Zeca, our night guard from Chimoio and the local person with whom I felt the greatest connection during the 9 months I lived in that crazy shared house, just found out today he is HIV positive. He was convinced to take the blood test by one of my ex-housemates. I question whether or not Zeca would have ever found out his positive status had our friend not urged him to go to the clinic.
Zeca has been quite ill for several months, a fact he attributes to a curse put on him by jealous neighbors. Back in March, when he was feeling especially sick, Zeca went to the local healer for a consultation. The traditional doctor said that a curse had been put on Zeca because he enjoys a relatively good life for a night guard from a dirt poor village. And it's true - the members of the collective household where Rico and I used to live make a special effort to look out for Zeca, and for Dona Margarida the maid, and for everyone who has worked to make our lives a bit better.
We would always give Zeca small presents, things that for us were insignificant but to him made a huge difference and were meaningful tokens of our friendship and respect. His favorites were the free socks that South African Airways puts in their international flight kits in economy class. These socks are knee-high and come in not-so-subtle colors like highlighter orange, grass green, sunshine yellow, and turquoise. Zeca loves those socks and proudly wears them, stretched up to his knees, with shorts and a beat-up pair of sneakers and a knit beanie on his head to keep warm.
In addition to the small gifts and a higher-than-average wage, we also all pitched in to give Zeca the money necessary to build a house, an upgrade from the mud hut where he lived with his daughters (we did the same for Dona Margarida). Because of all these luxuries, the traditional doctor said that Zeca's neighbors cast an evil eye on him, causing his health to deteriorate. Without a treatment, the healer said that Zeca would only get worse.
According to Zeca, in an excited play-by-play recount of the events the next day, the traditional healer pulled all sorts of strange objects out of Zeca's body including feathers, bones, animal claws, and hairballs. Zeca wasn't clear in his narrative as to how or where these things had exited his body, but there was no doubt in his mind: his neighbors had cursed him and the spell was manifested in these strange objects in his entrails.
After the first treatment by the traditional doctor, Zeca's health improved slightly. At the time, we all were unsure what to believe. Perhaps Zeca's illness had been psychosomatic, and the treatment by the healer had been sufficient to cure him because he believed that it would. On the other hand, maybe Zeca really had been cursed and this was the necessary remedy. Or maybe he was sick with some other illness and had gotten slightly better because, once again, of his faith in the traditional doctor's treatment.
A few weeks ago Zeca's condition began to worsen. He started losing weight, had diarrhea and stomach problems. Once again, Zeca consulted the local healer who told him that the neighbors had re-cast their curse and that the only solution was to receive a treatment from a traditional doctor in Cabo Delgado, the province where Zeca was born. So Zeca asked our ex-housemates for permission to miss work for a week so that he could travel to his homeland and consult with a healer. At this point, seeing Zeca's fragile state, one of our friends convinced him that perhaps it would be prudent to get an HIV test before spending so much money and time on a trip back to Cabo Delgado.
Zeca agreed, and this afternoon he went to the local health clinic for a blood test. Not surprisingly, it came back positive. Zeca will go back later this week to determine his T-cell (CD4) count, and only then will we have an idea of how severely the virus has attacked his immune system, and whether or not he already has an AIDS diagnosis. I don't know whether or not Zeca will have access to anti-retroviral medicines. With all the billions of dollars that are being donated and spent in Africa on the war on AIDS, it is an outrage to me that there would even be the chance of a seropositive person not having access to proper treatment. Unfortunately, this is the reality...
In the central region of Mozambique where Chimoio is located, more than 26% of the population is HIV+. One in four people. And Zeca is now part of an unfortunate statistic. With this news my heart grows heavy with a cloud of rage and indignation and sadness. I wonder how Zeca became infected, whether his daughters are also positive, whether he will ever receive the treatments so easily accessible to patients in the developed world, whether he will die before I am able to see him again and let him know that he was the person with whom I felt the greatest connection in Chimoio.
