In Lesotho, AIDS Widow Fights for Life

MASERU, Lesotho (WOMENSENEWS)–When Charlotte Musi married a furniture salesman almost 10 years her senior in 2001, she counted herself lucky to catch a handsome man with a good job.

In her photo album, he is lanky, with sideburns and a charming sideways grin. "He loved me sooo much," says Musi. She laughs as she remembers how her husband, Quenehelo, tried to teach her to drive when she was pregnant with baby Sekabatho, now 2 years old.

Quenehelo’s first wife had died. Later, after Musi was married, she heard whispers among her in-laws about how her predecessor had slowly withered away.

Her husband refused her requests to go together to be tested for AIDS. He was frightened and didn’t want to know if he carried this deadly virus.

Sekabatho was less than a year old when Musi found herself tending an ailing husband. The dining room of the five-room brick home she was so proud of turned into a hospice for her withering dreams.

Eventually, when he was so sick he could no longer walk he agreed to be tested for HIV, the virus that causes AIDS. He tested positive and the news was like a death blow. In Lesotho then, anti-retroviral drugs were available to only a privileged, wealthy few.

"After that he got so sick, he had no power. He just gave up."

Musi buried Quenehelo in April 2003, borrowing 1,800 maloti, about $300, for a coffin and funeral feast from an elderly woman. Her relatives came to sing and weep. They ate the funeral feast and left her there in Naledi, a sprawling neighborhood of potholed dirt lanes on the outskirts of this small country’s booming capital city, which is surrounded by rocky hills.

One Saturday the following May, still grieving but fearful for her own future, Musi went to the Maluti Hospital, run by the Seventh-Day Adventist Church, to have her own blood tested. The tests confirmed her fears. She too carried the virus.

Risks of Incomplete Therapy

Her doctor should have given her a combination of three drugs, a treatment known as Highly Active Anti-Retroviral Therapy, but Musi could not afford the full regime. By taking the incomplete therapy, she risked becoming resistant to the drugs, but as it was, a month’s supply cost almost half the salary she made working 10 hours a day as a line manager in Maseru’s rapidly expanding textile sector, sewing GAP and Old Navy T-shirts for export to the United States.

"If I don’t take these pills I will die. If I don’t eat, I will die," Musi says tiredly. "I am too poor to live."

The months ticked by, and Musi’s body weakened. She often went hungry while she tried to pay off the debt from her husband’s funeral.

Out of each paycheck of between 650 and 1,000 maloti, depending on overtime, the old woman who lent her the money took 500. A year after Quenehelo’s death she was still paying. Each month too, she paid 200 maloti to the young woman from a distant village who watched Sekabatho while she worked. And she needed at least a hundred for transportation to work.

Never Enough Food, Money

Even with the help of Quenehelo’s grandfather, who gave her part of his government pension each month, there was never enough food and no money for new clothes to keep growing Sekabatho warm during Lesotho’s cold, mountain winter. Her own shoes, navy blue heels, pinched, especially on the days she had to walk to work because she lacked the 80 cents for transport.

As the virus wore down her immune system Musi grew thin and began suffering from skin rashes and sores. A few months after Quenehelo died, she fell ill with tuberculosis. For three weeks she languished in the same makeshift sick room where her husband had died. Neighbors and friends from church would come on Sunday afternoons to visit, clucking quietly over her.

"Most of them just thought I was going with my husband. They didn’t say it, but they thought, ‘This one is finished,’" she says.

Although Musi recovered, the illness frightened her. She did not want to die. At the factory where she worked, Palesa Motsoneng, a nurse who provided HIV-testing and counseling, told her about Videx, a new drug that could help HIV positive people.

Musi knew little of the global battles that had been waged for the previous several years to bring down the prices of drugs such as Videx, the brand name of a common anti-retroviral Didansosine, in poor countries like Lesotho.

Price of Medication Falls

By mid-2004, when Musi went to Maluti hospital in search Videx, the prices of many anti-retroviral drugs had dropped dramatically after large pharmaceutical companies had either agreed to drop their prices or waived their patents so lower-cost generic makers could produce the drugs for sale in the developing world.

But even then many patients, including Musi, found paying the $50 needed for a month’s supply was still a struggle.

Musi scraped together enough to buy her drugs for two more months. But in mid-November, she was forced to stop. The money lender was still taking the bulk of her salary and her relatives were no longer willing to help.

Christmas was subdued. She could afford no presents for Sekabatho and the normal feast had dwindled down to a single chicken. Musi went to church but had no energy to visit relatives or celebrate.

Just after the new year, she dragged herself back to the factory, but grew more tired each day. Nurse Motsoneng worried that she was depressed or suffering from AIDS-related dementia.

"There is something wrong up here," Nurse Motsoneng says, tapping one finger to her head. "She must go to see a special doctor for the head."

But before she could help arrange such a meeting, Musi quit. She had finally paid off her husband’s funeral debt. She decided that if she could make a just few hundred maloti each month selling apples in the market she could feed her family. Since she no longer had to be at the factory each day at 7 a.m., she could enroll in the government’s fledgling free anti-retroviral program, a complicated process that required days of standing in line to wait for pre-therapy counseling.

On March 18, Musi rose before dawn to arrive at the government hospital, known as Queen 2.

As she was waiting in line, she listened to the others talk and gossip. Women traded tips on the use of garlic to cure mouth sores, while a man complained that a neighbor who had come to nurse him had stolen soap and flour from his house. But Musi didn’t pay a lot of attention. Today she would start the anti-retroviral drugs again. She was determined to survive.

Her biggest problem now, she says, is to find 80 maloti to buy an umbrella to shelter her from the sun and rain as she sells apples.

Nicole Itano is a freelance reporter based in Johannesburg, South Africa. She is currently writing a book about HIV/AIDS in Africa.