Stories of AIDS in Africa

There are 28 million people living in sub Sahara in Africa, who have HIV or AIDS and I have living there for last four years reporting on this issue full time for The Globe and Mail, which is the national newspaper of Canada and came to see along the way that the idea of 28 million people is so big and so paralyzing that there is no way that people can engage with that. And you know, before we can start to have an intelligent conversation about how we want to respond to this issue, we need to know who those people are and so that's where the idea for this book came from. I have been on, I have been fortunate enough as a reporter to be on the big story, lots of time, to be in Iraq for the end of Saddam Hussein, to be in Afghanistan for the fall of the Taliban. There is a big gratifying thing for a reporter that comes with being on the big story. There was lots of satellite trucks, there was the heavily made up CNN producer, you feel like you are in the center of the world but when I wasn't doing those stories I would go to Africa and I started to see after a couple of years that what was happening there was actually much bigger than anything else that I covered anywhere in the world. I started to wonder where all the other reporters were and I came to understand that HIV was not just one disease in a place that had lots of diseases, but was affecting everything, you know, my editor said to me when I said I wanted to go right about this full time they said, well why HIV why not anything else and I said that HIV under lays so many of the other things and that it was crippling economies, when it took away, it affects people between 18 and 35. They are the most infected people in every country. So they are your productive workers, they are people who could grow your food and earn your wages in the city and they are the parents right and you were losing a whole generation of parents and that this was that HIV was having an impact that you know, we had countries where one in three adults had this fatal illness and that this was doing something to societies that we haven't seen since 1300s and that's why I moved to write about this. And so I guess, what I would like to do is just tell you a little bit about a couple of the people in the book. One of my favorite stories about couple of kids in Addis Ababa in Ethiopia called (Tigus) and(Yohanus) , they have been living on the streets in Ethiopia since their mom died. Tigus was nine and Yohanus was six and five - he was five and they went back to the village to bury their mom and when thank you - after the funeral their aunt and uncle said are you going to come and live here with us now, their father had already died of AIDS and they said they said they looked around and they saw all these kids who were plowing and fetching water and carrying firewood and doing all the stuff you do in Ethiopia to survive as a kid and there was no school and they said no actually we want to go back to the city and their aunt and uncle who already had more orphans than they could care for, said well, okay good luck and they went back to the city and Yohanus started making a bit of money braiding hair or Tigus made money braiding hair, you know couple of cents here and there and Yohanus started making a couple of cents here and there shining shoes and they have managed to keep themselves in school and keep it together for the last six years living on their own in a house, the house is a sort of size of area in front of these chairs. It's made out of little bits of scrap metal and they share a little bed. They go to school everyday and Tigus remembers when her mom was alive Yohanus doesn't, but Tigus remembers and she remembers a little bit what it's like to be parented, so she tries to do the things for Yohanus that she thinks her mother would have done. She says don't scratch ,don't pick your scalp, don't pick your nose, do your homework, wash your uniform and at the end of the couple of the days that I spent with them I asked them separately first I asked Yohanus if you had a little money what would you do and the first thing he said was I'd get a TV and that was kind of funny because they don't have electricity. Right? And then he said no, I had any money I would pay for us to go to best school in all of the Ethiopia and then he said, you know, if I had any money I would use it to take care of my sister and then he went outside to play and I said to Tigus if you had any money what would you do and she said that if I had any money I would use everything to take care of my brother because it is up to me now. I am the only person he is left and they are you know, they are doing okay. I check in on them every so often and they are still in school and they are doing pretty well and pretty soon Tigus will over in that - school is free in Ethiopia up till but she will be in grade 10 and then she will have to pay school fees and there won't be she would like to start a little restaurant business, she thinks but there won't be a way for her to stay in school unless they can find some one to pay the fees for them but for now they are doing okay. The next person that I would like to tell you about is a guy named Noe Sibisaba and he lives in Burundi in a little town called Serenjuru and Noe comes