AIDS – we’ve all heard of it - the staggering figures of infections throughout the world, how to prevent the spread and the need to raise awareness for the disease – our knowledge of AIDS are only to this extent. There is no real need for anyone who is out of the know to want to find out more about AIDS, who it affects and what happens after people are affected. This is the first step to generating an interest about AIDS and only when enough people are concerned will something actually be done about it. Nolen’s book has given the masses 28 chilling accounts of AIDS patients’ encounters with AIDS, and how it has affected their lives. It gives the readers a personal insight as to how this disease has affected them on a one-to-one level.
“People die in their houses because they know that if they go to the hospital there is no one there – they die without even a little Tylenol to relieve that pain because they can’t even afford that.” I read this line with a stinging in my heart. It is truly heartrending to know the conditions of the healthcare industries in Africa.
This book raises many questions that speak to us and our conscience, ultimately. Why is it that the epidemic was first detected it was in the US, and only after several testings did they find it rampant in Africa, where it first emerged? The level of treatment in a First-world and a Third-World country is so disparate that it brings to mind the phrase that ‘some animals are more equal than others’. Does being born in another country deny one of basic human rights that people in First World countries expect? What is being done about AIDS in Africa, and how much are people willing to give to solve ‘someone else’s problem’? Is it really someone else’s problem? How altruistic can we really be? Shouldn’t companies receive hard-earned money for their years of research to find an antiretroviral drug? How much of a social responsibility do we have to give to rebuild someone else’s country?
Indeed, selfish questions like some above have added to the full-blown epidemic of AIDS in Africa. This is a pressing problem that requires intervention immediately, and even though organisations such as Médecins Sans Frontières (MSF) have stepped in to aid with the HIV crisis, there still is much to be done.
Every single story plays on the emotions of the reader – tugging at our heartstrings and making us wonder what indeed is being done for most of the 28 people and similar patients of HIV. Yet a lot of these 28 are strong advocates that have changed the mindsets not only for the people in Africa but also our mindsets as readers. If I were to get HIV, my first thought would be “How long till I die”, but these people possess a tenacity that did not hold them back from accomplishing what they set out to do, or what they can do. People in positions of high authority came out of the shadow and shared how they contracted HIV, and became the best people to speak about prevention. Others such as nurses or doctors work tirelessly to help infected patients in their own ways. Personally, I see how God has been working through many of these patients and what purpose they served. Africa consists of countries with corrupted governments, low standards of living and education, and now epidemics of HIV that does not seem likely to ease up if people still engage in casual sex without any protection. People are also unwilling to speak up and step out to share their story, which is understandable. Even in 2005, when 800 people a day died of AIDS in South Africa, no one liked to say the word. HIV-positive patients who have spoken out are seen in a different light – “the hate and hostility [Winstone] had encountered in his twelve years of living openly with the disease”. As Nelson Mandela said, “Let us give publicity to HIV/AIDS and not hide it, because the only way to make it appear like a normal illness, like TB, like cancer, is always to come out and to say somebody has died because of HIV. And people will stop regarding it as something extraordinary.” Sadly, the shame of the disease is still so great that many continue to deny any possibility that they could be infected even as they display the symptoms, leading to even more infections.
“There are three main external variables in the AIDS equation debt: debt, aid and trade.” This is a vicious cycle that has left much of Africa devastated. Debt has left reserves high and dry, aid has been insufficient and poorly put to use, trade has been susceptible to exploitation (such as sweatshops by U.S. firms such as Nike and Gap). This has left Africa in ruins. Low wages, the very real possibility of contracting HIV and the condition Africa is in has led to the drain of medical personnel to other developed countries such as England. There are not enough people to handle the epidemic. Malawi “lost the equivalent of a whole year of graduates from its nursing colleges to the United Kingdom, and many of those who stayed behind deserted the public system… It wasn’t hard to understand why: the massive workload, the appalling conditions (few hospitals can keep latex gloves in stock, for example), the fact that before ARVs there was nothing they could do for most patients – all that for $100 a month?”
All over Africa there are people with HIV, who, because of cost or logistics, cannot get access to the medicines that would keep them alive. However there are also well-educated, gainfully employed people in Zimbabwe who cannot afford the drugs because the prices have been pushed entirely out of reach by rampant inflation. Moleen knew “she was dying because of an entirely artificial crisis, created by a megalomaniac president and perpetuated by the failure of other African leaders and the rest of the world to intervene.” The solution now is not to try to change the African government, but like the direct need of doctors, implement policies to intervene in the crisis. Although new generations of politicians and healthcare personnel have to be trained and raised, the more pressing problems have to be solved by foreign intervention.
Much of the discussion about the politics of AIDS in Africa focuses on the response and lack thereof of the West, but domestic African policies is just as pivotal. The first response towards the West’s claim was one of denial, and cited racism as a purpose. The governments, especially in South Africa have failed to embrace AIDS. Mbeki, for example, was against ARVs, and suggested that the furor around AIDs was a façade drawing attention away from inequity questions. He had let racism cloud his mind and failed to recognize what his country desperately needs. As Zackie puts it, you cannot let other people’s perceptions and prejudices draw your policy. “There is no doubt that strong leadership is the key to any effective response in the war against HIV… When the top person is committed, the response is much more effective.”
