As so often happens when one leaps from book learning to practical experience, Clippinger had missed something fundamental: many of the country's HIV patients did not have access to ample food. HIV/AIDS drugs work most effectively when patients are eating a sound diet. They work poorly when patients are malnourished. Experts called this situation "a nutrition gap."
Photo by James McWilliams
Clippinger called it "a nightmare."
Plus, she noted, it was inexcusable. Rwanda is fertile. Most of the country (about 70 percent) enjoys an abundant supply of water. Agricultural cooperatives benefit from ample government support in the form of land, irrigation, seed distribution, and agricultural schools staffed with highly trained Rwandan scientists. Even more maddeningly, most of the country was executing bold agricultural initiatives to supply Rwanda with locally produced food. Healthy Rwandans were taking charge of their food supply. But AIDS/HIV victims were excluded from these governmental programs because they were deemed physically incapable of participating.
Clippinger might not have known much about farming, but she knew this was wrong. She shared her thoughts with Emily Morell, a Yale undergraduate also working as an intern with the Clinton Foundation. Together they looked into nutritional and agricultural support programs targeting people with HIV/AIDS. Finding such programs to be lacking, Clippinger and Morell joined forces with Rwanda's National Network for People Living with HIV/AIDS to create a "nutrition through agriculture" initiative.
When Clippinger returned to Brown in the Fall of 2006, she and Morell raised $16,000 by shaking down friends, family, and a few foundations. Cash in hand, they went back to Rwanda over the winter break, hired two Rwandan agriculture experts who began to teach the HIV/AIDS population to grow their own food, with their own labor, through agricultural cooperatives, and with land that the government donated. "Through collective and collaborative agricultural production," Clippinger explained, "we knew they could improve their nutrition." Lo and behold, she was right.
Photo by James McWilliams
Even Clippinger herself is surprised with how the idea, as she puts it, "took off." Through dozens of cooperatives and hundreds of home gardens, HIV-positive individuals have, over the past three years, substantially increased their access to nutritious food. According to Julie Carney, who was hired in 2008 as the Rwandan director for Gardens for Health International, "crops are chosen mostly on the basis of their nutritional value." They include papaya, avocados, amaranth, spiderplant, cowpea, soy beans, beets, swiss chard, collards, carrots, tomatoes, garlic, chili pepper, tephrosia and, Carney adds, "some sunflowers (for their seed, for their aesthetic value!)" Growers have been especially enthusiastic about indigenous greens called dodo and isogi, which have a higher iron and vitamin A concentration than spinach. Provisional ingenuity prevails: pesticides include neem, garlic, and chili peppers; multivitamins come in the form of leaves from the moringa tree; old tires serve as planters; no kitchen gray water is wasted.