Father to them all

Yesterday, a top United Nations official accused rich states of 'obscene neglect' over Africa's Aids crisis. Here, John Carlin visits a Kenyan orphanage where one remarkable man is bringing hope to hundreds of children suffering from this terrible disease
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Protus Lumiti has reared, loved and buried 100 children. He is 34, unmarried and has no children of his own. What he does is entirely out of the kindness of his heart: acting as father, mother and big brother to abandoned Aids orphans. Right now, in his capacity as head of the Nyumbani orphanage, in the countryside near Nairobi, he has 91 under his care day and night, all of them HIV positive, all of them precariously alive, but currently only one - a little boy called Samuel - at death's door.

Protus Lumiti has reared, loved and buried 100 children. He is 34, unmarried and has no children of his own. What he does is entirely out of the kindness of his heart: acting as father, mother and big brother to abandoned Aids orphans. Right now, in his capacity as head of the Nyumbani orphanage, in the countryside near Nairobi, he has 91 under his care day and night, all of them HIV positive, all of them precariously alive, but currently only one - a little boy called Samuel - at death's door.

It may be the saddest job in the world, but Lumiti has the consolation of knowing that it would be almost impossible to do it any better. If you were looking for someone, somewhere, to squeeze the most hope and joy out of a brief and parentless life, Lumiti would be the man, Nyumbani the place.

Funded almost entirely by individual foreign donors, Nyumbani is the only place of its kind in Africa, as well as a model of what the rich people of the world can do for the poor when they put their minds to it.

The children live in small "families", each supervised by full-time surrogate "housemothers", in clean, airy cottages. There is specialised health care on the premises and access to that rare commodity for victims of the great African plague: life-extending anti-retroviral medication. There are fountains, lawns to play on, and an abundance of toys and swings that would not be out of place in New York's Central Park. The natural setting is magnificent. Nairobi's altitude and latitude makes for an abundance of pines, cacti, and banana trees growing in a thick black soil from which carrots, cabbages and bougainvillea also sprout.

It would be paradise, save that in paradise there are no cemeteries. Behind the cabbage patch, neatly arranged under a tall eucalyptus tree, are 13 little white wooden crosses. Most of the children's bodies are recovered for burial by family members in the communities where they were born. These crosses mark the graves of the forgotten children, those who no one outside Nyumbani wanted to know.

Burying children is a growth industry in a continent where some of the few people getting rich are undertakers and coffin-makers. Three million children are living with HIV in Africa, the vast majority orphans who rarely survive beyond five years old. At Nyumbani the luckiest of Africa's unlucky children are beginning to beat the odds, thanks to the expensive anti-retrovirals (commonly known as ARVs) that the foreign donors provide. In three years since the drugs appeared on the market the mortality rate has been reduced. Before that, one child died each month at Nyumbani.

Lumiti has been living day and night with the children since the orphanage was founded in 1992. How has he coped? How does a human being respond to such relentless sorrow?

"When they feel sick, I feel sick," he says. "When they go down, I go down. I see them grow, I get to know them, I get to love them as if they were my own. Then I see them go down. I have seen a hundred die and been with them all in the last stages, holding their hands, and at each burial. Every single one."

Lumiti, a trim man in a blue suit and tie, speaks with no righteousness, no pride. None of that vanity one sees sometimes in people who know they are doing something that is exceptionally selfless and good. Far from lugubrious, without a whiff of self-importance, he convinces through the quiet force of his personality and the extraordinary drama of his life, simply told. He sits across a desk in a small cramped office, a normal human being doing a superhuman job. When I ask him if he has developed any special emotional defences he says he has not. He cannot afford to show it, he says, but he remains, in truth, as vulnerable as he did on the day he started work.

"It always pains you, it always drains you. When a little girl of 11 died in '99 I almost left. I almost could not take it any more. It was too much. But then I thought: if I leave, what will happen to the nurses and the housemothers and the other staff, will they leave too, will they follow my example? I had to stay."

Staying means learning to control your own pain and plunging with enormous wisdom and patience into the world of a group of children who are psychologically damaged in a way science has not yet had time to understand. "Each little child who arrives has, to a degree, been rejected, not been loved, not been touched as a child should." Those of the children able to acquire some level of normality then have to face the ordeal of school. "They have been treated so cruelly by the other children and even by the teachers. They have been told they are going to die, and have been shunned. Although things are getting better as people become more educated about Aids, the children are still stigmatised. It has been terribly traumatic for them."

The next hurdle comes when adolescence begins. "They start asking why they are here at Nyumbani, why the medicines, why are they different. And we tell them frankly. We have one-on-one counsellors to help them adjust."

Nyumbani - Lumiti does not disagree - is a Rolls-Royce of an orphanage. It was set up by an American Jesuit priest with mostly private American money, and the children would not get better treatment in the finest establishment of its kind in California. Nor would they receive attention more devoted than that which they receive from Lumiti, around whom the children crowd when he goes out among them in the playground, almost as if he were Christ.

The beauty and relative opulence of Nyumbani diminishes the tragedy, but also in a way makes it more poignant. "They ask themselves once they are 15 or 16 what their future will be. The problem is they want to be involved in normal life, are impatient to be like normal people their age, have sex, marry, have children. The doctors say they can, but in the real world it is not so easy."

Which is a lot better than to have no lives at all. The greatest trauma for all the children comes, Lumiti says, when there is a death in the orphanage. They began to see the place that has been a place of refuge for them in a more dark and sinister light, as the ante-chamber of death. "They start to worry and think they will be next, They start imagining symptoms and feel they too will die soon. And at this stage we must redouble our energies to give them hope and help, and in time they forget and life returns to normal."

