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Thursday. October 20, zoos THE KENTUCKY KERNEL“ A www.ltyliernel.com
Special Section

NOT so FAR AWAY

 

You’ve probably already seen images like the
ones inside these pages — Africans,
of all ages. suffering through a life
dominated by HIV and AIDS.

But something changes when you witness
this painful reality with all your senses,
not merely your eyes.

A University of Kentucky medical student
and a Lexington woman tried to make
a difference this summer in Lesotho, which
lies in the heartland of Africa‘s AIDS country.
A Kernel photographer and writer
followed them there.

And in a land 9000 miles from Kentucky.
this global problem quickly hit
close to home.

 

 

 

Stories by Crystal Little | Photos by Jonathan Palmer

 

Top: Matseliso, 10 months old, lives at Touching Tiny Lives in Mokhotlong, Lesotho. She is
one of eight children living at the safe house, which takes in orphans whose family mem-
bers can no longer provide the care they need.

Above: Nirmal Ravi leans against a wall. exhausted, in the operating room in Maluti Adven-

tist Hospital after finishing a 14-hour day. Ravi assisted doctors in eight surgeries in one
day and saw more than 30 patients in the hospital's outpatient ward.

Orphanage reaches out to save 1 Two textbooks and some dedication: , Support group's solidarity
tiny lives from hardship . all one doctor needs to save lives 3 key to overcoming stigma

paoeM paoeAIO ‘ moeAfl

 

 

 Thursday. Oct. 20. 2005 | Pris/l?-

 

 

 

 

 

Nirmal Ravi watches Dr. Dada Kasumps perform her first Caesarean section on an HIV-positive mother. The majority of the births in Maluti Adventist Hospital involve C-sections. By delivering babies in this manner, the threat
of HIV transmission from mother to child greatly decreases.

FIGHTING AN

UK student, Lexington resident try to help a nation riddled with HIV and AIDS

 

s;

”THE LANGUAGE

A guide to conversational Sesotho

Six hours from Johannesburg and
several wrong turns later. Lexington res
ident Tara Loyd and UK medical student
Nirmal Ravi inch through the Lesotho
border after sunset.

This seedy town near Flt‘ksltlll‘g.
South Africa. resembles
nameless border towns: dilapidated tin
andplywood shacks line the dusty.
cracker] asphalt and groups of curious
bystanders hunch into faded wool blan»
kets. their faces hidden in shadows and
their eyes lit from the fires of trash bar-
rels.

The tiny Volkswagen l’olo. crammed
with passengers and luggage. crawls to-
ward the border post. After passing one
checkpoint. Loyd warns Ravi against
getting out and walking the unlit 200
yards to the bitrder-control office.

"it‘s just not very safe at night." she
says in a hushed voice.

This slow approach toward the bor-
derrontrol office is Ravi‘s first look at
poverty in sub Saharan Africa. Their
destination is Lesotho. a tiny. mountain
ous country about the size of Maryland
that has the thirdhighest infection rate
of HIV in the world

It's also where Loyd and Ravi will
spend a tiionth of their summer. volun
teering separately at hospitals and clinr
ies. visiting malnourished infants and
organizmg an HIVtesting day.

They’re entering a country that
needs help. where one in three people
test positiye for HI\' These two Lexingto
nians are about to face an AIDS pan
demic that until a few days ago felt thou
sands of miles away.

But in the moment. as they creep
across a dark stretch of African country
side. us anything but far away.

Ravi's humbling experience

“It‘s AIDS."

The diagnosis stuns Ravi. a stdifipti
ken 23 yearold who came to [K from
Kerala. India

Dr Tonnv .\lw;ihury‘s iintnediate as
sessment of an emaciated ti.3;\'e:irolrl
woman still surprises the medical stu
dent. even though he‘s spent three weeks
in constant contact with HIV positive pa-
tients

The woman came to .\I\valtury 's elittr
1c and told Ravi that she couldn‘t eat
without vomiting soon after. He exam
ined her and concluded she had a classic
case of gallstones.

Mwabury disagreed.

“He comes in and llls‘t looks at her
and says. ‘It's AIDS] “ Ravi said, "I guess
it comes from experience. from all these
cases of HIV day in and day out.

"When you hear hmlbeats. you think
horses. not zebras But in Africa. you
think zebras you don‘t think horses.

