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AIDS: A GLOBAL ASSESSMENT : AFRICA : Toll Threatens Hard-Earned Gains in Nations With Meager Resources

August 09, 1987|SCOTT KRAFT | Times Staff Writer

KYOTERA, Uganda — Margaret Nandawula's father, a once-prosperous trader, sold the family home last year to pay a few doctors and, when they did not help, a few witch doctors, who could not help either.

Then he was buried amid the banana trees behind her grandparents' house here, gone before 35. This year, Margaret's mother was buried next to him.

Margaret, 13, and her five brothers and sisters were orphaned by the disease that people here call "slim"--acquired immune deficiency syndrome.

The AIDS epidemic in this region of southern Uganda is among the gravest in the world. While dozens of AIDS orphans peddle ground nuts on the streets, adults go to funeral after funeral. Seven AIDS victims were buried in one recent work week in Kyotera, population 30,000.

"A lot of people, they are dying," Margaret said not long ago, sitting cross-legged on the dirt floor of the grandparents' house, her 9-month-old sister on her lap.

Her mother called the infant Birabwa--"what will come is God's will." Birabwa, born after her parents had developed the disease, has a 50-50 chance of dying of AIDS before she is old enough for first grade.

Orphans and infants are a major, frightening part of Africa's AIDS epidemic. The disease here spreads primarily by heterosexual contact, and roughly equal numbers of men and women--often mothers and fathers--are affected.

Large numbers of women with AIDS, in countries with the world's highest birthrates, mean thousands of newborn children in jeopardy. A recent study predicted that 6,000 infants will die of AIDS this year in Zambia alone; fewer than 400 babies have died of AIDS in the United States since the disease was identified.

The AIDS epidemic in some urban pockets of Africa appears to be more severe than anywhere else in the world. But recent evidence indicates rural areas have much lower rates, and large sections of the continent, including most of West Africa, appear to have fewer cases of AIDS than the United States or Europe.

No one knows how many people will die of AIDS in Africa in the coming decade. Most of the deaths are expected to be concentrated in a thick band of south-central Africa stretching the width of the continent from western Zaire to eastern Tanzania.

In half a dozen capitals in that region, including Kinshasha, Kampala, Lusaka and Kigali, as much as a fifth of the sexually active population, both men and women, is carrying the virus that causes AIDS, according to recent studies. That level of infection substantially surpasses New York and San Francisco, the hardest-hit cities in the United States.

"Most Americans can still, with a fair degree of justification, comfort themselves with the argument that AIDS isn't going to hit them," said Jon Tinker, president of the London-based Panos Institute, which studies Third World problems. "That isn't the case in Africa. Every sexually active adult is vulnerable."

Thus far, however, AIDS has infected large numbers of Africa's urban professionals, in whom developing countries have invested much of their meager resources for education and training. A massive death toll among those future government and business leaders, some African experts argue, could threaten the political and economic well-being of several nations.

In this region of southern Uganda, for example, a doctor and a high-level government official have died in recent months. A small U.S. embassy in one Central Africa capital has lost several African employees to AIDS.

When AIDS first appeared in Kyotera seven years ago, it struck the wealthiest men in town--those who thrived in this region by sailing the glassy waters of Lake Victoria to trade everything from paraffin to radios in nearby Tanzania.

Suddenly they were wasting away in alarming numbers, and no doctor seemed capable of stopping it.

Villagers figured the trouble was not medical so much as spiritual. Perhaps, people said, the traders had the bad sense to leave unpaid bills with the bewitching tribes on islands in the lake. It had to be a curse.

But then the traders' wives began dying.

Badru Rashid, chairman of the Revolutionary Committee, or town council, remembers seeing one of his friends begin to lose weight in 1980.

"I told him he was slimming up like those new slim-cut shirts," Rashid recalled. A few months later the friend was dead. By then, everyone was calling it "slim disease."

Health officials think the traders probably picked up the disease from some of the thousands of prostitutes who cater to the truckers and businessmen traveling long distances on the roads of Africa, away for weeks at a time.

AIDS has killed about 3,000 of the 300,000 residents of this district, and they now die at the rate of one a day, officials estimate.

No one knows for sure the extent of AIDS here, however. Health records are poorly kept, if they are kept at all. Even if the town had facilities to test for AIDS, which it does not, few could afford the $20 fee and fewer would want to know the results.

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