from a family of peasant farmers who nobody had in the family had ever been to school, but Noe wanted to go to school and graduated from High School which his parents were very his parents were confused. They have never really known anyone to go school before but Noe loved school. They sold their only cow and they put him through school and he graduated and he got a job with the local government because in Serenjuru only six people had ever graduated from High School and so that qualified him as a heavily educated person. And he when he started working for the government in early 1990s Burundi's periodic civil war was reemerging and he Noe great flaw is that he is a pacifist and a believer in compromise and so when Hutu rebels with threatening this Tutsi government, Noe advocated a dialogue and talking to the rebels and that had the effect of making everyone suspicious of him. And so Noe is a Hutu, the government of Burundi is Tutsi, and was Tutsi and a very violent repressive military government and one day when Noe was away on business, the government decided to teach him a lesson, believing that he supported the rebels and they sent a squad of soldiers to his house and they gang raped his wife, (Agrapine) she was five months pregnant at the time. And so when Noe got home and found her he realized that they had to leave and they fled over the border, they waited till she had the baby because she really couldn't travel before then, but as soon as she had the baby they fled the border into Tanzania and they joined 800000 Burundians who were living in refugee camps all along in these huge open plains in western Tanzania. And Noe talks with great eloquence about what it's like to have been a respected person that, you know, for we and the west room, when we see refuges, we see these columns of people with their stuff on their heads and we think one more refugee. But he had been a person, he was really respected in his community and he had all his ambitions for how he was going to build up Serejnuru and now all of sudden, he was just this guy in this camp reliance on handouts that he went one day to try and get a pair of pants, because he had no clothes and they said well we don't have any pants but here have a dress because that's was there was in the cast off clothing box that day. When Noe fled he took a little bit of money and his family photos and a couple of clothes and his copy of Les Miserables by Victor Hugo which was his most treasured possession. So living in this camp one day Noe was walking by the clinic and they say we really need blood for blood transfusion, there is no sort of permanent blood supply, could you donate blood and he is so sure I am an universal donor, I am type O. So he donates blood and then they don't use his blood and that's how Noe finds out that he has HIV and at that point there are 800000 people in these camps and nobody who will say openly that they have HIV because of this incredible fear and shame that goes along with the disease, the way it used to be here 25 years ago. And Noe wants to tell people, he is teaching by this point at the school in the refugee camp and he wants to tell people that he is infected and his wife won't let him. She says if we do, we will be completely ostracized and so he has to keep it a secret and he is really worried about his students because he sees these girls who are having sex with aid workers or with men from town to make a little money to support their families or to buy a pair of shoes and he knows that they are risk for HIV but he keeps the secret. Agropine died and their second baby Lena also died of HIV and at that point Noe figured, I have nothing to lose and he went public in the camp and said I have HIV. And like Agropine had feared older people in the camp completely ostracized him but his students organized a rally and when Noe got there, they were singing and they were singing this traditional [0:09:09] (Kirundi) song that's reserved for heroes who come back from a war and he listened to them for a long time before he realized that actually they were singing for him and his students completely supported him and started this organization that took care of orphans, took care of people who were sick and started to organize, made it possible for a lot of people to come forward and say that they had HIV. By the time he left the camps three years later he was repatriated to Burundi which is now at peace and rebuilding, there were 1700 people living openly with HIV and he took all of those skills back to Burundi where he was trying to setup the organization. Noe is a- yeah he is pretty amazing, he is a very quite gentle person with his unbelievable strength. And the last person that I will tell you about is a guy named Pontiano Kaleebu who is a microbiologist and I like to talk about Pontiano because we and the west often have this perception that the response to AIDS is about us going to help and we forget that almost of what's been done to respond to the pandemic has actually originated in Africa from Africans and that includes not only care for orphans and sick people but also Pontiano works for something, he heads something called the Uganda Virus Research Institute where they have been doing work on an HIV vaccine and a vaccine is incredibly important, it's