes or children in ubiquitous plastic tubs that serve many household purposes. Inside, patients were sitting blankly on beds. All looked unbelievably traumatized and dark. Most clutched babies, and a few had been made pregnant by their rapists. One was disfigured from having been burned, her otherwise night black skin raw and pink. A clutch of women in a doorway, mute and scared, stared at me when I wished them a good afternoon and said goodbye and thanked them for letting me visit.

  It was like walking out of the gates of hell, and I was ashamed of myself for feeling relief at escaping, to put this
place behind me and head for the Women for Women International compound.

  In the midst of this ragged and seemingly doomed city is a walled courtyard filled with grass that is actually green, a garden that is actually tended, a building that is clean and proud. Zainab Salbi had notified the women in advance of my visit, and I was greeted with joyous clapping, singing, and ululating, the great African vocalization. I ran to the throng and threw myself at them, dancing and exclaiming my hellos.

  We sat together for hours, each woman taking her turn to stand before her sisters and me, sharing her life story. They were each so incredibly beautiful! The eyes, the cheekbones, the lips—but mostly their spirits. They wore traditional, colorful dresses, and I so wanted to learn to wrap a foulard (head scarf) like that! WFWI teaches appressed, victimized, poor women to bathe, to feed themselves and in fact produce and sell food to others, to read, count, and write, and offers them parenting skills, social skills, money skills, a trade. Almost as important, it then gives them a network of sisters to rely on for support. Each woman is in contact with her American sponsor, who donates $27 per month—less than $1 a day—to pay for her counseling and training. All of the women had been in the program for about one year and would soon graduate. Having sponsored in WFWI for three years, I was familiar with the radical improvements self-described in a sister’s entry and exit interviews.

  This is what their stories that afternoon sounded like to me:

  I am an orphan, my husband was killed, my three sons were killed, I could not read, I could not write, I could not count, I lived like an animal, I have thirteen children, I have ten children, I am a widow, I am a refugee, I fled with nothing, not even a cup, I was half-mad, I was crazy, I was a corpse … People in the street were afraid of me, I begged, I scavenged in the dump, I treated my children like animals, my husband went to other women, my husband’s people pushed me from our home when he died, I was run off the land, I was cheated because I did not know how to sign my name, my children died, I knew nothing, I was filthy, I smelled bad, I came to this area to escape violence, I carried loads with my body to earn money for food, I starved, I had nowhere to go, I was dead, I was in a constant panic, I lived in terror, I abused everyone around me, I was in a rage, I was abandoned …