Monday 9 July 2012

It is a Plague

One of the parts of life you can never escape from in Lusaka is the prevalence of HIV.

I remember distinctly the first time I heard about AIDS.  I was in the third grade and my father, who has had an uninterrupted subscription to Time Magazine since the invention of the wheel, left out this issue.  I can't remember the circumstances under which I picked it up, but it was probably left in the bathroom.   That is where all magazines seemed to end up.
 

I can't say why this particular issue of Time stuck with me, but for weeks after I would find myself repeating the words, "Acquired Immune Deficiency Syndrome" in my head.  My parents' friends were talking about this illness a lot, I think I believed it would make my second grade self sound smart if I knew what the acronym stood for.  

It also terrified me.  At that time, AIDS was a boogeyman plague.  We had some information, but not enough to rest easy.  For all I knew, I was going to get it from a toilet seat in my elementary school.  I mean, we were assured that it was not passed that way, but we didn't really know.  

From third grade on, AIDS and later HIV were a constant small presence in life.  Not just for me, but for anyone of my generation.  From that first magazine cover, there came an entire movement of red ribbons and HIV awareness and rock stars and movie stars advocating condom use.  Our parish priest left us when I was in late elementary school to minister to AIDS victims.  I remember how we discussed his bravery - for us at that time, AIDS was something akin to leprosy.  We knew how it was spread, but did we really?  Father seemed to be walking voluntarily into the most terrible danger.  

For our generation there was Ryan White, and then there was the shock of Magic Johnson.   The AIDS Quilt, which seemed such a novel idea to me, is taken as a matter of course by my children.  It has just always been.

And that's the way HIV infection is viewed by most people now.  It is something that some people live with, much like some people live with lupus or arthritis.  HIV infection in the US worries me less than heart disease, because it is easier to prevent.  We take that for granted.  

It is not like this in Africa.

There is an omnipresence of HIV and AIDS related campaigns - signs on billboards that warn a person's sexual partners are not in the past.  Painted onto walls are urgings for testing and treatment and reminders that prevention is the best way to avoid this plague.

And it is a plague here.  There is no other way to describe it.  

We spoke to a Zambian doctor the other day, and he said that his statistics show about a 1 in 6 infection rate in Lusaka.  One in six people are HIV positive!  When you adjust that for social class, as HIV infection definitely strikes the poorer and less educated with far greater frequency than those whose behavior reflects the ability to think beyond the next meal, the plague designation becomes even more appropriate - and even more horrifying.  

About 19% of children in Zambia are orphans - and an overwhelming majority of those children became orphans because of AIDS related death.  These children who have no one left to care for them get into a reputable orphanage if they are lucky.  If not, they band together with siblings in the compounds to try to eke out an existence.  They are children caring for other children, and they become fodder for the next generation of HIV infection.  

The campaigns for HIV awareness are omnipresent.  The resources for identifying HIV carriers and treatment are also available, and thanks to programs heavily sponsored by the US - low cost or free.  So why is this disease still striking with such regularity?  

Numbers do show a decrease in HIV infection rates, but the problem isn't one of availability, it is one of education and a stark illustration of the adage, "You can lead a horse to water, but you can't make him drink."

HIV carries a stigma here that those of us from the US are no longer used to.   People do not admit to infection, although it is illegal to discriminate against those who are HIV positive.  It is not unknown for family members to abandon those who are HIV positive to their own devices.  In a society that is so tightly knit at the family and tribal level, such a thing is a death sentence.  It is like becoming a ghost before you die.  

"People don't want to know," the doctor told us.  

It is a way of thought that I, with my Western experience and background, can't wrap my mind around.  

We drove by Mother Theresa's Lusaka chapter of the Sisters of Charity the other day.  They do very good work.  The Catholic Church is very present in Zambia's charity organizations, and in what seems like a full circle for me, remembering my parish priest from so many years ago - they are ministering to those who are HIV positive or orphaned by AIDS.   But the problem seems so overwhelming, there is so far to go and so much resistance toward getting there.

Last week as we drove to a Land Rover dealership to check on a car we wanted to buy, we passed Lusaka's cemetery.  As I was not sure of the propriety, I refrained from taking pictures, but business at the cemetery was booming.  I was assured by the doctor that the odds were heavily in favor of HIV related death at these burials.  

Africa is one of the most beautiful places I've ever seen; a wild, raw beauty that overpowers everything around it.

Except this.  This plague casts a pall over everything.  


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