The Bridge: Cynical Public Health Campaigns in Africa

The Bridge

This is what public health looks like in Africa – clumsy, cynical, and lost in the ruckus of daily struggles to survive.

It’s May. I’m in Zimbabwe, playing for a bridge. The bridge was opened up by his Excellency President Robert Gabriel Mugabe himself. He cut a ribbon maybe. Who knows? I don’t. Some other people know because they were there, but me, I was not there. I did not see his Excellency the President of Zimbabwe cut any ribbon or cord or give any speech to tell Zimbabweans how great they are and how wonderful their country is. I did play for the bridge. A slab of concrete climbing over a busy road, held up by two spirals of concrete hooking themselves into the ground like the claws of Baba Yaga’s hut. In the center of one spiral is an open space, and that is where we played. In the center of the other spiral, in a whirlwind of concrete, grow a Masau Tree tangled with a Guava Tree. The people stand on the side of the empty space, opposite the trees, and that is where we play for a bridge that, as I was told, ‘never worked.’ People never walk across it. They pee in it, and they take drugs on it, but the flow of people going from one side of the road to the other somehow, has never been diverted onto the bridge. Perhaps the President did not intone the right blessing. Roads need blessings too, you see. Roads need to trust and be trusted. To put your foot onto a bridge, to cross over to another side – these are serious metaphors to be living in a country that is as contentious as Zimbabwe, where metaphors are hunting for their livelihoods with sharpened spears of consequence, and – my oh my – it is difficult to survive.

Never ignore life’s metaphors, truly – illness being one metaphor nobody can ignore, even if we try as diligently as possible to shut out the metaphorical aspects of the experience. And yet the soul craves metaphors like the body craves food, and the two of them crave each other also.

(We are complicated creatures indeed.)

So I played for a bridge, and I crossed the bridge, twice, and I talked to the Masau tree, and I heard her silence.

In order to rejuvenate the spirits of the bridge, every Friday and Saturday artists perform in this treeless whirlwind of concrete. This Saturday was no different, except that as it was during the Harare International Festival of the Arts, artists from HIFA were invited to perform, among them a group called ‘Crazy Poets’, featuring a poet from Bulawayo. The Poet was performing with a man representing an NGO committed to building conversations about health with the aim to stop the spread of HIV. The two of them had published a book of poems called 10 Conversations for Health. They were both reading the poems off of pieces of paper. The NGO man was not a poet, though he co-wrote the poems that were read. Rather, he wanted people to think about their health (wanted, or was paid to want?) Their voices grated. The words crashed about in a most clumsy and patronizing fashion, like drunk birds flapping broken wings against the concrete bridge and the ears of those standing around.

My son Shakespeare, do not just shake your spear everywhere.

Certainly, there is music that is thrown out for entertainment, to plaster people like an exploding water balloon, splashing people whether they like it or not (volume volume volume), and then there is music that casts a gentle net over its audience and pulls people in, and loves them. I prefer the second kind. When you perform in a whirlwind of concrete in front of a supermarket in a place where ladies from the Movement for Democratic Change sit with their legs outstretched waiting for kombis, then you play the kind of music that is meant to splash over people, and maybe also over the lonely and empty bridge that was built to save people’s lives and now is simply a depository for urine. Such bridges become dangerous. Ghosts hang around such bridges, swinging off the rafters.

(One must never build bridges lightly. Sometimes you don’t know what such a crossing will invite.)


The Crazy Poets were cynical. The NGO man read from his sheet of people: “You are your own doctor. Health is 80 percent of what you do. Health is what you eat. Health is what you drink. Health is what you don’t drink.” The Poet rhapsodized: “My son Shakespeare do not just shake it, a hunter uses his spear in many ways.” Their voices were cynical and they read like cynical men. What do I mean by that? They read like men who were aware of their crimes against beauty, and so they distanced themselves from their actions in the moment of acting. Such men can never be caught red-handed, for their souls are always looking the other direction.

They stood and waved their arms and flapped sheets of paper, surrounded by people who merely looked and listened and waited. They did not cheer. They simply stood and watched. The noises around them – kombis and cars and vendors and all of us children of the sun – were loud enough. By all accounts, the silence was not enveloping. There was no communication.

This is what health campaigns look like in Africa. They take the form of giant billboards urging people to wear condoms – in the middle of the Botswanian desert, where only donkeys loiter long enough to take in their message. They take the form of artists and non-artists reading off of scraps of paper, telling people to go to the doctor and get tested today, trying to script conversations for people in a country whose story is profoundly flamboyant and brave and surprising and difficult and rattled and nothing has ever, ever been scripted.

(No wonder the Spirits of the Land are confused.)

*          *          *


My boyfriend and I go get tested for HIV at a local clinic. The clinic is aptly named NewStart and I am told it is a popular place to go. Testing costs a dollar and the tests given are self-tests. This was not always the case – a few years ago the tests done here were blood tests.

A woman sits taking our blood pressure while we sit on plastic chairs and watch a video of self-test instructions on a big screen. Afterwards, we are each given a sealed packet containing the test, and then ushered into a cubicle, our privacy ensured by a thin blue curtain.

From the very beginning, the self-test instruction video declares: this test sometimes produces false negative results. If you have HIV, then do not take this test.

What does that mean? What can that mean?

