Photo Story of HIV and Tuberculosis

When i look at this photo I see an object that has been in contact with so many people living with HIV (PLHIV) who get debilitated by the opportunistic infection, tuberculosis. The combination of HIV and TB in the lives of these people causes a disability that makes them wheel chair bound, as both virus and bacteria take over cells in their bodies via blood vessels, they are unable to function as they normally would, becoming dependent on people around them for care. One of such people is Melusi.

I met Melusi when i went to the Nhlangano health centre in the shilseweni region of Swaziland. This was a 3 hour journey from the capital, Mbabane, where i am currently carrying out HIV research with two organisations, the Clinton health access initiative (CHAI) and the Swaziland network of people living with HIV and AIDS (SWANNEHPA). On this day, Melusi was being pushed around in this wheelchair by a nurse called Simpiwe.  After a long conversation with Simpiwe i found out that Melusi had been in the health centre for over 6 months. I tried to have a conversation with him but he seemed very weak to make coherent sentences. Simpiwe brought him out to get a bit of sun and fresh air and so i sat there with him for over an hour. She was a nice nurse, not like the rest. She seemed so passionate about caring for sick patients. She treated them like she had a deeper connection with them, like family. I immediately realised she was different from other nurses who went about their own way. Sometimes texting on their phone and other times having loud conversations between themselves. Simpiwe’s connection was simply based on the fact that she herself had taken care of 3 family members who had HIV and TB. She felt their pain, experienced their suffering and also got stigmatised both for having infected family members and caring for infected family members.  Her passion for caring for HIV patients got sparked and she decided to go to nursing school. This is why she connected so well with Melusi and treated him like family even though he was just one of many strangers she has pushed on that wheelchair.

I returned to the same health centre 5 weeks later and this time, Melusi was sitting on a little rock outside his ward. He remembered me and we conversed for a while. He is a truck driver and got infected through his many sexual encounters by the border near South Africa. He has a wife and two sons and couldn’t wait to go home to his family. His sons got kicked out of school because they could not afford the fees and now they barely even eat a meal a day. Poverty is the reason he took the truck driver job as he got to a point where he could no longer cater for his family. He didn’t like being away from home but he had no choice because his family’s survival depended on the truck driver job he managed to secure.

Melusi didn’t know he could get any disease from having unprotected sex and said he couldn’t afford to buy condoms regularly. He didn’t complete his secondary education you see, because his parents also could not afford to send him to school.  He felt if he knew of the virus he would have taken extra measures. He only hoped he hadn’t infected his young wife, who also did not make it through junior secondary school. He felt responsible for his actions and expressed how in a culture where polygamy and extra marital affairs are not frowned upon, it’s very difficult to be faithful to one woman.

Having been on Anti retroviral medication (ARV/ART) for some months now, he felt so much better and was beginning to get his strength back. Luckily, Melusi will not have to pay for his treatment as he gets them for free. The Global fund cut didn’t mean he wouldn’t keep getting ART’s; luckily he is a citizen of an African country where political will does exist as the Ministry of health actually provides free ART for its people. Also, the presence of international organisations like CHAI also means he will keep getting access to ARTs. Without this free medication Melusi could have died as his CD4 count before ART initiation was only 20. He had no clue he had HIV and only came to the clinic because he kept falling sick. He was able to access the clinic in just 30mins because of decentralisation of hospitals.  Prior to decentralisation, it would have taken him over 2 hrs. Now there is a health centre in every rural district in Swaziland where PLHIV could get free access to ART. Melusi has decided to dedicate his life to HIV advocacy. He has decided to join the network of PLHIV to work as an expert client.  Local organisations like SWANNEHPA will ensure he gets empowered and his rights stay intact through his journey. They have been working very hard to reduce stigma and discrimination of PLHIV and Melusi seemed very happy about his future prospects.

As Melusi was telling me about his life plans when he leaves the health centre, another young man was being wheel chaired into the TB ward.  He was very frail and had just bones left on him.  Melusi knew who he was. In a country of just 1 million people where 70% of them live in rural areas, it was not surprising. They live in the same region and probably also have the same socio economic situation surrounding them.  As the wheelchair went past me with this young man in it, I hoped that his story would be very similar to Melusis’.  I hoped that his happy ending would include HIV advocacy and empowering of other PLHIV. Unfortunately my hopes were shattered as right in front of me; on that same wheel chair this young man lost his life.  As the retrovirus took over every cell in his body and his throbbing heart came to a screeching halt, so does this story. I can’t say i have been the same ever since.

On population control

The argument surrounding population control has really been quite annoying to me. Annoying because it all does not make any sense. For one, i really dislike when the west tries to impose certain policies on Africa that will be very beneficial to them. Call me pessimistic, i do NOT believe human beings are that altruistic. The most popular argument is, population reduction will mean that Africans will be able to care for themselves, both on a macro and micro level. So for instance, the government will be able to plan and cater for its population size, and parents will be able to better provide for 2/3 children as opposed to say 5/6. Now why this may make a lot of sense, it is DEFINITELY not the only way the government and parents can provide the best.

Africa has tons of natural resources. Africa basically supports the rest of the world with its resources, so how  difficult will it be to support the continent alone?  For a country like Nigeria for example, if government officials stopped stealing billions of Naira and we had a government that did their job and wants the best for its people, the man that has 7 children would not have any issues at all. The reason some parents may not be able to take care of their kids is because the country does not have a system. no planning, no jobs, no basic healthcare, no proper education, no security..NOTHING. Every household in Nigeria is its own government.

if people in power had common sense and did exactly what they are in power for...their JOB, the country will not be in its current state.  if we had all of the above, our economy would definitely be so much better. if we had a social welfare system, we could definitely support those that are not able to get by.

Population growth for me is a positive thing. if handled right. if Nigeria puts all the needed infrastructure in place and invested in human development, we would be a country to reckon with. our birth rate is high and majority of the population are in the working age. that immediately translates to an economic boom.  we are getting to that demographic transition stage called the demographic dividend and we need to take advantage of it and not let it pass us by. if it passes us by, we can kiss development goodbye and continue to rely on the west for their support and austerity measures that always have clauses attached to it.

Nigeria should not be passing a birth control bill. Thats a violation of human right. China did it with their one child policy and now they have an ageing population their younger generation cannot even manage. every individual has a right to reproduce and people have their cultural beliefs that should not be tampered with. The west have tried all avenues to control Africas population growth. the most recent argument they are using is global warming..when we all know Americans have the largest consumption. they know what to do..Yes! all Americans can reduce consumption but NO...they want to keep living excessively at the expense of Africans.

Unfortunately we have stupid leaders that have no common sense. The Nigerian president has clearly been spoon fed this bill...he is going to pass a bill he lacks total understanding of in terms of negative impacts. He needs to focus on HUMAN DEVELOPMENT...if we dont take advantage of this demographic dividend..we are doomed...a part of me feels thats what the WEST really wants...so that they can keep controlling Africa for its natural resources just so they can carry on with their ridiculously excessive lifestyle. They dont really care about Africa. All they care about is their own interests..Altruism does not exist.

What i find very silly is how they are going to enforce a bill when there is no simple birth registry in the country. the fact is, we have no clue how many people live in Nigeria..165 million is probably just a projection. So, Goodluck will need all the luck he can get passing this ridiculous bill..if i were him, id focus on more important issues. then again i guess his priority is warped.