AIDS Tests Resources in African Nations

The skeletal young man with jerking, sweat-drenched limbs waited four hours for care in the emergency room of Harare’s main hospital.

He finally made it to a ward with other AIDS sufferers, where he spent a few days before being sent home to die. With him went a leaflet on basic AIDS care with tips for those unable to afford medication, such as sucking overripe tomatoes to soothe mouth lesions.

Zimbabwe’s state hospitals and clinics offer little else for victims of “mukondombera”--which means “the big kill” in the local Shona language. AIDS has spread so far and fast in the southern African nation that government resources and medical care cannot keep up.

No one is exempt--soldiers, scholars, politicians and babies in the womb are being infected. In a chilling example of priorities, the few AIDS patients requiring expensive kidney dialysis have been cut off by the government, which decided that it could not afford to spend scarce health funds on dying people.

The situation is similar in other impoverished African nations where AIDS is rampant and the governments are short of money for treatment or even education. Zimbabwe now has the highest infection rate in Africa, partly because horrendous death tolls in Uganda and other spots in central Africa have wiped out many of the afflicted.

At the end of 1995, nearly 97 of every 100,000 people in Zimbabwe were infected with the AIDS virus, the World Health Organization says. The number was 66 in Botswana, 58 in Congo, 49 in Malawi, 45 in Ivory Coast, 33 in Togo, 25 in Kenya, 24 in Guinea-Bissau, 23 in Uganda and 20 in Chad.

In comparison, the United States had a rate of almost 23 for every 100,000 people. But health experts stress that WHO’s figures are based only on reported cases, and the U.N. agency says African nations grossly understate their AIDS cases.

Health Minister Timothy Stamps estimates that by the end of this year, the epidemic that began in the early 1980s will have killed 270,000 of Zimbabwe’s 10.8 million people.

At least 300 victims die each week, according to official statistics, and the actual figure is believed to be two or three times higher because many people do not disclose that they have the disease. By contrast, a little over 800 people die from AIDS each week in the United States, which has nearly 25 times the population.

Up to 60% of Zimbabwe’s military is believed to be infected with the AIDS virus, and AIDS-related diseases are prevalent in poor areas rife with prostitution and traversed by truckers.

In the cities, one in three babies born in government clinics is infected in the womb and will die before age 5, doctors say. About 25% of urban adults ages 19 to 45 have contracted the AIDS virus, mostly from heterosexual promiscuity rooted in polygamous African traditions that idolize sexual conquest.

President Robert Mugabe’s government encourages voluntary testing but shies away from mandatory examinations, saying that could lead to discrimination against infected people. The government also worries about creating a moral obligation to provide care that it cannot afford.

Superstition, ignorance and fear are hindering attempts to educate people about preventing AIDS.

Helen Jackson, director of SAFAIDS, a southern African AIDS information service, said many people wrongly believe that AIDS can be spread by coughs and sneezes, by everyday contact at school or work and by toilet seats, telephones, towels, cutlery, cups and glasses.

“People are afraid of telling anyone [they are infected] because they will be ostracized by colleagues and friends,” she said.

Stamps, the health minister, pointed out that using condoms is sneered at amid sexual customs that emphasize “skin to skin” contact.

“You don’t take a shower with a raincoat on. One hears this quite a lot,” he said. “But I think things will change. Human nature is such that even the most obtuse person will eventually avoid things that kill him.”

Unlike some regions of central Africa, AIDS has yet to reach epidemic proportions that wipe out villages and communities. But the U.N. Children’s Fund forecasts that by the end of the decade, Zimbabwe will have more than 500,000 AIDS orphans, about 5% of the population.

The independent National AIDS Coordination Program believes that AIDS will reduce average life expectancy from 68 now to 40 within the next few years. It says that could cancel out one of Africa’s highest birth rates--3%, which produces an average of six children per family.

Many teachers, engineers and top-ranking professionals, including prominent politicians, have died from AIDS. Poor migrant workers forced to live apart from their families also are in the high-risk category.

“AIDS is attacking the vital areas of our economy,” Stamps said. “The disease is coming to its maturity after a peak infection period in the late 1980s and early 1990s.”

Since 1985, numerous public figures, entertainers, television stars and at least three government ministers have died from AIDS complications, but each time the secondary infection was given as the cause.

Only one personality, David Mankaba of the Bhundu Boys pop group, publicly admitted that he had AIDS. On April 6, Vice President Joshua Nkomo became the first prominent person to announce an AIDS death in the family--son Edward Thutani, 41, a prominent former guerrilla and businessman.

“We need someone like [U.S. basketball star] Magic Johnson to give impact to AIDS education,” said Jackson of SAFAIDS. “Right now, people are frightened.”