By Jan Raath
THE last time I saw Emmanuel Chitsere alive, he was struggling to get out of the back door of my pick-up truck. His wife, Memory, was trying to get him on his feet. I had to blink away my tears.
Chitsere’s feet were painfully swollen.
As I left their one-room home in the Mbare township of Harare, I felt optimistic. After a month battling with Zimbabwe’s failing health system, I had won: Chitsere, who had Aids, was in possession of two little envelopes of anti-retroviral drugs (ARVs). I was not able to stay to ensure his health, though.
The next day my lawyer phoned to warn me that police were soon to pick me up on suspicion of “spying” and of “working illegally as a journalist”. I stuffed a couple of suitcases with belongings. And overnight, I fled Zimbabwe.
Fifteen days later Chitsere (39), was dead. I still don’t know why. He had enough ARVs for six weeks, renewable indefinitely. I found out that he was taken to his rural home soon after I left, because it would be easier to nurse him there. In the end, it made little difference. No bus would take Chitsere in his state, so the family had to hire a taxi. He died in the car, 10km away from his home in Chirumanzu, about 200km south of Harare. He was buried on March 4. A prudent man, he had joined a burial society, so the coffin and pots and plates for cooking for the mourners were paid for. One of his four cattle was slaughtered to feed them.
I hired Emmanuel Chitsere in 2001 as a night guard, not out of fear of burglars, but as a first defence against Zimbabwe’s secret police, who tend to burst into the homes of journalists at 2am. We got on well from the outset. He was an avid reader of newspapers, and we laughed at the latest anti-Mugabe jokes. He did chores for me, such as gardening, without being asked. Occasionally I would find him sleeping on the job. He always denied it, but I didn’t mind. His presence was reassuring.
My landlord, Andy Moyse, phoned me in Cape Town two days after Chitsere’s death and told me of it. After shock came anger. There was no excuse for him to have died. His demise had been brought about through ignorance, confusion or superstition. But at the same time, I felt relief. If Chitsere had recovered, I would probably have had to provide ARVs for the rest of his life. And from where I am now, 1 500km away, I could not guarantee that. I also had to think of the living. There is a strong chance that Memory, in her twenties, is HIV-positive. Without Emmanuel, her only source of income is selling tomatoes at the bus terminus.
Aids in Zimbabwe today brushes you personally every day. The country has one of the highest rates of HIV infection in the world: one adult in four carries the virus. Life expectancy has collapsed to 38 years because of Aids. Seventy percent of patients in hospital are being treated for the virus. In the 1980s I was news editor of a domestic news agency to a generation of young black journalists. Nearly all are dead. I have found myself driving the hearse for one of my office messengers. In my pickup, I took the dead members of his family to the cemetery, women mourners keening about me.
Over my time in Zimbabwe, I learnt that for all but a tiny minority, early death is certain for Zimbabweans with Aids. About 10 000 have access to ARVs but it kills 200 000 each year. ARVs are unaffordable for ordinary Zimbabweans. The price is doubled by the import duty that the government charges. Even donated anti-Aids drugs are charged duty.
Last year Chitsere sickened. First it was flu, then a sore throat, then a cough that wouldn’t go away. With Vitamin C, extra food and aspirin he recovered temporarily. I said nothing. How do you say to someone, “Excuse me, I think you should see a doctor about a virus that will probably kill you”? I returned from holiday in January to hear that he had been off work most of the time I was away. I was told that he was in St Theresa’s, a Roman Catholic mission hospital at Chirumanzu. The phone never worked. On the morning of January 22 I was about to drive to Chirumanzu when Chitsere turned up on my doorstep. “I have come for my duty,” he said. He had shrunk to half his size in just over a month. His head was swollen. But the spell in hospital seemed to have cheered him up.
I phoned an Aids-prevention charity, the Centre, which provides a low-cost diet of nutritious basic foodstuffs and herbs to boost the immune system. The Centre also issues ARVs as a last resort. It agreed to see him immediately. I told Chitsere that I would take him to someone who would help him. I did not mention Aids, but I’m sure he knew. When I dropped him at the gate he didn’t even turn to wave as I drove off. I’m sure he knew that he was about to face someone who would try to force him to confront his condition. He did go in, I found out the next day. Fortune, the counsellor, told me: “He just said, ‘But I can’t have Aids’.”
Two weeks later Chitsere came back, escorted by his son, Simbarashe. He was desperately sick. Diarrhoea had shrunk him even more dramatically in a fortnight. His mouth was raw with thrush; his lips stiffly pouted to ease the burning that breathing caused.
I discovered later that after his counselling session he had gone for an HIV test at a municipal hospital for sexually transmitted diseases and it had turned out positive. Too frightened to tell anyone, he did nothing. Then I launched the campaign to get him on ARVs. You cannot get them without a prescription, and the doctor cannot issue one without a CD4 count, a measure of the cells that manufacture the body’s immune-defence system.
None of the depleted state laboratories can do CD4 counts. Unless you are one of the 10 000 on the state ARV programme, you have to go to a private laboratory. They charge $1,2 million — two months’ wages for a guard.
Chitsere couldn’t walk to the bus stop, so I collected him from his spotlessly clean room to take him to the laboratory. He lay on his bed in only his underpants. His ribcage was like a large hump with hollows between each rib, his stomach was sunken, his hips stuck out and I probably could have closed my hand around the middle of his thigh. We waited five days for the results. ARVs are usually introduced at a count of 200. Chitsere’s was 16 and he was withering by the day.
I took him to my GP for a prescription and just happened to phone the doctor while he was seeing Chitsere. The GP told me: “He said nothing about Aids or ARVs. He went on about a pain in his stomach.” The next day, armed with the prescription, I got Chitsere to the Centre to pick up the ARVs. He now had a two-week starter pack and a month’s full ARV medication with nevirapine. On top of that, every day he had to take anti-diarrhoeal drugs, anti-emetics, antibiotics for the thrush, electrolytes, three vitamins, mineral supplements, zinc and selenium — to be administered by his wife, who was educated no farther than primary school and speaks no English.
That night I was forced to stop at an intersection as President Mugabe’s 28-vehicle motorcade of gleaming new Mercedes-Benz limousines, Yamaha motorcycles and troop-laden 4×4 behemoths roared past, and I was filled with rage. It was a horrible symbolic sight: a reminder that people like Chitsere and three million other Zimbabweans with Aids are paying for Robert Mugabe’s gross and cynical excess.
*The Times (UK).