Zeca and I didn't communicate much, the result of language barriers and, quite honestly, social barriers as much as that disturbs me and leaves me feeling guilty. But the interactions we did have were always energetic and upbeat, full of smiles and genuine laughter, the result more than anything of Zeca's incredible charisma. Just today I was looking at one of the few pictures I have of him, remembering fondly one of the few highlights of my time in Chimoio.
And now this...
Were I back in the US, in my previous job as Director of HIV Prevention Programs at The Wright House Wellness Center, I would have such a different perspective regarding Zeca's diagnosis. I would think, if Zeca walked into my office, "Well, this is terrible news but with the right medical care and the support of community, family and friends, Zeca will be able to live a good life for another 10, 20, who knows even 30 years." I would offer Zeca references to counseling and support groups, and would encourage him to become a client of the Center so that he could receive low or no cost acupuncture, massage, reiki, and other energy treatments to help improve his quality of life and lessen the effects of the virus and of the medications. I would encourage him to become a volunteer with the Center, to share his story with others and find power and peace in knowing that his words and experiences could save another person's life. I would hope to witness Zeca walking the path of so many friends and clients that I've known, people that refuse to be limited by a virus and who have seized the opportunity to transform their lives.
But I live in Mozambique, and Zeca is a poor Mozambican, and the situation couldn't be more different. My hope for Zeca is that he has access to treatment, that his daughters are not infected and that they will be cared for, that he is able to live his last days with dignity, that he does not suffer, and that he is able to find peace with this diagnosis before his death. I fear that it will be sooner rather than later, and the undeniable injustice of the entire situation makes me feel sick myself.
I wish there were something I could do. I'm sure there is, but I am lost at the moment and don't know where to start.
10 comments:
I don't know what to say, except I hope Zeca stays well for as long as possible and that his daughters are ok. It's all just such a sad loss of lives
the statistics are saddening, the personal tragedies overwhelming... thank you for this thoughtful ray of hope in what at first sight is a hopeless situation...
we, the people of the "civilised" and "developed" world should be paying much more attention to an epidemic which WE have the resources to more or less control, but withold from those who aren't able to pay for it...
your heart's in the right place, ali... keep well...
Yes, shamely that area is one of the most touched of Africa... But because it's still such a shame having AIDS, many of the sick people will never ever tell they are sick and from one day to another they get sick and die. And for the family, whether they know about it or not, they'll say "s/he died of TB".
Not saying, they will never get the test done and try to have the retros, which is a miracle if he's one of the few.
We Africans are strong Animists and our national healers. Sometimes it helps, other times, we just have to face it. There is no craft, no bad eye, no nothing around, but sickness is real.
It will take a long time to try change mentalities. In Uganda, they're trying the way they can promoting fidelity, monogamy and so. But who cares to follow those in the 21st century? :|
Yes, and do you know WHY they are promoting strategies like abstinence and monogamy and fidelity in places like Uganda when these are obviously not the most effective strategies for Africa in the 21st century?
Because adhering to this morally-based agenda is the only way to get federal funding earmarked for HIV/AIDS from the US government. If they don't comply with this agenda (this goes for organizations in the US as well), they don't get the money.
A program must promote the so-called "A-B-C's of Prevention", in the following order of importance: A is for Abstinence, B is for Be Faithful, and C is for Condoms (if all else fails, you turn to C).
I think it is laudable that Bush has pledged more dollars for AIDS around the world. I think it is a sign of hope that donor countries throw billions at Africa each year to help combat this disease. But the question remains: Why is there so much money and so little progress?
Prevention and treatment strategies, I believe, must be culturally competent in order to be effective. Imposing a western, moral agenda is not going to work when faced with a behemoth of an epidemic like this one.
And certainly compounding the problem is the fact that NGOs and local government agencies that receive these HIV/AIDS dollars are not made to be accountable enough, and there is not enough collaboration between them to make programs effective. While a few of these NGOs and agencies actually do good work and make sound use of their budgets, from my experience the vast majority wastes money that should go to treatment buying things like new Land Cruisers and luxurious homes for all their directors. Yes, the conditions here are sometimes precarious and this warrants a few extra perks to keep one's motivation high. But for the level of effort many of these people put in, and for the quality of work they are able to deliver, these "perks" are exaggerated, as is a salary of US $10,000 per month plus all sorts of allowances.