the only thing that will eventually stop the pandemic but HIV is incredibly difficult to vaccinate for because of the way that it works. It targets our - the same immune cells that would normally wipe out a germ is what HIV lives in and its really sneaky. It will get in your body and hide for ten years. It coats itself in these sugar proteins so that your body can't recognize it even if you you can give someone a vaccine and then the HIV will effectively put on a disguise so that the vaccine doesn't recognize it. So what Pontiano was going to be a Pediatrician when he went to medical school in Kampala in Uganda and then along the way he got side tracked into into virology, into vaccine research because he saw the incredible impact that HIV was having on Uganda. When he graduated from medical school one in five adults was infected and the other thing he noticed was that all the work that was happening on an AIDS vaccine was on what's called Subtype B. HIV comes in a lot of different strains, Subtype B is the one that you have here on America. Fewer than 10 percent of the people in the world with HIV have that strain of the virus but that's where all the research was because those are people with the money. 90 percent of people have A or C but nobody was looking for a vaccine for A or C because they don't have any money. So Pontiano helped to show that it was possible to do, he was the principle investigator on the first aids vaccine trial ever held in Africa and he has helped over the last ten years to show that its eminently possible to do that kind of research in Africa. And they you may remember the press conference that the Reagan administration held in 1982 when they said they would have a vaccine for HIV within two years. There is still no sign of it, Pontiano is an optimistic guy but he on his best days says it will be ten years before they have a vaccine. The thing that I really came to understand about when I spent time with him at the Virus Institute is that its not only this great scientific puzzle for him as it is for researchers here in US but when Pontiano needs to do a trial on a vaccine candidate to see if that works you know give half the people a vaccine and half the people a placebo and see what happens he has got to get those people by going to his kid's school and to the church and to his community center and saying to his own family I need you to come and be part of this and then every time it doesn't works he has to go down to the church on Sundays and stand up and say you know, I am really sorry, we tried again, it didn't work. We are going to do another one I need you to come back and let us to do this again and and its you know it's a great fascinating scientific puzzle for him and its also of course incredibly close to home. So these are that are kinds of stories that are in the book and I have tried as much as possible to include not only the description of the destruction that's been caused by the virus but also to tell the stories, you know, there how we think of this as an incredibly depressing story that aids in Africa is just this great monolithic disaster and in fact even in the four years that I have been living there, there have been incredible changes. When I moved there, there were fewer than a 100,000 people on anti retro viral treatment, the treatment that has in America made HIV a chronic illness like diabetes. There are when I left two weeks ago there were 1.5 million people on treatment which is a 13 fold increase. Everybody said you couldn't do it that you couldn't treat anybody in Africa and in fact they are treating millions of people and along with that with the role that the treatment has come a real change in how people talk about the disease, the shame has lessened, the fear has lessened and people have a a lot of the stories are in the book or of people who were just kind of minding their own business who were teachers or nurses or civil servants and kind of going through their lives, wanted to see their kids grow up. Didn't have a set of ambitions that were particularly different, you know, than probably most of ours and all of a sudden get told that they have this bug something they can't see, that they have never heard but that's going to kill them and they well most of them were reluctant activists but with no supports from within their own communities and almost none from outside they have noted these extraordinary moments that fought their families and their communities and their governments and our governments and international pharmaceutical companies to to bring treatment to Africa and to change it from being a fatal illness and they have been astonishingly successful and it is people say to me a lot. I am audience I was talking to in San Francisco today, asked me - a couple of people asked me how do you do this job. It must be really depressing, and in fact its very rarely depressing. It's often incredibly exhilarating because I get to meet and spend time with these extraordinary people. So along with the very real face of the incredible damage done by the virus in Africa I wanted to make sure that I told some adverse stories because I don't think that we hear those nearly as often. So I will not stop prattling and if any body has any questions I would be glad to answer them.