There is No Me Without You – Book Review

Haregewoin had one color photo of Atetegeb holding her baby. She enlarged this photo until its lines turned all pastel and soft. She framed it and centered it on the wall above the sofa. She framed a smaller black-and-white photo of Atetegeb and Suzie as teenagers laughing together. Under the glass she placed a slip of paper upon which she’d typed the words from a pop song: “There is no me without you.”

A child cannot live without a mother or father. A mother or father cannot live without the child. – from There is No Me Without You, page 134 –

A widowed, middle-class woman grieves for her daughter who dies horribly from AIDS. More than a year later, depressed and still mourning, she enters a church to request a hut in the cemetery near her daughter’s grave – she has decided to go into seclusion and live out the rest of her life in grief. Instead of seclusion, however, the priest offers her something different – to become a foster mother to an orphaned teenage girl whose mother has died from AIDS. The decision to accept the priest’s offer is a turning point for  Haregewoin Teferra and her life begins again.

She had lost her daughter. And God sent her these precious children. – from There is No Me Without You, page 259 –

There is No Me Without You is Haregewoin’s story told by award-winning journalist Melissa Fay Greene. When Haregewoin took in her first orphan, her heart was opened to the plight of her country’s children. Thousands of Ethiopians were dying from a virus with no cure, and leaving behind their children who were shunned because of fear. The options for these children were few – many ended up on the streets, starving, selling sex for food, or dying from the same disease which had taken their parents. Haregewoin Teferra was an angel of mercy. Very quickly she  found her small home filled with children who had no other place to go.

Greene provides the historical backdrop for the AIDS pandemic in Africa which later made its way to every country in the world. She explores the variety of theories about why AIDS arrived in the human population…the most compelling of these being the theory of serial passage – that a weak pathogenic virus is strengthened through mutation of the virus as it is injected from one host to another. In the case of AIDS, unsterile injections of vaccines in third world countries may have been the genesis of the disease whose roots have been found in African monkeys. I was shocked to learn that even as late as 2000, there was an estimated thirty to fifty billion unsterile injections occuring per year…even though a single-use autodestruct disposable syringe had already been developed. Why were these new syringes not being used? Of course, the reason is money.

Global health experts agree that safer needles are a crucial step toward eradicating the iatrogenic spread of diseases, but where will the funding come from? WHO’s budget is insufficient and the big donors are not coming forward. – from There is no You Without Me, page 84 –

Greene reveals the incredible poverty and poor delivery of medical services which has allowed AIDS to continue killing people by the thousands in Africa, while in the United States people are surviving the disease because of access to life saving drugs. She examines the greed of the pharmaceutical companies who initially charged upwards of $15,000 per year for the latest AIDS drugs, while production costs for those drugs were somewhere in the range of $200. Patent protection contributes to the inability for poor countries to acquire the medications needed to save their communities. When GlaxoSmithKline’s (GSK) patent on AZT expired in 2005, generic drug makers were able to provide the drug for $105 per year, a marked decrease from GSK’s price of $3893.64 per year. Despite the ability to now provide generic first line AIDS drugs to patients, multinational drug companies continue to fight for exclusive patents on the second line drugs…a move that makes them out of reach for poor countries.

The statistics Greene shares with her readers is stunning and heartbreaking; the numbers staggering:

  • 81% of Ethiopia’s people live on less than two dollars a day; and 26% live on less than a dollar a day (page 12)
  • By 1999, UNAIDS estimated that 33 million people around the world were living with HIV/AIDS and that 16.3 million people worldwide had died from the disease. (page 113)
  • In 2000, AIDS had killed more than twenty-one million people, including four million children. More than thirteen million children had been orphaned by AIDS – twelve million of them in sub-Saharan Africa. Twenty-five percent  of those lived in two countries: Nigeria and Ethiopia. (page 20)
  • By 2000, Ethiopia had the world’s third-largest HIV/AIDS-infected population, trailing only India and South Africa. (page 117)
  • Spending on health per person in Ethiopia in 2002 was two dollars per year – across all of  sub-Saharan Africa during that time, it was ten dollars per person per year (page 14)
  • In 2005, Ethiopia had 1,563,000 AIDS orphans; and 4,414,000 orphans from all causes – the second highest number in Africa (page 268)
  • In 2006, 4.7 million people were in immediate need of lifesaving AIDS drugs, but only 500,000 had access to them. During that time, sixty-six hundred Africans were dying each day of AIDS. In Zimbabwe, a UNICEF report stated that every twenty minutes a child either died from AIDS or was orphaned by the disease. (page 25)

The hardest hit by the AIDS pandemic in Africa are the children who continue to be orphaned by this disease. They are also the most innocent of victims – often being born HIV positive because their mothers are ill with the disease.

In North America and Europe, it had been discovered that triple-dose combination therapies, beginning twenty-eight weeks into a women’s pregnancy, could reduce transmission of HIV to the baby by 98 percent and save the mother, too. Public health campaigns, counseling, prenatal care, and ARV therapy for HIV-infected pregnant women in the United States reduced childhood infections to below 2 percent of births. In 2002, the number of new cases of pediatric AIDS was ninety-two.

And in 2003, fifty-nine.

But fewer than 10 percent of HIV-positive pregnant women in Africa had access to these drugs.

