BULAWAYO, ZIMBABWE // Ivy Sibanda, a frontline worker in Zimbabwe's fight against the HIV and Aids pandemic, recalls her shock after finding a woman and her grandchildren alone in their house at the point of starving to death. The grandmother, Aramu Ndlovu, who is in her seventies, was looking after her five grandchildren, orphaned after both their parents died of Aids three years ago. The youngest, a three-year-old boy, is HIV positive after being infected through his mother.
Zimbabwe is in the grip of a deepening food crisis, caused by recurrent droughts and the government's own lack of funds to import food. But people living with HIV and Aids are hit the hardest. When Mrs Sibanda found the family in their home in the Nketa suburb in Bulawayo, they had spent five days without eating. "All the six were very hungry," said Mrs Sibanda, the head of the Silundika Aids and Health Council, a grassroots Aids services organisation.
"The granny was collapsing but the three-year-old was worst because of his condition. The baby was so weak and could not cry. They had reached a stage where they were dying." Neighbours could not help as they were struggling to feed themselves. "I used to see pictures from Sudan of children dying of kwashiorkor [malnutrition], but I saw it on the baby," Mrs Sibanda said. "The young baby's condition is now very complicated because, being HIV positive, he already had a compromised immune system. The condition was so bad when I saw them. I do not know what will happen to the baby."
Late last year the National Aids Council, a statutory body that co-ordinates the national response to HIV and Aids, discontinued its programme of providing food packs to people living with the virus. The situation worsened in April when the government of Robert Mugabe, the president, banned field operations of non-governmental organisations, which feed the majority of people, including orphans and sick adults.
Although the ban has been lifted, the effects of the disruption in their food distribution schedules linger. The World Food Programme and aid agencies estimate that about two million people are in urgent need of food. Musa Sibindi, a community capacity development manager for Matabeleland Aids Council, said the plight of people living with HIV and Aids is grim because of the widespread food shortage.
She said because of their weakened immune systems, people infected with HIV or those who have developed Aids need proper food - in the right quantities and quality especially at the critical stage when they start suffering from other infections, diseases such as malaria, flu and tuberculosis that take advantage of HIV-positive people's weak immune systems. Ms Sibindi refused to rule out the possibility of some HIV-positive people starving to death in a country where some households, especially in rural areas, are surviving on wild fruits.
"When there is food insecurity, HIV-positive people are some of the worst affected yet they need high-quality food," she said. "They do not just need food, but nutritious food, in the right quantities. But because of the food shortage, they scurry for it on queues out there, competing with healthy people. So some end up eating whatever is available without necessarily doing so to keep their weakened immune systems in check. This increases their stress levels, thus further weakens their immune systems."
Ms Sibindi said most HIV-positive people do not have predictable incomes as they tend to be too weak to work. Zimbabwe has a high HIV rate, estimated to be 15 per cent. About 1.6 million of its 13 million national population are infected with HIV, statistics issued last year show. Mrs Sibanda lamented the spiralling cost of food, fuelled by an inflation rate of 230 million per cent and a recent government decision to allow some retail outlets to sell foodstuffs in foreign currency.
"We are talking about people who are sick and have no steady incomes. To expect them to buy food in foreign currency or in local currency at exorbitant prices is asking for too much," she said. Her organisation has run out of food to feed its 750 registered minors, including HIV-positive ones. Faced with starvation within its ranks, the Zimbabwe Network of People Living with HIV and Aids (ZNPP+) has written to the Reserve Bank of Zimbabwe, appealing for urgent food aid.
Two months after appealing to the central bank, the organisation is still awaiting a response. Benjamin Mazhindu, chairman of the organisation, said the case of the three-year-old Bulawayo boy epitomises an unfolding national catastrophe. Mr Mazhindu said only a few ZNPP+ members have a secure source of food. "Most of us are taking anti-retroviral drugs," said Mr Mazhindu, who is infected with HIV, "and as you know an HIV-infected person is medically not encouraged to take these drugs on an empty stomach."
"If you take the medication without proper food, your condition often worsens, resulting in death most of the time." *The National