CENTRAL AFRICAN REPUBLIC (AFP) – Annie struggled to draw breath after speaking and her spindly legs barely supported her, but the Central African HIV sufferer continued to defy the debilitating illness.
“I have six children – who is going to take care of them if I die? I must live!” the 37-year-old said, touching her neck which was bloated by swollen lymph nodes.
Annie had received treatment for three days in the only community hospital dedicated to caring for patients at an advanced stage of AIDS in Bangui, the capital of the Central African Republic.
The facility offers hope to those suffering from the incurable illness in the country, which has been racked by near-continuous civil war since 2013.
HIV affects around 110,000 of the Central African Republic’s 5.4 million people, but a lack of testing means many sufferers are not counted.
According to the World Bank, almost 70 per cent of the landlocked nation’s population lives below the poverty line.
That makes the cost of a test – typically between XFA2,000 and XFA3,000 (USD3.5-USD5) – prohibitive.
“In Bangui alone, the prevalence of the epidemic is two times higher than the national average,” doctor Jennifer Stella said.
She added that many people remain unaware of their HIV infection, with two-thirds of HIV-positive people already at an advanced stage of the illness when they begin treatment.
“My husband died of HIV, that’s how I knew I was HIV-positive,” Annie recalled.
Supported by the charity Doctors Without Borders (MSF), Bangui’s community hospital has 68 beds and a further 15 for intensive care.
Stella manages teams within MSF’s “advanced AIDS” project, which offers emergency care to patients before referring them to health centres where they can receive treatment for life.
In an annex to the internal medicine service, two men wearing yellow rain boots sprinkle chlorinated water as a nauseous odour emanates from blocked pipes.
Six HIV-positive patients watch them silently. Unknowingly affected by HIV for years, their immune systems are now severely weakened and struggle to fight off infections.
The thin body of a young woman disappears under a white sheet. She no longer has the strength to turn towards her carers.
“Many of our patients arrive in a coma,” doctor Stella said. “Our death rate is between 10 and 15 per cent. Some adults weigh 30 kilogrammes on arrival and around 70 per cent have tuberculosis,” she added.
Most patients in the hospital have HIV, with large boxes of medicine sitting at the end of their beds distinguishing them from other patients.
They are placed in rooms with others “without it being a problem”, said Stella.
But outside the hospital, HIV sufferers face another uphill battle as the social stigma surrounding the illness compounds their woes.
Widespread hostility forces them to hide their diagnosis. Keeping the news a secret is the surest way of avoiding rejection by family and friends.
Malika, a 43-year-old whose flowery yellow garment cannot conceal the emaciated state of her body, discovered her HIV infection during pregnancy in 2006 – only her eldest son and her husband know.
“I have always been scared of the taunts or judgement of the people around me – my illness is a secret,” she said, a weak smile brightening up her sombre gaze.
Malika began treatment immediately after the diagnosis and, to her great relief, none of her children or her husband have HIV.
Although countries around the world have launched public campaigns to fight AIDS, the Central African Republic’s efforts against the debilitating illness have been more muted.
Yet Stella was convinced the battle against the disease could be won. Vital antiretroviral therapy is extremely expensive, but the Bangui community hospital provides them for free to HIV sufferers.
“The medicine reduces the viral load and means HIV does not get transmitted. We can live with AIDS,” she said.