"In Africa. you think HIV. not gall

:‘

hundreds of

 

 

 

stones "

And in Lesotho. where the average
life expectancy is less than 37 years old
and :to percent of the population has
tested positive. the virus is a silent men»
ace nnposflble to ignore

"I had not realized the pandemic was
so big." Ravi said, "It's one thing to hear
numbers. :io percent. ()K. what's 30 per
cent'.’

“But when you see people. one after
the other. testing positive for HIV. that's
a different thing, That's the power of
reallife experience. You really have to go
be a part of it to truly comprehend it."

Ravi will likely never forget his own
experience nights spent shivering

Sesotho (“sah-soo-too"): The language of Lesotho

Lesotho ("Iah-soo-too"): Mountainous country in sub-Saharan
Africa with the third-highest HIV-infection rate in the world
Sesotho ("bah-soo-too"): The people of Lesotho

Mosotho ("mah-soo-too”): An individual in Lesotho

Ausi ("ow-see"): Sister; 3 term for a girl or young woman

We (“may"): Mother; a term of respect that refers to a woman
Abuti ("ah-boo-tee"): Brother; a term for a boy or young man

Above: Nirmal Ravi, 25, is a
second-year medical student at
UK. This summer was his first
trip to Lesotho.

Left: Tara Loyd, 28, is a former
Peace Corps volunteer who
continues to raise awareness
about HIV and AIDS around Lex-
ington. This summer marked
her second trip to Lesotho
since leaving the Peace Corps
in 2001.

”I'm just trying to
figure out how not
to ignore this
incredible problem."
Tara Loyd

lexinglon resident,
on coming to grips with HIV and AIDS

next to an inadequate propane heater.
studying medical textbooks by candle-
light and rediscovering what a treat in
stant pudding can be. even in the midst
of such a stark situation.

Three days into the trip. Ravi had al-
ready assisted in two circumcisions. a
handful of (‘aesarean sections and an
obstructed bowel procedure. The bowel
surgery involved a woman in her 703
who had been vomiting feces. Ravi said
that scenario alone attests to the con
trast between American medicine and
health care. in a developing country.
where patients often don't go to the (loc-
tor until their condition is nearly un-

bearable.

“It‘s a humbling experience." he said.
zipping his slim, 5—foot-2-inch frame into
a blue Coleman sleeping bag. “I’m from
a developing country. but that‘s devel-
oped when compared to Lesotho."

Loyd's mission to dispel myths

During her two years of Peace Corps
service in Lesotho. Tara Loyd fell in love
with the country and its stark moun-
tains. brilliant, cloudless skies and the
genuine warmth she felt from the peo-
ple.

Five years later and 9.000 miles away.
the 28-year-old still worries for its peo-
ple. This is her second stint in Lesotho
since the Peace Corps in 2001. She's still
most concerned for the children or-
phaned by the AIDS pandemic. Their fu-
tures will probably lack the support they
desperately need. Those children are to-
morrow's community leaders and role
models.

Loyd knows Lesotho hasn‘t seen the
worst of it.

“We haven‘t really reached the tip-
ping point where enough people have
died that the society feels it as deeply as
it‘s going to," she said. “I think there‘s a
lot of infection in the population right
now that‘s not talked about yet. that’s
not recorded in any kind of census."

She worries, too. about the percep-
tion of Lesotho in the United States.
She‘s afraid Americans will decide the
Besotho are ignorant. poverty-stricken
people with nothing better to do than
have sex. Lesotho's HIV-incidence rate is
just behind Botswana and Swaziland.
which are ranked first and second in the
world.

“Every time I think about it. I think.
‘Why is it really different from anywhere
else in the world? Why southern Africa?
Why is it more affected than South
America. than the U.S.'?' " Loyd said.

“I really don‘t know that it is, but
somehow, all of these factors have come
together here and just exploded.“

Poverty and a 40 percent unemploy-
ment rate are part of the problem. as
well as a lack of women‘s rights. at least
in the Western sense of the term. In
2003. the Sexual Offences Act was
passed. which made rape a crime for the
first time.

More than 60 percent of Lesotho‘s
able-bodied men worked in the diamond
mines of South Africa until two years
ago. when the majority of mines shut
down. The men were gone for months at
a time. Away from their wives and chil-
dren. it‘s commonly accepted that they
would have sex with prostitutes. Loyd
believes it's far too easy to point accus-
ing fingers at the sex workers who will
accept a higher price to have intercourse

See Lesotho on page A3

Htate (“nnn-dot-tay"): Father; a term of respect
that refers to a man

Lumen ("doo-may-Iah"): Hi

I! phola loong ("ooh pay-Iah jwong"): How are you?
He pheIa hontIe ("kay pay-Iah ahn-clay"): I am fine/I feel fine.
Lokhol ("Iah-hoe-ah"): White person
Le he ("lay ki"): Are you here?

