Race Against Time: Living Under Pandemic

[This blog post covers the chapter “Pandemic: My Country Is On Its Knees” in Race Against Time. I’ve got a bunch of those posts– I think the book has important things to say.]

The process of dying is not an easy one. Unlike what we see in movies, death is not tragically pretty, and it does not happen quickly. And this goes double for wasting diseases.  If you thought watching someone die for five minutes in a movie was hard, try watching them die over five days. Over five weeks. Over five years. With the prevalence rate of AIDS/HIV in Africa at this time, one would have to be very very lucky to not have to live through the long, slow death of a friend or a family member. In this book, Steven Lewis mentions that a growth industry in Central Africa is the manufacture of coffins; regular and child-sized.

So that’s one massive impact AIDS has had on the culture, the sheer prevalence of death. Another has been the manner of that death. Once someone has been diagnosed with a fatal disease, it takes money and medical attention to make the time till their heart stops as easy as possible. Morphine isn’t expensive, as drugs go, but it still takes about 8 dollars for a week’s supply for someone with severe pain. In Africa, there are between 400 and 500 Million people who survive on LESS than a dollar a day. So no pain medication.

And checking into the Hospital is a good option, in many places. In Lilongwe Central Hospital, in Malawi’s Hospital, there is one night nurse to deal with a ward holding sixty or seventy people. All of these people, by the time they go to the hospital, are in such a state they would be in intensive care if they were in Canada. Instead, they are packed in two to a bed, often with another person on the floor under the bed, all dying. They regularly wheel in carts to take out the bodies.

Malawi is a country with a 20% infection rate, as I’ve mentioned. Of your five best friends, one of them would be dying.

I feel like words do not adequately express the horror of the situation. Language is completely insufficient.

People lose friends, parents lose children, and children lose parents. So many children lose parents. It’s suggested that the last epidemic that left orphans in such numbers was the Black Death, and we have little data about how cultures dealt with the loss of parents in such numbers. Children are intensely indebted to their parents for support structure both physical and emotion, and reliant on their parents for teaching about everything from “how do deal with puberty” to “how to be a good person.” Instead, children of parents with AIDS have to be caregivers and wage earners, and then they have to bury their parents. They have to bury their parents when they are 14, or 12, or 8.

Again, words fail me.

And then after the children are left alone, what do they do? In some situations they are able to rely on their grandparents for support, but other times they are left alone. This happens frequently enough not to be a community-rocking tragedy, after all. So you have situations in which grandparents in their 70s and 80s are raising the children of their children. Sometimes they raise the children of several of their children. You also have situations in which children are the heads of their own households, again at age 14, or 12, or 8.

The emotional toll this takes on a country is bad enough, (horrifying enough), but there is also an economic toll. AIDS has been ravaging Africa long enough that two generations of wage-earners are decimated. Industry fails– and importantly– farming suffers. When your food is still chiefly grown in your back yard, not having people who can go out and deal with it means you starve.

So this is the magnitude of the issue Africa is dealing with.


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