BABIES
GIVE LIE TO AFRICAN AIDS
By
Neville Hodgkinson, Nairobi
The Sunday Times (London) 29 August 1993
FATHER Angelo
d'Agostino is puzzled. He sits at the heart of Africa's alleged
AIDS epidemic with a hospital full of HIV-positive children who,
health experts say, are condemned to die. Except that they are
very much alive.
As a result,
d'Agostini, in common with growing numbers of scientists and doctors
around the world, is beginning to question whether HIV really is
the killer it has been made out to be. He, like them, suspects that
many "AIDS" cases are really old diseases given a new
name and that people who test HIV-positive are not, as most have
been led to believe, the victims of a new, inevitably lethal disease.
As founder
of the Nyumbani hospice for abandoned and orphaned HIV-positive
children in Nairobi, Kenya, he had expected to see much disease
and death. But his so-called "AIDS babies" are confounding
all predictions.
A year has
passed since the home opened and only one of his first 45 children
has been lost an ailing six-week-old infant who had to return to
hospital almost immediately and died two weeks later. The rest,
who are aged up to six years, are thriving and Nyumbani, which means
"at home", teems with life and laughter.
Yet elsewhere
in Kenya and across sub-Saharan Africa, according to the World Health
Organisation (WHO), tens of thousands of children are dying because
of HIV, usually in their first year. Its regional office in Brazzaville
says infant mortality has increased so much because of AIDS that
gains made in child-survival programmes of recent years are being
eroded. WHO says the virus has infected 8m Africans and will be
killing 500,000 a year by the end of the century.
But if HIV
is causing such havoc elsewhere, why is it apparently proving so
innocent in the children of Nyumbani?
D'Agostino,
67, is a former surgeon who trained as a Jesuit priest and became
a professor of psychiatry in Washington before going to Africa 10
years ago. "I'm a physician and I bought the theory that HIV
is the cause of AIDS," he said. Now he is surrounded by smiling
faces that cast huge doubts over it.
"It is
surprising. We expected more deaths, and a lot more serious illness.
According to most predictions, the children should have died within
two to three months of coming to us. Instead, we have now had to
set up a nursery school and I'm planning to negotiate their entry
into primary school.
"I had
also been preparing to establish group therapy for the mothers to
deal with their grief at the loss of the children. Instead, the
only losses the hospice has are happy ones: some of the children
become HIV-negative, and are taken back by relatives or ordinary
children's homes."
Even those
who persistently test positive are staying well. "I don't have
any explanation for it," d'Agostino said. "Will they be
alive this time next year? I have no reason to doubt it; they are
healthy."
What d'Agostini's
hospice provides is very basic care. "They are very sick when
they come to us. But as a result of their care here they put on
weight, recover from their infections and thrive. Hygiene is excellent.
Nutrition is very good. They are really flourishing."
All this is
in contrast to the way most children diagnosed as HIV-positive are
treated. "People think a positive test means no hope, so the
children are relegated to the back wards of hospitals," d'Agostino
said. Abandoned by their HIV-positive mothers, the children are
killed by multiple infections, malnutrition and misery rather than
by AIDS.
At Nyumbani,
most of the hands-on work with the children is done by women, usually
single mothers, who are quick to bond with the babies in their care.
"They have no money and no husband, but they have been mothers
that is their big advantage."
Most important
to the babies' survival, according to Sister Mary Owens, d'Agostino's
assistant, is a big dose of "TLC" tender loving care.
"Their whole experience in the home is one that makes them
happy children."
Some of the
babies become HIV-negative after a few months. The usual explanation
for this is that they were never truly virus-infected, but instead
inherited their mother's antibodies to HIV, which fade with time.
But mothers, too, are being misdiagnosed.
D'Agostino
tells of one woman who turned up with her sick baby, begging to
be allowed to work for the hospice in return for care for the child.
"She had been to hospital seeking treatment for the baby, and
they found among other things that it was HIV-positive as well.
The baby's grandmother threw both of them out of her house.
"We took
them in, and three to four months later sent the baby for another
test. It was negative. The mother was delighted. The grandmother
took them back. The mother kept working for us and some months later,
when she was assigned to go with another child who was to be tested,
she asked if she could have a test at the same time and lo and behold,
she was negative too."
The experience
at Nyumbani flies in the face of the coventional theories about
the history of AIDS in Africa. Dr Robert Gallo announced in 1984
that HIV, a newly discovered virus, had been identified as the cause
of the immune system breakdown devastating homosexual communities
in the United States and Europe. Western doctors invaded Africa
with HIV testing kits and computers to map the extent to which people
were infected there.
Virus-hunters
did succeed in finding large numbers of positive test results, and
as far back as 1986 there were said to be 5m HIV-infected people
on the continent. Lurid predictions followed, such as one newspaper
claim that within 10 years AIDS would leave "vast areas of
now-populated land devoid of a single living person".
The tests that
led to those estimates are now admitted to have been unreliable,
producing a high proportion of false positive results. Newer tests
are said to be more accurate, but according to a recent review in
the journal Bio/Technology, none has yet been scientifically validated.
The article
showed that multiple, non-specific assaults on the immune system,
which are extremely common in Africa as a result of poverty, prostitution
and the breakdown of medical and social services, may be causing
millions to test positive when they are not infected with HIV.
Encouraged
by WHO-funded units and numerous non-governmental organisations
involved in the fight against AIDS in Africa, doctors are reporting
growing numbers of AIDS cases. But researchers have not established
the extent to which these are genuinely the result of a new virus,
as opposed to a consequence of an intensification in long-established
threats to health.
Observers say
poverty has driven millions of women into prostitution. Young African
males have also been drawn into the trade. "AIDS" deaths
are common among these prostitutes, especially when treatment of
the resulting repeated infections is either absent or inadequate.
Those whose immune systems collapse, as well as those who harbour
a cocktail of infections, can become lethally infective.
However, a
huge gap remains between this widely acknowledged increase in threats
to health associated with prostitutes and their contacts, and the
apocalyptic vision of Africa's future espoused by WHO on the basis
of its HIV statistics.
As well as
using a test that may be useless, these statistics are based on
small and often inadequate population samples. Dr Hedvig Pelle,
WHO co-ordinator for the Kenya National AIDS Control Programme,
said: "AIDS is there. No doubt about it. And it is widespread
and increasing. My colleagues in the other countries can tell you
the same." But she added: "If you come with this postulate
that there are a lot of false HIV-positives, it is very difficult
to tell."
Political factors
appear to play a part in determining whether a country has a major
AIDS problem or not. Kenya lost an estimated Pounds 200m in desperately
needed foreign currency in November 1991, when the industrialised
world decided to try to force political and economic reform on the
country by cutting aid. A recent crisis announcement on AIDS by
the country's health minister is seen within the international aid
community as an attempt to win back donor sympathy and funds, according
to the journal Africa Confidential.
The announcement
followed a warning by WHO-sponsored researchers that Kenya alone
has an estimated 1m HIV-positive cases, and a cumulative total of
120,000 AIDS victims since the first case was diagnosed in 1985.
"A far-from-veiled theory in circulation says figures which
show AIDS spiralling out of control have been massaged to extract
sympathy," the journal said.
If the HIV
theory of AIDS turns out to be flawed, scientists may prove to have
done Africans, more than any other people, a huge injustice. Propaganda
on the spread of AIDS has discouraged investment, increased poverty
and cast a new shadow of fear into the hearts of a people long besieged
by health and social problems. *
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