Project: The African AIDS Pandemic

Doctor: Medication allows people to 'enter society again'

by John Carr

The HIV/AIDS rate in Botswana is nearly 40 percent.

At the turn of the century, the once booming economy faced economic disaster in the next decade. The crisis threatened the economic peace and security of the stable nation. With intervention Botswana fought back in a race against time.

The best insight to the HIV/AIDS issue and the future of the nation came from a long discussion I had with a physician, Doctor Raili, in central Botswana. This esteemed physician received his undergraduate and doctorate from well known schools in Europe. He discussed his practice and the outlook for Africa. In his rustic office hung posters of various diseases including a HIV/AIDS sign. An old fan rattled from the ceiling.

The most common problem he sees is the flu and neck and back pain. “I very rarely see malaria. There is some around Maun and Kasane. With the rain some cases will come,” said Dr. Raili. “Tuberculosis was coming down when I arrived in Botswana in '93, but in 1996 it sharply increased for a few years and gradually increased every year since,” he said. But HIV stays in the forefront.

“HIV is the biggest problem here and all over Africa,” he continued. “It is not getting better. The government says it is and maybe on paper it is but it is not here in the country.”

I told him I had read that the government is trying very hard to stop it and he laughed. “I do not see it here, only the medicine. It is a big hurt on the economy. The work absentee is very high. People get sick and do not show up.”

Although he said the rates were not going down, he noticed the economy had been saved. “In 1999 when the antiretroviral drugs were introduced it was like a miracle. People here who could not get out of a stretcher began walking around and having jobs,” he said. “It is very nice to talk to someone who says I have an appointment at a specific time,” as he pointed at his watch. “I have studied the numbers and it is across the board. If there was not treatment there would be no teachers at school, no doctors, no gas station clerks…. The medication has allowed these people to enter society again.”

Dr. Raili said seeking treatment is sometimes difficult. “There is much stigma with the medicine. The stigma has lessened as people with HIV are re-entering society, but still very high.”

He has a very grim outlook for the disease. “You would think the youngsters would stop spreading it. They are not afraid of it. Most of them contract it after leaving home. They are out without their mother or father and go wild. It is not until they settle down they discover the disease. It is human nature. It will never stop,” he said.

“There is very little family tie in Botswana. A man will be with a woman and she will be impregnated and he will move on. Many boys on campus I see just laugh about having multiple partners,” said Dr. Raili. “Most men have a large house and a small house. The large house is his wife and family, and his small house is his other girl. You can ask someone where is your small house?” Dr. Raili chuckled “And they will say which one?”

Dr. Raili explained Botswana is not alone. Even in his native country of Kenya, HIV/AIDS is devastating. “It’s very bad. Even in Kenya, when a man dies his brother or cousin takes on his wife,” he said. “You can see the HIV trend. Ask any old woman. The 60 and 70 year old woman know who has HIV from the people who have died. You will see one man die and then another. She can point and say she has HIV.”

While some argue that doctors are pessimistic people, Dr. Raili offered some insight to the future. One nurse said she wished these large pharmaceutical companies would quit spending so much money on drugs and find a cure for the HIV/AIDS. A cure is without doubt the best solution.