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December, 2009
A Child and I

November, 2009
A Gift of Life

October, 2009
Pupils per chair: 48

September, 2009
Microfinance, Security, and Self-Esteem of Impoverished Women

August, 2009
ALL WE DO IS KEEP PEOPLE ALIVE

July, 2009
The Engines That Could, And Do

June, 2009
Hurry

May, 2009
An Orphan's Tale

April, 2009
A Message from Rural Malawi

March, 2009
A Rural Health Center

February, 2009
The Whole Program

January, 2009
A Special Message to Donors

January, 2009
A Member of the Family

2010 Archive

2008 Archive

2007 Archive

A Child and I

The child shown above is lucky. He is well cared for by a Malawi organization that we support. They take in infants in the zero to two years range whose mothers have died. They stabilize them and attempt to return them to relatives in their mother's village. Some of the kids are sero-positive for HIV, others not. The facility caring for this tot once had a death rate of over 50% but more recently, thanks mostly to a wonderful matron (head nurse,) that rate has fallen to around 10%. The place is a beacon of light, of hope.

Meantime in North America we head into winter. Just now we may be a little more aware of what the darkness symbolizes, perhaps the loss of protecting, nurturing parents, or of siblings, or friends. Something about the season reminds us how arduous life can be - for ourselves, for others.

For others: You may have seen in a recent New York Times Book Review the Russian fable first told by a peasant and later published in "The Brothers Karamazov." It is about a selfish woman whom devils pull into a fiery lake after she dies. Her guardian angel intercedes with the deity, describing the one generous act the woman performed in life - uprooting an onion and giving it to a beggar. God answers that the angel should extend the same onion for her to grasp to be pulled from the lake; if it doesn't break she will enter paradise. The angel does this. But others in the lake, equally desperate for rescue, cling to her. She kicks them away. The onion then breaks, and she is lost.

Perhaps in dark December one of those disturbing questions comes home to us, which is who we are, what we have become. The fable, and I think most of the world's religious literature, suggests an answer. It is found in what we have done or not done concerning the stranger.

December is the month of least sunlight, the shortest day, in the U.S. But in southern hemisphere Africa now is the greatest light. Our own encounters with darkness bring us more deeply to our humanity, and children a world away, like the little boy above, will have a chance to live and even flourish.

We are deeply grateful for your help.

William Rankin
President & Co-Founder of GAIA

We left Malawi a week ago. At the end of our stay there we had visited a number of villages, where chiefs ardently stated their appreciation for our help to orphans. Keeping the orphans in school is always of greatest importance to the headmen and headwomen of rural villages.

After the welcoming ritual in one of the village centers was concluded, we waded through a sea of orphaned children and finally reached our vehicle. We drove further down a long dirt road, finally stopped, then walked into the bush. Ahead were two small adobe brick dwellings with thatched roofs. We spotted an older man seated in front of the newer of the two buildings. The building beside this was falling apart. With us were Alice Bvumbwe, our Southern Region Projects Officer, and two young women wearing the GAIA T-shirts used by all the village caregivers whom we trained in this area. We knew by this time that the man we approached lived with HIV and was being helped by the GAIA caregivers.

He had been asked in advance if he would talk freely with some visitors from the U.S., and he had agreed to do so, through Alice, our translator. This is what we learned: That he indeed lives with HIV, and had become very weak before being tested and finally put on anti-retroviral medications, which was done with the help of the GAIA caregivers. That he had lost everyone in his family - wife, children, all, - and has no one to help him apart from the caregivers. That the caregivers (the two surprisingly young women with us) had personally built his new dwelling since the old one was collapsing around him. ("You built this?" I asked the women in astonishment. I wasn't surprised that they were capable of this; it's just that construction is not what we ask them to do. They nodded, smiling.)

We learned that he struggles with Kaposi Sarcoma, an HIV-implicated cancer presently in his legs and feet. We learned that thanks to the GAIA caregivers he is now treated with vincristine, an anti-cancer medication that sometimes helps with KS. In his case the medication seems to be working. Through Alice he says he has his life back. To him, says Alice, this is a great miracle, and the two young GAIA women are responsible for it. They connected him to the antiretroviral medications that bring life even to an old man.

Nowhere are any earthly goods to be seen, apart from a tiny two-room dwelling, the narrow cot covered with a mosquito net provided by the caregivers, a cooking pot, a spoon, and a plate, but such great joy fills the space around us because once a man was dead and now he is alive. Such pure and simple joy. Such deep gratitude for the gift of life.

