Singing in the shadow of death

Kibera, Kenya, Africa's largest slum.

African musicians respond to a pandemic with songs of sorrow, resistance, advocacy, and hope.

Image: Almost a million people live in Kibera, Kenya, Africa's largest slum.

© Jonah Eller-Isaacs


I’d seen Alec Nyirongo in his last days, and although he warmly welcomed me to his chiefdom, his body revealed a deep distress. His eyes were jaundiced, his handshake weak, his breath tubercular. Today his relatives have gathered in the family compound to mourn. They drape the carved pine coffin with strands of bougainvillea—red, orange, yellow, magenta; death dressed in glorious clothes. The sobs of the widow and her fatherless children break the chill morning air. As I walk with the family down the narrow path to the cemetery, we pass under the branches of broad acacia trees and through fields of pale yellow tobacco leaves and wilted maize.

For four days, drums and voices have echoed across the courtyard of my quarters here in Malawi, high in the foothills of Africa’s Great Rift Valley, as the village mourns its departed chief. I ask my hosts if it would be possible for me to attend the final night of remembrance. After a long discussion, the elders decide that I can enter the mourning house.

A family member accompanies me inside and the mourners part to make a small space for us on the concrete floor. I sit close to my escort and can smell the rank cane spirits on his breath. My eyes adjust to the dim candlelight and I set up my microphones. Soft singing begins.

The arrival of a local choir strengthens the exhausted relatives. The choir finds room in the cramped space for their drums and dancing feet. The air is thick and smells of burning paraffin and sweat. Some songs are quiet, a few voices singing hymns; some are loud and accompanied by drumming and bells. Grief sits heavy in the room, but the music lightens the atmosphere, and some people smile as they sing.

Although his official cause of death was tuberculosis, it’s all but certain that Alec Nyirongo was one of nearly 100,000 Malawians who died from AIDS or AIDS-related complications in 2004, one tiny statistic in the global HIV/AIDS pandemic that has claimed more than 20 million lives worldwide and inspired Unitarian Universalists and their congregations to action. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), more than 14 percent of Malawi’s 12 million people are living with HIV, the Human Immunodeficiency Virus. That compares to three-tenths of 1 percent in the United States. And Malawi’s devastating infection rate ranks just eighth out of sub-Saharan African nations, with Swaziland topping the list at an incomprehensible 38.8 percent.

Statistics like these are hard to put into perspective, but imagine that two out of every five people you see on the street or in the grocery store are living with an incurable disease and that access to medication is limited at best. In sub-Saharan Africa, more than 25 million people are living with HIV—equivalent to the combined populations of the Eastern seaboard states from New York to Massachusetts. Although sub-Saharan Africa represents just over 10 percent of the world’s population, it accounts for more than 60 percent of global HIV cases.

The African HIV/AIDS pandemic has been in the news for a decade, but other horrors including the genocide in Darfur and the spreading of bird flu have upstaged it lately. It’s easy to miss the good news that infection rates have declined in some of the worst-ravaged countries, not just because of aid from the developed world but largely because of the strong spirit of the people who live day in and day out surrounded by the deaths of family members and friends. They are creatively rebuilding their communities in the midst of disaster.

Unitarian Universalists are looking for ways to help, too. Moved by a lecture about this grim pandemic at the General Assembly of the Unitarian Universalist Association of Congregations in 2002 by Stephen Lewis, the United Nations Special Envoy for AIDS in Africa, Ann Pickar and Madeleine Lefevbre from First Unitarian Church of Portland, Oregon, started the UU Global Aids Coalition. The coalition provides opportunities for global advocacy as well as direct service to those living with HIV here in the United States. In 2003 the UUA General Assembly passed its third resolution since 1986 concerning HIV/AIDS, urging congregations to “[bring] to bear our values on the matter of the global AIDS pandemic” through education and activism. The UU United Nations Office held an intergenerational conference on the pandemic in 2005. The UU coalition reports that a dozen UU congregations from Florida to Alaska are active in the fight against AIDS globally and that its newsletter goes to members of 98 congregations in 29 states, Canada, and the United Kingdom.

A different kind of Unitarian Universalist connection led me to a surprising story about HIV/AIDS in sub-Saharan Africa. In 2002, the Rev. Robert Eller-Isaacs, my father and (along with my mother) co-minister of Unity Church Unitarian in St. Paul, Minnesota, went to Malawi. He organized the trip to reinvigorate a long relationship between the church and the Nyirongo family, which operates clinics the congregation has supported since helping Dr. Trywell Nyirongo, Alec Nyirongo’s uncle, attend medical school forty-five years ago [“An Enduring Bond,” March/April 2004].