He too. (“liay ting"): I'm here.

 

  

Lesotho

Continued from page A2

 

without a condom.

"If a woman is employed, she
works in the garment industry so
far from home that she can‘t real-
ly go home except for a few times
a year," Loyd said. “She has terri~
ble working conditions — so bad
that sometimes, she has to trade
sex for food or sex for rent or sex
for money to send home to keep
her children alive.

“I think it's easy to put your-
self in a place and think, ‘I would
never do that; I would never sell
my body for anything,’ " she said.
“But you watch your little sister
starve to death in front of you be-
cause you‘re unwilling to sell
your body for anything, and I‘m
sure you would."

In addition, myths, miscon-
ceptions and stigma surround
HIV and AIDS. Some people in
Lesotho don’t believe HIV actual-
ly exists; it’s viewed as a scare
tactic from the Western world to
keep the people of Africa from re-
producing. Others think white
people brought the virus to Africa
as a means to genocide, and that
HIV doesn‘t exist in any other
part of the world. Some believe
condoms cause HIV — the ratio-
nale being that before there were
condoms, no one heard anything
about HIV, and now that condoms
are freely distributed, HIV is
everywhere. Condoms have
worms in them. HIV came from
monkeys. The list goes on.

But one myth in particular
terrifies Loyd: In some communi-
ties — especially in remote areas
- it’s believed that HIV can be
cured by having sex with a virgin,
which has been loosely Wet-
ed to mean anyone from an infant
to an old woman. >

“When I first heard that myth.
I wanted to think. ‘That can't pos-
sibly be true,’ " Loyd said. “But
when you go into rural. rural
clinics 931d you see official lami-
nated‘zfposters that say, ‘Raping
this &by girl will not cure you of
AIDS, it will just infect her.‘ or
you go down to the capital to the
Lesotho Child Counseling Unit

“lily/Alps

Above: Nirmal Ravi heads to Mokhotlong Government Hospital at unrise. Most days, he was gone by 8 am, and he had to
return to his cinderblock house by sunset, which was usually at about 5:30 pm.

and meet a woman who is house
ing and taking care of 12 or 15
kids who've been a victim of that
crime " she trails off. her voice
shaking and her blue eyes brim-
ming with tears.

“I want to believe that people
are so afraid that that‘s why it
happens ~ they really. truly
think they can be cured —— but it's
just devastating to me. And it
makes this place a very danger-
ous place to be a young girl or a
child."

Despite her intricate knowl-
edge of these horrifying realities.
Loyd insists she's a normal per-
son. She shops for clothes online
and waits tables at Harvest on
South Ashland Avenue in Chevy
Chase. Regulars who know she‘ll
be returning to Africa often leave
her a little extra tip and ask that
it gets to the children at Touching
Tiny Lives, the orphanage where
she volunteers.

The willowy University of
Virginia graduate has a mortgage
and a serious boyfriend. and

HIV: Human immunodeficiency virus; a virus
that infects the body through blood or blood
products and iSLalso transmitted through sex-
ual intercourse. the virus invades human tis-
sues and cells in the body and also targets
cells in the immune system, using certain
types of white blood cells called lymphocytes
to replicate itself. After the virus replicates, it
kills those white blood cells, which depletes
the immune system. The virus sprtah'mto lit
tissues of the human body. including the

brain, spleen and spinal cord.

AIDS: Acquired immune deficiency syndrome;
AIDS is the most severe manifestation of
infection with HIV and can be triggered when
white blood cells called lymphocytes drop to a
count of 200 or less, and/or when the patient
becomes ill with opportunistic infections such
as tuberculosis. In many cases, AIDS is marked
by debilitating weight loss, extreme tiredness,
bouts of diarrhea and a high susceptibility to

infection.

Antlretroviral drugs: Also known as ARVs and
ART (antiretroviral therapy): these substances
are used to kill or inhibit the multiplication of
HIV. Antiretrovirals are usually combinations
of different types of drugs used to combat the
virus. the first of which was Retrovir (zidovu-

dine), also known as ZDV or AZT.

