More insidious than drought, more deadly than famine, more chronic than war

800 dying of AIDS in Ethiopia every day

ADDIS ABABA, Ethiopia - Sister Benedicta has devoted her life to caring for the sick and dying rescued from the streets of the Ethiopian capital. A member of Mother Teresa's Missionaries of Charity Order, she has been here nearly a decade - long enough to see AIDS burst from the shadows.

``I came here nine years ago and saw them come from famine and the war. But now I see them come from AIDS much more. It has exploded.''

As she speaks, she surveys scores of beds with women now in the final stages of the syndrome. They will spend their remaining days at the order's Pure Heart Home for Sick and Dying Destitutes. These women range from their teen years through to their early 50s. With the exception of rapid, shallow breathing, there is little motion in the room.

``The women's stories are nearly always the same,'' she explains. ``They come from the villages and are offered work in Addis. They get into prostitution, they have children, they get sick and wind up on the streets.'' She is straightforward about how those stories end.

``Then they come here and they die.''

There is food here, shelter and medical care. Three of the nuns are doctors and two are nurses. Based on previous tests and current symptoms, they believe 80 per cent of their patients are HIV-positive. The charity cannot afford, nor does it see the purpose, in testing everyone.

``In this country, with this poverty,'' explains Sister Benedicta, ``it makes no practical sense for them to know if they are HIV-positive or not. Because there is no health care (they can afford).''

As The Star's Bill Schiller reported last fall in a series currently nominated for a National Newspaper Award, AIDS is the single greatest threat facing the people of Africa. It is more insidious than drought, more deadly than famine, more chronic than war. And it is stalking Ethiopia with a vengeance.

``Every day in this place, without exaggeration, five or six are dying,'' says Sister Benedicta. Those bodies are taken away, daily, by local ambulance. ``We once had three days when the ambulance had broken down. We had 28 bodies (before it returned).''

The latest figures indicate that 300,000 of the country's 60 million people die annually of AIDS-related illnesses - a rate of more than 800 every single day. More than 3 million are believed to be HIV-positive, and the ministry of health predicts that number will top 4 million by 2009. In southern Ethiopia, where Médecins sans frontières is now operating a feeding centre, a physician emphasized that drought is not the country's biggest problem.

``There have been a lot of deaths here,'' says Dr. Maya Hites, ``but nothing compared with AIDS.''

It is this creeping menace that prompted the country - in the midst of this food shortage - to form a national HIV/AIDS prevention council last Sunday. It will focus on widespread urban and rural education campaigns.

The campaign comes too late for 38-year-old Takkele Fitie. He lies in the charity's tuberculosis ward, an echoing room where coughs reverberate constantly. An educated and dignified man who speaks flawless English, he has both AIDS and tuberculosis - an infection that often strikes those with weakened immune systems.

``At this moment, to be very frank,'' he says, ``I feel I am on the verge of death. There is no other language (for it). This is what I feel. Honestly.''

Fitie can still manage a smile, despite the hardship the past decade has wrought. Jailed for political reasons from early 1992 to early 1994, he emerged from prison to find his wife and young daughter had left him. Though skilled as a broadcaster and teacher, a broken Fitie was unable to find work and soon became ``lost.'' He wound up living on the streets of Addis where he fell ill.

``I couldn't get any medication outside (this hospice),'' he says. So he came here.

In 1997, Ethiopia's health ministry pegged the rate of HIV infection among sexually active adults in urban centres at 21 per cent. During that year, the relative rural rate was estimated at 4.5 per cent. Since the majority of Ethiopians live in the countryside, any narrowing of that gap has profound implications.

``It's increasing,'' says pediatrician Dr. Bogale Worku. ``You see a lot of cases in children. They get it from their mothers.'' Then one parent, or both, die or become too ill to care for their children.

There are now so many HIV-positive orphans that Mother Teresa's devotees in Addis now operate a place specifically for such children, across town. The Gift of Love Home has 155 youngsters.

``There are people who come from an adoption agency and see a child they like,'' says Sister Benedicta. ``And then they're tested . . . they cannot be adopted by Ethiopian law (when there's a positive HIV test). There are even parents who tell us they would still like to adopt the child (but are prevented). It has happened many, many times.''

Some children have grown up there, reaching the ages of 9, 10, 11. Old enough that other kids begin to ostracize them, in a nation where AIDS carries tremendous stigma.

``They come to realize they are being marked by being in this home,'' she says.