When he got back, my father told stories full of music. He attended an educational presentation where health professionals integrated music into their lectures. He listened to high school students sing about the painful losses of AIDS. People were searching for ways to slow the spread of HIV/AIDS, and I became interested in the possibility that this music might be a powerful agent for change.

The relationship between music and culture was a central part of my college studies, through which I’d learned that music is deeply rooted in many societies in Africa. It’s not just a form of artistic expression; it’s an arena for social commentary and oral history. Music is the language of the spirit and of the community. I began to wonder if music-based health education could make a difference in the fight against HIV/AIDS.

Through the generosity of donors primarily from Unity Church Unitarian and the First Unitarian Church of Oakland, California, I organized an independent research trip, eventually spending six months in Malawi, Tanzania, Kenya, and Uganda. For nearly the entire journey, I lived with local families like the Nyirongos in Malawi. These families showed me endless hospitality and provided me with a gateway to understanding the realities of life surrounded by HIV. I recorded hours of music, starting with Alec Nyirongo’s mourners, heartbreaking tales of loss, and inspired accounts of strength in the face of overwhelming tragedy. Since coming home, I’ve tried to do justice to these stories and songs. Through a radio documentary broadcast for World Aids Day 2005 by Minnesota Public Radio, along with educational lectures I’ve presented at churches and schools around the country, I’ve presented this story as a new way for those of us an ocean away to understand the experience of living in the midst of the HIV/AIDS pandemic.

Like many Americans, I was accustomed to the mainstream media’s portrayal of Africa as a desperate, monocultural continent laid waste by disasters of near-biblical proportions. Yet throughout my travels I encountered people using music to build strong and healthy communities. In the HIV/AIDS pandemic, music is a form of creative resistance that provides hope, strength, and courage to stop the destruction. The following stories come from a wide variety of locations and people, but they all share a common thread. For those living in the shadow of this devastating disease, music truly is life.

Roots and rhythms: Tanzanian hip-hop

In Arusha, a Tanzanian city of nearly 300,000 residents and a world away from the remote hillside villages of Malawi, there is no more common sight than a minibus, the ubiquitous means of public transport. Minibuses covered with stickers and hand-painted messages like “No Sweet ’til There’s Sweat” or “Rastaman” would pick me up every day. Passengers dangled out the open doors, hanging on for dear life as the banged-up vans throttled along the dusty, potholed roads. A thumping bass line would fill the air as the driver shouted and laughed with the music and a scramble of Swahili lingered in my ears.

A decade earlier and the pounding bass would have accompanied a bouncing, melodic Congolese guitar riff. Things have changed. Today the bass provides the foundation for the most popular style of music in urban Tanzania—hip-hop. The growth of Tanzanian hip-hop culture known as “Bongo Flava” has made superstars out of the most successful lyricists. Although the influence of American and European hip-hop is undeniable, artists in Tanzania and across Africa have claimed it as an African art form, rooting their craft in ancient African ideas of song as story, beat as myth.

Hip-hop has a significant role in the lives of Tanzania’s youth, and some organizations fighting HIV/AIDS in the country are harnessing this combination of rhythm and poetry to reach their target audience. One of the most prominent health organizations in Tanzania is Ishi (Live! in Swahili). Ishi’s aggressive social marketing campaign promotes the ABC model of HIV prevention (“Abstinence, Be faithful, use a Condom”). Nassoro Ally, a regional outreach director for Ishi, describes their strategy: “We have TV ads, we have radio ads, we use magazines, we use billboards, so it reaches a lot of youth. And for those who are not able to read and write, we reach them through our community concerts.”

To engage youth, Ishi had a group of top-selling artists record hip-hop versions of their messages, and during my time in Arusha, the streets and airwaves of Tanzanian cities were saturated with Ishi’s catchy theme song “Usione Soo” (“Don’t Be Shy”). Ishi isn’t simply promoting its messages to young people using popular music: It is also actively empowering them as artists and community leaders, inviting urban youth to help craft its messages. Even as “Usione Soo” was peaking on the charts, Ishi officials were sitting down with urban youth across Tanzania asking how youth were responding to their messages and what sort of slang they were using to talk about health and sexuality, and inviting them to suggest slogans that might be effective in the future.

