(WOMENSENEWS)--When Nicole Itano stepped off the plane in Johannesburg, South Africa, in early 2001, it dawned on her that she didn't know a single person on the continent.
She was 23 and had arrived via a one-way ticket after turning down a full-time newspaper reporter gig in the United States.
By the time Itano left Africa five years later, she had met her husband and reported from 20 African countries. She had also closely covered one of Africa's largest health issues, AIDS.
Itano expands on her AIDS coverage in her new book "No Place Left to Bury the Dead: Denial, Despair and Hope in the African AIDS Pandemic."
Released by Atria Books in the United States on Nov. 20, the book shows how the AIDS epidemic has disproportionately affected women in the southern African countries of Lesotho, South Africa and Botswana. Itano shares the stories of three women and their communities over a period of more than a year and reveals different aspects of this plague.
"Women were the ones bearing the brunt, especially young women, of the epidemic," said Itano, who now lives in Athens, Greece. "This was both in terms of being affected at high rates and also in the communities. It's women who were nursing the sick, taking care of orphans and dealing with the fallout in society from this disease."
In sub-Saharan Africa, 61 percent of people infected with HIV are female and Itano's book coincides with a heightened global attention to the feminization of AIDS in Africa.
Journey to Africa
When Itano moved to Johannesburg in 2001 she thought she'd only stay for one year.
She had worked as an intern for the Times-Picayune newspaper in New Orleans and had completed a history degree, with a focus on post-colonial Africa, at Yale University.
But one year turned into two, which then turned into five. Though Itano's base remained in Johannesburg, she often traveled to cover everything from the Liberian civil war and the beginning of the Cote d'Ivoire war to the elections in Zimbabwe and the AIDS epidemic.
During this period, Itano produced more than 20 stories with various African datelines on a range of subjects for Women's eNews, and also reported for the Christian Science Monitor, the New York Times, Elle magazine and other publications.
Though Itano didn't intend to focus on health issues, she said it was impossible to avoid them.
Southern Africa is the subregion most affected by HIV and AIDS, accounting for 35 percent of all people living with HIV worldwide and almost one-third of all new HIV infections and AIDS deaths globally in 2007, according to the World Health Organization and UNAIDS, the Joint United Nations Program on HIV-AIDS. The HIV prevalence among adults exceeded 15 percent in 2005 in the three countries Itano focused on (Botswana, Lesotho and South Africa).
"It was a very interesting time for AIDS reporting, but I was also frustrated," Itano said. "What I was reporting was superficial in a way. The stories were short and we'd go into an HIV-positive community and not see the people again. You never knew if they were just telling us what we wanted to hear. I wanted to do something that scratched the surface more."
To deepen her coverage, Itano decided to write a series of articles examining three generations of women coping with AIDS.
At the same time, an agent contacted Itano about writing a book. The series developed into the book, begun in 2004.
"At the time I started writing this book there weren't many accessible books about AIDS," she said. "And a lot of writing about AIDS and Africa, particularly about women in Africa, grants sainthood to people with AIDS and strips them of their humanity. I wanted to show the characters as real, complex people who make mistakes. I wanted to show their depth."
In her book Itano shares the stories of Adeline Majoro, a mother who left her abusive husband and was diagnosed with HIV at the age of 22; Mantombi Nywao (Gogo), a woman who took care of her five grandchildren after her daughter died of AIDS; and Seeletso Isaacs and her young son Thabang, both of whom are HIV-positive.
Itano spent more than a year between 2004 and 2006 visiting these three women and their communities. (In 2005 Women's eNews ran a four-part series based on this reporting.)
Through their stories Itano shows how issues such as domestic violence, poverty, alcoholism and a culture of multiple sexual partners are intertwined with the AIDS epidemic.
"Nicole spent real time with these women she followed, more than any other journalist I know," said Laurie Goering, a friend of Itano's and a former South Africa correspondent for the Chicago Tribune. "She saw them in various stages of their infections, in various stages of dealing with their families, attempting to get treatment and deal with the stigma surrounding AIDS and so on . . . Her book does a superb job of painting a portrait of what AIDS means on the ground in Africa."
A Continuing Epidemic
In addition to bringing attention to these women's stories, Itano said she also wanted to give people a better understanding of life in Africa and the issue of AIDS.
The five years Itano spent in southern Africa was a time of enormous optimism and change regarding AIDS, she says in her book. Effective treatments emerged, grassroots activism arose around AIDS, international money poured in and new treatment centers opened up.
"Nicole's reporting and her new book come at a very interesting and important time," said Simon Robinson, a friend of Itano's who also worked as a reporter in South Africa and is currently Time magazine's South Asia bureau chief. "The spread of the epidemic seems to have peaked. People are still being infected, but at slower rates. With the spread of cheaper AIDS drugs you now also have some success in keeping HIV-positive people alive. Nicole's book helps explain this moment and really clearly and beautifully puts it in human terms."
Still, Itano says much more could be done to combat AIDS in Africa. Among other changes she suggests a more effective use of international aid, a focus on preventing mother-to-child transmission of HIV, better access to treatment, and greater involvement by men.
"Women are very frank about what's spreading the virus," she said. "They say it's part of the culture for men to have multiple partners and this culture needs to be eliminated. But I didn't find a single man who talked about this. Until men tell other men to stop sleeping around there will be no change . . . If there is a single issue that the future of Africa depends on, especially southern Africa, it's how AIDS plays out."
Juhie Bhatia is a writer in New York City.