Sunday: Tanzania...Reconciling With Reality

Generations dead. I was on the continent where millions have died from HIV/AIDS before they even had a chance at life. The average Tanzanian rarely has a chance to die from heart disease because they simply don't live long enough. The HIV death numbers are presented to Americans in cold, black print. But seeing the faces is chilling. Coming to Africa I think is something you can't really describe but it is my duty to try.

Whereas I am just beginning my mission to report on this epidemic here, I instantly knew I wasn't in Kansas anymore when I stepped outside of the airport. We piled into our UN buses, passing poor Tanzanians sitting and standing about in the hot, humid air, and I wondered how many of these people are dying right now from HIV? How many know? And how many are able to do something about it?

As we rode to our hotel -- exhausted -- we passed broken sidewalks, run down buildings much in need of painting, barefoot kids, pools of dirty, standing water from lack of proper drainage (ie mosquito haven), and people cooking food on make-shift grills on the street. Then one of our U.N. escorts told us, 'This is downtown Dar Es Salaam.' Admittedly, I was in shock and awe that this was a major, downtown city. I've been to third-world countries before, such as Jamaica, but this -- my heart sank.

It is important to have an image of this type of poverty, because it is a major factor in the complex picture of HIV across Africa. Women have it particularly hard. Gender inequality exists even in the U.S. surely but not to this gravity. Women here are secondary to get health care consideration in the household if only one person can get treated. Even with lifesaving mosquito nets, the experts in N.Y. said they are last to get them because if any one person in the house is going to get them, it will be the man. The same goes with HIV drugs, which are prohibitively expensive to most. The economy can't afford to pay doctors and nurses so there is a shortage to treat patients even if they could afford treatment. We were told during our U.N. briefing 90% of medical students in Tanzania go elsewhere to practice.

"Is HIV top of mind for people in Tanzania? We hear about the problem in Africa all the time in the states but is it real to the people living here day to day?" I casually asked a UNICEF representitive as we had coffee later before our welcome dinner.

"Yes, but it is a very complex issue," she replied.

Giorgina is a native Tanzanian. She says one of the major hurdles is stigma. She says that people can be thrown out of their families and become social outcasts if they admit they have HIV. For women, we know they depend heavily on men to support them and their kids.

So what happens? People don't tell and then continue to have unprotected sex. Spouses don't even tell each other. Condom use is high among youths, she notes. They get the message. Married women, however, are virtually powerless when it comes to asking their husband to start using condoms if they wanted them to, or they just trust their husbands are faithful. But there are many cases, unfortunately, when the spouse is not.

There are other reasons people don't disclose their status, Giorgina continues. She says maybe 50,000 people out of half a million in Dar will get vital antiretrovirals. So what is the use in being labeled an outcast if you won't get the necessary treatment anyway?

I know now just after this short chat that there are many faces to HIV, which is why this has been such a hard problem to solve. I have my work cut out for me.

Related Topics: CDC: Everyone to get HIV test

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