Los Angeles Times Staff Writer
July 22, 2004
A bottle of Dark and Lovely hair gel in hand, Kassim Issa pushes his withered body down a dirt
path through Nairobi's biggest slum, peddling a few ounces at Mama Washington's and other
tumbledown salons.
For Issa, Dark and Lovely is life. The 20-cent profit from one bottle
can pay for an injection to dull the chronic pain of AIDS. Two bottles can pay for a hospital
visit. And selling 10 means he can afford a chest X-ray.
"I am fighting every day to
stay alive," Issa said. "Every day I live, I win."
Winning means another day of
difficult choices — a dinner of bitter greens or medication. Issa can buy one or the other,
but usually not both. Without the right food and drugs, it's hard to find a better job. On top
of that, drugs that make him stronger also make him hungry for food he can't afford.
In
sub-Saharan Africa, where half the people survive on less than a dollar a day, life is a struggle
for food, clothing and shelter. Issa and 28 million other Africans stricken with HIV and AIDS
face the extra burden of finding and paying for treatment.
Nearly 7% of Kenya's 32
million people are living with the human immunodeficiency virus, which causes AIDS. The epidemic
claims the lives of 700 Kenyans each day. Across the continent, 3 million people died of
AIDS-related illnesses last year. The U.N. reported last week that life expectancy has dropped
as low as 33 years in some African countries, largely due to AIDS.
The disease has
decimated the ranks of teachers and shuttered schools. It has wiped out subsistence farmers,
slashing food production. It has taken mothers and fathers, creating millions of orphans.
Years ago, when Issa was healthy, he brought home about $100 a month from his job selling
Dark and Lovely shampoos, gels and hair straighteners.
The salesman also brought home
HIV. Three generations have suffered because of it. His wife is dead. Because he cannot care
for his 6-year-old son and 4-year-old daughter, the children live with their grandmother in a
distant village.
For Issa, the disease created its own twisted logic of survival. To
qualify for free doses of the most important medication — antiretroviral drugs — from
the aid group Doctors Without Borders, Issa needed his immune system cell count to drop to
dangerous levels.
He prayed to get sicker. In a few weeks, he lost 40 pounds from his
slender 6-foot-2 frame. His cell count plummeted. His prayers were answered.
"I could
live a little longer," he said.
Once in a while, Issa gets a letter from his
mother-in-law, Adelaide Maraga, who is caring for his children in Chavakali, a
village in western Kenya near Lake Victoria.
Maraga loathes Issa because he never paid a
dowry for her daughter, Khadija. Then he gave her the disease.
Now he has saddled Maraga
with his children.
"I am completely not happy with you," Maraga wrote in one letter.
"The children you've left with me, did I produce them with you? Come pay dowry and get your
children. Don't tell me you are sick. You've killed my child. Then you leave me with the
children. How stupid are you?"
He can't argue with her. He knows that he brought
disaster on his family, even if he didn't mean to.
"Sometimes I feel responsible for what
happened, but then I tell myself that things come and go," he said. "I didn't do it
intentionally. I tend to think that this is the fate that befell us."
He believes that
he contracted the disease from one of the women who frequent the bars here in the Kibera slum.
"I had a line of them," Issa said.
He would pay the women about $1.25 for sex. When
he was broke, the women would settle for a drink of changaa, a potent homemade brew of
fermented corn.
Issa suspects that a woman named Rose gave him the virus. He still sees
her near the bar. Issa has noticed that she appears ill. She has sores, like his, on her body.
He has never urged her to get tested for HIV "because I don't want the situation reversed on me.
She might tell me that I gave it to her. I don't want to be like the hunter getting hunted."
Issa lives in a one-room shack made of mud and rusty metal sheets in a neighborhood known as
Mashimoni, which means "in a hole." The hovel sits at the bottom of a dirt path that turns into a
small swamp when it rains. A bare wall is covered with green plastic to keep crumbling mud from
falling into the living area. He pay $10 a month in rent.
He is reluctant to venture
outside. Even though AIDS is rampant, he can hear neighbors whisper. They shun him as
jimmi, a dog.
"It used to be worse," Issa said, his reddened eyes widening. "They
would want to beat you. But because so many people have relatives with HIV, they realize it's not
a laughing matter anymore."
He shared the shack with Khadija and the children until she
died in 2000. She was buried in her home village. Issa dared not attend the funeral.
"I
have friends and other people who come back from such funerals with one leg and one eye," he said.
"Their in-laws say: 'You've killed our daughter, and now you've come to mock her. You are a
killer.' "
Issa's mother-in-law haunts him.
"You are there in the city, and
you're working," she berated him in another letter. "You can't send 50 shillings to pay for your
children's food and pay their school fees? You think I'm your mother who has given birth to you?
You are a very lazy man. I do not want to see your face."
The letters give him
headaches, but he can't throw them away. He is incredulous that his mother-in-law thinks he has
money to spare. Even the healthy suffer in Kibera. For the sick, staying alive is a full-time
job.
"Because I live in the city, she thinks I'm a very rich man," Issa said, burying his
head in his hands. "She doesn't know that I have nothing, that I am trying to keep from falling
down."
Issa's antiretroviral pills sit beside a copy of Barbara Taylor Bradford's pulp
novel "The Women in His Life." Issa escapes with Bradford's billionaire tycoon as he seduces
women and dabbles in gourmet food, fancy clothing and opulent furniture while jet-setting to
London, Paris and Venice.
