The Reality of Africa Finally Sinks In

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.