To all the great people who support our village interventions, I hope you can see in this one man just one good outcome, one out of the many thousands. We are so very grateful for your help.

William Rankin
President & Co-Founder of GAIA

Recently a needs assessment arrived here from a rural Malawian school in which we have an interest. I thought you might be as affected by this as I am.

When I visited there a few years ago several chiefs from the surrounding villages had convened to try to face down the enormous obstacles to education for all children, but especially for the girls. Male chiefs helping the girls: What a powerful statement.

Today the total pupil enrollment in this school is 2,325 - evenly divided between girls and boys. The 501 first grade students are divided into three classes of 167 pupils each. The second grade has 442 students squeezed into two classes of 221 each. Grades three and four have 489 and 312 pupils respectively and are also squeezed into two classes each. The higher grades are no different. Due to lack of classroom space students in grades two to four are taught under a large tree even in the rainy season. Classes are canceled during downpours.

Of the 14 teachers here only three are female -- not ideal for girls needing role models. The report says, "Under normal circumstance there should have been 40 teachers." Because of the teacher housing shortage only six faculty live on campus. The rest must walk in from surrounding villages. During the rainy season they slog through mud and ford streams when coming and going.

The community's residents have prioritized what they would like to do if they could. First, they would build more classrooms. Second, they would build more teachers houses. Third, they would improve the supply of safe water.

Country-wide, the most recent study of Malawi's educational readiness was concluded in 1997. Here are a few of the findings:

• Students per teacher (all teachers): 61
• Students per qualified teacher: 123
• Students per permanent classroom: 119
• Pupils per textbook: 24
• Pupils per chair: 48
• Pupils per desk: 38
• Schools with safe water: 20%.

I've never forgotten Martin Luther King, Junior's prescription for quality education. Teach the children to believe in themselves, he said.

Some children do have a modicum of self esteem. When I look at what the kids must overcome I am amazed that so many do so well. But the challenges are enormous. We help as we are able, and we are determined to do more.

We are grateful for your help.

William Rankin
President & Co-Founder of GAIA

This story recently arrived in our office. It describes some effects of our microfinance program in a remote, food-insecure, high HIV prevalence area in southern Malawi's Thyolo (pronounced Cho-Low) District. The program serves over 1000 women. You can glimpse in this the importance of having a reliable income in a country with no safety net, where women's economic dependence upon men is a factor in HIV transmission. Possibly the self-efficacy of a hard-working woman can be sensed as well, and the self-esteem that accompanies it. Bill Rankin

The hopes of a middle-aged mother have been realised. She has obtained a loan for her business venture. Judith Banda happily described her experience at her home in Sani Village, Traditional Authority Nanseta in Thyolo District. She had joined the 20-member Phyelephyele club and received her loan.

For many years Judith had struggled in small businesses but none produced a stable income. After her qualification by GAIA as a loan recipient and the training that is part of this, she obtained an initial loan of 10,000 Malawi kwachas, equivalent to 70 U.S. dollars.

Last November a young GAIA loan officer, Esther Munyawa, had come to Judith's village to describe the loan program. Judith knew that November was but the first of Malawi's "hunger months," when most households would have little or no food. She decided to start a produce business. With her loan she was soon able to realise a profit of 50% on the initial capital. She has since secured her earnings in her own bank account and is now qualified to receive a second loan.

Judith expects to earn five times the loan amount since she has now found a larger market for her produce. She is also involved in bee keeping and has just harvested their honey.

She says that the loan group members counsel each other on their business plans and their planned requests for continuing loans. She believes that if she obtains more loan funds and is able to make a good profit again, she can pave the way for others to benefit from GAIA loans. Judith adds, "I would like to invest my savings in my business so that I can one day become independent."

As we were leaving Judith was busy packing honey that had just been harvested and processed into 500ml bottles.

Tawina Sukasuka
GAIA Office Manager, Limbe, Malawi

This true story was recently sent by our Malawi Country Director. I have edited it for readers whose first language is English. Bill Rankin

Martha Thipa is a 34 year old mother of a 16 year old son. She was born at Nkhakamira village, Traditional Authority Mabuka, in Mulanje District. A brother is the only other surviving member of her family of origin.

On less than half a hectare of land Martha, her husband, and their son produced enough food for themselves with a bit extra to sell for necessities. She anticipated a long married life into old age.

