An Integral Approach to AIDS/HIV in Africa
August 24, 2006 23:39

~posted by Corey W. deVos

“Sub-Saharan Africa has just over 10% of the world’s population, but is home to more than 60% of all people living with HIV—25.8 million. In 2005, an estimated 3.2 million people in the region became newly infected, while 2.4 million adults and children died of AIDS.” (source:

When I was young--about nine years old--my Aunt Diane died of pneumonia, which she contracted after being diagnosed with AIDS. I still carry the memories of her in her final days with me: her long, beautiful, ebony hair had become tattered and brittle; her full, vivacious cheeks were replaced with a hollow and tormented patience as she awaited the inevitable. It was absolutely horrible. When she passed away she left behind two gorgeous little girls, and sent violent shockwaves through the entire family which still resound today. It is a twenty year old wound that will never ever be healed.

So I have had a taste of the immeasurable pain this disease can inflict upon a single individual and his or her family. When I read statistics like “25.8 million infected with HIV” or "In 2005… 2.4 million adults and children died of AIDS” I can honestly do nothing but shut down. It is simply too big for my mind to understand; it is impossible to translate a dry, inert number like “25.8 million” to the unimaginable misery of an entire continent of people. My human heart rips apart when contemplating even a single person walking through this, never mind the absurd magnitude of suffering that these statistics point to. In fact, the impossible gravity of this suffering demands that our tiny human hearts be thoroughly broken and torn to shreds, so that we can truly open ourselves to Big Heart, the Heart that cannot be broken, the very same heart that is, always and already, forever broken. Only from this infinite perspective, from the eternally radiating warmth of Big Heart can we even begin to hold sweet, precious Africa in our arms.

While Big Heart provides us with a space from which we can actually begin to feel the gravity of the situation, the question remains: now that we can feel it, what do we do about it? We can circulate the pain through us in our Tonglen practices, taking the misery of the world into our Big Heart and release it into emptiness, but then what? What, on the phenomenological side of the street, are we to do?

And this, as you may guess, requires a framework.

The AIDS epidemic in Africa is not something we can begin to address without recognizing the extraordinary complexity of all the countless factors contributing to this problem. We need to consider the economic complexity, the political complexity, the astonishingly wide range of developmental complexity, the various belief systems, the many layers of interpretation of what AIDS means, etc. And beyond that, we need to identify the global conditions in which Africa is embedded. What a hideous mess, how will it ever be possible to tease all of this apart, to get to the core of a genuinely effective global response to this epidemic?

Several months ago, I was elated to read an email from Barrett Brown, the co-director of the Integral Sustainability Center at Integral University, letting us know that there are several leaders within the United Nations Development Programme (U.N.D.P.) who are beginning to use “integral approaches” to address the African AIDS epidemic. A document summarizing these approaches can be found here. This is in no way to suggest that any official programs have been initiated within the U.N. or the U.N.D.P., but the simple fact that these leaders are beginning to recognize that an integral response is essential to alleviating the suffering of Africa (and the world) fills both of my hearts with hope. Anything less, from my perspective, is likely to be ineffective, or could even make the situation worse.

For example, an integral approach tells us that it is not enough to just address the illness--we must also address the many different sicknesses that are associated with the illness. What’s the difference?

“In any disease, a person is confronted with two very different entities. One, the person is faced with the actual disease process itself - a broken bone, a case of influenza, a heart attack, a malignant tumor. Call this aspect of disease 'illness'. [...] Illness is more or less value free; it's not true or false, good or bad, it just is - just like a mountain isn't good or bad, it just is. But two, the person is also faced with how his or her society or culture deals with the illness - all the judgments, fears, hopes, myths, stories, values and meanings that a particularly society hangs on each illness. Call this aspect of disease 'sickness'. [...] Science tells you when and how you are ill, society tells you when and how you are sick.” [Grace and Grit]

HIV/AIDS is the illness. You can see it in a microscope, study its effects on the human anatomy, and try to distribute chemical cocktails to curb its proliferation in the body. But HIV/AIDS prevention begins with recognizing the sicknesses, the many cultural interpretations of the illness that exist. Magenta Africa, red Africa, amber Africa, orange Africa, and green Africa all have their own sicknesses. And unless we can begin to deal with that, the monological imposition of orange science will continue to fall short of controlling this epidemic. Bill Gates can throw all the billions of dollars he wants into Africa (and he should), but without the extremely important concept of development the money is mostly limited to research and development, while bringing effective solutions to Africa remains just out of reach.

How else could we hope to “educate” Africans about HIV/AIDS prevention, without adapting the content of the education to the various developmental levels that exist there? Rational descriptions of the virus and it’s effects, campaigning for the distribution and regular use of condoms, even providing people with the essential medication they need, can be next to impossible in certain cultures that maintain magical belief systems (e.g. having sex with multiple virgins will cure a man of AIDS.) What works in the first world is almost guaranteed to break down in the third world. So, at the very least, we need a response that appreciates the fact that developmental levels exist, whatever names one wishes to use for those levels.

The human condition demands it, or else we risk drowning in God’s tears.

“So what can I do?”

- Let it in. Look at the image that accompanies this blog--it is a funeral procession for Nkosi Johnson, regarded in South Africa as a hero, who died of AIDS at the age of 12. Empty yourself of thoughts and distractions, and just look at the image. Try to feel Nkosi. Try to feel how much you resist feeling Nkosi. Without judgment, just notice how much resistance there truly is, notice how much we simply do not want to feel this.  Let your heart break; let Nkosi inside, as well as the other 490,000 African children that died last year from AIDS-related illnesses.

- Circulate it. Breathe in the impossible weight of the suffering in Africa. Feel it come down the front of your chest, across and through your wide open heart. Feel your breath extend down the length of your body, to your toes and fingertips, until you are as full as you can be. Notice the still point between your inhale and exhale, and let this point be your sacred altar, the sacrificial stone upon which you pay tribute to the inherent suffering of manifestation. Then release your breath; feel your breath rise up your spine and out the top of your head. Feel this release as liberation, watching the pain fade into the effortless expanse of this very Empty Moment.

- Talk about it. Spread awareness, breach the invisible walls that keep us from discussing such painful realities with each other, realities that are simply too big for any of us to sit with alone. Challenge your own contractions and resistances, and challenge those within the people you love. Remember, wearing the little red ribbons are not enough, without actively bringing attention to situations like this together.

- If you have the means, support any of the multitude of charities working to enhance the lives of millions of afflicted Africans. There are many wonderful organizations out there, just do a little bit of research. This requires support from both the elite and the grassroots. Bill Gates, Brad Pitt, and Angelina Jolie can’t carry the entire continent on their backs alone!

- Practice safe sex. Don’t contribute to the already horrifying statistics.

- Ultimately, remember this: If you are having a dream, in which millions and millions of people in the world are suffering beyond description, what is the quickest way to end their suffering? Wake up.

(For more about an integral approach to humanitarian work in general, check out this dialogue between Ken Wilber and Julia Ormond.)


Funeral procession for Nkosi Johnson, 12 years old

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