Monday, December 16, 2013

Despair, Hope, Perseverance - AIDS in Uganda

Following is a piece I wrote about the impact of AIDS in Uganda during the late 1980s when I was posted there.  A version of this article appears in the December 2013 edition of the Foreign Service Journal.

AIDS cut a wide swath through Uganda in the late 1980s.  Newspapers were replete with notices advising  death  “after a short illness,” but everyone knew the code.   The disease struck down those in the prime of life, many from the burgeoning middle class. Despite the presence of dozens of medical researchers from around the globe focusing on the malady, no cure was available and there was little knowledge on how to retard the inevitably lethal progress of the disease.  There was, however, knowledge about how AIDS was hetro-sexually transmitted and a growing conviction that if peoples’ sexual practices changed then the rate of infection in society at large could be diminished. To that end President Yoweri  Museveni and his government team undertook to campaign publically about the ravages of AIDS.  They promoted condom use - there was a television clip of the minister of health in the city market demonstrating condom use by putting one on a banana.  The slogan “zero grazing” resonated with the populace who understood the metaphor of a cow tied to a post who could then only eat in a circle, a zero. The cow-to-post linkage symbolized connection to a single partner while the zero reienforced the idea of not straying into other pastures.  There were many other efforts to deal honestly and effectively with the scourge and a growing network of counseling centers for those infected and their families.  Indeed, part of Uganda’s successful endeavor to curtail the spread of AIDS was to diminish the shame attached to its sexually transmitted origins.

Still against this backdrop AIDS continued to take a toll.  Local employees of the U.S. government convinced the embassy administrative officer to rework their benefits package so that upon the death of an employee his male relatives (in accordance with tribal custom) could not seize remittances to the detriment of his spouse and children.  This change was unfortunately necessary as during the last three years of the 1980s, at least seven FSNs died along with a dozen local guards. All organizations were hard hit.  The colonel in charge of training for the army confided to me that he had to have ten soldiers tested for AIDS in order to find two non-infected and thus eligible for US  training.  While he was on leave, however, a subordinate falsified records and subsequently two Ugandan soldiers died of the disease while in the states.  Along with several embassy personnel I joined the Mountain Club of Uganda that grouped rock climbing and hiking enthusiasts.  We mounted expeditions to nearby rock faces and to the Mountains of the Moon. Over half of the members were twenty-something Makerere University graduate students.  Sadly, over the next decade virtually all of them died from AIDS.

Yet hope always flourished.  East African newspapers made much of the discovery of an AIDS cure dubbed Kenron by a Kenyan scientist and took the opportunity to proudly proclaim that Africa too was in the forefront of science.  Because further trials proved the remedy marginally useful, the story faded away.  Similarly one day Kampala’s New Vision newspaper headlined that a woman in Masaka - about sixty miles south of Kampala - had found that eating the clay from her backyard had cured her daughter of “slims.”  Thus began a rush to the site, hundreds of persons converged and shortly turned her yard into a deep pit.  I asked several well placed, well educated contacts about the allegation and expected to find them skeptical, but they too were believers.  “Eating it might work and if not, it’s just dirt. I am going this afternoon.”   Of course, it did not work and that story soon faded away as well.

What did work, however, was the effort to teach about AIDS, removal of the sexual stigma, the use of condoms and changed sexual behavior.  Combined, these approaches reduced the infection rate and held the line until anti-retroviral medicines were available.   Today Uganda remains afflicted by AIDS, but in the context of thirty years experience is coping with the scourge.  Now Ugandan society is thriving and its economy prospering.  Thinking back makes you wonder what might have been if those tens of thousands of citizens had not been struck down early in life?


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