One day of intermittent cold rain, Martha walked to a forest reserve 5 kilometres distant to gather wood for fuel. Returning with a heavy bundle in periods of downpour was difficult, particularly because her tattered skirt and thin blouse provided no defence, her throat was sore, and she felt feverish and achy.

Martha's symptoms persisted for two weeks, despite medicine. The radio had said that people with recurring fever and chills should be tested for HIV. She was apprehensive, though not panicked. She had always been faithful to her husband, and he had assured her that she was the only woman in his life.

Soon Martha experienced severe pain in both legs. She was unable to walk without a cane. She could no longer do house chores or gardening. Her husband undertook all the house work. He also did the gardening, but then began to be absent for entire days. One day he left for good, with no word of farewell. She learned that he had taken another wife in a village an hour's journey away. She was devastated, and quickly had to devise a plan to prevent her son's and her own death by starvation. Her son found piece work at a trading centre some 800 meters away. The boy became the sole earner in the home.

Friends carried Martha to a hospital, where both legs were x-rayed, but the doctor sent her home. She decided that he did not want to shock her with a lethal diagnosis. She prepared to die.

~

On a warm day with a soft breeze coming across the nearby Ruo River, Martha was half sitting, half lying outside her home when a young woman approached. She said she worked for Global Aids Interfaith Alliance, which had just come to work in the village.

After Martha narrated her ordeal, the GAIA staffer asked her to go a hospital for HIV testing. Maybe the Doctors could treat her. Martha was stunned at the offer of help. She had ceased to believe there were good people in this world. She was found to be HIV positive, and placed on medications.

When I asked Martha what she would say to her husband should she meet him, she said sadly, "The man is ill. I have many times advised him to go for an HIV test so he could get help if he is found to be positive but he seems resigned to his fate." She shook her head.

When I asked if GAIA could tell her story to help other women, Martha smiled. "Do you think I conceal my condition from the village? No! Take me to talk to anyone about my condition any time you want. If I can help others avoid the suffering that I endured I will do it."

~

"If it were not for Mphatso and GAIA I would have been dead by now," Martha told me. "I now receive treatment and GAIA gives me nutrition supplements, medicines, and other necessities." She laughed. "Now that I am alright I can do all the work I used to do, including gardening. This year my son and I have harvested enough food crops to see us through. GAIA personnel have told me that I now have to be removed from the list of home based care patients." Martha said this last with pride. She added, "But please, I still need GAIA's help to start a small business. This would enable me to continue purchasing medications and other necessities that I may need."

Martha allowed me to take her picture, to be attached to her story.

Jones Laviwa
Malawi Country Director

Moiling along the badly rutted dirt roads in the dry season or through mud in the wet, thejuly09 GAIA mobile medical clinics faithfully reach remote destinations in Mulanje District in Malawi's south, arriving at each close to their scheduled times. The Muloza and Chitakale mobile clinics each draw 180 patients per stop, far more than the anticipated 70.

Temporarily unused church buildings become health centers staffed by each vehicle's 2 nurses and 1 clinical officer, with the vehicle drivers helping to triage the patients to ensure that the weakest among them are served first.

The vehicles, their staffs, and all the medications and test kits are an extraordinary gift to GAIA from the Elizabeth Taylor HIV/AIDS Foundation. We couldn't be more grateful.

Both clinics operate daily from Monday through Friday. One day each week is set aside for HIV counseling and testing because of the large number of patients seeking to learn their HIV sero-status. Their urgency is heightened by the prohibitively long distance on foot to the nearest health facility 10 or more kilometers away.

During the rainy season malaria rates have risen, and thus anemia cases. Anemia can be deadly when blood is lost, as in childbirth. Recently the clinics have treated large numbers of patients for malaria, schistosomiasis, pneumonias, eye infections, and sexually transmitted infections.

The mobile clinic staff present health information on preventable diseases, conduct pre-natal blood pressure checks, weight checks of babies, and they do HIV counseling and testing for new patients. They manage AIDS-related opportunistic infections and collect sputum samples for TB, arranging for follow up care for those testing positive.

Returning to the office, the vehicle personnel compile descriptive data enabling us to monitor what we are doing, and how well. And they pack medications for the next day's work.

It's not all simple. Following up on neonates during their first two weeks is a challenge, since many pregnant women are still delivered by Traditional Birth Attendants in local villages -- there being no health facilities nearby. Becoming aware of these mothers and their children is difficult, and finding them may be as well. Another challenge is helping the increasing number of people seeking the services provided by our vehicles.

