Africa Vision 24

Africa Vision 24

AIDS & CAR

N’Djamena, December 20, 2007

Today I visited the World Food Program. The sisters of Bebedja had handed in a project proposal end of August for supplementary food for HIV positive patients with an emphasis on pregnant women. At the doorstep I bumped into the gentleman responsible for the evaluation of the project proposal and in his slipstream I slipped into the office. Once in his office I started my hard sell technique for the project. But alas, to no avail. The end of the year is also the end of the money so my dear sisters have to wait until the third week of January until they will get a potential positive response. We then meandered on about the different programs in the South, one for the refugees and one more specific in Mondou and for sero-positive patients. Bebedja however is another district and province than Mondou so there needs to some scratching of heads to be done so as to accommodate this project.

I wish the project all the success. What is clear is that nutrition I one of the most vital parts of arresting the progress of HIV to AIDS (HIV and complications thereof) It is not for nothing that the old name in many parts of Africa was SLIM disease. Patients are wasted as if they come from areas with chronic droughts and food shortages. The benefit of taking regular antiretroviral medication will be undermined when suffering from malnutrition. A person who is HIV positive also needs qualitative better and a large amount of food than a healthy person. Malnutrition on its own is a risk for opportunistic infection imagine what it means in a person’s who’s immune system is suppressed.

In Bebedja St Joseph Hospital the wards are still filled with malaria patients. The hospitals of doom as I have seen in the past with nearly all the beds taken by patients co-infected by tuberculosis and Aids are not yet the case in Chad. Although the infectious disease ward in the General Referral Hospital in N’Djamena (happily mixing with dermatology and mental health) is and a dire indicator for the epidemic that is about to unfold in Chad.

Broken down health services, civil strife, war, lack of resources, rape as a weapon of war, rape as a common part of society, labor migration, polygamy, prostitution, poverty, lack of education, refugees and displaced people are a potent mix for a massive epidemic of Aids. Also the proximity to Central African Republic where the Northern part of the country has suffered from a neglect and destruction that makes the South of Chad look like the land of milk and honey does not help.

Last night I went through the report of Human Right Watch of September 2007. The following struck me as extremely sad. Calling it a forgotten conflict would imply there was a prior understanding of the plight of the people in CAR. Clearly nobody knows or wants to know. The scale of the atrocities in numbers may not be as in Darfur but there are also hundreds of thousands of people living in the bush. Haunted down by groups of bandits, persecuted by government forces and exploited by ‘liberating’ groups of rebels. Another thing that comes to mind after reading the report was that how deeply involved the French are involved and responsible for the mess in CAR. There is a military agreement and as a result it is the French who decide which dictator will get the chance to do his time until it is deemed better to replace him with the next crook. All transitions in CAR since independence have been military coups.

Obviously it is not only the French who are to blame. There are long standing conflicts between Christians and Muslims, pastoralists and agriculturists, North and South, bands of bandits, incursions from Chad and Sudan.

Yet it seems that before the end of the colonial phase in many cases the French did as the Belgians did in Congo. Absolutely not prepare the countries for independence. Fifty years later and CAR and Chad are still struggling to find their feet.

Namaskar

Ashis