20 Years after an HIV Scare in Africa
January 8, 2012 1 Comment
– Brian Guse, RPCV, and PC Trainer, Mali
I was perusing the National Peace Corps Association site on Facebook today and saw a post urging readers to check out an RPCV’s blog titled “No Going Back – There Is Only Forward.“
The author is a young woman who was recently med-separated from Peace Corps after contracting HIV while in country (Zambia). Her story is one of courage and strength and she is an inspiration to all – Peace Corps or not, HIV positive or not.
After reading her blog I couldn’t help but think back to where I was 20 years ago and the intersection HIV made with my own Peace Corps experience. By no means do I compare my “scare” with what she is going through, but I think some of you might be able to relate to the story I am about to tell.
20 years ago, almost to the day, I was sitting on an airplane crossing the Atlantic on my way back to Mali. I had been away from my village, my friends and my Malian family for more than 45 days – on medical evacuation for a serious life threatening illness. After having spent a week in Georgetown University hospital, another 2 weeks recuperating in the Virginian Hotel in Rosslyn, VA (Washington, DC) and a couple of weeks fattening up back home in the Midwest, I was anxious to get back to my mission and finish my remaining months as a Peace Corps Volunteer.
To many of the other PCVs I met on medevac, the time spent in DC was like a vacation – time to recuperate from whatever ailed them, job hunt or visit the sites of the Nation’s Capital. For me, those weeks in DC were some of the most frightening days of my life; a time when I thought I was going to die.
As a sexually active gay man in the late 1980’s and early 1990′s I was extremely aware of and paranoid about the prospects of acquiring HIV. Nonetheless, safe sex was a concept but not always a reality for me. Getting tested for HIV was a nerve wracking affair yet throughout college I had been pretty good about getting tested on a regular yet anonymous basis. Then, as now, Peace Corps required a full physical including an HIV test in order to be placed in a country. Before submitting to the full physical, I went to a city health clinic and was tested anonymously one last time. I tested negative. I was ready for the real deal, the official, named and documented HIV test. I tested negative.
I was living in Chicago the day the acceptance letter arrived. Mali, West Africa. Never heard of it. Still, what a happy day. I sat at my favorite Chicago hotdog stand and cried tears of joy and relief as I opened the acceptance letter. The moment the invitation package arrived, the HIV testing stopped. I wanted nothing to get in the way of being a PCV. I knew testing positive would put an end to my dreams of joining Peace Corps so I put it out of my mind and assured myself that I was and would remain negative. If later I discovered I was positive I would be compelled to disclose the information to Peace Corps and end my PCV experience before it ever began. Better not to know. In four non-celibate months I would be on the plane to Mali. Nothing to worry about.
I wasn’t sure of my HIV status the day I flew to New Orleans for pre-service orientation. Stupidly or rather naively, it never occurred to me that Peace Corps would require one final HIV test before allowing me to get on that flight to Mali. The test took place on the first day. I lost sleep in New Orleans. While my fellow trainees were out enjoying their last few nights in the US, I sat in my hotel room shaking with fear. I wasn’t afraid for my health or even my long-term future. Testing positive meant only one thing to me: the end of ever being a Peace Corps volunteer. I tested negative.
After getting settled into my rural village the fears of HIV passed and I focused on other things. In 1990, AIDS hadn’t penetrated land-locked West Africa yet. Peace Corps hadn’t even begun to build an HIV/AIDS sector yet. In my mind the next 2+ years would be a time free from worry. HIV would not get near me.
Several months into my service I received a cassette tape (yes it was the 90’s) from my best friend back home. We went to high school together and came out to each other at a time when coming out was not in vogue. Hearing his voice was wonderful; hearing news about our friends and families brought a smile to my face; hearing him cry as he told me had tested positive for HIV devastated me. HIV had returned to my life; it suddenly became of part of my reality albeit it through someone else; someone for whom I cared deeply but could not comfort in person. I immediately got on my motorcycle and drove to the capital. I placed a phone call to my mom asking her to arrange for my friend to call me from her home the next day. He and I talked for an hour. We laughed and cried and discussed how he became infected. We talked about the future – my future. I felt selfish and petty talking about the community garden I was working on when all he could focus on was whether he’d live long enough to see his 22nd birthday and avoid a slow and painful demise. The early 90’s were an especially frightening time for people with HIV. My generation witnessed the sudden loss of the gay generation before us to AIDS. We had no mentors; we had no role models. To us, AIDS meant death. He was positive. I was negative. He could only focus on the present. I was able to look forward; look to the future. Guilt.
Fast forward one year to three restless nights of fevers and sweats in my mud hut. I had already come down with malaria a few times while in country but this was something different. My Malian host mother had seen enough and insisted that I make my way to the capital to seek medical attention. She sent word by mouth from village to village until a nearby PCV learned I was ill and gave me a lift on his motorcycle to the capital. A few days later I was unable to eat; was losing weight too quickly; had abdominal pains and high fevers. PC sent me to several specialists – no one had an answer. During that time a close friend came to country for a visit. When he saw me at the airport his jaw dropped. I looked bad. In a way that only close friends can speak to one another he said, “You look like you have AIDS.”
Months before, as part of our mid-service physical, Peace Corps required an HIV test. I tested negative. Shortly after the physical I went on vacation to Europe and made up for sexual lost time. For the most part, I was safe. I had nothing to worry about. Until, “You look like you have AIDS.”
The Peace Corps medical unit was unable to diagnose what ailed me. The only choice was medevac. My heart sank. I knew deep down it was HIV. I knew that once it was confirmed Peace Corps would separate me and I would never again see my Malian family. I would never have the chance to say good-bye.
The Peace Corps doctor escorted me on the flight to DC where I was immediately admitted into Georgetown University hospital. I weighed 109 lbs. I had lost 50 lbs in less than a month. The fevers continued. I couldn’t eat. I was delusional at times. I called my mom and told her she needed to come to DC. The doctor spoke with her and said make it quick.
For days, doctors examined me. Phlebotomists drew blood. Nurses held my hand. Students studied me. Most had never seen my symptoms. One intern, I never got her name, boldly suggested a bone marrow exam. She had an idea. She was correct. Typhoid. Curable. Not HIV. No, that test came back negative. Twice. Called mom and said not to worry. “I’ll come visit you once I recover.” Bacon – the first solid food I ate in weeks. I love bacon.
A week in the hospital. Christmas and New Years in the Virginian hotel. Finally, home to mom. More bacon. I spent a good amount of time with my friend. I was embarrassed. I had been worried about myself. I was negative. He was positive. But in those months since sending me the cassette tape much about him had changed. He had come to terms with HIV and was under the care of a number of HIV/AIDS specialists. In the time since we had spoken on the phone he had become positive about life again. He was looking forward; looking to the future. He was not defeated.
20 years later he still is looking to the future. He has lived with HIV for over 20 years. He has suffered losses and buried a lover. He graduated from college. He witnessed his brother’s wedding and watched his nephews grow into fine young men. He bought a house and started a career. He and his partner adopted one too many pugs. Through his strength and perseverance he has inspired all who know him.
I remain engaged in international development. Over the past 20 years I’ve seen African nations fall victim one by one to HIV/AIDS. I’ve seen hope disappear and reappear on the faces of the farmers, students and professionals that I have come into contact with. This month marks the 20th anniversary of my return to Mali. Not a day goes by where I don’t think how lucky I was to have a second chance on life – a second chance to complete my Peace Corps service – although really, come to think of it, do we ever really finish Peace Corps?
You can contact Brian Guse at email@example.com and visit the story on the blog that inspired this article “There is no going back, there is only forward.”