604+ cells: The terms CD4+ cells and T-cells
are used interchangeably. A CD4+ cell is a
type of white blood cell called a lymphocyte.
These cells are integral to fighting off infec-

tion within the body: without them, the

immune system is weakened. HIV uses these
cells to duplicate, then kills them when repli-
cation is complete. When the count drops to

200 or less, HIV becomes full-blown AIDS.

I It is possible to be HIV-positive for many
years before a patient realizes he or she is
sick. This “asymptomatic phase “ can last as

long as eight years.

South
Africa

I It's important to note that HIV treatment
does not only entail medication - proper
nutrition. exercise and rest all contribute to
maintaining a healthy lifestyle. Poor nutrition,
in fact, can be more harmful than a lack of
available medicine for HIV-positive patients.

SOURCE: Dr. Ardis Hoven, infectious disease specialist,
UK Chandler Medical Center

laments the lack of hair dryers
and good peanut butter in
Lesotho.

But her two years of Peace
Corps service as an HIV volun-
teer have left an impression that
surfaces in even the most ordi-
nary of circumstances.

Like Christmas dinner at her
grandmother’s house, when she
and her uncle. a physician.
launched into a conversation
about condom use in southern
Africa.

“My mom (was) nudging me
under the table." Loyd said with a
half-hearted laugh. "Maybe talk-
ing about condoms at Christmas
dinner is a little extreme.

“I don‘t mean to be depressing
or overwhelming." she said.
“Maybe my chit-chat is not really
normal anymore.“

Readjustment came eventual-
ly, as Loyd played catch~up with
cell-phone technology and Mi-
crosoft Office. Trips to Wal-Mart
and Meijer became culture-shock
milestones.

“The excess. and the realities
of what gets wasted. how isolated
our society can be, and how little
we sometimes know about the
rest of the world , all that takes
a while to get used to.“ she said.

In May 2004. three years after
she returned to Lexington. a
phone call from Lesotho took
Loyd back to Africa , literally.

The call came from Ken
Storen. a fellow Peace Corps vol-
unteer from Loyd's group of
trainees. After five years in
Lesotho. working at Gardening
for Rural Well-Being. a non-profit
agriculture and orphan outreach
organization in the village of
Mokhotlong. he had seen count»
less infants and children lose
their parents to AIDS. He‘d
watched as relatives. already car-
ing for other children. tried
and failed , to take on the re-
sponsibility of another family
member. He saw these relatives
struggle to feed the older kids
while buying exorbitantly expen-
sive baby formula.

LOCATING LESOTHO

 

Thursday, Oct. 20. 2005 I PAGIAB

 

Vole-1mm In“
"hum-Inland
ummmwfim.

 

 

Above: This UNICEF-sponsored poster
in Lesotho dispels one of many myths
surrounding HIV and AIDS. Some
Besotho believe that having sex with a
virgin will cure them of the virus. This
interpretation has led to the raping of
infants.

“Ken decided to open up his
home to orphans.“ Loyd said. “He
felt like he'd watched enough ba»
bies die unnecessarily"

Loyd soon became something
of at Lexington liaison for Storen
and the safe house. Touching
Tiny Lives. Loyd made phone
calls and typed dozens of e-mails
to engage people in Kentucky. She
researched tax deductions and
how to achieve non-profit status.
doing as much legwork for Storen
as possible.

Loyd wrote letters to everyone
in her address book. asking for a
$10 donation each month. She
stressed that this was not Sally
Struthers' ”Feed the Children" « ,
in this instance. donors would
know for certain that their money
reached the kids, buying formula.
bottles. food. toys. clothes and
medicine.

She also helped spread the
word about Storen‘s own way to
engage people: “Six Degrees of

See Lesotho on page A8

BY THE NUMBERS

22.2 .

Population, in millions

320,000

Adults and children,
ages 0-49, with HIV

Estimated percentage of
adults with HIV

29.000

AIDS-related deaths in 2003

51

Percentage of women,
ages I5-24, with HIV

25

Percentage of men,
ages 15-24, with HIV

90.000

Orphans, ages 0-15, primarily
from AIDS-related deaths

36.8

Average life expectancy.
in years

 

 Thursday. Oct. 20. 2005 | Pm: Aft

 

Six degrees of hope

Touching Tiny Lives offers solace in midst of AIDS pandemic

When Ken Storen‘s 9-to»5
day at the office ends. his
real job begins.

