Secretary of State Colin Powell went on MTV last week and said that sexually active young people in countries ravaged by AIDs should use condoms.  He called them the “vital defense” against the virus. Now the right wing is vilifying him, but he has not retreated and calls their criticism “irresponsible.” Good for Colin Powell.

On February 26 President Bush will meet with three African leaders, including President Chissano from Mozambique, to discuss a range of topics including the need for more funds to fight HIV/AIDs. Their pleas will be desperate.

I have just returned from Mozambique and Malawi where I — and eight others — spent ten days visiting community-based projects for people with AIDs, including orphans, run by Save the Children/US and other non-governmental organizations. Our lives were changed by what we saw and whom we met.  We, too, came away understanding the “vital defense” that Powell describes. What is happening is no longer the loss of millions from an epidemic; it is the impending disintegration of nations.

Take Mozambique and, in particular, the Gaza Province in the south. Many of the houses are concrete, a sign of some prosperity, and many kids wore shoes to schools that had tin roofs and blackboards; things we rarely saw in Malawi. Many of these young people have fathers who work in the mines of South Africa and send much-needed money home, but they also bring HIV home when they come to visit. These returning miners infect their wives; then they die. Then, following Mozambican custom, the brother of the dead man marries the widow. The widow infects the brother-in-law. She dies, and then he dies, his first wife dies, and all the children are left behind. Maybe one, probably the oldest boy, will attend school, but how will he pay for his pencils and notebooks and when he goes to high school who will pay the school fees? And what if his teacher dies?

I visited one child-headed household in Mozambique where a 14 year old girl takes care of her three brothers and sisters in a village where no adult relatives have survived. The children have been on their own since 1999. Only the oldest boy goes to school.  The others seemed numb, already dead.

Rumors about the disease abound.  Many believe if a man sleeps with a virgin he’ll rid his body of AIDs.  Consequently young girls, taught in initiation ceremonies to be submissive to men, have sex with older men who have tempted with gifts.  Then they, too, become infected. 

When they begin to waste away they go, if they can make it, to the district hospital where 15 doctors cared for 1,000 patients who often sleep two to a bed, sometimes on the floor.  There are few medicines, not even to ease the pain. They die.

The only person I met with access to antiretroviral drugs must walk to the main road from his village, wait for a bus to Blantyre, spend the night on a city sidewalk, go to the hospital in the morning, wait for the doctor, get his medicine which costs one-half of his monthly pay check, walk back to the bus terminal, wait again and return to his village. It takes him two days and he does this once a month.

The US Ambassador to Malawi, Roger Meece, an impressive Foreign Service professional, says that the most critical labor issue he confronts is whether or not the US government will pay the expenses of sending his employees’ coffins back to their villages when they die.  On the streets of Lilongwe hand painted signs for coffin makers hang everywhere.

It is now estimated that 50% of the Malawian army, a respected and disciplined force, is infected with the HIV virus and the government has begun to   screen applicants surreptitiously.  If a recruit has HIV he’s rejected from the army, but not told his status; there’s nothing to be done anyway.

It is estimated that 33% of the teachers and nurses are HIV positive. In one hospital in Malawi they are 250 nurses short. The overall infection rate has hit 20% which means one-half of all 15 year olds will die of AIDs. In Mozambique the prevalence rate is slightly lower because their bloody civil war, ironically, protected them from the arrival of HIV. But still Mozambique is at 15% which means one-third of all the 15 year olds will die of AIDs. The entire social fabric of these countries is unraveling. And what traditions and values will shape the few survivors? Who will be in control?

And what can be done? Obviously vaccines are desperately needed, as are affordable drugs and new health care delivery systems. In villages throughout both countries we met community volunteers trying to address these gaps. I met one woman, a subsistence farmer with four children, who spends two days a week tending to sick people in her village. She walks from thatched hut to thatched hut, visiting and comforting and bathing and feeding patients too weak to care for themselves. She had 14 patients last year; now she has three. Her efforts, although generous and gallant, will not change the reality.  New ideas and attitudes about traditions and taboos are needed.

We met young people, many of them orphans already, guided by village leaders,  who meet regularly to talk about HIV prevention. They write and perform songs and skits about abstinence, fidelity and condoms. They sing about Mr. HIV who kills indiscriminately. They condemn the rumor that says condoms cause AIDs. They sing about night sweats and wasting and sores on the body, all symptoms of the disease. They sing to urge girls to say no to sugar-daddies.   They sing about staying faithful to one’s spouse. They dance and wave condoms.  And if they do not listen to themselves they, too, will die.

Why should we care and why should President Bush care? Obviously for humanitarian reasons, but Malawi and Mozambique are also partly Muslim countries. Although not radical fundamentalists, the people are desperately poor and hundreds of thousands of people are dying. Foreign aid from Iran, Kuwait and Saudi Arabia builds roads, schools and mosques. Gifted students are sent to Pakistan for further study. But just as we rallied to the cause of September 11 and its victims we must do the same now for Africa.  Not just because it’s the right thing to do, but because it might save us, too, one day.

Contact Gretchen

Save the Children
Save the Children COPE stories
Malawi Journal
Malawi Journal part 2
Malawi Journal part 3
Malawi Journal part 4
Malawi Journal part 5
Malawi Journal part 6
Mozambique Journal
Mozambique Journal part 2
Mozambique Journal part 3
Mick's reflections
HIV / AIDS in Africa
Advisory Board Biographies
Advisory Board Visit Agenda
'net links to Malawi & Mozambique
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 Last updated September 18, 2004

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