Nelson Mandela’s sharing of his son’s having AIDS made AIDS ‘all a bit more normal, a little less shameful’. The first step is to not be ashamed of your family member who has AIDS – how he will disgrace your family name – but to come to terms with the disease and accept him. Ironically, Mandela did not do much to help or publicise AIDS when he was in office. He could have done so much to help, but he did not. “In 199 ways, he was our country’s savior. In the 200th way, he was not.” The epidemic signifies a human struggle, a failure of leadership (“When historians write about HIV/AIDS, when they write about this period in time, they will ask – ‘Where were the leaders of Africa?’ “)
Ida, one of the ‘savviest, most dynamic AIDS educators’ in Africa had HIV. Doctors, nurses, military personnel, highly educated people who should have known better have contracted HIV and AIDS. Yet the solution to this problem is not quarantine, like we would normally avoid people who confessed what they were a victim of HIV. The social stigma of HIV and AIDS will always be present, but proper education should reach out to the masses to dispel this connotation. Avoidance and stigma show a lack of knowledge and a character that shows the ignorance and narrow-mindedness of the people. Diseases are aplenty in the world, and it would be difficult to not know someone who has an incurable disease even today. Avoidance is not the answer, but rather acceptance and encouragement.
We learn how HIV has affected these people’s lives, and how they try hard to live a normal life. For example, Andualem married an HIV-positive wife and tried to minimise the risk of his child being born with HIV. If I were him, I would give up all thoughts of living, much less marriage or offspring. Some of these accounts display extraordinary courage that some might term selfish. But to me, it is a brave attempt to carry on their lives in the most normal way as possible. Getting the disease is not the end of the world, but a mere turning point. It is up to the individual to decide if this turning point is for better or for worse.
What these people possess are optimistic spirits that proclaim: “A world without AIDS may not happen in our lifetime, but it is possible.” It is one thing to find hope, but another to find hope among such despair and chaos amidst a country with an AIDS epidemic, corrupted government and immorality. Yet as Ibrahim Umoru, who benefited from MSF’s programme puts, “I was a lucky man, but what about everyone else?” We see the lack of knowledge about HIV and AIDS even in Africa herself. We would expect the Africans, who have been most heavily hit by this epidemic, to know much more about HIV than other people out of the loop, especially when it is so close to home. Yet myths and lies such as using condoms will exacerbate the spread of HIV and fat girls do not have HIV unveil the lack of awareness where it is much needed. Religious actions such as condemning the use of condoms in the Catholic faith only serve to worsen the condition of HIV. The ‘A’ and ‘B’ of the ‘ABC’s of protection does not help to alleviate the condition in Africa now given the normal social practices. Even by themselves, ‘A’ and ‘B’ contradict with ‘C’. These are mixed signals that can only confuse the masses in Africa. There has to be a united way of spreading unified information.
One of the stories that touched me deeply was the short but moving story of Mpho. She did not indulge in unprotected sex, she did not deserve HIV or AIDs in any way – she was just twelve. ‘Virgin wives who waited 34 years’ to have sex on their marriage night had HIV, patients who were unwittingly infected with unsterilised needles in the hospital contracted HIV … these people did not deserve to get HIV. Yet they live in a society where HIV is prevalent and they can do nothing about it. Every single day people in Africa live with a higher risk of being exposed to the disease, either through their partners or through shared needles.
Women also get HIV by being with their husbands, voluntarily or not. In the case of Morolake, she had sex with her husband to comfort him although he was confirmed to have HIV. Divorce is almost unheard of in their society, and even if the husband is infidel or marries 2 other wives, divorce is not an option. Her fate is sealed if her husband contracts HIV. “Socially, culturally, religiously, everything around you screams ‘No’ to divorce.” Women make up the bulk of AIDS victims as biologically; they have a larger surface area of the mucosal cells which HIV attaches to. Their genital tissues are also much more likely to tear during sex. “Yet a toxic mix of culture, religion and economics often leaves women unable to do anything about that risk.” Many women also have to exchange sex for trade, right to pass and food. In a society where women’s rights are not widely recognised, it is difficult for a woman to escape this fate of being stricken with HIV and AIDS. There are many areas that ‘this global travesty’ can be relieved, and there has to be a multi-pronged approach to this epidemic. Ultimately it’s not only curing a continent of AIDS or HIV, but also treating the problems that are so deeply rooted in the societies, the societal norms, the leadership and so much more.
The epilogue ends with “Each day in Africa, 5,500 people die of HIV/AIDS – a treatable, preventable illness. We have twenty-eight million reasons to act.” Indeed, this is what Nolen’s book strives to portray. She uses real-life stories to convince people that something has to be done. Each one of the 28 stories speaks for itself. She not only shows us the gravity of the situation, but also why she risks her life to do her job in dangerous Africa and what has to be done to salvage what seems like a hopeless case at standing. All in all, 28 Stories of AIDS in Africa is a plea for something effective to be done, an educational tool to equip people everywhere with awareness and knowledge of how HIV/AIDS has affected patients’ lives, and a strong question for mankind as to what we are really doing to our world. Can we really sit back and watch another 28 million people die before action is taken?
