Aids in Africa
As part of her job at the Department for International Development (DFID), Sarah White (28) travels to many countries. She tells us how meeting HIV positive people in Africa has affected how she's thinking about Aids on World Aids Day.
The facts and figures
Next time you are in a pub with your friends, look round and count out every fourth friend. I began doing this after I went to Namibia in 2001, because one in four people in Namibia were estimated to have HIV. Fortunately, the figures are much lower in Britain. The National Aids Trust estimates that out of a population of over 60 million, only about 58,300 individuals are living with HIV in UK. In contrast, Malawi is one of the most severely affected countries in the world - with 14.2% of 15-49 year olds infected (approximately 900,000 people).
There is a danger with Aids in Africa, as with many issues, to think it's too far away to matter to us. But the more I've learned about Aids in Africa during work and travel, the more relevant I realise it is for us in the UK. It reminds us of how devastating Aids can be and why it's so important to practise safe sex, no matter where we live. For World Aids Day, I want to share a few reflections from my time in Zimbabwe, Namibia, Zambia and Malawi, to remind us how just one night of unsafe sex risks life-changing consequences.
Aids in Africa
I will never forget meeting Grace in Namibia, in 2001. I had tried to interview her a few times before, but she had been too sick to meet with me. When I finally met her, I was struck by how frail she had become from Aids-related illnesses. But most of all I was struck by how old she was. She was 24, the same age as me. I had my whole life ahead of me, unlike Grace, who was not only HIV positive but lived in a country too poor to provide life-enhancing Anti-Retroviral Treatment (ART). It was a dramatic wake up call - while Grace and I lived thousands of miles apart, all that separated me from being HIV positive like Grace was one night of unsafe sex.
Of course HIV is not only transmitted through unsafe sex. I never asked Grace how she became HIV positive. She could have been the unlucky recipient of an infected blood transfusion. Her boyfriend or husband might have been unfaithful, then passed HIV to Grace, without her ever knowing her sexual relationship with him wasn't safe. Perhaps transmission had occurred through injecting drugs or even from a HIV positive mother.
This year in Malawi, I met a church-based community group providing day care for over one hundred "orphans and other vulnerable children". All of them had either lost one or both parents to Aids. Approximately 25% of them were reportedly HIV positive. It was heartbreaking to look into the faces of these tiny, innocent children and to think how much harder their lives would be due to the loss of their parents to Aids. And how painful to think that so many of them might not live to be parents themselves.
I also met a Grandma in Malawi who had lost all her children to Aids. Now, instead of being cared for by her family in her old age, she had resumed the role of mother to her six orphaned grandchildren. She could barely afford to pay for her own shelter, food and medicine, let alone for her six grandchildren. When I worked in Zimbabwe, I started asking children I met who they lived with because I soon realised that my assumption that 'families' consisted of parents and children was so inaccurate. So many children were orphans, living with their grandparents, not parents. Today, both Zambia and Malawi have an estimated one million orphans each.
The Aids stigma
While Aids-related illnesses obviously bring physical pain to those living with Aids, the stigma many experience and the way other people treat them must be equally, if not more, painful. Again, an experience in Namibia in 2001 has remained vividly logged in my mind. I can't recall all the stories Simon told me, but what I have never forgotten is how much he suffered from the stigma of being HIV positive. He was just 28 but had been shunned by his family, friends and lost his job.
But my experiences in Africa haven't only given me powerful warnings of why it is so important to practise safe sex. They have also provided powerful stories of hope to challenge the pessimists who say that Aids is always a death sentence and a global challenge that cannot be overcome.
In Malawi this year, I was privileged to listen to Tumi talk openly in a support group about how she became HIV positive; how she felt when she found out; how others treated her, and her hopes and fears about the future. I didn't dwell on the details of what she said. Rather I dwelt on the fact she felt comfortable to speak openly about her HIV status and that she thought it worth talking about the future. This was such an improved situation from the one I found Simon in, in 2001. I was so encouraged to hear Tumi argue that with growing, albeit still grossly inadequate, provision of ART, she realised that being HIV positive didn't mean an automatic death sentence. She had come forward for HIV testing, as she felt better able to face the possible consequences. As more people came forward for testing, they began to speak out about their experiences of being HIV positive, allowing them to support each other and challenge the stigma they faced in their communities.
How it affects us
As with Tumi's story, I don't expect you to remember all the details of my article. But I do hope you will remember Simon, Grace and Tumi. Zimbabwe, Namibia and Malawi may be miles away, but there is no special reason to prevent British HIV rates ever reaching those of these African countries. If we ignore safe sex messages, believing "it will never happen to me", then counting out one in four will no longer be just an exercise to illustrate another country's experience, it will be a reflection of our own lives.