JAPANESE AID IN AFRICA A helping hand, not a crutch.

Japan is the biggest donor of aid to Africa, but as its own economy begins to suffer, cuts in disbursements are on the way. What impact will this have on the pace of development in Africa? African Business editor, Anver Versi went to Kenya and Zambia to take a closer look at vital projects supported by the Japanese International Cooperation Agency (JICA). This is the first part of his report. Part two will appear next month.

Minani Kazuko laughs uproariously as the little infant she is cradling reaches up to tug at her ear-lobe. Ms Kazuko coos at the baby in a mixture of Japanese, English and Dhiluya, a local dialect in vogue around Oyugis, a small, forgotten town in the Nyanza province of Kenya. The infant has Downs syndrome. "Her legs are very weak," says her mother who has walked some 12km to attend the once-a month mobile clinic run by Ms Kazuko. "But her arms have become much stronger since last time," beams the 26-year-old Japanese volunteer.

The mobile clinic has been set up in a disused classroom at a local school. We are surrounded by babies and their mothers. Ms Kazuko and a couple of cheerful nurses are busy weighing, measuring and checking scores of infants.

The mothers sit wiping away the sweat from their faces in the intense heat. They are glad for the breather. Most have walled several kilometres to come to the clinic. A long walk back awaits them. Then they will have to prepare the evening meal for the family.

"Life is difficult for us," says the little girl's mother; then pointing to the Japanese woman, adds "but she is giving us hope."

Minani Kazuko is one of the thousands of Japanese volunteers sent out by the Japanese International Cooperation Agency (JICA) to various parts of the developing world. They get involved in all sorts of tasks. During our tour of Kenya and Zambia, we saw them beavering away in automobile workshops, teaching disabled children, instructing the police in self-defence, raising chickens, running water supply systems, setting up small business units, running hospitals and carrying out research into deadly tropical diseases and AIDS.

The volunteers (on two-year contracts), and the experts who bring their technical skills to the developing world, are the human interface of a vast network that forms the Japanese Official Development Assistance (ODA) programme (see box).

Minani Kazuko was working as mid wife and surgical nurse in Sapporo, north Japan when she saw a telecast of the appalling conditions some African children were in. She decided there and then that she would dedicate a part of her life to try and help the children. She applied to JICA, was accepted and spent three months training and learning English. When she arrived in Kenya, she picked up Swahili and some Luo.

When we met her, she seemed perfectly in her element, rattling off phrases in the local dialect and making everybody she came into contact with smile at her charm and boundless energy. She occupied a small office at the Matata Nursing Home -- built and stocked by the Japanese but now running as a private hospital. It is a clean, airy building with facilities for a hundred in-patients.

The Matata Nursing home was our last destination in Kenya. I had arrived a couple of days earlier and joined up with a group of some 15 Kenyan journalists. After a briefing at the JICA office in Nairobi and a tour of a couple of projects, we had flown out to Kisumu on the shores of Lake Victoria.

The next day, we bumped along terrible roads to the village of Enzaro in the Vihiga district. The fields on either side were green and sparkling after their recent shower; the earth was a deep, rich red. This looked like healthy farming land. What struck us however, was the almost complete absence of young people. Someone explained that many had left to work in Kisumu or Nairobi. Still, it seemed strange that given such bountiful land, there were only children and older people around. We were to discover the shocking truth a little later.

Holistic health system

Our first stop was a JICA sponsored Population Education Promotion Project centred around a health clinic also built and equipped by JICA. A group of elderly matrons, clad uniformly in pink and white, greeted us with songs and hand claps. They had formed a woman's collective which, apart from going around from home to home explaining the use of birth control methods, also delivered babies and gave invaluable advice on mother and child health.

To maintain the clinic, they engage in a number of income raising activities. Two women showed us how to make bricks using a simple device donated by the Japanese. They also ran a little cottage industry which included a posho (maize) mill, a tailoring outfit where trainees were busy making mosquito nets, and a general retail shop.

A sprightly lady of around 70, wearing the blue and white uniform of a traditional birth attendant (TBA) led us to her house where she proudly displayed the Enzaro oven. The oven is the brainchild of a JICA expert, Kesa Kishida who has now gained legendary status in the area. The traditional method of cooking is to place a pot on three stones and use fuelwood or charcoal. This has led to dramatic deforestation in the area -- you can actually see the forested areas being chewed up in large chunks. She came up with the Enzaro oven based on ovens used in her birthplace, Iwate Prefecture in Japan.

The oven, built of sun-dried bricks, has three openings so three pots can be heated up simultaneously -- using a fraction of the firewood needed before.

The women's group carries the gospel of the Enzaro stove around the district. They take a specialised stove builder in tow. While at it, they encourage families to always have a pot of water constantly on the boil to prevent water-born diseases and to wear cheap but very effective reed sandals called pati pati so that worms and infectious matter are kept out of the household. They also introduce mosquito nets and encourage families to make raised beds -- again to keep harmful bugs at bay. All the items are made by the women's group.

Slowly the picture of a holistic health system begins to come into focus. The term sustainable development takes on concrete form. You see how one idea leads to another and you also see how progressive ideas spread throughout the community.

