The silent killer

World AIDS day passed quietly this past Monday, much as the pandemic does everyday across the world. For Minnesotans and young students, it’s almost inconceivable to understand that approximately 6,000 people — 8.5 percent of the University of Minnesota student population — die every 24 hours from AIDS.

For most of us, AIDS has no familiar face.

These numbers too held little significance for me two years ago.

The only HIV-positive person I knew was a family friend who lived the past 30 years with the disease without substantial medical complications, thanks to his daily fitness routine and religious consumption of antiretroviral drugs — the medication that curbs the duplication of HIV in one’s body.

But that was before I moved to a rural Kenyan village that had an almost incomprehensible infection rate of 30 to 40 percent. The national average is roughly 7.8 percent.

Since then, AIDS slowly began to invoke a face — of 10-year-old heads of households struggling to feed their younger siblings, of nurses and doctors unable to provide basic treatment to a dying community and of mothers forced to choose between buying expensive condoms or feeding their family.

This is what HIV/AIDS now looks like to me.

There are the thousands of testing centers scattered across the Kenyan highlands, with discrete indigo signs advertising low-cost counseling and advice about safe sex.

The centers always have snaking lines that wind out their doors and onto wide open-air waiting areas where women — mostly young mothers with babies slung across their back in rainbow cloth — patiently wait their turn.

Inside the blue room they will be read their future — positive or negative — death or life.

There are a Western pastor and his roadies setting up sound equipment and gluing posters to hospital buildings advertising a weeklong healing session. The pastor spits out psalms in his British twang under the setting sun as his partner translates to Kiswahili: “He can cure AIDS! But you must repent first!”

There is me, and I am laying mud bricks in the searing African sun with my coworker, Robert. His wife, who ushers us into her one-room café every afternoon for cool water and sugar bread, is too sick to rise from bed today.

She’s a regal woman, with an unparalleled resilience toward life and the love of my own mother.

“Oh Kate, it’s just malaria,” Robert says, shrugging off my concern.

“Have you two been tested for HIV? You know, just to make sure?”

“What’s the point? We couldn't pay for treatment.” he responds. “I'd rather die than know.”

There is Sweany, Robert’s baby girl, who visits me after school every afternoon, and we share sweets under the church’s tin roof. I wonder what her future will hold.

There is the Saturday funeral commencing for a minister’s wife who died of Malaria two days before — surprisingly quickly, everyone whispers.

The silence between their words implies it was something more than a mosquito bite, but they cannot say what.

The family buries their family, dirt dropping on a wooden coffin as we wonder who will be chosen next to meet Bwana.

And there are the carpenters, the only ones profiting from this pandemic (besides the pharmaceutical companies) who build endless coffins, satin lining and pillow for a few hundred shillings more.

But perhaps more interesting are the things I didn’t see in Kenya — the silence between.

There are no hospital beds of AIDS patients waiting to die, with shriveled, wilting skin like the crusts of raisins.

Instead, there are grocery store workers, bus drivers and mechanics who yesterday were present and today are gone. Many die without even being tested.

There are no antiretroviral drugs that President Kibaki of Kenya said would be distributed free of charge to the 2 million HIV-positive citizens in the country seven years ago. Instead, hospital cabinets remain empty and citizens still vainly wait for their lifesaving cocktails.

There are no pamphlets or billboards to teach rural citizens about safe sex. There are no condoms and not enough money for most in our area to buy them if there were.

These are the astonishing ways that HIV/AIDS affects a country like Kenya: silently and quickly, with little outside intervention or much shame.

Though the world has acted far too slowly to curb this wasting disease, some African countries are finding success in prevention campaigns, universal testing and distribution of antiretroviral drugs, which are desperately needed in rural areas.

But until both international and domestic communities are ready to commit to fighting HIV/AIDS on a long-term scale, the disease will continue to kill thousands every week.

Approximately 18,000 people died since I began writing this column three days ago.

Kathryn Nelson welcomes comments at kgnelson@mndaily.com.