Stretched out on the
floor with his back against
the couch. Storen cradles 3.
itionthold Likhetho in one
arm. holding a bottle to the
infant's tnouth with his free
hand. while 18-iiionth-old
'I‘umeliso and lti~month-old
Matseliso vie for his atten-
tion. alternately tugging on
the sleeve of his gray shirt
and crawling up his bat-
tered khakis. ’I‘wamontlr
old Litsepiso is bundled in a
tleece blanket. asleep. on
the couch behind Storen's
shoulder.

This is what Storen calls
his real job not the eight
hour day he puts iii as man-
aging director for Garden-
ing for Rural Well-Being.

It's here. in Storen‘s
three bedroom house in
.\lokhotlong. that Touching
'I‘iny Lives became a reality
in May 2004. It's a safe
house for children who‘ve
lost their parents to HIV
and AIDS. whose relatives
don‘t have the finances or
other resources to care for
another child. It's not exact-
ly an orphanage. because
the goal is for these chilr
dreii to eventually return to
’heir extended families and
communities.

“I love working with
duldren." Storen said. "You
look at so many problems
a'ound you riii Lesotho)
.i.id \‘oii can get over-
whelmed by allot them. so I
tet'ided, ‘\\'eII I‘ll work
-.\ ith the group I like best.' "

Iiuring his third year of
I‘eace (‘orps service. the na
tiye New Yorker worked
web the non pl‘till! organi
x'ttion (lRlM‘ to facilitate
iirphan-outreach pi‘ogi'aiiis.
Steren knew many of the
children affected by the
.\II).\‘ pandemic were living
with little food and no eino
tional support He hoped
these workshops could help
"each main oi them

‘It wasn't enough." he
said “We had kid.s who had
lust nowhere to go,

"We had children coin
plelely malnourished and
\Il'h' and there was absolute
iy nothing being done. it
seemed. to provide for
IIlt'Ill ”

Then with help from so
rial worker .\IaIinthoana
Khania. \‘toien met I and .c

 

 

Kananelo, an l8-month-old girl, is one of eight orphans who lives at the
Touching Tiny Lives orphanage in Mokhotlong, Lesotho. After 13 months
at the orphanage, “Kani” found a permanent home with her uncle this
summer and was able to return to her community.

half~year-old Tiisetso. who
was living in nearby Tha»
hang. the village where
Storen was stationed for his
Peace (‘orps service.

'I‘iisetso‘s HIV-positive
mother had died and he was
living with his aunt and un-
cle. who were already car»
ing for two other orphans.
The couple didn‘t really
want the added responsibil
ity of another child. Storen
said.

"They thought he was
going to die his mother
had died of AIDS and he
was sick. so they left him in
a house by himself." Stolen
said, “No food Occasionally.
a 1 year old would throw
scraps for him to find."

'I‘iisetso was living alone
in a dark. one t‘otii‘.‘ Iiut.

malnourished and covered
in sores. His uncle would
sometimes intentionally
leave him outside on partic
ularly cold. rainy nights.
hoping he‘d find the boy
dead the next morning.

"They‘d just find him
crying (instead)." Storen
said. shaking his head in
disbelief. "They called him
the crippled infected boy.
and they were just waiting
for him to die.“

Storen and Khama took
Tiisetso to Khama‘s home

he was skinny. covered in
rashes and unable to walk.
He began drinking formula.
then juice and milk. gain»
ing weight and growing
stronger. Now. the healthy .‘l
yearold still lives with
k‘hama.

 

And while Tiisetso actu‘
ally never spent time at
what would become Touch‘
ing Tiny Lives. he was the
inspiration behind the safe
house, which now boasts an
ll-person staff of local
women.

“This little guy from my
original village helped get
this whole thing started by
being a cute little l-anda
halfvyearold," Storen said
with a laugh.

Tiisetso‘s story is also
why Storen stays in
Mokhotlong.

Today. feeding Likhetho
with Tumeliso and Mat-
seliso beside him on the
floor and Litsepiso sleeping
on the couch behind him.
Storen knows why he stays
in Mokhotlong.

For Tumeliso. Matseliso
and Likhetho.

For Litsepiso. who came
to the safe house at six
weeks old. weighing less
than she did at birth.

For Z-and-a-half—year-old
Retselisitsoe. the only or-
phan who has tested posi-
tive for HIV.

For 19