Each day, Issa takes from eight to 11 pills in two doses. One
is so big he calls it a horse pill. The medicine makes him among the lucky AIDS patients in
Africa. Across the continent, only a tiny fraction of the people in need of AIDS treatment
receive it. The treatments might cost only a couple of dollars a day, but they are too expensive
for individuals. Governments and aid agencies are overwhelmed by the number of victims. Many
people seek out potions from traditional healers. Thousands die a slow death, never realizing
that they have AIDS.
On most days, Issa's breakfast is mandazi, or fried sweet
bread, and some chai that he buys for about 8 cents from a neighborhood stall. He eats kale and
grits when he can.
Several months ago, he treated himself to half a pound of beef, using
the 50-cent profit from two bottles of Dark and Lovely. It was his first taste of meat in
months.
Issa's strategy is to skip meals. Sometimes he goes without breakfast, takes
lunch, skips supper and then has breakfast. But the medicine makes him hungry.
"The only
problem with the ARV is it wants me to eat," he said. "I can finish two plates of food if I have
it."
Once a week, Issa walks four miles to an outpatient clinic at Mbagathi Hospital to
pick up his free medicine. The key to the treatment is sticking to a schedule for taking the
pills, and Issa said the threat of death has imposed discipline on him.
"I've become more
in control and responsible for my own life," he said. "If I don't take the tablets, I die."
Issa is guaranteed free pills for five years. But he needs ointments for his rashes, and
painkillers and checkups. And the cash-strapped Mbagathi Hospital, where 80% of the 200 beds are
occupied by AIDS patients, demands payment for these.
For $1.25, Issa gets an outpatient
card that he must show to a social worker before he can obtain other services. A doctor's exam
costs $7.50, but if he is feeling gravely ill, Issa begs the social worker to waive the fee.
He exults when the social worker is absent or reassigned to another department. Then Issa
can beg new favors from the replacement.
But he can do nothing for his children.
His 6-year-old son, Isa Gazemba, is fine. Issa says his daughter, Mwanaidi, has tested negative
for HIV but that she has the same rashes and coughs he had before he was diagnosed.
He
hasn't seen the children in almost two years and won't visit them in the countryside because there
are no clinics and the trip would interrupt his treatments.
"Medical help is what is
keeping me alive," he said.
Issa worries about Mwanaidi, but says he has nothing to offer
her now.
"I feel sorry for my daughter because she has a dark future, with nothing to
cling on," Issa said. "She will have dark memories."
'I have sent you two other letters,
but you haven't replied … why?" his mother-in-law wrote in a third letter. "Your daughter
is always sick, you don't care. I completely don't like your attitude. You don't even send a
piece of cloth. What do you think they wear?"
He is trying to earn more money. If he
succeeds, he might be able to pay his wife's dowry — a cow, which would cost about $125,
plus 2,000 shillings, or $25. After that, maybe he could afford to support his children.
"I want to be around for my children," he said. "I don't want to live a meaningless life."
Sometimes when he feels well, Issa walks five miles to Nairobi's Industrial Area to look for
work.
The guards at the gate usually tell him that there is none. When he is lucky, they
let him through. But once the bosses glimpse his body sores and blistered lips, they tell him to
move on.
"They know HIV when they see it," he said. "Everybody is an expert."
If he had a job, he might have the $6 to buy ointment that could heal his lips or the money for
reading glasses to compensate for his failing eyesight. But he can't do either on what he makes
selling Dark and Lovely ounce by ounce.
Issa's mother-in-law has no time for such
excuses.
"Be warned young man. Come let us settle, you collect your children as soon as
possible," she wrote. "I'm not writing another letter after this one. If you have ears, you
hear."
A few months later, she showed up at Issa's shack with his daughter. They had
taken the nine-hour bus ride from Chavakali to Nairobi. Issa was elated. He had not seen
Mwanaidi since she was an infant. His mother-in-law stood icily in the room and told the girl
that this was her father.
Issa watched Mwanaidi for some sign.
She had no idea
who he was. In a few hours, she was back on the bus with her grandmother.
Soon, Issa was
back on his rounds.
As a hard rain pounded on Kibera's tin roofs, Issa stepped into a
pair of pink pants, a faded blue denim jacket and rubber boots. He put a few bottles of Dark and
Lovely into a gym bag and set out to collect on old sales and to make some new ones. He had many
stops to make: Ladies Choice Hair Salon, Powerful Hair Kuts, Mama Anyango Hair Salon.
But rain kept most of the customers away, and when they have no customers, salon owners won't
buy.
He found one of the salons completely empty. A tailor who runs the shop next door
said that the owner had died of AIDS.
She owed Issa about 75 cents, money he needed for
food and medication.
"I can't ask the family to pay this money," he said. "They have
their own grief."
About this series
The number of people in sub-Saharan
Africa living in dire poverty has nearly doubled in the last two decades. Times staff writer
Davan Maharaj and photographer Francine Orr traveled the continent over nearly two years to
chronicle the continual struggle to survive on less than a dollar a day. The six articles in the
series:
PART 1: July 11 -- Eking out an income.
PART 2: July 12 -- Staving off
hunger.
PART 3: July14 -- Settling for castoff clothes.
PART 4: July 16 --
Living in 100 square feet.
PART 5: Tuesday -- Locked out of school.
PART 6:
Today -- Surviving AIDS.
On the Web:
More photos, narrated reports by
the reporter and photographer, previous articles in the series and information on how to help can
be found on the Times website at: latimes.com/pennies.