With JICA's help, the local community has dug well-protected boreholes and built concrete ramparts around springs. Taps spew out clean water which is regularly checked for infectious bacterium. The local health worker told us that the impact on health had been dramatic. Water-borne diseases had virtually been eradicated and malaria had been contained.

Once the local groups have started, there is no stopping them. They bake and sell their own bread, raise chickens and quails (which fetch a high price) and even turkeys. Tafrosa Omamo, secretary of the tailoring association, said the income raised from the sale of items went towards maintenance of the health centre and to pay wages.

Some distance away, we ran into another women's group who were busy turning out school uniforms and other items of clothing. Mrs Jones Kaurana Omamo, the obvious leader, told us that the group had come together in 1991 and pooled money to buy a cow and some foodstuff to sell. JICA had then stepped in and donated three sewing machines and helped to build protected springs. The group has been thriving since and now say they need help to buy their own premises. These groups are mostly on their own now. Their main complaint was that when machinery breaks down, they find it difficult to carry out repairs or find spare parts.

Again we noticed an ominous absence of young men and women.

We then set out on a fairly long journey to Oyugis in south Nyanza where we visited the Matata Nursing home and met the ebullient Minani Kazuko.

The first item on the agenda was a puppet show put on for our benefit by the Matata Theatre and Puppet Group. The group's leader, Michael Oyingo-Ojoyo, told us the group had come together in 1994 as part of an AIDS awareness programme.

HIV 

It was only here that we were hit by the full impact of the devastation caused by AIDS. Reliable statistics are hard to come by but educated estimates point to HIV infection in about 50-60% of the adult population. Most hospital beds are occupied by AIDS patients. Drugs such as AZT are as far out of the reach of the common man as is the moon. "We do the best we can for these patients," a doctor told us "but what really worries us is that children are now also becoming infected."

The biggest problem, according to Mr Oyingo-Ojoyo is cultural. "We have a tradition here that when your brother dies, you inherit his wife and children. This has been the basis for a strong support system for time immemorial but now it has become a problem. When a man dies, usually of AIDS, his wife, who is usually also infected, then moves into her brother-in-laws house and could end up infecting the family there and so on. This is how the disease spreads."

Puppet show

The other problem is that men in particular just do not want to believe that they have a disease and that using simple preventative methods like condoms could stop the spread of the killer illness. "They believe the symptoms they have are the result of everything else under the sun except sexually transmitted disease," said Mr Oyino-Ojoyo. "The symptoms are also almost identical to those caused by Chiraa -- witchcraft -- so they spend their time going to witchdoctors and performing all manner of 'magic' rituals."

While we were there, we witnessed a funeral. Incantations were said over a hen and we were told that when the body was being taken to burial, the hen would be released. Whoever picked up the hen would 'inherit' the curse that had caused the person to die.

The plot of the puppet show was about the dangers of the 'wife-inheriting' system. In the play, the man agrees to inherit his brother's wife but, under pressure from his own wife, takes the woman for an HIV test. He is passed clean but the widow is infected. He still allows the woman to live in his house but vows never to have sexual relations with her without protection.

Quite a crowd, mostly mothers and children, had gathered to watch the puppet show and the message seems to have got through. "Where are the men?" I asked. Someone shrugged. "Many are dead and more are dying."

A mood of deep gloom descended on our group. Some of the journalists said this was the first time they had faced the reality of AIDS.

But the day also coincided with one of Ms Kazuko's mobile clinics. With her bright, cheery outlook, she made us feel ashamed of our long faces. When we arrived at the school where the clinic was being held, about 200 children of varying ages milled around us, laughing excitedly and having a great time.

Nevertheless we realised that many of these children either were or would shortly become orphans. "Some of the girls will not see 15," the doctor in charge, a tall man whose shoulders seemed to be sagging under the weight of his burden, told us. "Some men believe that having sex with a virgin will cure them. Once the girls are orphaned, they stand no chance."

What is the government doing, I asked. Not very much, I was told. "Everybody prefers to brush this under the carpet. There are even people going around saying there is no AIDS here."

The journalists in our group vowed to expose our experience in the local papers and on national radio and television.

What can be done? we asked. "The people have to be educated about this disease. There has to be a culture change," said Ms Kazuko. The puppet group, for example is woefully under-equipped. They rely on volunteers who are given a free lunch if they are lucky. They have no video or television facilities, they have no funds to produce posters or other education material.

Ms Kazuko has one four-wheel drive all-purpose vehicle which also serves as an ambulance. At the Matata Nursing home, they have no surgery facilities. What happens if there are birth complications? "We rush them to the district hospital," she says. That is a good 40km away and the roads are awful.

We left Nyanza sobered and deeply disturbed. This is one of the most densely populated parts of Kenya and potentially a hive of industry and growth. It is going to pieces. But we also left with at least one ray of hope. The people, especially the women, are fighting back. Organisations like JICA are providing an invaluable and absolutely essential helping hand. More, not less of their support will be needed for quite some time to come.

