African Woman and Child Feature Service

The death of Dr Margaret Atieno Ogola marks a loss for the literary world and the medical fraternity. Ogola lived a full life as a nationalist, writer, mother, wife and friend to many. Thus, she is moaned by the Kenyan nation.

As a journalist, I have met a number of impressive people in Kenya.  Somewhere near the top of the list is Dr Ogola, who at the time I first met her headed the Commission for Health and Family Life for the Kenyan Episcopal Conference. Ogola was a pediatrician, a mother of four and the medical director of the Cottolengo Hospice in Nairobi for HIV-positive orphans, a centre similar to Nyumbani Children’s Home.

In her spare time, Ogola wrote prize-winning novels. Her first novel, The River and the Source, won the 1995 Jomo Kenyatta Prize for Literature and the 1995 Commonwealth Writers' Prize for Best First Book.

I sat down with Ogola to discuss the HIV/AIDS crisis. Kenya has at least 200,000 AIDS patients who should be on anti-retroviral treatment, but only 20,000 actually get the medicine. Ogola knew how important ARV therapy can be. At Cottolengo, she watched it make the difference between life and death. Yet she says there's a sense in which the question Western journalists always ask, why more people are not on ARVs, misses the point. "It's futile to think that ARVs will solve the problem of AIDS," Ogola said. For one thing, she said, people with empty stomachs can't absorb the toxicity of the medication and hence either vomit or don't take it. Furthermore, deciding who gets ARVs and monitoring their use, requires complex laboratory set-ups that Kenya's medical infrastructure, badly depleted in the 1980s by World Bank-mandated structural adjustment programmes, can no longer manage.

Without "serious efforts at poverty eradication," she said, the AIDs crisis will continue. Among other things, she said, poverty has broken down traditional African social structures that surrounded sexual promiscuity with taboos.

Ogola said that the best bet for ARVs in the developing world is the Indian pill, which sells for about $7 and comes in single dosages. Yet funding provided by the American Government comes with a stipulation that it be spent on the more expensive, and more complex, ARV treatment manufactured by American pharmaceuticals.

Since Ogola worked for the Catholic Church, I brought up the inevitable topic of condoms. She wearily expressed frustration that so much good work by the Catholic church on AIDS has been overshadowed by the condoms debate, handing me, for example, a list of 93 Catholic charitable homes and community-based programmes in Kenya. She said that when journalists call looking for comment on the condoms issue these days she refuses, unwilling to fan the flames.

Ogola also acknowledged, however, that many African priests quietly counsel married couples in which one partner is infected and the other is not that the use of condoms in such circumstances can be tolerated.

Ogola was clear that she doesn't believe condoms are the solution. "It's the one gadget in medicine you have to use correctly each and every time," she said only "massive public education" followed by changes in behaviour holds real promise in the fight against HIV/Aids.

Ogola said that as a physician, one of her main worries about the AIDS crisis is the way it falls disproportionately upon women. As a result of social customs such as wife inheritance, in which a husband's oldest brother inherits his widow, women are dependent upon men and thus less able to protect themselves from infection. This is because women are considered men's property. It is a rare African woman who can say "no" when her husband demands sex, even if he's infected. Moreover, when family members are infected, it is the woman who cares for them.

Ogola rejected the image frequently floated in the West that Africa has a hyper-sexual culture. She offered the example of a security guard in Nairobi who comes from the rural area. He may work in the city for a year in order to accumulate savings to take home, and could well be faithful to his wife for almost all of that time, perhaps visiting a prostitute just once. During the one week his boss gives him to go home over Christmas, he might have relations with his wife just once. Two infections, the husband and wife, might well result from those two sexual acts. That, Ogola said, and not some mythical African promiscuity, is the normal way AIDS spreads.

Finally, Ogola acknowledged that some Africans, and even a few politicians and bishops, believe that the HIV virus was deliberately manufactured in the West as a sinister means of limiting population in the developing world. She said she finds that hard to believe, since letting loose such a lethal virus would be an act of the highest madness. We groped for a term to describe it, eventually settling on "omnicide." In any event, she said, the virus is here, and no matter how it arrived, the point is what one does about it.

I realised, when her colleagues told me of her death last week, that, although I felt that I knew her well, I had only talked to her several times. We had had tea together at her office but I had in a real sense, overheard her. Nonetheless, I experienced her integrity. One sensed her complete dedication to the truth and immersion in the mystery of Christian living that allowed her to take on life and death unblinkingly.

Thornton Wilder observes through a character in his play, "Our Town," that we have "to overhear" everything that is important about each other in life. It is no wonder that Ogola can be heard so clearly in the voices of those who now remember her. I overheard similar reactions from her colleagues in the medical profession. In their pauses to find the right word, silence revealed itself as the true medium for the unforced responses of the heart.

This was not the oppressive "silence" that poet Emily Dickinson described as filling "a house on the morning after death," but an interlude crackling with electricity, seeking to ground itself to illuminate the depths of their freshly uncovered emotions. One could overhear their unwillingness to speak casually of their comrade and friend; they sounded as if they needed to step back to get a better perspective on a stature that they suddenly realised was greater than that whose shadow had fallen so gently.

As an artist, Ogola was so sensitively attuned to the world and she wrote about issues that mattered. She plunged into responding to such issues as housing and welfare reform, ceaselessly re-inventing herself. She did this as Picasso did by changing her viewpoint and her style to match the challenges before her. Ogola became an advisor to several religious houses in Kenya and beyond.

Archbishop Zacchaus Okoth of Kisumu Catholic Archdiocese recalls that Ogola "had that sparkle and smile with each new idea and the passion to see them through from conception to reality."

With her family, Ogola faced with faith, the advancing spectre of cancer and lived as fully as she could until the end.

We overhear all this in her name: Atieno - Luo for child born at night, a stove, a hearth that gives light and warmth. A fireside is very welcoming to those who are cold and weary or worn down by life. Family and friends gather at such a hearth for its flames, like the breaking waves of an ocean that symbolise the deep mystery of existence.

It is not surprising that we overhear Ogola spoken of as being warm, giving light to those around her.

Her work speaks for itself. As a medic, she crisscrossed the country. In the course of her work at the Kenya Episcopal Conference, she firmly crossed swords with many public figures on contentious issues, and heartily applauded others. She had strong opinions, but a moderate approach; She was a centrist who heard people out.

That was the professional Ogola, but her attributes there were simply magnified on a personal level with colleagues and friends: a kind, unflappable, caring person; a decent woman, in every definition of the term – one with a quietly wicked sense of humour.

Most books on the gender debate revolve around the axle of imbalance in the way men and women relate to one another, in their division of labour, including sharing the products of that labour, such as property, and these books further declare that whereas women are part of division of labour, there’s discrimination in distributing the fruits. This is what Margaret Ogola tackles in her works, especially The River and the Source.