By Hugh McCullum
Zimbabwe has suddenly, in just two years, turned into the deadly centre of the
world’s AIDS epidemic. It has the highest infection rate in the world, a rate which
is getting out of the control of health practitioners and, most of all, the society.
There are too many sick people and too few to look after them. Too many men are dying,
leaving mothers and grandmothers to bury the children, the boys, the brothers, the
husbands and the fathers.
There are too many orphans.
Two years ago in Zimbabwe, 500 people died each week. Last year it was 750. Today it is
1000. In the newspapers they either die of a "short illness" or a "long
illness". Ages aren’t printed. "Loving son" or "beautiful
daughter" tells it all. The statistics are horrendous, the human stories pitiful.
Dr Bonoparte Nkomo runs a clinic for sexually transmitted diseases in Bulawayo. He sees
130 people a day. He detests the word "hopeless", saying it’s just a code
word for "Forget Africans." He is the only doctor and has few major drugs.
"You have to assume that almost everyone who walks through the door is going to get
AIDS. But you can’t dwell on it because if you do then you just walk out and go home
for good."
He talks about Mildred, a well trained nurse who earns about US$100 a month. She is middle
class but recently has been too sick to work. She has fevers, headaches and no appetite.
Her husband works for the railway. Neither has ever had an AIDS test. For the last month
they have been on a desperate hunt for enough antiviral medicine to keep her alive. They
have three children and a nice brick house.
She told the doctor she doesn’t know how she got AIDS. "I can’t explain
it," she said, fighting back the tears. "I can’t explain it at all. I never
had any extra love. I have always worked hard. I don’t deserve to die and I know I
don’t have to."
There are many drugs in Zimbabwe to treat the secondary infections caused by AIDS, such as
pneumonia and other ailments that come when a person’s immune system is too weak to
do its job.
But the latest Western therapies to treat the virus itself are not available and there are
very few people who could afford them. So Mildred and her husband went to South Africa to
buy a stay of execution.
"The doctor told us it would be about US$1,000 a month for the drugs," her
husband said, moaning softly. "That was some kind of discount price. I make $200 a
month. We could afford the drugs for maybe one month or so. And that is nothing. It would
only make us poor. So, we are waiting now for God to help us. We are hoping God will help
us."
The savage virus has left almost none of Zimbabwe’s 12 million people untouched. It
has devastated families, villages and cities.
"You can’t keep track of it," says one rural doctor, a young 32-year-old
expatriate who, with another Belgian, serves 140,000 people in south-west Zimbabwe. We
want to control it, but it is getting harder."
A gentle young man, he becomes scathing at the optimism of the West where cures and costly
medicines have reduced the incidence of AIDS to a smaller and smaller number. "Here
there is no cure, there is no treatment, there is no hope and -- as in almost every
country in Africa -- far more pressing problems to face each day."
AIDS is just another word for dying, just another disease like malaria and tuberculosis,
hepatitis, measles and cholera and all the other diseases of poverty and hunger. With less
than $10 a year spent on each person’s health, there is no money for tests, fancy
cocktails of drugs and support networks.
Most people know there is an epidemic but the vast majority have no idea they are infected
with AIDS, and most don’t want to know.
But it is impossible to ignore. Average life expectancy here was 61 by 1993. By the end of
the century it will likely be 49. In 10 years, say UN officials, it will be closer to 40.
That will push development back nearly a century.
"AIDS is the basic fact of life but it is not the only fact, and it is a fact we
cannot do much about," says Dr. Timothy Stamps, the health minister who saw his
budget held at 1997 levels while defence rose 10 per cent.
It would be hard to do anything anyway. Last year 4 million people were newly affected in
sub-Saharan Africa and 10 million have died -- that’s 90 per cent of the world’s
AIDS deaths -- and because there is so little hope of access to the best drugs, at least
20 million more will almost certainly die of fevers and wasting and pneumonia and TB.
At this year’s international AIDS conference in Geneva, there was particularly grim
news about Zimbabwe and neighbouring Botswana. Thirty per cent of all adults may now be
infected with HIV. In some places, like the tourist crossroads around Victoria Falls, the
rate is closer to 40 per cent.
It would be a staggering rate anywhere, but especially in a country that can afford to
spend so little on health care.
Hugh McCullum is a Canadian journalist who has spent most of the last 10 years in Africa.
You have to assume that almost everyone who walks through the door is going to get
AIDS: Dr Bonoparte Nkomo.
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