We have discovered what Dame Elizabeth Taylor knew all along. Mobile medical services are enormously effective in hard-to-reach remote villages. In an ideal world we would have a large fleet of these vehicles, with medications, test-kits, and staff for each.

William Rankin
President & Co-Founder of GAIA

I have saved a phrase from playwright Tony Kushner's Vassar College commencement speech of 7 years ago: "Hurry hurry hurry, now now now, damn the critics and the bad reviews: the world is waiting for you! Organize. Speak the truth."

What helps us break through practiced detachment, not noticing the moral claims of a sister or brother in need?

Sometimes another's story or the friendship bond can reach us. Eva Banda is a dear Malawi friend living in the U.S. Here is part of her story, told to some of us on May 3:

"HIV/AIDS stopped being statistics to me in 1997, when my brother died. It hit home because of my 5 siblings he was my best friend...

"A once vibrant man was now blind and suffering from what was then diagnosed as meningitis. Two weeks after he entered hospital he died. He was only 41. By this time, his wife who was suffering from tuberculosis was very sick. Six months later she too passed on. She was 37. The 2 daughters they left behind were ages 12 and 10. They were being taken care of by extended family, while my sister and I provided the financial support. Since then both girls have worked very hard and now attend college. Considering their circumstances they are well-adjusted children because they have had a strong support system. My brother's children are a success story.

"In contrast, I have nieces and nephews whose circumstances are far less hopeful. My brother-in-law died from HIV/AIDS at age 36, leaving behind 1 son, and my two sisters-in-law died at ages 49 and 39, leaving behind 11 children between them. All 12 children were left in the care of my mother-in-law, who is overwhelmed...

"All these orphans need someone to give them hope. They need someone to tell and show them that they are not responsible for their being orphans, and that they can have a bright future. With GAIA's programs, many orphans are given a chance to shape their future. They are given hope where hope seemed impossible. They can see that someone cares. They may not know who it is personally but they see it through all the programs GAIA has in place. They can see that someone out there feels they are worth fighting for. That alone is so empowering to a child who has nothing and no one. "

HIV is like a giant thresher churning through Africa, in the words of a Ugandan health official, destroying vast numbers of people in every age group. The situation is urgent, and saying so is speaking the truth.

We are so grateful for your caring and committed help. You have helped us help the people of Malawi a lot.

William Rankin
President & Co-Founder of GAIA

The following first-person account is slightly edited to condense it and smooth its consequent transitions. It was written by a 25-year old Malawi woman who received a GAIA Nursing Scholarship and now is a member of the faculty of the country's leading nursing school. She will influence hundreds of future Malawi nurses.

"We were all created for a purpose. Challenges may come but all we need is a helping hand to push us through the tunnel so we can see the light. My name is K. I am the only girl born into my family. My father died when I was three years old and my mum died when I was eleven. Her death started my journey to find the best in myself and make meaning out of my life. I realized then that I can choose to be miserable and mourn their deaths or I can become what they always wanted me to become, "a successful, independent woman". I chose the latter.

"My dream of becoming a nurse started when I was 10 years old. After my mother died I worked hard and was selected to go to secondary school. I was not sure how I was going to manage financially at school but I was lucky to get a government scholarship.

"After my secondary education I gave up my dream and took a job as a petrol station attendant but I was not satisfied with who I had become. However I did not have enough money to pay for further education but I wrote my 'O' levels again and met the university entrance requirement. I was selected to go to Kamuzu College of Nursing and I enrolled on 20th October 2002....

"In my second year I heard of GAIA which sponsored students in their education. I visited their offices and told them my story and they asked me to write a letter describing why I needed to be sponsored in the college. I wrote a letter and they accepted to sponsor me. This made me glad as I realized that I was going to achieve what I wanted. In my letter to GAIA I promised them that with their assistance I was going to make them as proud as they made me proud of myself.

"In nursing college I received awards for best nursing student in different departments and because of my performance I was sent to the Netherlands in 2006 for my internship. While there I learnt more from people of different nationalities on the importance of hard work and education. I also attended a short course and was awarded a certificate in Global Nursing. I graduated from the University of Malawi in 2006 with a Bachelor of Science in Nursing with Distinction and was employed by the Ministry of Health at Queen Elizabeth Central Hospital, one of largest referral centres in the country. The government later sent me to pursue a course in midwifery at Kamuzu College of Nursing because of the high maternal mortality rates in the country. I graduated again with a University Certificate in Midwifery with Distinction. The college awarded me the KADMSA-distinguished midwifery student award. I was also offered employment as an assistant lecturer in the Maternal and Child Health Department in the University of Malawi; Kamuzu College of Nursing.

