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Book Review: 28 – Stories Of AIDS In Africa by Stephanie Nolen

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I'm sure most people have noticed how numbers play this strange trick on the human mind; the higher they get, the less meaning they have. I mean when somebody mentions the size of the American government's deficit as being in the trillions of dollars, does anybody really understand what that means? Or if they do, why aren't they as upset about it as let's say you or I are about our personal debts that may only amount to a few thousand dollars?

The whole 'the higher the number the less it means' concept is especially telling when dealing with casualty figures. While we can get whipped up into a state close to hysteria when we read about the killing of one person, the deaths of millions of people won't cause us to turn a hair. Is it simply a matter of protecting ourselves, in that if we ever let ourselves feel the horror that we should feel from that many deaths we would never stop crying? Or is it because numbers that high are just incomprehensible?

When the death of one person is reported in the news we are usually given details of that person's life. We learn about those left behind to grieve, what they had accomplished to date, and what they have been prevented from accomplishing by their untimely demise. When the death total is from an earthquake or other natural disaster we might be told something about the town or city which has suffered the calamity, and be shown pictures of collapsed buildings, but we won't learn anything about individuals and the grief will stay impersonal.

Stephanie Nolen.jpgCurrently there are somewhere between 26 and 30 million people infected with the AIDS virus on the continent of Africa. To give you some idea of what that number means, it's the equivalent of saying that nearly the entire population of Canada has AIDS, as we have a population of around 33 million. Those numbers are only estimates, as many governments in Africa are either unable or unwilling to provide an accurate count of the numbers of people with the virus.

A trade paperback edition of Stephanie Nolen's 28: Stories Of AIDS In Africa, that was first published last spring by Random House Canada, being released this  April 15, is a timely reminder that there are faces and lives that go with each one of those 26 to 30 million people. Each of them have families, had hopes and dreams that are now withering, just as surely as anyone who is killed in a car accident or a house fire.

In the introduction to the book Ms. Nolen explains her rationale behind choosing twenty-eight as the number of people she would profile in the book — one person for roughly every ten million infected with the AIDS virus. She also says in the same introduction that she fears that even the thirty million figure quoted above is a conservative estimate based on how deeply rooted AIDS has become in Africa and how often she witnessed case numbers far exceeding official estimates in areas she visited researching this book.

In 2003 Ms. Nolen convinced her editors at The Globe And Mail, Canada's national newspaper, to allow her to investigate the AIDS pandemic in Africa. She moved to Johannesburg, South Africa and spent four years traveling across the continent and attending international AIDS conferences, as she struggled to come to grips with the enormity of the situation facing Africans of every race, creed, nationality, and social status.

The amount and depth of her research is obvious when you read the introduction to 28; its probably the best written history of AIDS, not only in terms of Africa, but the disease itself, that I've ever read. The disease did not spring up overnight among North American homosexuals in the early 1980s as I'm sure many believe. The first known human cases of AIDS can be traced back seventy years ago to Cameroon. Simian Immunodeficiency Virus (SIV) is a disease found in chimpanzees, an animal that used to be fairly commonly hunted and eaten in Africa. A virus that is non-lethal in one species can be death to another, and such was the case with SIV, which was not particularly dangerous to chimps, but as HIV has proved incurable in humans.

Scientists figure that it would only have taken ten or twelve incidences of hunters butchering infected chimps and becoming infected themselves for HIV to take root successfully among humans. Once that happened it was only a matter of time before it spread. Thankfully HIV, in spite of any propaganda you might hear to the contrary, is not one of the easily transmitted diseases and requires the transference of bodily fluids in order to have a chance at survival, unlike airborne ones like TB, ebola, influenza or the common cold.