Japanese aid

Despite their current severe financial difficulties, the Japanese are still the world's largest aid donors. However they are now re-evaluating their aid strategy and have decided to lope 10% off the budget every year. Notwithstanding, Japan's total bilateral aid to Africa in 1996 was $1.06bn from a total of $8.3bn world-wide.

Unlike other aid donors, the Japanese have been very reluctant to blow their own trumpet. This is partly in keeping with the Japanese character-- achievement, they say, speaks for itself-- and partly because they have a very different philosophical attitude towards assistance. They do not see aid as a political or economic lever nor as a means of increasing their influence in the world; instead, they genuinely believe that their own prosperity and security depends on a more prosperous and therefore less conflict-laden world. Hardly surprisingly, the bulk of their aid flows to the area nearest Japan -- Asia.

Africa rates high on their list of priorities. The potential of the continent, they feel, has hardly been touched. While they are as keen as anyone else to sell their products in Africa, they realise that the size of the market will depend on people's disposable incomes. Therefore, reduction of poverty, capacity building and a general upliftment of the standards of living is not charity but enlightened self-interest.

What is even more pertinent in this case is that Japan had been virtually destroyed, literally and metaphorically, after the Second World War. That they were able to rebuild in less than 50 years and can now boast the second strongest economy in the world is proof enough that with a little help, anything is possible. It is this helping hand that they want to extend to Africa. "But only Africans can build Africa," insists Mr Hisayoshi Ogiwara, JICA's resident representative in London. This gives Japan's aid an added twist. The aim is to transfer skills, technology and organisational methods to Africans so that after a while, projects are taken over and run by Africans themselves.

Japan's ODA falls into three categories: (1) Bilateral grants; (2) Bilateral loans and (3) Multilateral aid which comprises subscriptions and grants to international organisations such as the World Health Organisation.

Bilateral loans are given to individual countries at a very low rate of interest for projects such as dams and roads or to support commodities or for debt rescheduling.

Bilateral grants are just that -- grants with no repayment required. These again split into two categories: (1) Economic Development Assistance e.g. setting up fisheries, increasing food production, building schools, hospitals, supporting cultural activities etc. and (2) Technical Cooperation. The real purpose of this is to develop human resources. It involves sending volunteers and experts to various countries, inviting trainees to Japan, organising

projects and providing equipment. Most of this activity is handled by JICA.

A cure for AIDS?

Perhaps the most impressive collaborative venture between JICA and the Kenya government is the Kenya Medical Research Institute (KEMRI) in Nairobi. Over the next few years, great advances are expected to emerge from this centre, perhaps even a cure for AIDS.

Before the collapse of the East African Community in the 1970s, medical research into various tropical diseases was carried out under the umbrella of the East African Medical Research Council. However, when the three east African countries, Kenya, Tanzania and Uganda went their different ways, the Research Council was scrapped.

In 1979, Kenya requested assistance from Japan to set up a national medical research initiative. The Japanese had themselves suffered from diseases like tuberculosis, schistosamiasis, filariasis, viral hepatitis and others similar to those found in Kenya. An agreement was struck -- Japan would construct and equip the headquarters and a state-of-the art laboratory and provide technicians and research experts. They would work closely with Kenyan doctors and in turn learn about tropical diseases and how to deal with them.

The sparkling and ultra-modern complex was completed in 1985. Now researchers could try and get to the roots of diseases that have plagued Africans for centuries.

We walked into a world peopled by intense, white-coated scientists peering into microscopes while bold signs warned us to keep out of areas where there might be the danger of contamination.

The complex has a 40-bed hospital, a library, a 250-seat conference hall, an engineering workshop, an electron microscopy room, an animal room, a medical illustration unit, an animal house and a warren of offices and laboratories.

Here the enemy, harmful viruses and bacteria, are isolated and broken down, often with the use of the electron microscope, into their tiniest component parts. The germs are subjected to all sorts of tests and reactions. The war against disease is in full flower and the warriors in most cases are Africans themselves.

Some major victories have already been scored. The institute has developed a cheap, very effective kit to test blood for Hepatitis B which afflicts some 70% of the adult population in Kenya. The kit has been in wide use since 1993 and it has dramatically reduced the danger of infected blood getting into the blood-donor system.

Another kit, which should come on the market soon, can be used to test for HIV-infected blood. At present, fairly expensive kits from Europe and USA are used but they are designed to identify the sub-type B strain of the virus whereas the strain found in Kenya is sub-type C. Thus the foreign kits cannot detect early infection. The new kit from KEMRI is specifically designed for the African strain.

It came as a bit of a surprise when we learnt that a significant part of the institute is given over to the study of traditional medicine. But this is herbal medicine subjected to the rigours of modem research. Dr W.M. Kofi-Tsekpo, Chief Research Officer & Director, told us in so many words that they had produced a cheap drug which alleviates the impact of AIDS in the same way as the very expensive AZT. His lab had also come up with an anti-malaria prescription that was better than anything else available on the market. "We still need to do a lot of testing and someone has to pump in a lot of money before these drugs can be sold to the public. But if there is going to be a cure for the dreaded AIDS, it will come from herbal medicine," he said with strong conviction.

The Japanese obviously believe him. Hopefully, so too will the rest of the world, and soon.