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Fighting AIDS in Tanzania
By
Sonia Smith, Slate
June 9, 2011
Tanzania
Maria Paulo sat
on a bench in the middle of the playground outside the children's
tuberculosis ward at the Kibong'oto National TB Hospital, adjusting her
red shúkà wrap and bobbing her 3-year-old grandson, Musa,
on her knee. She had brought Musa to the TB hospital from their Maasai
village, after both traditional medicine and a two-month stint in the
Monduli District Hospital had failed to cure him. Musa's advanced TB,
which Maria said he probably contracted from his father, was diagnosed
with an X-ray. "His lungs were black," she said. Treating the Maasai
has been a particular challenge, since many believe that AIDS, TB, and
other ailments are "not for the Maasai," and so they do not seek
treatment until they are very sick, if ever, doctors told me.
The nomadic
lifestyle of the Maasai and their trust in traditional medicine hinder
attempts to provide them with modern medical treatment. "The situation
at the hospital is not like home, but Musa is getting better, so I
forget about all my other problems," Maria told me. At home, Maria
lives in a polygamist household, but at the hospital she is her
grandson's sole caretaker, sleeping on a bed next to him in the
pediatric TB ward. The room was airy and bright, with knotted mosquito
nets dangling over the bed. Kibong'oto is surprisingly cheery: The
lush, well-manicured grounds are bisected by swept red paths and dotted
with tidy cinder-block buildings with green metal roofs. The hospital,
which has 340 beds, opened as a tuberculosis sanitarium in 1926, when
it was thought that the fresh air at the base of Mount Kilimanjaro
would heal the patients, who came to the hospital from around British
East Africa. "There were no TB meds then," said Dr. Liberate John, the
hospital's administrator. "They thought that sunlight would kill the
bacilla."
Today, the TB epidemic looks very different. HIV and tuberculosis often
march in tandem, with the former fueling the spread of the latter. In
1983, before HIV really took hold in Tanzania, 11,750 people were
diagnosed with TB, according to government statistics. Today there are
64,267 diagnosed cases. Together, HIV and TB kill around 91,000 people
in Tanzania each year, according to UNAIDS and WHO statistics. In
Tanzania, 30 percent of AIDS-related deaths are caused by TB, and some
20,000 TB patients are HIV-positive.
A two-hour drive away from Kibong'oto on the Maasai Steppe, the
Mererani Health Center serves the mining town of Mererani, which has a
much higher HIV rate than the surrounding area. Anywhere from 50 to 100
patients who have both HIV and TB visit the health center every day,
center director Reginald Msaki said. The clinic opened in 2007 and
serves as the main health facility for the town of 10,000 people. While
most of Mererani's Tanzanite miners come from around Tanzania and East
Africa, some are drawn from the local Maasai community. "Some Maasai
contract HIV in town and bring it back home, where it spreads among the
community like wildfire," Msaki said, blaming polygamy and the Maasai
belief that HIV is for the non-Maasai. "The majority believe they can't
contract the disease, but those who have been counseled have changed
their minds." Mika Parasoi, a Maasai gem dealer interviewed on the dirt
road outside the clinic, said no one in his family has ever been tested
for HIV. "If someone was HIV-positive, we would prefer to use
traditional medicine," he said.
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