Imagine this Reality

Imagine if in every college classroom in the US, 10 out of 50 students were dying. If in your intimate group of friends, at least one or two people had only a few years or months to live. In your company of 200 people, 40 are terminally ill. Imagine if almost one-fifth of the country had a chronic, fatal disease. Someone in every household. Imagine if thousands of people were dying, almost all young adults. What would happen to our infrastructure? Our mentality? Morale?

That is what AIDs looks like in Mozambique.

Is it big enough to be called an epidemic? Stephanie Nolen, author of 28: Stories of AIDs in Africa explains that "anything above one percent is considered a 'general epidemic,' indicating that a disease is spreading in the population as a whole and is difficult to control." If, of every 100 people, one person has a disease, it’s an epidemic. Like this:

In this example disease above, one out of 100 people is infected. The disease is out of control and would be considered an epidemic.

In Mozambique, seventeen out of 100 people are infected with HIV. Like this:

Yes, it’s an epidemic…seventeen-fold. What do we even call that? What do we do? How much worse does it have to get before it will get better? What does the future of this population look like?

Of the hundreds of people I’ve met in Mozambique, I can think of 5 who are openly seropositive (infected with HIV). I met four of them because they go around educating people about being HIV-positive. All five are activists. There is still a huge stigma around AIDS. It’s the plague of the present. In some places, AIDs victims have basically the same status as lepers. Here’s a story that I heard a student telling her friend, while they sat braiding each other’s hair one day:

“My mom did an HIV test, and the hospital told her she was positive. They gave her a medication and told her it was to treat HIV. But they actually lied that she had HIV in the first place, then gave her drugs that would give her AIDs.”

There are so many misconceptions like this one surrounding HIV and AIDs. Here are some of them:

•           You can get AIDs by touching an infected person
•           Condoms give you AIDs
•           The government is spreading AIDs on purpose
•           AIDs doesn’t exist, the media invented it
•           ARVs (drugs used to treat AIDs) are what actually make you sick (they can have bad side effects, but it’s better than leaving AIDs untreated, and dying)
•           HIV is spread by mosquitoes
•           If you have sex with a virgin, you will be cured
•           If you get HIV, your life is basically over

 Before I began Peace Corps, I didn’t know the difference between HIV and AIDs. Here’s a crash comic on how HIV works: 

In a healthy person, the immune system protects the body by fighting off diseases.

HIV blocks the immune system from fighting off diseases, so the diseases attack the body more fiercely.

AIDs is the state of having an immune system so weak that it can no longer fight off any disease, and the person dies – not directly from HIV or AIDs, but from other diseases that took advantage of the weakened immune system.

When a person starts taking ARVs (antiretroviral drugs), the drugs prohibit HIV from holding back the immune system. The HIV is still there, but its destruction is put on hold. It’s a treatment, not a cure – but people have been known to bounce back, inches from death, when they started taking ARVs.

Lack of information kills people. And a combination of other factors make it difficult to fight this particular enemy. How do you stop a virus that is spread by sex, something that nearly all adults do, but have difficulty talking honestly about? What do you do when you invest in training people in a skilled profession, and so many of them die before they utilize their skills? How do we talk about these issues openly and educate ourselves, when some families will disown an HIV-positive family member?

We have to be careful which messages we send out. We don’t want people to engage in risky behavior that can expose them to the virus, so we say, WATCH OUT! PROTECT YOURSELF! AIDS KILLS! But, how will a child feel when she hears this message, a little girl whose older sister, parents, aunts and uncles all are infected? What about the 28 million people in Africa who already have AIDs? Is that the message we want them to internalize? It’s a delicate balance between positively supporting people who already have HIV, yet not downplaying it as to make a teenager think there’s no harm in taking risks.

There is also a huge socioeconomic factor in the disease. Poor countries have difficulty spreading awareness to prevent HIV, and treating those who are sick. The book I mentioned above shares this quote from a victim of this system: “I have friends, married couples, who both have HIV and they can afford ARVs for only one of them…so they’re trying to figure out which one will take the drugs. Will their kids keep a mother or a father? What kind of choice is that?” The already difficult situation of having HIV is exacerbated in places where people don’t have the means to eat nutritious food and have access to treatment drugs. The drugs are expensive. People can’t afford them. So they die.

In the US, it feels far away, another world, another time period. Here, I’m living inside the portrait that Stephanie Nolen paints. When I read this book, the back of my eyeballs feel dizzy. It gets harder to breathe every time I turn the page, knowing that these stories are not imaginary, they’re happening all around me. I get scared every time I hear that someone is sick. When someone is sick, all their family members and friends go visit them. My students’ mother. My colleague’s friend. My friend’s brother. One of The Girls’ sisters. Too often, it’s the last visit.

There’s an enormous microscopic killer raging through Mozambique. It’s not killing slowly and stealthily. It’s killing brutally and painfully. People are dying unnecessarily, because the country doesn’t have the money, infrastructure, and staff to care for millions of victims. This is not a scare, or a seasonal virus.

This is an emergency.