In Botswana’s Okavango Delta, all kinds of organisations – from homeopathy clinics and safari camps to government agencies – are banding together to attempt to combat the country’s HIV/AIDS epidemic. Doug McKinlay reports
In a clapped-out Toyota pick-up truck, Hilary Fairclough and colleague Liz Graham arrive at the Maun Lutheran Church, site of the Maun Homeopathy Project (MHP). After offloading their cases of treatments and encyclopedia-sized reference books, they get to work. It is a small crowd today – only five people.
The dustbowl town of Maun is at the heart of Botswana’s Okavango Delta, one of Africa’s biggest tourist destinations, and a place that attracts wealthy visitors from all over the world to view its rich collection of wildlife. They pay as much as $1,000 per day to stay in one of the luxurious tented camps that are spotted around the Delta, and Maun is perhaps nothing more than a blip for them. Yet without having to scratch too far below the dusty surface, the other reality of life in Botswana is easily seen.
‘Botswana is one of the fastest developing countries in Africa, and one of the fastest dying,’ says Fairclough, MHP’s co-founder, clinical director and a homeopathic practitioner from the UK.
A 2006 UNAIDS report found that 24 per cent of Botswana’s adult population is HIV-positive, meaning an estimated 270,000 people are infected. This gives Botswana, with a population of less than two million, the second highest per-capita level of adult HIV infection in the world. Only Swaziland has a higher rate of infection.
Keemetswe Motsembere is sitting quietly next to me in the shade, waiting his turn to see one of the homeopaths. He is a tall, lanky man with rheumy eyes and a sad countenance. At 59 years old he should be well beyond the usual 20 to 40 age range of most HIV-positive people. Yet here he is.
‘Before February the future didn’t look good for me,’ he says. ‘I didn’t think I was going to live much longer, even though I was on the drugs prescribed at the government hospital. My whole body was in pain, especially my legs. They were cramping so badly I couldn’t walk and I couldn’t work. A friend brought me to this clinic. Once I started to combine the prescription drugs with the homeopathic remedies, I started to feel much better. The cramping is now gone in my left leg, but not in my right, although it is not as bad.’
Motsembere’s government drugs are antiretroviral drugs (ARVs), medication with a proven track record of controlling HIV and allowing people to live as normal a life as possible. However, they are powerful drugs that often have painful side effects. It is these side effects and the trauma they inflict on people’s lives that the MHP professes to alleviate
‘We are not here to cure HIV/AIDS,’ says Graham. ‘That’s the last thing we would claim. Our job, in part, is to deal with the symptoms that the ARV drugs can’t deal with.’
The homeopathic approach to HIV/AIDS is seen in some circles as controversial. Homeopaths view illness as part and parcel of an individual, not just a malady on its own observed strictly from a scientific perspective.
‘Our approach is one where we listen to the concerns of the patient,’ says Fairclough. ‘It’s not just about the illness but how their lives are going in general. It is all connected. We are concerned about how their relationships with their families are, if they are eating properly or if they are working.’
Still, the project does not work in a vacuum and needed the approval of government health officials to open. But the doctors at Maun General Hospital were so impressed by the clinic’s results, they now refer patients to it.
It’s a good indication of how far-sighted the medical establishment in Botswana is,’ says Fairclough. ‘The government of this country is dedicated to eradicating HIV by 2016 and it is open to new techniques that will help it achieve that goal.’ The Maun Homeopathic Project started in 2002, two years after Fairclough’s first visit to Botswana as a tourist. She was travelling with colleague Philippa Brewster, who was researching a book, when their hosts described the problem Botswana was having with the HIV/AIDS epidemic. The idea of a clinic was born from that encounter. Brewster is now MHP’s co-founder and co-director.
The project began in 2002 as a twice-yearly clinic operating for six weeks at a time, in conjunction with other established non-governmental organisations (NGOs). By 2005, a permanent outreach program was established at the Maun Lutheran Church, which supports the project fully.
Stella Saranyan, 44, is a force to be reckoned with. She is tall – easily six feet – and impossibly thin. She is quick with a smile but determined to get her story across. She is an integral part of the outreach program at the Maun Lutheran Church. Arguably without her, and women like her, the Maun Homeopathy Project would not exist. She is HIV-positive and started the first support group in Maun for people living with HIV and AIDS in 1999. An achievement that on the surface may sound easy, but the reality was very different.
‘HIV was seen as a disease of the underclass,’ says Saranyan. ‘The perception was that if you were diagnosed HIV-positive then you are dirty and deserve it. That attitude meant a lot of people were ostracised from their families and communities. It was a very desperate time.’
She says that these days the stigma that so often hounded people with HIV to the grave is starting to lift, partially because of clinics like the MHP, where people can talk openly without judgment about their illness. She also acknowledges a mass education campaign launched by the central government that educates young people on how HIV is transmitted and prevented and that has resulted in free condom machines being installed in nightclubs and bars around the country. The dusty roads are dotted with billboard ads specifically targeting men. A typical one reads: ‘I am a real man. Are you? I have tested for HIV with my partner.’ AIDS workers insist this is because men are less likely to get tested or admit to being positive.
During a home visit, Fairclough and Saranyan meet 27-year-old Dineo Nkape. Flashing a 1,000-megawatt smile, Nkape looks the picture of health. Her clear, bright eyes shine with intelligence; her tall, lithe frame would give any runway model pause to think. But it was not always this way. Just a few months ago it was debatable whether she would reach her next birthday.