While in Arusha, I conducted a series of interviews with Ishi officials, after which I was given a hat and T-shirt with the Ishi logo. I would walk the streets of Arusha and find the shouts of mzungu (“white person”) had switched to Ishi! and Usione Soo! Through its straightforward educational slogans and memorable pop presentation, Ishi’s message has permeated the streets and made its way into the minds of freestyle hip-hop artists. The poetry these artists write and improvise becomes a new language for their generation, and Ishi’s campaign has brought out a focus on health and HIV/AIDS.

In my search to work with these young artists, I found Aang Serian (“House of Peace”), an Arusha-based organization that provides cultural tours to the villages of a few of the 120-plus ethnic groups in Tanzania. It also hosts a closet-sized hip-hop studio in the heart of the Arusha garment district. When I told the staff about my research, they gathered their friends and started to record. I spent the next month visiting local studios, watching and listening as gifted poets gathered to put their words to paper and a microphone to their lips. They integrated “Usione Soo” and Ishi’s messages into their rhymes and told stories of survival as they watched their friends and relatives give in to AIDS.

A report on responses to Ishi’s strategy prepared by experts from Johns Hopkins University and HealthScope Tanzania claims that youth exposed to Ishi’s musical message “Don’t Be Shy” are more likely to practice safe behavior. After seeing these artists in action, it was clear to me that youth exposed to Ishi’s message also understand that music, which resides in the spirit, can describe the raw experience of life and that even adolescents can harness its power to educate each other and change society.

Uganda: A nation and a pop song

How do you measure the impact of national trauma on a people’s spirit? What is it like to bear witness to devastation? Ugandans know all too well.

After the initial diagnoses of HIV in Uganda became known in the mid-1980s, it was only a short time before the virus began to tear apart the social fabric of the country. When I asked about living through the epidemic in which millions died, Ugandans responded with shaking heads and stoic eyes. James Kigozi survived and today works for the Uganda AIDS Commission: “Oh God, it was really bad. Hospital beds were occupied by as much as 75, 80 percent by AIDS patients. You could bury two, three, four people in a day, all of them known to you. In Uganda, everybody has lost somebody due to HIV. Your brother, a sister. Or even a parent.”

By the early 1990s, it was estimated that urban infection rates were as high as 30 percent—the highest in the world at the time. (Sadly, other countries like Botswana and Zimbabwe are worse now.) There are two million orphans now in Uganda, a country of fewer than 30 million residents. Translating that proportion to the American population would mean that every single person living in New York State was an orphan, with fully two-thirds of them thought to be HIV positive.

So it is all the more surprising that today Uganda’s HIV infection rate is down to 6.1 percent. Unfortunately, part of the decline in the infection rate was due to viral burnout: So many people died of AIDS so quickly that the virus couldn’t propagate effectively. But Uganda also managed to bring the spread of HIV/AIDS under some control through dedicated community and government efforts to teach people the ABC method. And many people point to a single song as the beginning of this remarkable recovery.

Ugandan musical luminary Philly Lutaaya stunned the nation in 1988 when he announced that he was HIV-positive. In the climate of fear and stigmatization that often accompanies the HIV/AIDS pandemic, many Ugandans believed his revelation to be a ploy or a publicity stunt. Then Lutaaya released his album “Alone” and forever sealed a place beyond superstardom as a national hero. In his title track, Lutaaya not only brought his status into the limelight, but also described his emotional experience of isolation and pain:

Out there somewhere, alone and frightened
Oh the darkness, the days are long
Life in hiding, no more making new contacts
No more loving arms thrown around my neck.

Lutaaya died in 1989, just months after releasing “Alone.” As music historian Joel Isabirye explains, Lutaaya’s impact was immediate and tremendous: “Philly Lutaaya gave, if I am right to say, a human face to living with AIDS. He made it seem as if it was not a monstrous thing. The landmark, the most significant moment started with Philly Lutaaya, and that is when music became very significant in dealing with stigmatization in Uganda.” It seemed every Ugandan I met could sing every word to “Alone.” Lutaaya left a legacy of emotional honesty in music-based activism that continues today. The song and its message are a rallying cry in the fight against HIV/AIDS and “Alone” is the unofficial anthem of TASO, or The AIDS Support Organization.