Nyumbani has what they call "the nursing room", a small, well-equipped infirmary attended by full-time nurses. Before ARVs appeared on the scene in 1999, Lumiti said, it used to be full: seven or eight children at a time. Once in they rarely came out. It was seen by the children - correctly - as the death room.

When I visited Nyumbani, Samuel was there on his own. Nine years old, and terribly emaciated, he sat in a cot with a little fluffy toy dangling from a string above his head. Every 20 seconds or so he coughed, a cough that seemed to have been dredged up from a hollow place deep inside his stomach, the telling cough of the Aids patients who are beyond all hope. I ask the nurse with him if she could come out outside to a second to tell me, out of earshot from Samuel, what his condition was but she said she was sorry, she had to be right there next to him all the time. I look at him in profile, against a window, and he turns to me for a moment, with what I take to be a look of heart-breaking sadness. Then he turns away and looks out of the window. Half an hour later I come by again and he is in the same position, still staring out of the window, immobile, thinking God-knows-what thoughts, but looking as solemn and ponderously reflective as a person ten times his age might in similar circumstances. "Samuel's body system is closing down," Lumiti explains. "He is in a full-blown state. We can only give him palliative support to give his pain some relief. He has been going down and down for three years; has had lots of blood transfusions, food supplements, iron, ARVs. And he is not responding to any of them any more. So, yes, it is terminal. Soon Samuel will die."

It is hard enough for me to bear this news - someone who has never even talked to Samuel but has caught only the tiniest glimpse of him. Lumiti has lived with him for over seven years. And yet what comes across is the sense of a man utterly self-contained, possessed of a deep calm, who smiles frequently but rarely laughs. There must be a wisdom one acquires when exposed to so much suffering. But also you imagine that he has to hold on to this image of quiet composure in order to create the necessary atmosphere among his staff, and among the children, for fear that if he reveals one crack the whole edifice will come crashing down.

Which is what nearly happened when the little girl of 11 died in 1999.

"Caroline was her name," says Lumiti. "She is buried here. She had no family. She came here with her brother who was younger than she was and who died before she did, when she was seven and he was four. For her it was another end-point because she looked after him. George was his name, he was her focus in life, her love, the life that gave her life joy and meaning.

"This little girl - all through her life she had these warts all over her face. [This is a symptom of HIV that we can get rid of now with ARVs.] But she never bothered about her swollen, sore face or her stinking pus and every day she held onto the hope that she would get better. Even in the last stages when her body was emaciated, she was full of this amazing vitality.

"She put up a terrible fight about going to the nursing room. She refused and refused to go, long after she should have done so. One day I visited her in her house to persuade her it was time to go and when she saw my face, how serious and determined I was, she cried and cried and cried. She said over and over, 'I wish I could live, I wish I could be better'.

"Yet she knew that she was going. I sat her on my lap and looked at her and she kept crying. I said, 'Caroline, you're afraid you will die?' And she nodded. And I explained to her, 'Just accept it. Say yes, and don't worry. Say 'I'm ready' and go to the nursing room, where it is quiet, and they will look after you.' And she nodded, and we brought her to the nursing room, which of course she saw as the death room, but somehow she looked happy.

"It was on a Sunday that she died. We were at Mass. I saw her before Mass and she was still talking in good voice, though the body was worn down. And in the middle of mass the nurse came and and said Caroline was gone. The nurse said, 'She told me, 'I want to go' and those were her last words and she turned as if to rest, and died. Somehow, irrationally, against all science I felt she might not die, she might pull through. That's how I had felt because there was such a spark of life in her burning always. I was prepared for a miracle, but at the end, nothing."

Lumiti is a believer. He was studying to become a Catholic priest until he received the call to work at Nyumbani. He may yet complete his studies, his faith unshaken by the cosmic injustice to which he is a daily witness. "Of course I ask the question: Why do innocent children have to suffer, why do they go through all this? But I still believe. Somehow our spirituality, our faith in God, is strengthened in this place. Maybe it is because we are so close to death, to the great mystery. But also because the children die in dignity."

I put it to him that he is in the hope business. "Yes", he says, with a large, easy smile. "That is what we do. If you look at these children's backgrounds here they are in heaven. We give them a vision of heaven on earth."

Before leaving Nyumbani I walk out of Lumiti's office, past the playground where the children are playing on the swings, behind the cabbage patch, and on to the children's cemetery under the eucalyptus tree. I read the names under each little white cross. To the sound of children laughing 40 metres away in the playground, I find the two inscriptions I am looking for. They could not be simpler, more honest and unpretentious, more faithful a reflection of the spirit of Lumiti. "Caroline 1987 to 1999" and "George 1991 to 21/7/95". Brother and sister are buried side by side. Flowers grow over the neatly tended little mounds.

I go back to say goodbye to Lumiti. A child that might have been Caroline's age comes up to him, takes his hand.

I get in a car and drive to Nairobi in a taxi with a labourer and a car mechanic who have been working at Nyumbani for several years. I say that Lumiti is a wonderful man and they nod effusively, in a very untypically African display of feeling before a stranger. "An extraordinary man," says the mechanic. The labourer and the taxi driver nod again. "You know, he knows the names of each and every child," the mechanic continues. "Each and every child," joins in the labourer. "He is just like a father to all of them." "He is the best of men," says the mechanic. "Everybody loves him." "Yes," says the taxi driver. "Everybody loves him."

May he live forever.

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