The effects of loss

Zambia, like most of sub-Saharan Africa, has a shockingly high HIV rate. Estimates of the prevalence in Lusaka are around 22%. To put that number in perspective, when you ride the minibus with 20 other passengers, 4 of them have HIV. Anyone who lived through the 1990’s in Zambia saw HIV and AIDS sweep through the population like wildfire. Everyone has lost friends, children, siblings, parents, spouses to the disease. When antiretroviral drugs hit the mainstream, it changed the virus from a death sentence to a cumbersome, but workable burden.

You can get any of these statistics out of a textbook. What you can’t get are the individual stories, or an understanding of how this seems to tie into the psychology of the population. A coworker, Mr X, once told me about his own family. X was the middle child in a family of 6. His younger brother got sick in the early 2000’s. After his brother backed out of it for many months, finally his family forced him go to the clinic for an HIV test, but his brother returned to the family and told them it was negative. More time passed; his brother got sicker. Eventually, he came to the family and he confessed he had AIDS. He died a few weeks later. His children are now being raised by X alongside X’s children. As he tells me this story, about denial and fear, X’s anger at his brother is palpable. He is frustrated, and he slams the steering wheel with his palm as he makes his point. As we near our destination, X confesses that he is afraid for the future of his own children, who are growing wild and rebellious, skipping school and drinking. He worries they will catch the virus themselves, or not be able to work without an education.

Another evening, I am sitting, talking to a white man (we will call him Mr Y) from South Africa. He tells me that he believes AIDS is a disease of stupidity. Y says that the disease is the consequence of a society that fails to be disciplined, that has fallen prey to bad behaviors. I suspect that many Americans would agree with him, deep down. I ask about the culture that emphasizes marriage and children as the ultimate expression of womanhood for young girls, who get married at 15, 16, 17, and who are relatively powerless in their roles to ask their husbands to wear a condom (nor perhaps do they want to, as large families are desired almost universally across Africa). He scoffs at this. He tells me of South Africa, where the prevalence is as high as 1 in 2 people, when sex education presented the choice as a either a condom or a gun to your head.

So, what does this do to a culture, the slow, quiet terror of those years, the mass sense of grief? When 20 years ago, 1 of every 4 people died of a disease which still continues to cut down those around you? When you were raised in a generation that lost their parents? Combine this with an official unemployment rate of 70% and an abysmal poverty rate? You can start to see how the future might become an abstraction, with the likelihood of an early death being almost a guarantee. Maybe you start to live only for the satisfactions and distractions you can afford - driving fast, alcohol, sex. The prospects that drive other populations to work steadily and go to school, like retirement, devotion to a craft, or savings, these become nonsensical. 

Just think about that for a while.