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I am talking with a man in Botswana about his illness.
The woman is a visitor.
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Darrell Ward, who is writing a book about the battle against
AIDS in southern Africa, was struck by the complexity of factors
contributing to the epidemic. He saw stunning examples of heroism
in places like Manzini, Harare and Gaborone, where as many as
35 percent of adults are HIV-positive, but he also learned that
resistance to behavioral change runs deep.
He talked with people in Botswana, Swaziland and Zimbabwe who
feared the disease was spread by condoms, and to a tribal chief
and elders in Swaziland, who worried that the condoms they were
being urged to use might have "worms."
Such suspicions greatly complicate prevention efforts in Africa,
and are not surprising after centuries of abuse by "outsiders,"
says Ward-with most of the condoms coming from "outside."
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Chief Ngcamphalala (in orange jacket) and four elders
in front of the chief's home in Swaziland. The man at the
far left end is Mvuselelo Dlamini, a volunteer with The
AIDS Information and Support Centre, the NGO I was working
with in Swaziland.
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Ward is a medical writer and associate director for research
communications at Washington University School of Medicine in
St. Louis. He spent six months in 2000 observing and talking with
authentic heroes: hospice workers caring for their countrymen
under the most desperate conditions, health workers in a country
whose public-health system has collapsed, operators of a "daytime
orphan" program. He hopes that the book he is writing, Heroes
of a Quiet Catastrophe: Africans Fighting AIDS in Botswana, Swaziland
and Zimbabwe, will help to dispel any myths about Africans as
passive victims, and convey his respect for those who let him
tag along.
Ward shared their frustrations. One day, for example, he was present
when a delivery truck arrived at St. Albert's Mission Hospital
in rural northern Zimbabwe bringing badly needed medical supplies.
The hospital was run by two women physicians, one Zimbabwean and
one Indian. Their patients were poor people from the Zambezi Valley
and the surrounding Zambezi escarpment who came to the hospital
with problem pregnancies, burns, broken limbs, malaria and, of
course, AIDS. The shipping order showed that the doctors had requested
131 items -- basics such as scalpel blades, syringes, disposable
gloves and wooden crutches, along with pain-killing drugs and
other medicines. Of that request, they received 17 items. For
each of the 114 unshipped items, the shipping order monotonously
read: Out of stock, please reorder; out of stock, please reorder;
out of stock, please reorder.... This and other experiences illustrated
for Ward the enormity of the challenge posed by AIDS in Africa
and how the professionals there use what is available to them:
their care and compassion.
But there were also inspiring and even funny moments along the
way. One night, he followed Patricia Bakwinya, a tireless Botswanan
educator, into a bar. Armed with a wooden phallus and a box of
100 condoms, she challenged one person after another to unwrap
and apply one correctly. If he succeeded, he received five free
condoms. If he made even a small mistake, as happened frequently,
she would demonstrate the correct method to a rapidly gathering
and raucous crowd. Women as well as men would try for free condoms
and as the night wore on, "it got to be a kind of sobriety
test," Ward chuckles. "They would horse around and make
cracks, but they also clearly thought this was important to know
how to do."
Ward was greatly energized by his Fulbright project, which he
says opened doors to other opportunities as well: attending the
international AIDS conference in Johannesberg, invitations to
lead workshops for activists and the media in southern Africa
in 2001 and 2002; and speaking invitations from doctors back home.
He also supported a Botswanan colleague's selection for a U.S.
exchange program; helped a 14-year-old Swaziland girl raise the
funds she needed to stay in school; and distributed 30 copies
of an AIDS handbook he had written to his African colleagues.
Travel is more rewarding "if you can also help people,"
says Ward, who doesn't think he is exceptional in any way. He
believes Fulbrighters undertake projects such as his "because
they want to contribute in some way, because it's a privilege
to be involved."
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