There's no way of knowing for certain how many people were infected with the disease prior to the discovery in the mid-1980s of the test we now have to detect its presence, but Africans were dying of what they called "slim", a mysterious disease that had been causing people to waste away since the 1950s. As we learned in North America when people caught HIV from tainted blood products, there are many more ways than sex and drug use to catch the disease. In Africa, mass immunizations where thousands of people were vaccinated with the same needle looks to be one of the ways AIDS was able to establish a firm grip among the general population.

While Ms. Nolen's skills as a journalist make the introduction invaluable reading, what makes 28 Stories Of AIDS In Africa so compelling are the stories of the twenty-eight people of the title. Some of them will be known to you, like Nelson Mandela, who in 2005 announced to the world that his son had died of AIDS. Since his retirement from the presidency of South Africa, Mandela has dedicated himself to the fight against the pandemic. Others, like Manuel and Philomena Cossa, a migrant gold miner from Mozambique and his wife, you'll have never heard of, and their stories will break your heart.

From 1967 until 2005 Manuel would spend two years at a time away from home and family working in the gold mines of South Africa. Most of those years were spent working under the iron fist of apartheid for little more then slave wages, but it still meant he brought money home to his family. But in 2005 he came home sick, and both he and his wife have now tested positive for AIDS. They now have no income; because Manuel did not test positive until he was home the mine owners don't have to pay him a disability pension as they would if he had tested positive while on the job. No income means their children have to drop out of school, or can't even start school because they can't afford the ten dollars for school fees.

Alice Kandzanja is a nurse in a hospital in Zomba in southern Malwai that operates at 400% capacity, meaning that each bed has three patients laid out head to foot. She has seen 2,000 of her sister nurses die since the AIDS epidemic hit Malwai. In 2006 Cynthia Leshomo of Botswana won the Miss HIV Stigma-Free pageant by taking her medication as part of her traditional wear portion of the competition. In Botswana, which used to have a lower infant mortality rate than most of Eastern Europe, people didn't get AIDS because it was only a poor person's disease. Yet in the year 2000 37% of pregnant women were HIV positive.

That is the real face of AIDS in Africa, how it affects more than just the person infected, and cripples the futures of so many people. Governments don't have the money to provide free education to their people thanks to the policies of the International Monetary Fund and the World Bank that have demanded they cut social spending if they want to get any aid money or debt forgiveness. A country like Mozambique doesn't have enough doctors and therefore no way to distribute drugs to people who need them even if they could afford to buy them.

One of the most common questions that Stephanie Nolen reports being asked is how can the world let this happen to us? Even when they do finally cough up money, as the Bush administration admirably has done to the tune of $15 billion dollars over five years, it's a case of too little too late, and with far too many strings attached. How can you insist that money for AIDS prevention not be given to groups that advocate condom use or planned parenthood or stipulate that only expensive patent protected American drugs can be purchased with the money?

From South Africa to Egypt in the north, tens of millions of Africans have been diagnosed with AIDS. Each day there is a good chance that a baby is born somewhere in Africa who is HIV positive, and the numbers continue to grow. Although conditions have improved since the early 1990s when governments in Africa refused to acknowledge AIDS even existed and in 2000 when funding was non-existent, the hole that has been dug is so deep that it might take decades just to reach the surface.

28: Stories Of Aids In Africa helps you remember that behind the numbers in the headlines, and behind the politicians' talk of costs, are human beings who are suffering. I defy anyone to read this book and still feel that governments the world over are doing enough to make a difference.

28: Stories Of Aids In Africa is being released as a trade paperback on April 15, 2008 by Random House Canada and can be purchased directly from them or from an online retailer like Amazon Canada.

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About Richard Marcus

Richard Marcus is the author of two books commissioned by Ulysses Press, "What Will Happen In Eragon IV?" (2009) and "The Unofficial Heroes Of Olympus Companion". Aside from Blogcritics his work has appeared around the world in publications like the German edition of Rolling Stone Magazine and the multilingual web site Qantara.de. He has been writing for Blogcritics.org since 2005 and has published around 1900 articles at the site.