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A Face in a Village: Remembering a First Encounter with AIDS in Africa

February 8, 2012

We’d already guessed there was a problem at the health post—we hadn’t received the last several monthly statistical reports. As a Peace Corps volunteer in the Central African Republic in the early 1990s, I reviewed these reports as part of my job at the regional health office. Another part of my job was to join a supervisory team as it traveled over dirt roads to check on health facilities from hospitals down to the village health posts staffed by a single nurse. A few months into my assignment, on our way to the provincial hospital, the team decided to stop by this particular health post to find out why we weren’t receiving reports.

That’s from “A Face in a Village,” the February Reflections essay in AJN by Susi Wyss, the author of a well-received recent novel, The Civilized World (Henry Holt, 2011). Set in Africa, the novel, like this essay, was inspired by the author’s international health career. In this essay, Wyss recalls a vivid first encounter with the ravages of AIDS and the hopelessness it inspired. (Click through to the PDF version for a cleaner read.)—JM, senior editor

7 comments

  1. With HIV/AIDS being a major deal in the United States, one of my biggest fears as a nurse is accidentally getting a needle stick while drawing a patient blood. HIV or AIDS was not a topic of discussion in my family, until two of relatives became infected with the virus. Even though most people in my family knew, it seems that my family still walks on egg shells around the family members. I can relate with the author about wanting to know how this happen to this particular person, but at the same time I don’t want to reopen a door that has been closed.
    Society has really changed over the years. The focus seems to be more on awareness “knowing your status”. Giving people hope that there is life after finding out the result is positive. I often wonder in Africa when a family member becomes HIV positive how do they cope with the situation.

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  2. The Human Immunodeficiency Virus is certainly the one of the biggest health challenges of our time. This virus is lethal and incurable so the only ways to be saved from it is not to get it in the first place. I believe that one of the main reasons behind the uncontrolled number of cases in the African region is due to lack of information about the disease and lack of resources to prevent its spread. However, informing people about the virus should not be an expensive thing to do, a simple propaganda or piece of paper can be enough. Now, if we analyze it more carefully we will see that a big portion of the African people is illiterate, then how can we expect them to understand the campaigns done to inform them about HIV, how can we expect them to even understand what HIV is? I strongly believe that to address this global issue we first have to address basic problems such as illiteracy because at the end everything is this universe is interrelated.

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  3. HIV, Human Immunodeficiency Virus is a very bad disease that up until now has no cure, it can very much cause AIDS and this can be fatal for many people. Especially if left untreated, this virus can destroy the immune system, I’m astounded, that in Africa there is still so many people, who are not being treated and at least informed that they have this very devastating disease. The worst part is that this article informs is that healthcare workers have not been given the necessary precautions for their own safeties, example HIV Cocktails, this is very bad because they can get the virus as they treat so many HIV Patients and of course this is cause more of a spread of HIV. This issue needs to be addressed by governments and health care workers because their own lives are a risk while they try to help others. I would try to have more organizations help out clinics maybe have other country reach out and help, provide some standard safeties for this health care employees and help increase awareness of HIV and AIDS in Africa and get more people who are undiagnosed, diagnosed and of course treat them so they can live a longer life.

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  4. HIV is a great problem around the world, but I think we are fighting against it. I understand each country gave different importance to these disease, and the health care is different in each place, but HIV is a disease that should be taken into account. Over the past decade the AIDS response has played a major role in producing better health outcomes for people in developing countries. The response mobilizes new advocates, networks, governments and stakeholders every day for greater health outcomes. The AIDS response is leveraging the resulting political capital to move and catalyze agendas to focus on HIV, health and human rights. However, the AIDS epidemic is not over in any part of the world. As long as there are more people becoming infected than people going on treatment, the world will never get ahead of the epidemic. The 33 million people living with HIV are counting on all of us to deliver results. The role of the health sector is central to achieving the goal of universal access to HIV prevention, treatment, care and support. AIDS is part of the global health agenda, just as the global health agenda is part of the AIDS response: neither can work in isolation. The AIDS response is an opportunity to improve health systems, and there is a need to further embrace other areas that contribute to health solutions, such as human rights, the law and education.
    There are an estimated 33 million people living with HIV, half of whom are women. Two out three people living with HIV are in sub-Saharan Africa. There are about five new HIV infections every minute, of which three are among children and young people. Each day about 5500 people die from AIDS-related illnesses. As a result, the number of orphans is growing; more than 12 million orphans live in sub-Saharan Africa. However, since 2001 there has been substantial progress in delivering HIV services to millions of people, especially in low- and middle-income countries. Today, nearly more than three million people are on antiretroviral treatment. By the end of 2007, the annual number of new HIV infections had fallen from 3 million in 2005 to 2.7 million. New infections among children have dropped, due to a rapid scale-up of services to prevent mother-to-child transmission of HIV. Young people in many parts of the world are waiting longer to become sexually active, are having fewer sexual partners or are using condoms. And millions of children orphaned by AIDS now have access to social support and protection. These gains have to be sustained in these tough economic times.

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  5. Human Immunosuppressive Virus (HIV) is a devastating illness and we do come in contact with individuals who have been infected. The devastating part is there is no cure. Health care workers put their lives in danger every time they take on the responsibility of patients that is proven to be infected or is not aware of the HIV status. The article is a perfect example of the difference between the health care system in America and the one offered in Africa. The fact that the HIV cocktail is not made accessible to all health care workers in Africa is mind blowing and should be a major area of focus in global health. Based on the amount of cases of HIV in this country the probability of a healthcare worker having an accident that may potentially lead to them developing HIV is very high. In the United States the HIV medication is paid through workman compensation.

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  6. Regarding the essay “A Face in a Village”, it emphasizes on the spread of HIV, but it personally reminds me of the conditions in which some health care providers have to work under in some countries. First, when it mentions that the nurse could have easily been infected by a needle stick, it reminds me of all the different syringe set-ups available to the nurses at my job for needle-stick-prevention. Another part that made me acknowledge nurses around the world was when the author, Wyss, Susi, asks: “If he’d known the risks of contracting AIDS from his profession, would he still have opted to become a nurse?” Consequently, I ask myself, if I lived in a developing country, with scarce resources for health care providers, and a harsh environment in which to take care of sick people, would I have chosen this career? Would I love it as much as I do regardless of the poor circumstances? This essay, like other documents I have read on global health issues, made me aware of everything I should be grateful for.

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  7. I have a friend who is an RN and serving as a Peace Corp volunteer in Africa. She has shared her experience through letters and they are very inspiring.

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