So, in Ethiopia, the number of new pediatric cases in 2003 was roughly sixty thousand. – from There is No Me Without You, page 214 –

In light of these kinds of statistics, Haregewoin’s mission to help the children of her country is even more poignant. Greene’s writing is compelling. She intersperses the facts with beautiful descriptions of Africa and its people. She captures the stories of individual children with a tenderness which made my heart ache. Many of the children mentioned in the book go on to find homes in adoptive families. Some do not.

Perhaps the strongest element of this book was Greene’s portrayal of Haregewoin herself. No one is perfect, but it would have been easy for Greene to place Haregewoin on a pedestal – make her into a saint. Instead, Greene describes Haregewoin’s weaknesses, struggles and ultimate triumph through a lens of honesty. Times were not easy. Choices made were not always the right ones. And yet, imagine stepping forward to take on what Haregewoin Teferra took on. She was essentially a volunteer who lived, breathed, and slept her mission of saving children. Sadly, Haregewoin passed away from natural causes last year. Her work, however, continues to live on.

There is No Me Without You is another one of those books which is hard to read. It is painful. At times it made me angry. There seems to be no end to the suffering in Africa. And yet, it is also a book which is important to read. There is hope within the pages – a glimpse of the humanity and kindness that can overcome the worst of situations. And for that reason, it is a book I recommend.

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  1. Lovely and informative review of a difficult and heart-breaking subject. I heard an interview on NPR a couple weeks ago with Dr. Anthony Fauci (and a couple of others) and some callers were objecting that Americans should not be helping to foot the bill for Africa’s problems. It being NPR, this was pretty eye-opening!

    But it was also interesting that the responses given mentioned charity and compassion and the like, but no one brought up the history of devastation to the African continent and its economies and social systems wreaked by Western imperialism. I would think that this might make a compelling argument that Africa’s problems are certainly not all self-inflicted. I’m interested to find out if this book brings this heritage into the equation. I will definitely look for this!

    • Wendy on June 9, 2010 at 21:08

    Thanks for this comment, Rhapsody…I think it is interesting that some people would be speaking out about providing aid to Africa. In the case of the AIDS pandemic, western pharmaceutical companies are a big part of why needed medications have not made their way to Africa. I think it is shameful that multi-billion dollar corporations should dig in their heels, jack up prices, and in so doing contribute to the deaths of not just a few people, but millions. When it comes to controlling a disease like AIDS, no one should be opposed to providing help. I would love your take on this book…I wish I’d seen the NPR show. It saddens me that the rich can sit and talk so calmly and critically about poor third world countries which have suffered so much when help is so available and yet so out of reach.

  2. That sounds like a book that is a must read on one level and deeply disturbing on another. It is so sad, but it’s wonderful to see that Greene has written such a good book about the subject.

  3. Some of the facts that you have peppered throughout your review are absolutely chilling. It sounds as if this book has a lot to teach and share and I think I would really like to read this one. I had known that the AIDS crisis was raging in some parts of the world, but had no idea that all of these other components were making it worse. It also really makes me angry that the drug companies are such vampires. These people need these drugs to survive, and the drug companies are only worried about how much money they can extort out of people, not anything else. It’s maddening, and I wish someone would do something about it!! Great review! I am going to be looking for this book!

  4. Beautiful review. This sounds like it would be a difficult book to read, but oh-so worth it.

    • Serena on June 10, 2010 at 05:39

    I have no idea how you wrote this wonderful review for a book that must have been incredibly hard to read.

    • Wendy on June 10, 2010 at 06:24

    Kathy: It is very sad. I do think more people should read books like this because it is easy to forget that people are still dying from AIDS. Here in the US AIDS has faded from the headlines because (although there is still no cure) treatment is so effective at keeping people alive.

    Zibilee: There is A LOT in the book I couldn’t share in a short review…and yes, the drug companies are despicable…also politics played a huge role in denying care to Africans (I was surprised to see that Clinton blocked efforts at setting aside some of the patent issues which would have helped get medications to third world countries). It is very eye-opening.

    Swapna: It is definitely not an easy read. I didn’t read it straight through, but took breaks for lighter reads because it was so sad. But it is worth the read.

    Serena: Thank you…I can usually write a review for a book in about a half hour…this one took me several hours over a couple of days. There was so much I wanted to say about it.

  5. I don’t even know where to begin about your review and about this book. First of, the book, and the woman in it, sound remarkable. My husband and I have been hoping to raise the money for an Ethopian adoption for years (still far away), but this review reminds me how neglected these children (and the people who take care of them) are.

    I also appreciate that the author showed the woman’s weaknesses, that she made her a whole, real person rather than a stereotype. Real people, warts and all, are always more inspiring because they remind us that we can do extraordinary things despite our “warts” as well.

    • Wendy on June 10, 2010 at 07:02

    Jen: Greene covers Ethiopian adoptions very completely in the book – I think you would find that section quite inspiring (Greene and her husband have adopted two children from Africa). It really is astounding the number of children orphaned…and the need for people like you who desire to make a difference.

    • Aths on June 11, 2010 at 04:41

    Amazing book!! This one goes to my TBR! It does sound very powerful in a very thought-provoking and hitting-home way!

    • Wendy on June 11, 2010 at 06:03

    Aths: I hope this book will resonate with you when you get around to reading it. It is very eye opening.

    • Care on June 15, 2010 at 12:31

    Sounds POWERFUL. great review.

    • Wendy on June 16, 2010 at 14:12

    Care: It was. Thank you!

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