- GABORONE (Reuters) - The
truly devastating threat that AIDS poses to Africa comes into painful focus
when the President of Botswana, Festus Mogae, says his country faces extinction
from the disease.
- Mogae, who leads this diamond-rich southern Africa country
of 1.6 million people, is not being alarmist or playing with rhetoric when
he speaks out on AIDS.
- The United Nations estimates that one in three of the
country's adults are living with HIV/AIDS, giving Botswana -- which is
roughly the size of France -- the highest percentage infection rate in
- AIDS has put the people of Botswana, probably more than
any other, on a knife-edge between prosperity and poverty.
- ``We really are in a national crisis. We are threatened
with extinction...People are dying in chillingly high numbers,'' Mogae
- ``We are losing the best of young people...It's a crisis
of the first magnitude, it's a tragedy.''
- At Gaborone's main hospital, up to 80 percent of the
medical beds in the male ward are filled with sufferers in the last stages
of the disease. More than a third of those in the children's ward also
carry the disease.
- Some patients fight for breath with the help of oxygen
masks while most just lie listlessly on mattresses, too weakened by the
disease to sit up.
- Like virtually every public hospital in sub-Saharan Africa,
no antiretroviral drugs to combat the disease are available because they
are too expensive. All that overworked staff can do is battle to treat
opportunistic diseases such as meningitis.
- Hospital head Howard Moffat fears that the hospital,
built less than 20 years ago, could soon buckle under the strain as the
number of people needing care from the later stages of AIDS is only expected
to peak over the coming five to 10 years.
- ``We're under very great stress. Already patients are
being discharged before they are well enough. For the staff it's very demoralizing,''
- Sexual Practices Slow To Change
- The alarming statistics and overflowing graveyards still
have little impact on the spread of AIDS across Botswana and the rest of
the African continent.
- Some 90 percent of the sex workers who ply their trade
with the long-distance truck drivers at the town of Tlokweng on the border
with South Africa are HIV-positive.
- Commercial sex is driving the disease throughout the
- In neighboring Zambia, Patricia works the bars at the
top hotels in the Zambian capital Lusaka where her clients are mainly government
officials, foreign businessmen and expatriates.
- Her tale is one of parental abuse and poverty that took
her into prostitution in one of the poorest countries in the world. She
says HIV/AIDS won't infect her.
- ``When a man doesn't want a condom, I ask for more money.
They usually pay extra,'' Patricia said.
- Patricia, which is not her real name, is hardly unique.
- A U.N. study in Ndola, Zambia, found that only one in
four sex workers used condoms with their last client and only one out of
seven used condoms with all clients.
- In South Africa, studies have shown that sex workers
are cutting their fees and increasing their number of clients in order
to feed their addiction for crack cocaine, which has only recently caught
on in the country.
- Young Slow On Safe Sex Message In Botswana
- Doctor Arzumand Banu Khan, who heads Botswana's AIDS
coordinating agency, holds out little hope for the young.
- ``I don't think the message to our young people has really
got through about the use of condoms,'' Khan says, looking down onto the
city's main square.
- ``Just look down there -- pick out one in three of those
people and they will be living with HIV/AIDS,'' she says.
- This alarming view is repeated across Africa where 24.5
million of the 34.3 million people with HIV/AIDS live. The vast majority
are without hope of effective drugs, proper supervision, basic health provision
- The number of deaths are going to rise and people are
going to get poorer as key family earners are lost to the disease. Life
expectancy in Botswana could fall to as low as 29, according to a study
by the U.S. Census department.
- David Schneider, an actuary at the Botswana Insurance
Company who has done sophisticated modeling on the future course of the
country's epidemic, says AIDS is already claiming three times as many people
as any other disease.
- ``By 2004 this will rise to four times,'' he said.
- Harvard Head See Vaccine In 5-7 Years
- AIDS has blazed through Africa through unprotected heterosexual
sex, high rates of untreated sexually transmitted diseases (STDs) and multi-partner
relationships especially by older men with younger women, which is condoned
in many African communities.
- A culture of silence around the disease, the stigma attached
to AIDS and the high cost of anti-AIDS drugs and basic care provisions
have all allowed it to go unchecked.
- A large migrant workforce dating back to colonial times,
particularly in the mines dotted throughout the continent, has also proved
a breeding ground for the epidemic.
- There is no sign of a quick cure.
- ``Hopefully an effective vaccine will be ready in the
next five to seven years...It is extremely important that the governments
of the U.S., the major countries of Europe, Japan and Australia work together,''
said Max Essex, chairman of the Harvard AIDS Institute, which has a research
station at the Gaborone hospital.
- In seven years, millions more Africans will have died
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