Baagi Mmereki is a scientist and a realist. He has wide shoulders and a broad nose, and a deep, generous laugh. Mmereki estimates that he has “two or three, but hopefully not three!” years left in his doctoral program in chemical engineering at U of T. He is anxious to return with his wife and young daughter to his native Botswana, where, he says, he is relieved that not very many people know him.
Although knowing people does not necessarily lead to sleeping with them, Mmereki explains that in Botswana this connection is more concrete. There, an active nightlife can have disastrous consequences. The triple cocktail of youth, time and money (Botswana is one of the richer African countries because of its diamond exporting industry), has contributed to the highest rate of HIV infection anywhere in Africa—more than 35 per cent in adults. Mmereki is well aware of how expansive the problem is. He talks about the first time the scope of the AIDS epidemic hit home. While attending a friend’s funeral, he looked around and realized more than a dozen other funerals were taking place at the same time. Since then, many other people in his hometown, including his uncle and his cousin-in-law, have died and funerals have become more and more commonplace.
“Monday through Friday were for work, and Saturday and Sunday were for funerals,” he recalls. Later, he reflects that although not all of the deaths were acknowledged as the result of AIDS, before the current crisis, “there were not so many people dying.” He says people were “dropping like flies.”
About 8000 African people die of AIDS every day. For the sake of comparison, about 3000 people died on September 11 as a result of the terrorist attacks. AIDS killed 2.3 million African people in 2001, and more than 28 million Africans now live with the disease.
U of T students, faculty and researchers have stepped up their response to this global health crisis. They have pioneered new fields of research, attended to the dying in the hardest-hit areas of Southern Africa and begun to think about developing countries, and their own lives in Canada, in an entirely new way. Amy Andrews is among the students who are learning, first-hand, to use their positions of privilege to answer a distant cry for help. U of T currently has few options for students to study abroad in developing countries, so Andrews designed a program herself to spend eight months of her undergraduate degree at the University of Natal in South Africa. She contributed to a range of humanitarian projects in the country, but says that it was discussing health care with a grandmother, who was also a prostitute, that “changed the face” of what she was doing there. The experience exploded myths about sex workers, and drove home the sacrifices these women must make to support their families. The next year, she returned to South Africa to discuss her experiences at the 13th International AIDS Conference in Durban. One of Andrews’ projects was a month-long trip to Namibia with U of T anthropology professor Richard Lee. Each year, Professor Lee escorts a small group of students to Namibia to lead workshops in “capacity-building”—essentially helping Namibians help themselves. The goal for each Namibian participant is to leave with a concrete research proposal and a little money, so they can begin AIDS research for themselves.
Dr. Kelly McDonald, director of the HIV research program at U of T, is also building partnerships across continents. She first visited Africa as a medical student in the late ’80s, and in the years since has started a collaboration with the University of Nairobi, where she lived and worked. It was in Kenya that she first understood the devastating consequences of AIDS. At the very start of the epidemic, Dr. McDonald treated migrant workers at a clinic in the slums of Nairobi. Although she estimates about a third of the men she treated were infected with HIV, few had reached what is euphemistically called the “end-stage.”
She remembers the day a skeleton of a man was carried in, rattling as he breathed. Gasping and emaciated in his last hours, the nurses comforted him, but were confused. One of the Kenyan women asked her, “Doctor, what is his disease?”
When Dr. McDonald explained that he had AIDS, the nurse turned to the lines of men crowding the clinic hallway and asked, “You mean all of these people are going to die like this?”
Then, Dr. McDonald said, “the spectre of what was coming hit us like a semi-trailer. I remember thinking, ‘I can’t just sit around and take care of people as they die. I have to do something.'”
Now, Dr. McDonald is not only a physician with practical research experience, but an immunologist and epidemiologist. She has taken her experiences in Nairobi and applied them to her research: a group of prostitutes from Nairobi appear to be immune to HIV. After years of sex work, pure luck cannot explain their resistance to the virus. Studying their immune systems, she thinks, may hold the key to a vaccine. She says she is simply “trying to figure out what Mother Nature is trying tell us.”
The early experiences in international health for both the students and aspiring doctors have had lasting consequences. One of the university’s most prominent new members began in medical school studying HIV in young Rwandan children. Twenty years later, in 1999, Dr. James Orbinski accepted the Nobel Peace Prize on behalf of Médecins Sans Frontières, “in recognition of the organization’s pioneering humanitarian work on several continents.”
MSF sends teams of volunteer doctors on humanitarian missions to the countries most ravaged by war and disease. They help people without consideration for their political or social positions, and the organization itself maintains complete political and economic independence. They are there, according to Dr. Orbinski, to “seek to promote change,” and to bear witness. Perfectly courteous, Dr. Orbinski is an intense man with a deliberate manner of speech. He was the International Council President of MSF when the group won the Nobel Prize, and was its Canadian head prior to that. MSF maintains about 50 projects around the world dealing with HIV. It is, he says, “morally indefensible not to advocate for treatment [for HIV] when treatment exists.”
As for students, and their role in mitigating the AIDS crisis, he feels the best thing a student at U of T can do is to learn as much as they can, to “challenge the normative thinking.”
In challenging norms, an individual “will find their way of making their contribution. This is a personal responsibility,” he says, “for everyone privileged enough to be here.”