TASO is a beacon of progress in working to encourage healthy and supportive behavior. The arts are central to TASO’s efforts in reaching out to individuals, teaching the ABC method, and working against discrimination. Music, says TASO official Anne Kadumkasa, is “very instrumental in breaking the ice between the community and the people that are HIV infected.”

Every TASO center supports a drama group composed of people living with HIV that provides an essential outreach service and creates a powerful therapeutic environment. Members attribute their full and generally healthy lives to their singing, drumming, and dancing together. Says one drama group member, Mahmoud Kayiwa: “When you come here, you rejoice, you sing, you dance, you see. So you can forget all about the AIDS. When we share each and every thing about the disease, we cannot get scared as when we are alone at home.” At TASO’s national headquarters, the drama group performed for President Bush during his 2003 visit.

Uganda is a success story in the fight against HIV, but some advocates fear complacency. The risk of another epidemic is also compounded by external influences. The Bush administration claims to support the ABC model, yet activists in Uganda assert that U.S. pressure to emphasize abstinence-centered education is hampering HIV prevention. (Thirty percent of U.S. funding is targeted to abstinence-only methods.) Ugandan health advocates recently accused their government of trying to appease the United States by holding 30 million condoms in storage, creating a nationwide shortage. Stephen Lewis, the UN Special Envoy for AIDS in Africa, who sees the ABC method as especially effective, has criticized the United States for pushing Uganda to change its approach.

Regardless of current fears, Uganda is a living example of the power of music to transform a nation. When the HIV-positive members of a TASO drama group performed “Alone” in the central Kampala hospital, it moved me to tears. Ailing TASO clients lined the crowded halls outside the performance in their hospital beds, and it seemed that the song gave voice to their hopes—to all our hopes—to live happy, healthy lives alongside our families, to hear choirs sing songs of understanding, and for love and support in our times of need.

Kenya: Forgotten voices

Kibera is the largest slum in all of Africa. Nearly a million residents cling to life in a long, steep valley on the west side of the Kenyan capital of Nairobi. A short walk through the neighborhood revealed brutal conditions. There is no sanitation, electricity, or running water. Plastic bags soar on the wind and sewage trickles through the streets. The corrugated iron shacks roast their residents in the stifling equatorial heat and provide little shelter from the cold nights. There is widespread malnutrition and AIDS casts its deathly shadow along the densely packed hillside.

Although Kenyan HIV infection rates have stayed relatively low (the current UNAIDS estimate stands at 6.7 percent), the virus continues to take its toll. Those struggling with living conditions such as those in Kibera are at high risk—particularly women and young girls, who are sometimes forced into prostitution to feed their families. As in neighboring countries, AIDS is killing the most productive age groups. Parents, as well as teachers, merchants, and workers, are dying and leaving behind a generation of broken families and abandoned children. Street children wander downtown Nairobi, dazed victims in an epidemic of glue sniffing, bottles held to their drooling mouths as they beg for money in the shadow of glittering skyscrapers.

Kenyan organizations are trying to get these children off the streets and into families, schools, and healthy living environments. Few, however, are reaching out to those who are HIV positive. Until recently many organizations viewed outreach to orphans living with HIV as a lost cause, a waste of resources that could support those with a better chance of survival. That has all changed with the founding of the Nyumbani Institute.

In 1992, the Rev. Angelo D’Agostino, an American Jesuit, began caring for a small number of HIV-positive orphans. Today, Nyumbani (the Swahili word for home) hosts nearly 100 children and provides off-site support to nearly 1,000 more. It is a model for respectful and effective faith-based work and a symbol of hope for the people it serves.

On my first visit, I was greeted by green gardens, colorful artwork, and screams of joy and unadulterated happiness. It was a bit of a shock. Volunteer Don Rawzi told me, “We had some reporters here. They were like, ‘Oh, where are the sick kids? We want to see the sick kids!’ ‘Ah,’ they were told, ‘these are the children of Nyumbani.’”

Antiretroviral drugs (ARVs) keep the children of Nyumbani alive. They are fortunate to have access to this life-saving medication: A recent study co-sponsored by the World Health Organization and Doctors Without Borders estimates that in sub-Saharan Africa, just 50,000 out of an estimated 4.1 million people in dire need get the drugs. Senior Nyumbani staff member Sister Mary Owens says, “This is the great injustice of our world, that there is medicine available and it’s not available here in sub-Saharan Africa. You see our children here. They’re all healthy: 62 out of the 94 are on ARVs. And that’s why they’re healthy. They’re living full lives. They have hope for the future. They’re like normal children, planning, dreaming. That’s the hope, the positive face of AIDS, and that’s possible for every person who’s infected.”

