While every attempt has been made to ensure this transcript or summary is accurate, Special Assignment or its agents cannot be held liable for any claims arising out of inaccuracies caused by human error or electronic fault. This transcript was typed from a transcription recording unit and not from an original script, so due to the possibility of mishearing and the difficulty, in some cases, of identifying individual speakers, errors cannot be ruled out.

 

FENLEY: - We join award winning journalist Sorious Samura in Zambia where he is helping out at a small rural hospital. His mission is to find out why AIDS is rigging such havoc in Africa.

 

UPS: - SORIOUS SAMURA - This is Zambia. AIDS kills over 240 people here per day and most Zambians can’t expect to live past their mid-thirties. I’ve come to the town of Mongu, in the western province, to live and work for one month in a hospital at the frontline of the AIDS epidemic. I want to find out why AIDS is destroying this continent and what responsibility we Africans have in stopping this disease.

 

UPS: - SORIOUS SAMURA - Well this is my first morning and I am reporting for duty. Where are the other people, the other members of staff?

 

UPS: - NURSE - They are still coming.

 

UPS: - SORIOUS SAMURA - Day one and I’m sent to the Male Ward.

 

UPS: - PATIENT - Ok thank you

 

UPS: - SORIOUS SAMURA - You are welcome

 

UPS: - SORIOUS SAMURA - I’m assisting Nurse Betty Mubita who’s been working here for nine months. She tells me her ward is often overrun with patients.

 

UPS: - SORIOUS SAMURA - What’s the normal capacity of beds?

 

UPS - BETTY - The normal capacity of beds is supposed to be, because here its twenty beds, there its eighteen beds so its, there are thirty eight beds.

 

UPS: - SORIOUS SAMURA - So its thirty eight and you get fifty eight people in one go.

 

UPS: -BETTY - Yes, yes

 

UPS: - SORIOUS SAMURA - So the rest will just lie on the floor?

 

UPS: - BETTY - On the floor and even the nursing care sometimes you are just alone on duty

 

UPS: - SORIOUS SAMURA - Most of these patients are in the last stages of AIDS and need help with the most basic tasks. Some lucky patients have relatives who are allowed to stick around to help.

 

UPS: - SORIOUS SAMURA - So is it just you here?

 

UPS: - SORIOUS SAMURA - For the staff the conditions are just as tough.  

 

 

UPS: - SORIOUS SAMURA - So are you coming to wash this now?

 

UPS: - CLEANER - Yes

 

UPS: - SORIOUS SAMURA - There are no protective masks; the water might just be splashing into her, mouth, eyes, face. Its tough job for you. I mean, even the smell, this place stinks. It feels like you just don’t want to be inside here.

 

UPS: - SORIOUS SAMURA - Because of the stigma surrounding AIDS many patients refuse to accept they are infected. Most decline the hospitals’ free HIV test. They’re admitted for other diseases like Tuberculoses. So the nurses here don’t know for sure who’s HIV positive and who isn’t.

 

UPS: - SORIOUS SAMURA - So doctor tell me how many cases of HIV/AIDS patients do you have here?

 

UPS: - DR ANDREW SILUMESII; ACTING EXECUTIVE DIRECTOR OF LEWANIKA GENERAL - Well over fifty percent of our patients have underlying HIV/AIDS

 

UPS: - SORIOUS SAMURA - Really. that big?

 

UPS: - DR ANDREW SILUMESII; ACTING EXECUTIVE DIRECTOR OF LEWANIKA GENERAL - and in fact it should be higher than that; maybe we are talking in the range of sixty to seventy percent. We really are at more or less at epidemic proportions of the infection.

 

UPS: - SORIOUS SAMURA - Has this virus in anyway affected your staff as well?

 

 UPS: - DR ANDREW SILUMESII; ACTING EXECUTIVE DIRECTOR OF LEWANIKA GENERAL - It hasn’t spared anyone. We have lost doctors, we’ve lost policeman, we’ve lost teachers it cuts across all lines.

 

UPS: - SORIOUS SAMURA - In the afternoon I meet Kenny, who’s been in and out of hospital for the past six months. Talking to him, I start to get a sense of why AIDS has spread so viciously in my continent.

 

UPS: - SORIOUS SAMURA - How may children have you got?

 

UPS: - KENNY - I’ve got five.

 

UPS: - SORIOUS SAMURA - Did you get them with this your wife, the same woman?

 

UPS: - KENNY - Non, no, no, from different mothers

 

UPS: - SORIOUS SAMURA - From different mothers? How many mothers?

 

UPS: - KENNY - Three mothers

 

UPS: - SORIOUS SAMURA -: Kenny, it looks like you have been enjoying yourself

 

UPS: - KENNY - Yeah sure I have been doing the job.