‘I was very weak before coming to the clinic,’ she says. ‘I was like a baby; I had to be carried everywhere. I had a constant upset stomach – vomiting and diarrhoea. I just wanted to die.’
Listening to her story, with her seven-year-old daughter sitting beside her, it is difficult to believe that she was so close to death. But hers is not an isolated tale.
Catherine Philips, 44, is a car mechanic who still fights the virus on a daily basis. She has a tough demeanour, essential if she wants to survive. Still, once she starts talking about her children, the hard exterior softens. They are not really her kids, she admits, but children orphaned by some of those who lost the battle to the disease.
When she was first diagnosed, the hardest part for her was the rift it would cause in her family. The stigma of HIV can sometimes be as debilitating as the illness.
‘It was very difficult for me,’ Philips says. ‘I couldn’t tell my parents I was sick. It took me over a year to work up the courage to tell them, and even then I had to get my older sister to do it.’
The virus showed up in Philips as tuberculosis – which is the case with many HIV-positive people – the treatment of which almost killed her. Once a proper diagnosis was made, she began taking the ARV drugs. ‘They brought me back from the brink of death, but left me with some terrible side effects such as open sores on my legs,’ she adds. ‘Eight months after starting the ARV drugs, I visited the homeopathic clinic. It didn’t take long for the remedies to help with the sores. And even though I still get them, they are not as bad.’
Homeopathic clinics such as MHP are not offering any miracle cure for HIV/AIDS, and they are the first to admit that their treatment does not always work.
‘We have our successes and failures,’ says Fairclough. ‘But then so does conventional medicine.’
However, the biggest obstacle facing the clinic is not an accounting of who lives and who dies, but funding. Run on a shoestring budget, MHP is at the mercy of private donations through its registered charity status in the UK. Some money was given to the clinic to run a pilot project in 2004 by the African Comprehensive HIV/AIDS Partnerships (ACHAP), an initiative that also involves the Bill & Melinda Gates Foundation and the Merck Company Foundation, but that money ran out long ago
Asked what would be at the top of her shopping list if more money were donated to the MHP, Fairclough quips: ‘You’ve seen our truck – we are in desperate need of a new one.’
Not all organisations in Botswana take the volunteer and charity route like the MHP. Others are commercial enterprises that believe making a buck does not preclude having a social conscience. One such outfit is the Conservation Corporation Africa (CC Africa), an organisation that runs some of southern Africa’s most well-appointed safari camps
‘CC Africa fully acknowledges that it is a business trying to make a profit, but at the same time people’s lives are every bit as important,’ says Laurens Kritzinger, manager at CC Africa’s Nxabega Okavango safari camp. ‘If CC Africa maintains its viability as a company, and sticks to its humanitarian agenda, then it’s a good thing for the community and a good thing for Botswana.’
Most CC Africa operations are in South Africa, Namibia and East Africa. In those regions the company is heavily involved in wildlife and environmental conservation projects. Its Botswana concern is smaller and concentrated more on the people of the Delta.
‘What CC Africa is doing in Botswana is promoting a positive health program,’ says Ronel Kennedy, a South African pharmacist working with the company in Maun for the past 18 months. ‘The whole idea is to improve people’s quality of life. We’re trying to help change attitudes, part of which is combating the social stigma that often comes with testing positive for HIV. One way to do this is to give people a goal in life, a positive motivator.’
In this regard CC Africa does not do charity work, but prefers to get involved in joint-venture operations through the Africa Foundation, the NGO arm of the company.
‘If we are approached with a proposal, the first thing we do is make sure it reflects the needs of the community, make sure those involved have the means to run it and make sure it is sustainable,’ explains Kennedy.
frica Foundation with the idea of starting a vegetable farm in Maun. The foundation helped him find suitable land to lease, helped with acquiring seeds and training and became his first client. And although CC Africa safari camps are still on his client list, he is now selling to a variety of businesses and people throughout the Delta.
The HIV/AIDS epidemic in Africa is an all-encompassing disease. It does not just attack the individual, but the society at large. It is damaging countries in a way that was once the preserve of war, made even worse in the developing world because of limited resources. Botswana is a country that made great gains since its independence from Great Britain in 1965, gains that are now under threat. However, all is not lost. With help from people such as Fairclough and Graham of the MHP and organisations such as CC Africa, Botswana is fighting back. And that is a fight we should all support.
Photography
I worked with a Leica M8 for the photography on this story. The M8 is Leica’s first foray into the professional digital photography market and I am impressed. It is a rangefinder and, unlike so many DSLRs, it is small and compact. Perfect for working up close with people and not being too intrusive.
SPECIFICATIONS
It has a 10-megapixel capacity, which produces images big enough for most picture usages. Its big LCD rear screen is great for reviewing pictures, while the viewfinder is bright and clear. As with all previous M-series Leicas, the lenses are excellent, making tack-sharp images from corner to corner. The only problem I had at first was working with a manual focus camera again, something I had not done in many years. The camera has such precise focusing it takes a little practice before getting it right. Another sticking point I had was battery life. Leica could, and will, improve on this, but until they do carry at least one spare. Overall, however, it is a beautiful machine. I will definitely be purchasing one
WHAT IT COSTS
Leica M8 body, £2,990 ($5,925). Leica Summicron-M 35mm f/2 lens, £1,520. Leica Elmarit-M 21mm f/2.8 lens, £2,230. www.leica-camera.co.uk