From what I understand, this is a warning for those people who come to the clinic knowing that they have HIV, and trying for a different result. (Why would anyone come and waste a precious dollar on such a thing? Unless they are trying to fool their new sweetheart that they do not have HIV? But how many people would do that, hoping for the small chance of getting a false negative result?)

Most importantly, how are people who do not know if they have HIV to read this? Before they even get tested they are told that they cannot trust the results.

Furthermore, in the test instructions we are told that if we get a positive result, then we should go to a different clinic and do a blood test to confirm. If we get a negative result we are told to do nothing. I don’t understand. In the video we were told that the test sometimes produces false negative results. Now we are told that we could equally have a false positive result.

How can any thinking person believe anything they are told in all of this confusion?

After we finish our tests we are told to fill out a questionnaire, seal both the test and the questionnaire in an envelope, and put them in a box where they will be collected for statistical analysis.

Nobody told me I was going to become a statistic today.

It cost me one whole ignorant dollar.

*          *          *

So start a conversation/about HIV/with reality and meaning/politics and feeling”

                                             - prattle the poets -

How can conversations be scripted if lives aren’t?

When does language become propaganda?

What are words when they no longer have music or dance?

*          *          *

What is health? The Crazy Poets asked that question. I also ask that question. I ask that question as my realities move into metaphorical states of being, into paying attention to clouds and birds, and my heart feels the hearts of those around me. I am living in a country that is totally fucked up (and which country is not?). And yet the artists here produce beautiful art. They don’t do it necessarily in opposition to anything. It’s just that their hearts are open. The singing of the Earth here does not listen to the government, and neither does the government listen to the singing of the Earth.

(Where else do we know that from?)

When I speak of illness, it seems, I can only speak of metaphor, in metaphors. I meet a dentistry student and a medical student, and we jam in the office of a former headmaster turned musician and luthier, who loves guitars more than anything else in life. We talk about plant ceremonies. We talk about ceremonies that require beauty for the Spirits to be so moved. We talk about the rains that come to hear the songs of the dancing and singing people.

What is health? What is sustainability? When I enter into the shops here, most of the food I find is imported, and the prices are ridiculously expensive. I find greasy food, unhealthy food, and I am dismayed. Some part of me feels angry for the pains of a country that is so beautiful. Some aspect of oppression must be swallowed and allowed to flow down the river of life for it to pass – otherwise, if we dam it up, then it will one day explode and there will be violence and blood. (There is already violence.)

When I hear the stories of the people and feel myself, as a person, then I know: it is the small indignities that drive people to the greatest violence, because within a giant system of oppression it is those small indignities where people feel they should have at least some ability to do something.

What are we not asking? What gives people joy? What allows people the ability to live and thrive and survive?

The question is ages old, and it’s what we think about Africa: why don’t those people want to get better? Why don’t they get tested? If we look at the question metaphorically, then it is the same question as before: why can’t you just fix yourself? But if it is a symptom of colonial co-dependency, then the Western world needs Africa to be fucked up. And the fucked-upedness of Africa is proving to the Western world that the sheen of rationality is just that – a less-than-paper-thin sheen. Still, that world covers its ears and howls louder.

Most Zimbabweans go to traditional healers before they go to Western doctors. I don’t think this is because of money or accessibility, but because Zimbabweans include dreams and spirits in their way of understanding the world. This way of understanding the world is not so dire as we paint it in the West – it is not simply a deeply superstitious and misinformed worldview that needs to find a scapegoat to blame for misfortune. It is an attempt to listen and understand the deeper music of every event. The Traditional Healer will ask about your spider-web of relationships – your family, your past, your traumas, your feelings, your dreams, your faith. When you feel – when you feel deeply – into the resonance of what happens in life, then you feel many things, many stories, many voices bubbling, a whole river of sound. And we wade in the river, and listen. This is our conversation with the Universe. This is divination. Any attempt to understand divination, or this metaphorical worldview, or African cosmologies, through Materialist, or Rationalist philosophies, will dilute these cosmologies and stunt them. Yet cosmologies also have suffered a genocide. How could it be otherwise? We have been kept out of the dreaming of the Earth for too long.

The traditional healer should be a wise person, never a person who assigns ritual for rituals sake, but somebody who is empty and knows how to listen. We can assign spirits names, give them stories and life, and who knows if these things are true, but in so many ways they become true. The Truth is in the trees. The Truth is in the land. When I was sick I found Truth in so many places, yet so many Truths my body did not seem to absorb. Even after finding Truth the body can still be in pain. Yet when we harmonize with our lives, it is also easier for the body to heal.

Western philosophies of illness are not disallowed from cosmologies. A cosmology encompasses everything, and so Western philosophy and Western medicine all have a place within a cosmology. A cosmology is all accommodating. It must be, for life is a constant flow of immigrants. A cosmology welcomes immigrants and gives them a seat at her table, and feeds them. The immigrants don’t always respect hospitality. Sometimes they respond with bloodshed. Sometimes they pull out swords and cut the heads off of their hosts.

It’s a shame, really. Opposition is illusion. The two sides of any road are connected by a bridge. Let’s walk that bridge and watch how those who walk towards each other can just as easily embrace each other as oppose each other.

The voices coming out of Africa today are clear – we are all, every one of us – ONE.