ARV therapy is more effective if the person living with HIV can minimize stress, doubt, and fear. In helping the children to understand their status and raise their spirits, Rawzi—who is also a musician and producer—recently helped the children of Nyumbani form a choir called Watoto wa Mungu, or “Children of God.” To all of Kenya’s surprise, singles from the group’s debut album topped the pop charts. The choir has brought an electric atmosphere to an already stirring humanitarian effort and has made a significant positive financial impact at Nyumbani. Watoto participants are proud of their place as a voice for their counterparts, as 13-year-old and lifetime Nyumbani resident John Mwiro explains. “I sing in the music group,” he told me, “to tell the other young artists coming up they should not give up. Come forward. It’s another way of explaining that you can live a positive life, a very good one.”

At Nyumbani’s twelfth anniversary party, Watoto wa Mungu performed an adaptation of The Wizard of Oz. Just two weeks before, nearly all my recording equipment had been stolen, along with my camera, credit cards, and my irreplaceable journal and field notes. (My recordings, thankfully, were safe.) For two weeks I’d been wandering the densely packed and dangerous streets of downtown Nairobi without equipment, unable to work, wondering whether I should just go home. Strangers with ill intent followed me back to my hotel and glue-crazy beggars accosted me. It was all worth it to watch The Wizard of Oz at Nyumbani. Tiny Kenyan munchkins with glowing eyes performed for ambassadors. Toddlers with paper flowers on their heads struggled to sit still in their role as the scenery. Dorothy belted out, “There’s no place like Nyumbani,” and clicked her tattered red slippers. Angelic HIV-positive orphans sang with all their might, “if happy little bluebirds fly / beyond that rainbow / why, oh why can’t I?”

The web of life

News from Africa often reads like a litany of horrors: plagues of locusts, famine, rampant corruption and mountains of debt that drain resources, armies of children cajoled into atrocious crimes, even genocide committed without significant international intervention. As with many international issues, the HIV/AIDS pandemic in Africa can seem distant and advocacy unproductive. One can forget that there is hope and creative resistance to poverty and pandemic alike, that both local and international organizations are making progress in creating livable and sustainable conditions in Africa.

Music is a powerful idiom for education and therapy. Even more, it is a universal language that speaks to the children surrounded by the pandemic in Africa just as it speaks to us living in relative comfort. On my first Sunday in Malawi, I accompanied my host family to church. It was Pentecost, and as the preacher pointed to a verse, a neighbor helped me find the passage in English. It was Acts 2:2–4:

And suddenly there came a sound from heaven, as of a rushing and mighty wind, and it filled the whole house where they were sitting. Then there appeared to them divided tongues, as of fire, and one sat upon each of them. And they were all filled with the Holy Spirit and began to speak in other tongues.

When the sermon ended, the congregation began to sing. I recognized the tune and sang along in a language that I barely spoke. Harmonies surrounded me that Sunday. When I came home months later, I discovered that we’d been singing “Hyfrydol,” the tune Unitarian Universalists know as “Hail the Glorious Golden City.” Now when we sing that hymn at my home church in St. Paul, I remember that powerful day in Malawi and I remember why the plight of people in faraway places makes a difference to us all. The hymn affirms our Unitarian Universalist goal of a world community of liberty, peace, and justice for all:

We are builders of that city.
All our joys and all our groans
Help to rear its shining ramparts;
All our lives are building stones
Whether humble or exalted,
All are called to task divine;
All must aid alike to carry
Forward one sublime design.

Related resources

  • Singing in the Shadow of AIDS.Companion website for Jonah Eller-Isaacs's radio documentary for Minnesota Public Radio includes recordings, photos, and more. (
  • UU Global AIDS Coalition.Unitarian Universalist advocacy group.
  • The AIDS Support Organization.TASO, Ugandan group, uses the arts to help infected people. (
  • Nyumbani Institute.Kenyan organization helps infected children. (
  • Aang Serian.Young people's organization in Tanzania promotes indigenous arts. (
  • UNAIDS.Joint United Nations Programme on HIV/AIDS. (
  • Avert.British charity provides extensive background information on HIV/AIDS. (

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