July 26, 2012
(USA TODAY) -- Like many of the thousands of other doctors attending this week's international AIDS conference here, physician Ngindu Zola is a man of science.
Yet Zola knows that science is not enough to save his patients.
Zola treats people with HIV and AIDS in the Democratic Republic of the Congo, where civil war has raged for more than a decade. Some 260,000 people have fled their homes because of new rebel attacks this year.
So Zola finds it difficult to share the general excitement resonating from the speakers' podiums here, as top scientists and diplomats pronounce the beginning of the end of the AIDS epidemic.
"How are we going to eliminate the disease, when in the last 10 years we've been dealing with wars that the rest of the world has completely forgotten about?" asks Zola, who works for Cordaid, the Catholic Organization for Relief and Development Aid.
"We have the opposite of hope," Zola says. "In the United States, you'll reach the end of the disease, but not in Congo, for reasons that have nothing to do with science or medicine."
In the Global Village, a basement-level exhibit hall at the Walter E. Washington Convention Center, many community organizers seem only vaguely aware of the optimistic buzz in the halls above.
Kenya's Daniel Mukundi says he's glad that people in his country are getting effective anti-AIDS drugs. Referring to American financial aid, he says, "We are very, very happy about what you guys are doing here."
But when talking about his work at a charity for women affected by HIV, Mukundi quickly turns to practical matters: transportation, jobs, schools, microloans.
Women in the countryside must make long trips to get medical care, sometimes traveling hundreds of miles by bus, Mukundi says. Children with HIV are often shunned by other children, and their families are ostracized. "Removing the stigma of AIDS is a challenge," Mukundi says.
For many ground-level troops in the fight against AIDS, surviving is a day-to-day struggle.
Mumderanji Mwamlima of Malawi, an AIDS caregiver, says her work never ends: fetching firewood, carrying water, cleaning the house.
In the eyes of her government, Mwamlima says, she isn't officially a worker at all. She's just a compassionate person who has cared for orphans and others affected by AIDS. "People see you taking care of someone and think you are a doctor, and they bring a patient to you," says Mwamlima, explaining how families sometimes abandon their own kin on others' doorsteps, both because of an inability to care for the sick and an inability to overcome the stigma and shame of having an AIDS-infected relative.
Mwamlima, unwilling to turn the sick away, found herself running a sort of unofficial hospice. "A family will bring a sick person to you because they are afraid they will infect them," she says. "We have to bathe them, feed them, take them to the hospital."
Mwamlima and other AIDS caregivers in Malawi have been campaigning for official government recognition of their work, hoping to receive financial support, such as transportation vouchers to defray the costs of taking patients to the doctor.
"That is why we are crying," Mwamlima says.
Others, however, say they owe their lives to the AIDS therapies developed over the past 16 years -- as well as to the generous relief programs, run by the USA and other nations, that have delivered those drugs to people in need.
Sam Mugisha of Uganda weighed just 88 pounds when he was diagnosed with AIDS in 2004.
"I was like a heavy goat," jokes Mugisha, now 147 pounds, whose disease has been brought into remission with antiretroviral drugs.
Those drugs have given Mugisha a second chance at life.
They may also have helped to protect his wife and two children, none of whom has the virus.
A landmark study last year showed that HIV patients whose disease is very well controlled, with virus levels at the undetectable level, are rendered virtually non-contagious. The finding has led to nearly universal enthusiasm at the AIDS conference for "treatment as prevention."
That strategy, Mugisha says, "is something very great. I'm optimistic."
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