Twenty-Eight: Stories of AIDS in Africa Paperback – 1 Mar 2008
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`The desperate stories of 28 people... [Nolen] also brilliantly gives the broader picture' -- Sunday Telegraph
About the Author
At 36, STEPHANIE NOLEN is regarded as a formidable young foreign correspondent. She has an MSc from the LSE, speaks 5 languages, reported on the wars in Sudan, the political crisis in Zimbabwe, the peace process in Sierra Leone and the genocide in Rwanda and won Amnesty International Awards for her journalism in 2003, 2004 and 2006. A Canadian citizen, she currently lives in Johannesburg. www.28stories.com
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Each chapter starts with a photograph of the primary individual as she or he reveals the tragedy of their lives. Some of them Nolen met only a couple of times, others have become close friends. Her ability to convey their stories vividly and with great empathy brings us as reader not only close to the unique aspects of each "case", but assists our better appreciation of cultural and political traditions and realities in African societies. The critical components of the HIV/AIDS crisis unique to African countries are addressed within the narrative without losing the personal and emotional primacy of the subject matter.
For close to ten years, Nolen, a Canadian journalist for the Globe & Mail, based in South Africa, has been following the HIV/AIDS crisis all over the continent. She has visited families, health clinics, scientists, care centres for AIDS orphans, and activists' organizations. She has walked with health care providers among remote rural communities lacking any medicines, yet trying their best to comfort and help the sick. Stigmas still attached to the infection have meant that misconceptions flourish: those identified with it have been shunned, thrown out of their family's house and left to die. For a long time, testing positive for the virus was perceived by people as an automatic death sentence, resulting too often in changing behaviour patterns. Without any concrete knowledge of this "disease of many names" it robbed families of one young woman or man after another and villages in despair with the ever increasing number of orphans left behind.
Contrary to the long-held prevalent view in Africa as elsewhere - that HIV/AIDS is a disease of minorities and of the poor - Nolen demonstrates the fallacy of this perception that has cost many their lives needlessly. Poverty remains an important factor where nutrition is inadequate, education non-existent, and money for treatment and care is not available. Nolen discusses how traditional societal norms of behaviour still contribute to the persistence of high infection rates, in particular among women. Abstinence, promoted by international, in particular US, aid agencies as a primary method to reduce infections, is only rarely an acceptable option, Nolen contends. Anita in Mozambique stands for many: "None of it" she said, "was up to me". On the other side, there are young professionals, like Lydia in Uganda or Ibrahim in Nigeria, fully aware of their condition, that are still caring for others, lobbying and fighting for access to life prolonging ARVs (antiretroviral medication). What shines through all the stories, is determination and hope despite the odds, the courage, resolve and perseverance that the individuals show in the face of unimaginable obstacles.
A substantial number of books are available on HIV/AIDS and its devastating impact on African societies and demonstrating the need for cheap medicines and vaccines. The human costs in countries where the HIV infection rate may be as high as 30 or more percent is unimaginable in its devastation for generations to come. As Machel put it: "I don't think I comprehend the dimensions of the havoc, disruption, discontinuity". Nolen's book stands out for her insightful descriptions of the human costs as well as the its fluid integration into the stories of aspects of socio-economic conditions and up-to-date science research surrounding the pandemic. Yet, she never loses the focus on the human beings who she got to know and who candidly shared with her their life's story. If you think you can only cope with one book on this subject, read this one. [Friederike Knabe]
In Bukavu, South Kivu, in the Democratic Republic of Congo, Christine Amisi, for example, left the safety of a UN compound to continue her work as a nurse for Doctors without Borders to ensure that her patients got supplies of drugs. Christine assisted in Doctors without Borders' anti-retroviral trials in the Democratic Republic of Congo, a country torn apart by civil war.
Nolen points out that there is a very real risk of creating drug-resistant strains of HIV should patients not exercise compliance in treatment; this is one of the challenges often cited in treating AIDS in unstable countries like the Congo. And yet, what did Doctors without Borders find? Patients had, in the long term, a 97 per cent adherence rate--taking their pills correctly and on time -- which is higher than the rate at most treatment sites in North America. Only 5 per cent of them had been "lost to follow-up," that is, stopped showing up and became untraceable -- again, a number about on par with North America, and remarkable for war zone.
In Bukavu, South Kivu, Doctors without Borders provides comprehensive HIV/AIDS care with counselling, testing and treatment of opportunistic infections, as well as antiretroviral treatment (ART). Doctors without Borders has worked in the Democratic Republic of Congo since 1981. Dr James Orbinski, who was president of Doctors without Borders when the organisation was awarded the Nobel Peace Prize in 1999, says of Nolen's book: "Read. Weep. Rage. And above all else - like those people described in this book - find the courage to do."
The book is divided into 28 stories of people living with AIDS or who have been affected somehow by the disease. From problems of children being left orphaned, corrupt governments to the understaffed hospitals and clinics which see to many of the suffers, Nolan gives a detailed account of all. It gives many interesting facts and a detailed read into how and why AIDS has spread so quickly and become such a big problem in Africa, including the socio-cultural processes that exist within Africa and how these affect it's prevalance. Nolan explains how this disease has affected many of Africa's countries in terms of economics and how it is affecting the people living there. Nolan includes stories from children who have been left orphaned due to their parents dieing from the disease and how this is a widespread problem as many of the children who are unable to get an education due to not being able to afford school fees. This Nolan then further explains is having an effect on many African countries.
What I liked most was the diversness of the storytellers, including those with HIV/AIDS, an AIDS researcher, a grandmother looking after her orphened grandchildren to Nelson Mandela who lost his son to AIDS.
The book I found to be very informative and well structured. The book includes maps of Africa (showing where each of the 28 people live) and a useful glossary of terms including many medical ones. The introduction provides a very good introduction to AIDS, from its discovery to the effects it is having across the globe.
Although it is well known that AIDS is a problem in Africa this book is a real eye-opener to how it is affecting Africa at large and causing and furthering the problems Africa suffers from such as famine. No need to listen to Geldof and Bono, this book is all you need.
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