"My life has had its ups and owns, I have had smiles and tears but I know I can achieve as much as I want to. We are all gifted in different ways and sometimes we just need someone to make us see the best in us, someone to help us through. Being orphaned at a young age made me cry, but it also made me start a different journey of my life -- a journey of determination, hard work and perseverance and I now cry with hope.... now I know that no matter what comes in my way to make me fall I refuse to remain fallen. I have made a choice to stand up again and again no matter how long it takes. I will never give up."

This young woman's record of success is exceptional, but we see her determination and bravery in other Malawi people as well. They inspire us in this office, reinforcing our commitment to them, and I hope they so inspire you too.

William Rankin
President & Co-Founder of GAIA

Our International Programs Director, Ellen Schell, sent a report after accompanying one of our mobile medical clinics to a remote Malawi area. This is an excerpt:

"The vehicle stopped at a church building that we use for a clinic site. Catherine, our nurse, began antenatal screening. A lovely, bright-faced 25-year-old bounded in. Catherine asked her if our regional staff officer, Alice, and I could observe the visit. This was readily agreed to. The patient was weighed, her blood pressure taken, and the baby was found to be appropriately head down. Everything looked good. While the nurse was listening to the baby's heart through the mother's belly the patient said this would be her third child and she wanted to have four altogether. She is her husband's second wife. The patient consented to be tested for HIV and syphilis. Catherine drew the blood by finger stick and ran both tests.

"We awaited the test results. Catherine, kind and forthright, asked the patient how she would react if the tests were positive or negative. The woman confidently said she would follow whatever Catherine told her to do, regardless of the results.

"The test outcomes were ready. As they were being read Alice stopped translating for me, but it was evident the tests were positive. In an instant, this lovely young woman's future had changed completely.

"Catherine spoke at length with the woman, then Alice did. The patient asked to be put on anti-retroviral therapy right away. Catherine explained that after delivery she would be evaluated regularly and put on medications when clinical signs warranted it. The patient said she would not reveal her HIV status to her husband as he would abandon her. She was afraid of being stigmatized. Alice encouraged her to reveal her status to her mother or a trusted near-by relative.

"She was advised to tell her husband about the positive syphilis test so he could be tested and treated, and the first wife also. The patient asked Catherine and Alice for their support, which was promised. She is to return to the clinic each week for follow-up. She will be given oral Nevirapine at the onset of labor to make mother-to-child HIV transmission less likely. The baby will receive liquid Nevirapine within 72 hours of birth.

"The patient was given a penicillin injection, oral follow-up antibiotics, iron tablets, and prophylaxis for Malaria. She folded the medications into her clothing, fearful that the pills would give away her HIV status. Alice explained no, these were not ARVs. They were the same medications people take for other conditions."

I release this account, first, because it is only human to lose interest in the terrible HIV epidemic because one "already knows about it." But as you see, it is as new and startlingly terrible as a 25-year-old's morning test results. The other reason why I send this story is that it shows women pulling together to help one among them in a grim circumstance. The women of Malawi daily face an enormous struggle. I cannot think of any commitment more worthwhile than to help them as each of us is able.

Two weeks ago I visited a remote health center in southern Malawi. With me was the young Malawi physician appointed by his country's Health Ministry to manage several such far-flung facilities in this district. Others with us were from UCSF, and a physician from South Africa and another from Tanzania. We had travelled several kilometers over some rutted and muddy dirt roads to arrive here by mid-morning. What we saw will stay in my memory a long time - seemingly countless women of all ages, children, some men, several elderly people. Many were patently ill.

The soft-spoken young Malawi physician - is he yet thirty years old? - led us past the long line of patient health booklets on the ground marking each person's place in line. Briefly we spoke with the Medical Assistant (the "in charge" here, a young man with two years of medical training beyond secondary school), also soft-spoken. "How many patients come here in one day?" "About 400." "Do you have any trained personnel to assist you?" "No. I am the only one."

This is the hot, rainy season in Malawi. With rain come mosquitoes. The greatest problem these months is malaria, with HIV infections in second place.