 

UPS: - SORIOUS SAMURA - Were you practising safe sex or you never considered it.

 

UPS: - KENNY - On that one sometimes it would be safe sex sometimes you know when you are just in a hurry you just do it.

 

UPS: - SORIOUS SAMURA - Let’s be honest I am an African man you are an African man here in Zambia I swear I seen in my country and most Africa people tell you hey I want the real thing. I want flesh to flesh I do not want to sleep with a plastic.

 

UPS: - KENNY - You know us blacks or Africans, for sure we always know, would want to know, to taste something really like you know skin to skin. You know its like you would like to eat a banana, and then you don’t peal it up you just want to swallow everything you know? I don’t think it will taste well.

 

UPS: - SORIOUS SAMURA - Kenny’s wife Maureen looks after him day and night. She too is HIV positive. Kenny’s attitude to sex isn’t unusual his father had twenty three children by 8 different mothers.

 

UPS: - SORIOUS SAMURA - Here at Lewanika hospital the consequences of this sexual behaviour are starting to become painfully apparent.

 

AD BREAK 1

 

 

UPS: - SORIOUS SAMURA - It’s my second week and I am moving in with the Kasanga family to find out how they cope with the disease. The Kasanga’s are a large family, headed by fifty six year old Felix and forty six year old Irene. Both have AIDS. Felix, suffers from TB, a heart condition and can hardly walk. Irene has to provide for her husband, four children and six grandchildren. It’s a family in crisis.

 

UPS: - IRENE - I’m worried. Considering now the situation which is happening if Felix will just be left alone and since as you notice he doesn’t move I have to be there

 

UPS: - SORIOUS SAMURA - Who will look after you if you also go down now?

 

UPS: - IRENE - That’s why last night Felix was weeping that if I become very sick then he will die or I don’t know.   Now he was the one who was advising me to be strong and make sure that I also get my medication.

 

UPS: - SORIOUS SAMURA - Irene accompanies me on my way to work. She’s going to collect Felix’s TB drugs.  I was shocked to find out Irene hasn’t revealed her HIV positive status to her family. 

 

UPS: - IRENE - I haven’t told any of my relatives, because of the stigma they might neglect us as I have learnt from some of the families. Because some they say, when I am tested if I am told that I am positive I can just hang myself or poison myself so that I die

 

UPS: - SORIOUS SAMURA - In traditional African families everyone depends on each other but those with AIDS can find themselves outcast. This means they have even less chance of survival. No wonder Irene hasn’t told her family yet. Back in the mortuary I find that even in death the stigma of AIDS remains. The official death certificates don’t even acknowledge it.

 

UPS: - SORIOUS SAMURA - These are some of the records of bodies brought in here. Its interesting to see that under cause of death for most of them it’s the same thing that is written there unknown, unknown, unknown, unknown. I mean its interesting it clearly shows that most people are worried here about the stigma. So they don’t even bother to allow the real cause of death to be written on the death certificates or in the records. Unknown, Unknown, there’s one different one, unknown, unknown. Its interesting.

 

UPS: - SORIOUS SAMURA - That evening back at Felix and Irene’s house, I’m reminded of how I grew up in Sierra Leone. Like these children, I lived in one room with my parents, so I was aware of and experimented with sex from a very early age. The thing that seems odd now is that my parents never talked to me about sex. From what Irene tells me, nothing has changed. 

 

UPS: - IRENE - Taboo is a big problem. Even me I have a boy; especially these days when I experience this I do fail to explain everything to him or to tell him, no, use a condom, I fail up till now

 

UPS: - SORIOUS SAMURA -: Why?

 

UPS: - IRENE - I get shy.

 

UPS: - SORIOUS SAMURA - It’s Monday morning, my third week and today I am working on the children’s ward. As a parent myself I have been dreading this job. I‘ve been told that many of the children here are HIV Positive. Most of these kids were exposed to the virus during childbirth or through breast feeding. My next job is to take what I assumed to be a mother and her son to be examined by Doctor Silumesii.  The boy is Swana; I thought he was about seven or eight years old but I’m way off the mark.

 

UPS: - DR ANDREW SILUMESII; ACTING EXECUTIVE DIRECTOR OF LEWANIKA GENERAL - We have a fourteen year old boy, but he looks much much smaller for his age. He is the last born in the family of three and unfortunately both of his parents passed away apparently due to long illness which I would presume most likely was immunosuppression or AIDS. He’s a candidate for ARV’s.

 

UPS: - SORIOUS SAMURA - The girl who has come with him is not his mother, it’s his sixteen year old sister Bitonda.  I can hardly believe she is only two years older than Swana.  He’s in the latter stages of AIDS.  

 

UPS:- NURSE - He is complaining of sores in the head…that at times produce maggots

 

UPS: - SORIOUS SAMURA - Jesus Christ

 

UPS: - DOCTOR -  What is it?

