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Caregivers on the Frontline of the AIDS Pandemic


In the war against HIV/AIDS, caregivers may have the most battle scars. Those scars are not readily seen because they are from deep psychological and emotional wounds caused by the deaths of loved ones. One caregiver from Zambia is touring the United States telling her stories about life on the frontlines of a pandemic.

Doras Chirwa remembers when HIV/AIDS made its presence known in Zambia. It was about twenty years ago when the first case was reported at the University Teaching Hospital in Lusaka.

She says, "At that time I think little did we know that the future would bring a nightmare so horrific and so large."

Now, sixteen percent of Zambia’s adult population is infected with HIV, the virus that causes AIDS.

"When you think of that proportion, it leaves all of us back home affected in one way or the other," she says.

Doras Chirwa works for the international humanitarian organization CARE and heads the agency’s HIV/AIDS sector in Zambia.

In the beginning, she says, AIDS was a mystery. People were dying, but no one knew why. But like many others in Zambia, and in sub-Saharan Africa for that matter, she came to know the disease all too well.

"First it was my elder sister and this was a woman I was looking up to. She was my mentor. She was my everything really. She inspired me. And she was gone. In fact, she was living alone. I had to move her to my flat because I couldn’t manage to be visiting her every day. I was so scared. I didn’t know what it was. And I didn’t talk about it. She didn’t talk about it and she went down just like that and died," she says.

She left behind four sons, who needed a place to live. Doras decided to adopt them. She already had three children of her own.

"Suddenly the house was overcrowded because now I was the mother of seven. My income was overstretched. I didn’t know how to share the attention among the seven children, but I had to keep on. As if that wasn’t enough, my brother died and left behind one little girl. She was two at the time. So I had to take in the girl. And unfortunately, the girl was also HIV positive. I became a mother of eight," she says.

In all, Doras lost two brothers and a sister and – as she puts it – “countless cousins.” In a recent speech she said, “Death is all around you. On better days, death takes a distant relative rather than a close one, an acquaintance rather than a friend.” Adding, “I don’t even want to talk about the bad days.”

Then a glimpse of what might be - successful treatment of a few patients with anti-retroviral drugs.

She says, "It was becoming a hopeless situation because you have colleagues that you are working with that are dying everyday. And where is the morale? Where do you draw the strength to even continue, to even talk about prevention? But when you see colleagues that were almost down dying and they are up again and becoming productive again, it gives a lot of hope. And it gives a lot of strength to even do more on prevention."

When people ask her what’s needed to fight HIV/AIDS, the Zambian activist tells them to use a holistic approach.

"I’m not talking about abstinence alone. I’m not talking about condoms alone. I’m not talking about treatment alone. I’m talking about everything," she says.

CARE – with the help of the US and Canadian governments and other donors – operates 126 AIDS projects in Africa, Asia, Europe, Latin America and the Caribbean. These include voluntary AIDS testing and counseling centers and prevention programs, as well as community projects to help the sick and care for AIDS orphans.

With so much personal loss from HIV/AIDS, one may wonder what sustains Doras Chirwa?

"At times I also wonder. I wake up. I walk around with a smile on my face. I smile a lot. And, you know, when I sit back I wonder what makes me smile or what keeps me going? Now I know there’s knowledge. Now I know there’s expertise. Now I know there’s treatment. And I know that if people worked together it’s a matter of time. This pandemic can be halted," she says.

As Doras Chirwa tours the United States and speaks to average Americans, she ends her speech with these words: “All life is precious. I think that’s the way all of you would want it.”

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