He is insufferably thin.
The whites of his eyes are yellow and his voice is barely audible as he talks about the illness that has plagued him for months.
“For now I am feeling just OK,” says Kampamba, who is seated on a bamboo mat on the ground, resting on a piece of dirty foam that leans against his modest home in the Mulenga Compound in Kitwe. “I am feeling very weak.”
The 45-year-old father of four claims to be suffering from tuberculosis.
However, his caregivers believe he is suffering from HIV/AIDS, which is commonly referred to in Zambia as the slimming disease.
Kampamba started taking TB medication in November, but his health hasn’t improved much.
He doesn’t have a cough.
But he has been suffering from diarrhea for more than three weeks.
He is not yet prepared to be tested for HIV.
Up until last fall, Kampamba had a job with a security company, but he hasn’t left his home in months.
“Since October I have been very, very sick,” he says in a strained voice as his wife and children, three boys and a girl, look on.
“I started feeling fever yesterday,” he tells his caregiver Helen Kambili, a volunteer with the Twafwane Christian Community Care Centre, a community-based organization that was formed in Kitwe in 1999.
Twafwane is a Bemba phrase that can be translated to mean ‘let us help each other.’
That’s just what the group does, providing homecare to residents living in the compound.
Life here isn’t easy.
“There are tough challenges, I can assure you,” says Phidelis Pailande, another of the organization’s volunteers. “It really strikes us when we go out in the field.
“What they cry for normally is food,” he says of the people who live in compound, which is plagued with poor water management and sanitation issues. “Most people in the Mulenga Compound do not work and when they are sick they don’t have the strength or the power to go and find food.”
About 23,000 people live in the compound.
Many are ill.
Twafwane’s 28 volunteers visited almost 1,300 sick residents during the month of February.
One of their greatest challenges is encouraging people to overcome their fear of being stigmatized if they test positive for HIV/AIDS, Pailande says.
“People are actually ignorant about the issues. They think they will be the laughing stock of the community if they are HIV positive. That has greatly hindered our program,” he says, adding most people who are receiving treatment are responding well.
Providing support to those living with HIV/AIDS is the main focus of Twafwane, which also runs a peer support group.
There are 162 members in that group.
“We have volunteered to publicly live positively so our colleagues, when they see us in the community, they see us doing good and they can also come out,” says the group’s secretary, Hughes Munethali.
It is estimated that 16.5 per cent of the country’s 10.9 million people are living with HIV/AIDS.
In fact, the Zambian Ministry of Health’s website notes that everyone in the country is either affected or infected by the virus, which killed 89,000 Zambians in 2003.
Zambia’s first reported AIDS diagnosis was in 1984.
At the end of 2003, UNAIDS reported that 820,000 adults were infected.
The main cause of transmission in Zambia, as is the case throughout sub-Saharan Africa, is unprotected heterosexual sex.
Non-governmental organizations maintain that thousands of cases could be prevented if people consistently used condoms.
But, for many, that means overcoming cultural and religious obstacles.
Mother-to-child transmission also accounts for a high number of infections in Zambia where an estimated 30,000 infants contract the virus each year, either during pregnancy or through breastfeeding.
Women are also at a greater risk of contracting the virus because gender inequality hampers prevention efforts.
Various aspects of Zambian culture also make women and girls more vulnerable to HIV/AIDS, including the practice of sexual cleansing, a common ritual in which a deceased man’s relative has sex with his widow in that belief that this will dispel evil forces.
Child abuse – or defilement – is also a common problem throughout the country due to the myth that having sex with a virgin can cure AIDS.
And, because HIV is a sexually transmitted infection, it is often assumed that those living with the virus brought it upon themselves.
And that stigma often hampers prevention and care, says Ignatius Kayawe, country program officer with the Southern African AIDS Trust (SAT).
“Stigma is still contributing to deaths,” says Kayawe, who notes that programs such as the one run by Twafwane are invaluable in combating the spread of the virus.
The Twafwane project is one of the 25 projects currently being funded by SAT in Zambia.
The organization, which is based in Johannesburg, was created by the Canadian Public Health Association in 1990 and is funded by the Canadian International Development Agency (CIDA).
“Our role is to facilitate … to help our partners work out their vision and strategic plan,” Kayawe says, noting that SAT also funds programs in Malawi, Zimbabwe and Mozambique.
CIDA is contributing $30 million toward SAT over five years.
That funding comes to an end next March.
“We keep our fingers crossed and our knees to the floor that we will get another five years again,” Kayawe says, adding there is still a long way to go in combating HIV/AIDS in Zambia.
“A friend of mine died last year. He was a medical doctor. He wouldn’t just access the drugs. He wouldn’t,” Kayawe says. “So you can imagine; here is a doctor who is supposed to be more knowledgeable about AIDS. But because of stigma, he didn’t want to identify himself as someone with HIV by taking the drugs. He was in denial. He died.
“Even among doctors (who) are working with HIV/AIDS you see denial. Even among counsellors, you still see that denial,” he says.
Kayawe continued saying, “As a result of HIV, there has been a stigmatization of people with TB. It is believed that if someone has TB, then most likely they have HIV.”
Sex and sexuality are also taboo subjects in Zambia, he says.
“It is not traditional to talk about death and planning for death. But also it is not traditional to talk about sex. Sex and sexuality are taboo. That’s where the stigma comes from,” he said.
Pailande, who has been serving his community by volunteering with Twafwane for the past four years, is committed to doing what he can to combat that stigma.
“I base my value on the scripture because God says love your neighbour as you love yourself. So I can’t leave my friends dying. As a Christian I must rescue my friend from dying,” he says. “My faith helps me a lot.”