 

UPS: - NURSE: Seventeen

 

UPS: - DOCTOR - Seventeen?

 

UPS: - NURSE - I took the wait last week and it was twenty two

 

UPS: - SORIOUS SAMURA - My God he’s lost five, Jesus.

 

UPS: - DOCTOR - So I am going to send him to Childrens’ Ward.

 

UPS: - NURSE - She saying she has two young children at home so if keep her in the ward no one will take care of the two children

 

UPS: DOCTOR - That’s another problem so she has two kids of her own?

 

UPS: - NURSE - The sister died and left her with the other kid and she has her own

 

UPS: - DOCTOR -  She has the sisters’ kid too. Her parents too died. 

 

UPS: - SORIOUS SAMURA - She said nobody helps there’s no relatives nothing. I mean I just don’t know how she can do this by herself.

 

UPS: - SORIOUS SAMURA - With both parents dead Bitonda is struggling to raise three children alone. She and Swana are just two of over 630,000 AIDS orphans in Zambia. There are over eleven million orphaned by AIDS across Africa.

 

AD BREAK 2

 

UPS: - SORIOUS SAMURA - I’ve been working at Lewanika General Hospital for three weeks, finding out what it means to be living with AIDS. This morning I’m keen to get back to the children’s ward to see if Swana, the little boy I left yesterday, made it through the night.  He appears to be much better. He’s had a blood transfusion. The doctors want to keep him in but his sister, Bitonda, needs to go home to get to her kids.

 

UPS: - BITONDA - I’m going home

 

UPS: - SWANA - Yes

 

UPS: - BITONDA - I’ll come tomorrow

 

UPS: - SWANA – Yes

 

UPS: - BITONDA - I’ll find you. I’m going to see your sick nephew.

 

UPS: - SWANA - Yes

 

UPS: - BITONDA - so don’t worry

 

UPS: - SWANA - yes

 

UPS: - SORIOUS SAMURA - After her parents died, leaving Bitonda in charge of the family, she had a child. She was only twelve at the time but she told me she knew about safe sex.

 

UPS: - SORIOUS SAMURA - Why didn’t you use a condom then?

 

UPS: - BITONDA - I wanted to become pregnant so I could have children to help me because I have no relatives.

 

UPS: - SORIOUS SAMURA - The church has an influential role to play in the prevention of AIDS in Africa. Bitonda’s church is lead by a blind Pastor who runs a home for 100 AIDS orphans. As these children’s parents died of the disease its likely most of them are HIV positive too.

 

UPS: - PASTOR - I wish to greet you in the name of Jesus, Amen

 

UPS: - PEOPLE - Amen

 

UPS: - SORIOUS SAMURA - The Pastor stresses abstinence. But his stance on contraception seems dangerously naive.

 

UPS: - PASTOR - Me I don’t support the issue of condoms. Because that has been made by man. Man shall not protect this. And so it is only God. So the only protection measure according to the bible is to stick to Jesus. Let us pray.

 

UPS: - SORIOUS SAMURA - I cannot believe that in this continent, in this day and age, in the middle of this epidemic, anyone would advise merely abstinence as a credible solution.

 

UPS: - SORIOUS SAMURA - That night, back in Mongu, abstinence is definitely not on the agenda.  

 

UPS: - SORIOUS SAMURA - Well this is the local bar that seems to keep us up all night. I mean right across the road where we live we hear the music every night and I am now coming  to check it out myself because this is where most of the young adults seem to come to drown their sorrow.

 

UPS: - SORIOUS SAMURA - These people seem intent on getting completely pissed. It feels like the whole village is here. Even the little girls are imitating the suggestive dancing of their older sisters. I wanted to find out about the sexual attitudes around here. I managed to corner a couple of young guys.

 

UPS: - JOSHUA - Myself when I finish drinking I just go for any girl and have sex with her. Direct. I don’t use a condom. Because I enjoy because I used when I was young. With direct, not even putting a condom, I don’t worry.

 

UPS: - SORIOUS SAMURA - So you do flesh to flesh

 

UPS: - JOSHUA - I do Flesh to flesh that’s what I believe

 

UPS: - SORIOUS SAMURA - Even if you do why not use a condom?

 

UPS: - JOSHUA - Yeah because I am HIV positive. There is no reason of using a condom once I am HIV. I am dying.

 

UPS: - SORIOUS SAMURA - So you’d prefer to take more people with you.

 

UPS: - JOSHUA - That’s the thing

 

UPS: - SORIOUS SAMURA -: Don’t you have conscience? Can’t you think that you’re destroying the world? You are sinking Africa. You are killing more and more innocent people and those people you sleep with without condom, they go and sleep with more and more people. Don’t you have conscience, are you crazy?

