Still an outrage

Zimbabwe Family Mourns AIDS Death
Cousin’s illness gave the author an insight into the desperate state of Zimbabwe’s healthcare system.

By J.J. Zhou in Harare (Africa Reports)

He called me on my mobile two days after the police had flattened his home in the Harare suburb of Mbare during President Robert Mugabe's now notorious Operation Murambatsvina [Drive Out The Rubbish].

He had nowhere to go, he said, and had spent the previous two wintry nights on the side of the road with his four-year old son. His wife had deserted him earlier when the ravages of Zimbabwe's urban poverty became worse than unbearable.

I told him he could come to my place. He was my first cousin and in our Shona society that meant he was family, and there was no way I could refuse to help him in his hour of need.

A four square metre wooden shack had been his home for a long time, so its destruction by the government was deeply traumatic - as it was for at least 700,000 other Zimbabweans made homeless by Drive Out The Rubbish. He had been orphaned when he was a schoolboy back in the mid-Eighties and did not have a rural home to go back to, which is what the ruling ZANU PF government suggested to those whose homes it wrecked.

Unfortunately, I did not have much space so I could only offer him the use of my garage, which had a small cooking stove and a door with access to our house and the bathroom. Down the phone, I sensed his relief. The garage was a much more comfortable and spacious dwelling than any he had lived in since he lost his full-time job 15 years earlier.

Once he settled in with his son, he tried his best to live a normal life. He would cycle every morning to the market where he touted for odd jobs. Initially, he took his son with him, but that became impractical. So we said our maid would look after the boy, a frolicsome, cheerful child who enjoyed playing in the street with the other kids.

Then my cousin's life changed dramatically. One morning he woke up with half his face covered in a rash of ugly blisters and purple splodges. After my doctor had conducted tests came the shocking news: my cousin had herpes but was also HIV-positive. The sores were symptoms of Karposi’s sarcoma, a skin cancer that is one of the most insidious opportunistic infections associated with the HIV virus.

We were all completely shattered. To make things worse, my cousin was soon completely immobilised as immense pain developed in his spine. He now spent his days lying on his back, and could not sit up at all. His meagre market earnings were no more. This badly dented his pride since he wanted to work and contribute to his upkeep and that of his son, no matter how menial the task he found at the market.

More and more frequently, he called me in the middle of the night to take him to the toilet because he had severe diarrhoea. He lost his appetite and went for days without eating.

The hospital did a CD4 cell count, an indicator of the strength of an individual's immune system which goes down as HIV progresses. His was 83, way under the benchmark 200, the point at which doctors put people with AIDS on anti-retroviral drug.

The hospital said they would get the drugs, but he would first have to undergo weeks of counselling before they would administer the first dose. This was so difficult for me to understand, because you did not need to be a medical expert to see that if he was to be saved at all he needed them immediately.

I soon discovered that the hospital had in fact run out of anti-retroviral drugs and that because of the pariah status of my country, 500 per cent inflation and a dire shortage of foreign exchange they could not be procured easily.

As my cousin waited, we could see him slowly losing his zest for life. Often he talked about the hopelessness he felt for his son’s future. He was literally surviving on water. He did not even have appetite for fruit. The doctor gave him stronger and stronger painkillers.

When the anti-retrovirals finally came he lit up with hope. We all thought, given our lack of expertise about HIV/AIDS, that the effect would be immediate, but 14 days after his first dose there was no improvement. He had not responded positively to medication. The doctor put him on morphine, because his Kaposi’s sarcoma had advanced badly. His back pain had become worse.

The hospital refused to admit him, saying he was terminally ill. We did not have enough money to hire a private nurse. He asked for crutches to help him get to the toilet.

My cousin talked more and more about his son’s future and began cursing Robert Mugabe. He had been a staunch supporter of Mugabe and the ruling ZANU-PF party, so much so that even when the majority of people living in Zimbabwe's towns and cities swung to the opposition Movement for Democratic Change he remained firmly behind Mugabe.

No one knows exactly what he had got up to in Mbare during the ugly events preceding the violent March 2005 general elections. I think it is possible he was a member of one of Mugabe’s vigilante groups who terrorised the ordinary people of Mbare who showed open support for the opposition.

When he moved in, it struck me that he had never imagined in his wildest dreams that Mugabe could be so cruel as to destroy people’s houses. It was not my cousin of old. He had seen the bulldozers for himself and military men beating up old women who could not understand why their homes were being razed.

Eventually he began messing his bed, an eventuality we had anticipated but dreaded. I thought there were limits to what I, his cousin, should be obliged to do. However, I could not ask our maid to clean him up and for cultural reasons my wife could never go anywhere near him.

Care fatigue was setting in. We asked other family members for help, but they were too busy with their lives to spare the time. I desperately sought someone to share the task of cleaning him regularly. I found his nephew, his sister’s son. He was duty bound to sit through what were now clearly his uncle’s death throes.

At the end, my cousin literally died in my arms as we were cleaning him, still hoping the hospital would be merciful enough to admit him and give him expert care in his last hours.

At the moment he died, his son was playing, as usual, with other kids on the street. It has not yet registered in his young mind what had happened to his father. We have taken on my cousin's boy as our own second son. I now have to prepare mentally and spiritually for the day when my new son will ask me what caused his real father to leave this earth.