New Vision - December 29, 2004
Charles Wendo

Today, the most known Ugandan living with HIV/AIDS is Major Rubaramira Ruranga. He has lived with HIV since the mid 1990s. He first had AIDS-related symptoms in 1989, when he was attacked by herpes zoster (kisipi).

To-date, though Ruranga dare not challenge a kanyama (body builder), his figure is far from the frailty seen in the earlier years of AIDS. This is despite the fact that he has diabetes in addition to HIV.

Ruranga is not alone. Slim no longer slims its victims to the extent that it did in the beginning. The typical picture of a pencil-thin patient with protruding bones, falling hair and constantly running nose has become less common. It now appears to be limited to rural areas and slums.

Though the Ministry of Health does not have concrete statistics on this, the Director General of Health Services, Prof. Francis Omaswa, confirms that some of the symptoms attributed to AIDS have become scarce.

What has changed? Has the AIDS virus become less virulent, or is man becoming stronger?

There is no simple answers, says Dr. Moses Kamya, an AIDS treatment expert who lectures at the Faculty of Medicine, Makerere University. One of the reasons is that improvements in care have changed the appearance of people living with HIV/AIDS, says Kamya.

By improved care, he means introduction of anti-retroviral drugs that suppress HIV as well as better treatments for opportunistic infections. In addition, because of increased knowledge, people with HIV/AIDS now eat better and worry less. "Those days if you knew you had HIV you would become depressed and die. Generally people now live longer with HIV," he says.

These are the fruits of the "positive living" concept, says Dr. Matovu, board chairman of The AIDS Support Organisation (TASO).

"People used to worry themselves to death but with counselling, you feed better, worry less and take better care of yourself. On top of that we've got drugs," he says.

Counselling has helped people realise that they can live long with HIV and livened up their spirits, says Dr. Jjuuko Ndawula, Director of the International Institute of Alternative and Complementary Medicine. When the mind becomes healthier, it leads to a healthier body. "At first when people got the disease they thought they were going to die. Stress and anxiety made them physically unhealthy. They would just slim and die. After counselling you accept the problem and live like any other person," says Jjuuko.

He adds that when a new disease emerges, it takes time to try out medications and find out what works. This applies to both allopathic and traditional medicines.

Jjuuko says traditional concoctions have helped many people living with HIV/AIDS to keep strong. One of the earliest ones was the famous kadomola, a concoction widely sold in small jerry cans. Since then various traditional healers have made effective concoctions that clear opportunistic infections or tone up the body. "There are many options in traditional medicine," he says.

Prof. Elly Katabira, who founded the AIDS clinic in Mulago Hospital, says in the past most AIDS patients went to hospital only when they became severely ill. "People used to come on wheel chairs. These days we see people who even have no symptoms coming to us," he says.

Another view shared by a sizeable proportion of doctors is that the virus and the human being appear to be adjusting to each other. This idea is based on the fact that some virus diseases become milder with time.

However, Dr Pontiano Kaleebu, an immunologist at the Uganda Virus Research Institute, cautions that research is needed before anyone can conclude that the disease is becoming milder. "It is true that we no longer see the extremely emaciated people but we need a good study so that we can talk from a scientific point of view," he says.

Until conclusive research is done, the explanations for the changing face of HIV remain assumptions, however plausible they may sound.

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