Later, when walking to our vehicles I noticed that the Malawi doctor had left my side to approach an elderly woman lying on the ground in a spot of shade under the overhanging edge of the health center roof. He knelt next to her and spoke softly. Then he helped her to rise and slowly walked her into the Medical Assistant's office.

This is what lingers in my mind: The heat and the humidity. The frequent downpours of Indian Ocean water. The remoteness of the place. The forbidding distance to the nearest hospital, and only a bicycle ambulance to convey someone to it in an emergency. Four hundred people waiting patiently to see one young man in a lab coat. The soft speech all around. The civility of the people, and their exhaustion. A young doctor in the Health Ministry bureaucracy who didn't need to pause to help a very ill elderly woman, but he did. Her leaning on his arm as they entered the facility.

We can strengthen the health system in this place. With your help we will fix it. With your help.

A close GAIA friend in Vermont suggested that we send to everyone a summary of our work in Malawi so people could grasp the entire program. We do that here.

Our U.S. and African staff closely collaborate to accomplish these objectives in Malawi:

• Train, equip, deploy, and mentor 4 to 5 village women in each of 40 southern region villages to deliver intensive, comprehensive HIV-related care to orphans and patients, and get people tested and treated for HIV and other diseases.
• Staff, equip, and operate 2 mobile medical clinics in remote Mulanje District villages for HIV-related prevention and care services.
• Keep 98 young Malawi women, many of them orphans, in nursing school for 3 to 4 years, and in exchange for which, they agree to serve 3 to 4 years thereafter in Malawi hospitals.
• Sustain a microloan program for 925 women in a remote part of Thyolo District.
• Construct a "safe birthing" facility at St. Joseph's Hospital, Ludzi, to reduce the alarming numbers of maternal deaths in the region.
• Continue grant support to selected community-based organizations and rural hospitals throughout Malawi, ensuring quality service delivery to the very poor.

By the end of 2008, with the wonderful help of St. Matthew's Church in Pacific Palisades, we have purchased a house in Malawi's southern region in order to convert it into a small office building for GAIA's operations. Our Malawi Country Director, Business and Finance Manager, and Southern Region Projects Officer will be based here. Until now we shared space with Churches Action in Relief and Development (CARD) and we are deeply grateful to them for their hospitable and invaluable support.

I had earlier indicated to everyone a dip in income during October and November, likely caused by concerns related to the recently announced economic recession. I asked people to remember in December the people in African villages, who have no cushion or safety net.

Your response was tremendous.

Our December 2008 income was greater than in December 2007, and in fact we have met all of our 2008 budget goals because of your great, great generosity and faithfulness to our sisters and brothers in Africa.

I can't thank you enough.

Looking ahead, we remain respectful of the possibility of future shocks to the U.S. economy, and any implications of these for giving to non-profits like us. But even more we respect the proven kindness and determination of all of you not to let down the people of Africa who have no room to fall further.

Thank you all so very, very much for your enormous faithfulness to the poorest of the poor, and for your confidence in us, which we do not take for granted.

We have lost no staffers since working in Malawi beginning in 2001, but some staff have lost family members. In anticipation of this we provide burial fees, funeral expenses, and related costs in our Malawi employment contracts.

When you travel down a Malawi road you may come to an area where tree branches are laid by the side of the road and extend into it. These signal a funeral in a nearby dwelling. Usually you can see a crowd gathered outside.

I wanted to give you a sense of one such funeral by excerpting from a message sent from Malawi by Ellen Schell, our International Programs Director, with a few of the names changed.

"Just wanted to let you know we are in Limbe and safely installed at the Assemblies of God guesthouse. They were very accommodating, letting us come a day early for Mary's husband's funeral yesterday. The funeral was a moving experience, held in James's village south of here and took all day--a real village funeral, probably about 400 people in attendance, including all the GAIA and UCSF research staff. The GAIA coordinators helped cook the meal served to the village and made the flower wreaths that covered the grave.

The service itself was held outside a relative's house on a hillside, with the body present. The coffin was then taken to the village graveyard about 1 km away and more prayers were said, after which friends filled the grave and the women covered it with flowers. My husband was touched and honored to be asked by the other clergy to join in. He gave the graveside benediction. Mary's pastor conducted the ceremony and both the church's former pastors were also in attendance. The singing throughout the day was beautiful.

HIV was not implicated in this death, but we believe James could have lived much longer with medical care of the kind that is mostly unavailable in his country.

We try to forestall as many funerals as we can, family by family, village by village, in this impoverished country, and we thank you greatly for your continued help.