Africa cannot wake up from this AIDS nightmare
July 14, 2000
IT IS Sunday 5am. I am at my computer because a nightmare woke me. This nightmare was a new one, but I knew its type, as soon as my head had flinched up from the pillow.
Staring around me, half-propped on one arm and trying to make sense of the faint red glow of the digital clock, I knew this nightmare had come to settle on my chest.
A crouching incubus will not be startled away by waking. It puts its face close to my head, to study my breathing and keep watch on my eyelids. At the first sign of relaxation, it slips its nails under my skin. At the first return of sleep, it stabs my brain.
I was standing at the edge of a beach in southern Israel, between Tel Aviv and Gaza, at a remote place where I would sometimes go scuba diving.
I was staring across the water at Africa, all unrolled like a map. I could see it all, from Cairo to Capetown. The soil was cracked and brown, even where the forests of Zaire and Gabon should have been. The coastline was singed black.
I could feel the waves of heat rolling off the continent, but the water between us cooled them. The edges of the map started to curl, and flames burst from the centre.
In a few moments the whole of Africa was a fireball, and the heat was so intense that the waters protecting me began to evaporate.
My breath was searing my lungs. My eyes smarted. I tried to raise a hand to protect my face, but my arm would not move. I looked down and saw my flesh was melting, like plastic under a blowtorch, bubbling together and dripping away.
My arm and my hand were part of the glue of my torso.
Now you understand why I have no desire to sleep again tonight.
I know what spawned the dream. Friday’s Independent, roughly folded on a stack of magazines, is still open at the headline ‘Doomed to die, a generation of African children’. And on top of it is this week’s New Scientist.
The children will die of AIDS. As the 13th International AIDS Conference opens in South Africa, 35 million people have the human immuno-deficiency virus.
Seventy per cent of them are in sub-Saharan Africa, where in some countries one adult in three is HIV positive.
The UN predicts half the 15-year-olds in southern Africa will die from the disease. Nineteen million people have already been claimed.
Zambia lost 1,300 teachers to AIDS in 10 months during 1998. There are not enough doctors and nurses to provide basic care to the victims — AIDS has cut swathes through hospital staff too.
One Irish missionary nun, explaining to reporter Mary Braid how many Zambian villages were peopled only with grandmothers caring for orphaned children who were born HIV positive, said AIDS was rampant in the countries least able to combat it, and added: ‘‘You would wonder how the devil thought the whole thing up.’’
One unexpected line of research suggests Jewish males are less susceptible to AIDS than most African men, though not for any genetic reason. We were circumcised as babies, and the foreskin appears to play a dangerous role in transmitting the infection.
Doctors are divided over the reason, though it could be the inner fold of the foreskin is the part of the penis most likely to tear during unprotected intercourse or ulcerate when infected by other genital diseases.
Some sceptics argue that circumcised men are more likely to live by strict religious tenets, and of course that is true of many Jews.
But controversial evidence reported by Ronald Gray at Baltimore’s John Hopkins School of Public Health reveals another element — in a group where 187 women were HIV positive, 40 of their partners contracted the virus. All were uncircumcised.
None of the 50 men who had been circumcised tested positive.
That’s an infection rate of almost 30 per cent among non-Jews — and zero per cent among Jews and other circumcised men.
The paper, in the New England Journal of Medicine, provoked outrage, because the women had not been treated for their HIV — and the men had not even been informed of the risk.
This obviously does not imply Jews are immune to AIDS. I have seen too many tragic cases at the Weizmann Institute, with the brilliant physician Dr Zvi Bentwich, to fall for that delusion.
But it does give real weight to the Jewish tradition that circumcision is cleaner and healthier.
Among non-Jews, it is one of the most mocked and reviled of our customs, often used to suggest that we are less masculine than other men with their foreskins, because there is a little less of our manhood.
We are also taunted with a Freudian obsession with the shape and size of our penises.
But comparisons of AIDS fatality rates in Benin and Cameroon, where boys are often circumcised, and Kenya and Zimbabwe, where they are not, has shown the practice can offer very significant protection.
The probability of infection seems to be two-and-a-half times higher in uncircumcised males.
Africa is burning up. My nightmare will not go away. The simple operation which has been part of Jewish culture for millennia will not stem the pandemic.
But we have a desperate responsibility to promote every defence that can possibly help.
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