And then there's overhead for all these NGO's. One American NGO I'm familiar with here has headquarters in Washington. Do you know what the overhead is for all the programs run by this NGO? 34%. Think about it. For each dollar in the NGO's budget that is supposedly being implemented in much-needed programs in Africa, 34 cents stays in the US to cover the salaries of administrative personnel at the Washington office. Yes, overhead is necessary. But keep it reasonable, like 10%. Siphoning off 34% of donor money is ludicrous.
Not only is the money wasted in-country by spending on administrative expenses and directors, there are also countless millions that just flow into the black hole that is corruption. A little fudging on the budget here, an off-the-record agreement there, and everyone is happy. Except the patient that is waiting, ill, with no treatment.
There. My rant is done for today. Good morning...
I'm really sad to hear about this. It seems like yet another example of the divisions in global society, based on such unfair and arbitrary things. There's just no end to the outrage, sadness, sickness, and anger I feel over this terrible tragedy -- although I know how meaningless that is, in the big picture, as I have no idea of what steps I, as an individual, can take to help, even in a small way.
Such a moving, powerful story! I'm so sorry to hear about the plight of Zeca and of course all the others like him. You write so beautifully about the contrast of medical care available in the West and in Africa. Such a sad reflection of how poverty and ignorance can lead to illness - not enough money for adequate care or the tradition that supports regular medical doctors and not enough education to enable people to understand how easily AIDS can be spread. Thank you for sharing a story that illustrates this painful reality. My heart goes out to Zeca and all the others who are suffering.
Telfair and any others interested -
Before moving to Africa my response to someone wanting to get involved and make a difference in the international fight against AIDS would have been to make a donation to an NGO with global programs. Today I don't believe that the money we donate will ever really make the difference we are led to believe.
Did you know that even the clothes so many people in the US and other countries donate to the "poor kids in Africa" end up being sold here? These clothes are not given away, as we are led to believe (or as we would like to believe). They are sold in markets and in bazaars, not made available to the people that truly and desperately need clothing.
So getting back to what you (one) can do about the whole AIDS thing... My recommendation these days would be for you to start at home, to volunteer your time at an NGO (in lieu of donating your money), become a buddy for a person living with HIV/AIDS, do some street outreach, educate yourself and then pass your knowledge on to another person, befriend a + person and ask what would make a difference in his/her life...
I think the only way for our efforts to truly be effective, in terms of helping a cause, is to help in a way that we control what happens to the resources we contribute. The only practical way to do this is to donate your time, not your money. Without greater ACCOUNTABILITY, the money will never be as effective as it should be.
I suppose I should add a disclaimer here that donating money is not necessarily a bad thing, and that many NGOs do quite a good job. Just be informed that the aid industry is exactly that - AN INDUSTRY - and it makes many, many people rich. The minute AIDS and poverty and malnutrition cease to exist, these people are out of a cushy job.
Okay, it's not quite so black and white as I portray it here, but I have been harboring super cynical feelings towards the NGOs and the humanitarian aid industry for some time now, for many different reasons (not just the ones above). With the news of Zeca's diagnosis as HIV+, I feel compelled to share some of this rage and disappointment...
Thank you for sharing your feelings. It's good to hear a point of view from "on the ground".
I guess my personal feelings is that systems in place (trade e.t.c) are inherently unfair so until that's rectified, NGO's are often no more then the proverbial boy with his finger in the dyke.
Safiya, I agree completely. I will spare you all a rant about how agricultural subsidies from the EU cost farmers their livelihoods in Africa and contribute to the cycle of famine and dependence on aid on this continent...
Okay, I just had a mini-rant, but I'll leave it at that. :)
The statistics sound awful. And not having the proper care for such a disease is even worse. I remember an ex colleague of mine telling us such stories of Nigeria, people dying of AIDS, no real treatment, you just stopped seing them one day...
I guess we all should do more about it and yes, it is easier in other countries. NGOs comming and informing us on this danger since we were about 15, Internet material that you can always access, doctors, support groups...Maybe in a near future we will hear less stories of this kind.
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