 

UPS: - SORIOUS SAMURA - Have you got sisters?

 

UPS: - JOSHUA - I have

 

UPS: - SORIOUS SAMURA - you have sisters?

 

UPS: - JOSHUA - me I’m having, two sisters.

 

UPS: - SORIOUS SAMURA -: What if other men knowing that they What if other men knowing that they are in your situation come and sleep with your sisters without protection. How would you feel?

 

UPS: - JOSHUA - If he is HIV positive,

 

UPS: - SORIOUS SAMURA - and he didn’t tell your sister, and sleep with her, how would you feel?

 

UPS: - JOSHUA - Nothing

 

UPS: - SORIOUS SAMURA - This is what it really means to be living with AIDS in Africa. Stripped of all respect for yourself and others. Where all hope is destroyed. 

 

UPS: - SORIOUS SAMURA - Back at the Kasangas’ and Irene’s health is deteriorating.  This family needs her to stay well as she is the sole breadwinner for a family of eleven.

 

UPS: - IRENE - I am not well today

 

UPS: - FELIX - A headache?

 

UPS: - IRENE - I have body pains and I feel sick. I have no appetite

 

 

UPS: - SORIOUS SAMURA - Felix and Irene have heard on the radio about the new scheme which could mean free Anti Retroviral drugs for 5 years. It’s on a first come first served basis but only 1500 people will be lucky. The family can only afford drugs for one. If Irene doesn’t get  ARV’s soon she will certainly die.

 

UPS: - DOCTOR - You qualify to start the ARV’s 

 

UPS: - SORIOUS SAMURA - So will these be free or will Felix continue paying

 

UPS: - DOCTOR - Even the husband’s are going to be free

 

UPS: - SORIOUS SAMURA - Wow 

 

UPS: - SORIOUS SAMURA - It’s good news.  Felix and Irene have been unbelievably lucky. In Zambia over a million people have HIV/AIDS but only 23,000 are getting the drugs. Felix and Irene have finally decided to tell their two teenage daughters, N’yama and Bertha, that they have AIDS. 

 

UPS: - IRENE-  I am sick. I am HIV, your father is also HIV. So whatever happens we have to face it together, the 4 of us.

 

UPS: - SORIOUS SAMURA - The news prompts N’yama and Bertha to be tested for HIV.

 

UPS: - NURSE - Now I am going to start discussing your results. Bertha, we have checked for the presence of HIV. We have discovered HIV is not present. Now, N’yama we have checked your blood. You have HIV

 

UPS: - SORIOUS SAMURA - It’s a cruel blow for Irene and her family, who already have so much to cope with. After my shift at the hospital I get back to the village to find Felix has got worse.  He’s taken his ARV’s but he can’t keep them down. If Felix cannot eat, the drugs are less effective. To stay healthy he needs proper nutrition along with the ARV’s  Throughout the night Felix suffers terrible bouts of diarrhoea. The pressure on Irene is just too much.

 

UPS: - IRENE - The problem is I’m very worried with the diarrhoea, because he has lost weight. Me, I’ll eat tomorrow.

 

UPS: - SORIOUS SAMURA - You’ll eat tomorrow? You have to stay strong, if he doesn’t eat you should eat, at least you can look after him. If you don’t eat because he doesn’t eat what will happen if you too fall down. If you become very very weak and very ill, who will look after who?

 

UPS: - SORIOUS SAMURA - I’m sorry.

 

UPS: - SORIOUS SAMURA - It’s my last day at the hospital and it’s it time to say goodbye to Bitonda and Swana.

 

UPS: - SORIOUS SAMURA -: How are you doing this morning? Hm, ok? And this man eating…

 

UPS: - SORIOUS SAMURA - Swana has made a pretty good recovery. It’s amazing the effect the blood transfusion and the ARV drugs have had on him. They both look much happier. This is the first time I have seen these two smiling and joking like children. Swana has been discharged and they will be going home today.

 

 

UPS: - SORIOUS SAMURA - I can’t say I’m not relieved to be leaving the pain and suffering of Lewanika hospital.  In the past twenty eight days over eighty people have died here, many of AIDS. It seems to me AIDS has found its perfect victims in the poverty, stigma, and sexual taboos of African culture. But my real anger is reserved for African men, who have multiple sexual partners at the same time, without using protection. Their behaviour is one of the main reasons why AIDS is sinking this continent.

 

UPS: - SORIOUS SAMURA - After four weeks working in Mongu’s hospital. It’s obvious a lot of things need to be improved. But I know that even the best equipped hospital couldn’t stop the epidemic here. It’s up to us Africans on the frontline to win the war against this horrible disease

 

 

Felix Kasanga died one week later.  He was fifty six years old.