First AIDS orientation

I want to look at the AIDS problem. When I lived in Zambia AIDS was a strange disease we read about in the western press; a disease that attacked gay men and IV drug users in the United States.
We had no idea it was heading this way, and we did what we always had. We soaked needles in disinfectant before reusing them; autoclaved surgical gloves and wore them until the rubber popped and delivered babies with our bare hands.
But after I left, the disease traveled fast. The long-distance lorry drivers who carry goods 2000 miles to and from the coast are believed to have helped it spread like a plague. As a result, news reports have shown an Africa I don’t recognize – poor weakened folk with their hands out appealing for help. I have hated those images, and the reporters who brought them, including Saint Bob Geldof. I’d find myself peering into television looking for signs of the vibrant, humorous people I remembered; the people who had bolstered me when I felt overwhelmed. But the newsreel would always grow more miserable as the journalist’s voice grew sympathetic at the plight of these poor people.
The stats are harsh, around 17 percent infection rate, although no one knows exactly as that’s only a percentage of those who agree to be tested.
Last year, Zambia became one of the first southern Africa countries to offer free antiretroviral therapy to those testing positive. It’s an expensive programme paid for by international funds, and I’m keen to see how it’s working.
M. suggests I visit a friend of hers, a doctor working to prevent HIV. I telephone expecting to be given an appointment for an interview in a week’s time. Instead Dr. Kasonde says she can chat over lunch.
She’s a small woman who apologises for having back pain. The clinic is private, treating middle-class Zambians who can afford to pay, but Dr. Kasonde spends only part of her professional life here. In her other job she visits workplaces to lecture on AIDS. She grows immediately heated when I ask about this work and talks quickly.
Too many Zambian men think they don’t need to be tested, she says. And there have been too many conferences at hotels and civic centres where the audience sleep while doctors lecture on the dangers of HIV.
“No more,” she says.
Dr. Kasonde goes to factories, mines, farms and barracks timing her visits for lunchtimes, shift changes and, to catch the military and police, she turns up during parade times.
She asks them if they know how HIV is contracted.
They always nod, she says.
Do you know your status, she asks them?
They shake their heads.
Do you know the status of your partner, she asks?
They shake their heads and look away.
“To me, the message until now has been too general,” she says. “We need to challenge them!”
The anti-HIV slogan in Zambia is ABC – Abstinence, Be faithful and Condoms.
“That’s too far too general,” Dr. Kasonde says, and the old men criticize mention of condoms as promoting promiscuity.
When it comes to being faithful, many men ask her, “Doctor, what do I do if my wife goes out of town?”
“So, I have to say – if you can’t be faithful, then use a condom. They start giggling, but I have to bring the message home.”
The country is recovering, she says. The death rate is falling and the sick are coming for treatment.
Importantly, the rate of infection among the under 25s has dropped. “The message is getting through.”
The key is the workplace because people spend so much time at work, she says. But still too many of Zambia’s rich and famous go overseas for testing and treatment to avoid the stigma.
Dr. Kasonde’s hands find her painful back and she looks at her watch. I know I must leave her enough time for rest before her next patient. In the waiting room are several men in their twenties – I wonder, immediately, about their HIV status.
I step outside wondering which direction to go. Mr Mutale had dropped me off at Dr. Kasonde’s clinic, and I had told him I would find my own way back. He had pointed to the clinic corner saying it was the best place to find a taxi. But I stand at the corner watching only private cars pass. I decide to walk to the junction with the Great East Road. The road is busy with traffic. There’s been no rain for six months so the dust rises and blows into my face with each passing vehicle. There are plenty of blue cars but none with the red license plate of a registered taxi driver. Blue minivans that act as local buses slow down and their young drivers honk and point to the nearest bus stop.
I look away and feel a little desperate. An elderly woman approaches from the direction of the clinic. She’s dressed in a blue blazer, red blouse and pleated skirt. She watches me and somehow I know she will help. As she gets close I ask where I might find a taxi.
“Where are you going?” she asks.
“The British Council Building on Cairo Road.”
She points to one of the blue minivans in the parking bay, and a young man rushes out the side door and toward us. They talk quickly in a local language.
“He will take you to Cairo Road,” she said. “It’ll cost about 1,000.”
I shake my head, knowing that I have one million kwacha in my purse and I can’t take it out in any public place. “I think I should take a taxi.”
From somewhere a blue taxi appears. The old lady puts her head through the passenger window and talks with the driver.
Eventually she looks up at me. “He will take you for 10,000 – don’t let him charge you anymore.” She pokes her head back toward the driver. “Remember! 10,000 you charge her.”
That lady was a gift – and that was the cheapest taxi ride I ever had in Lusaka.
But the office I want to visit is closed, so I walk along Cairo Road looking for a small café.
I see small bars selling chicken and nshima, but I want something with more taste. Cairo Road is the main commercial road, and it still looks the same as it did 25 years ago – lots of small shops with barred windows dwarfed by large banks and public offices. Everything is shut, but a few small traders have hung men’s suits from shop awnings and laid out shoes on the pavement. I see a small man try on a pinstripe jacket – his grin tells his aspirations even though there is no mirror to reflect admiration. He takes off the jacket to show a dusty torn t-shirt underneath.
My stomach is growling and I find a hotel foyer. I step into its air-conditioned hallway, and my feet lead me to the restaurant. It’s empty except for three white men with laptops. A pretty young girl brings me the menu. Chips sound heavenly. I wonder what to have with them. Chicken, hamburger, curry? I decide to play safe and opt for a toasted cheese sandwich.
I really do have to be more adventurous. In Pret-a-manger on Chelsea’s Kings Road I used to watch people scrutinize the racks of sandwiches before making a choice. They’d peer through cellophane wrappers as if looking for bugs. I remember one woman examining a salad so closely its cellophane misted under her breath. Another peered at the rows of juice bottles, finally taking one from the back. A man examined the bacon, lettuce and tomato sandwiches as if counting the strips of meat.
I used to wonder what they were looking for? What are any of us looking for in a sandwich? In Chelsea it certainly isn’t sustenance. I don’t have a weight problem. In fact I come in below the ideal weight, according to the NHS. But in trendy Chelsea I look like I ate all the pies.
At yoga class, my 55 kilo frame looks fleshy and plump compared to the meager limbs that surround me. In downward dog – where we use our bodies to make an up-side-down V – I’m self-conscious as my tum sags loosely toward the floor.
I feel stares from the skinny girls around me and want to yell, “I’ve given birth to two hefty boys.”
After class, no one ever talked to this pudgy girl. But when I travel back to our village in Cambridgeshire, I seem to shrink in size. Out there I’m known as ‘petite’, and other mothers ask how I stay so trim.
But Cambridgeshire and Chelsea are so far away from the Protea Hotel on Lusaka’s Cairo Road. The toasted sandwich and fries have filled my belly and the three businessmen pack away their laptops to leave. As I finish the last chip on my plate, I feel very alone.