World AIDS Day 2008: Brendan Bannon blog - Day Seven
In covering HIV/AIDS stories over the last four years, I am always struck by how much this medical condition is also a social condition. One way or another, the hand of HIV touches everybody and everything in a place where prevalence rates are above 30%.
Weekend rituals include funerals, which are usually held on Fridays and Saturdays. For those on ART, daily rituals include punctuating each day with pill taking and bi-weekly or monthly doctor's appointments.
People adjust - and those who don't die; or they contribute to the epidemic in ways they may not realize.
Photographing the epidemic is always a challenge. It is vast and it is everywhere and nowhere at the same time. The focus could be the clinics and hospitals where treatment is given. But that is only the most obvious place to look.
There are always opportunities to make pictures of the destruction - the destruction of bodies. We know those images well. The real challenge is to effectively show the way that the epidemic is infused in daily life. People really do live useful and full lives with HIV. Their continued presence is important to the people they love.
And yet we can not ignore the reality that people are still dying everywhere. Especially in areas far from clinics. Communities that are not isolated from the spread of the virus are sometimes isolated from the spread of information that may save them.
When they do have the information, they may not have the means - emotional or financial- to convert that information into treatment or prevention. In order to reach the hospital, some people have to travel five km just to reach the road and another 30km on that road to the clinic.
Sometimes you see generational change. I spoke to a woman named Jane who found a way to deal strategically with her life only after she began ART treatment. She began in the fish business, trading her body for the opportunity to buy fish.
"If you didn't sleep with them, they wouldn't sell you fish," she told me.
Most of the fishermen and the fish buyers she knew in her youth have died.
There is a new generation on the small islands and beach communities that has taken its place and will likely repeat the mistakes that she made.
"You would need a lot of money to reach these places and organize the women and educate the men," she told me.
"When I started in this business of fish, there were so many of us. Competition was strong. Getting fish to sell was a problem. There were men admiring us and ready to sleep with you in broad daylight. There were women going along and they bought fish very easily. My husband was still alive and had no job. We had children. So it forced me to compromise for the daily bread.
"If I look for the lives of my colleagues at that time, I cant see them. They have all died. When I realized I had the virus, I realized I would die if I continued living that way. With the ARVs, I knew I would live longer and it gave me a moment to plan. My husband was dead and I was alone. I needed to respect my children. I had to plan how I was going to live.
"People understand things differently, they perceive things differently. I understood my life differently than others and decided to live it in my own way.
"What I am trying to say to whoever will listen is that you must think strategically, especially if you are HIV positive. You have to think, 'Take care and not poison other people'. There is no reason to die early. Life is how you take it.
"Treatment has changed my life and replaced despair with hope."