Photo & Text by Michael Fink
- Commandos at Attention
These soldiers are part of the Angolan army's elite Commando Battalion, based near the town of Cabo Ledo, two hours south of Luanda. They were among the most feared and effective fighters in the Angolan military during the 27-year civil war. Highly trained and highly motivated, they fought in Angola, as well as in the neighboring Congo and the Democratic Republic of Congo. Angola's civil war ended in March 2002. Today, the Angolan military, the third largest in sub-Saharan Africa, is turning to face a new, hidden enemy that gravely threatens the security of the nation -- the AIDS epidemic.
- War Torn Kuito
War is a brutal fact of life in this region. In 1999, over half of the world's conflicts occurred in sub-Saharan Africa, involving more than three quarters of the countries in the region, but people here are 10 times more likely to die from AIDS than they are to die in war. Angola has experienced nearly 40 years of armed conflict, leaving much of the country's basic infrastructure -- buildings, roads, bridges, and hospitals -- in ruins. The human tally of the war's impact is equally stunning: over 500,000 people killed, 50,000 orphans, and 4 million people displaced from their homes.
- Live Shells
Although fighting officially ended in 2002, the lethal consequences of Angola's civil war will continue to be felt for many years in the future. Four decades of fighting have left unexploded ammunition and landmines scattered like confetti around the country. The United Nations estimates that there are between 6 to 7 million mines and unexploded devices remaining in the ground, placing Angola near the top of the list of the most heavily mined countries in the world, along with Cambodia and Afghanistan. The country reports one of the highest percentages of amputees in the world.
- Drinking with Prostitutes
Well-paid by local standards, Angolan soldiers often use sex with prostitutes or local girlfriends to relieve the tensions of military life. Studies of militaries around the world indicate that soldiers are two to five times more likely to develop sexually transmitted diseases than civilians, according to UNAIDS. In times of conflict, that rate increases. A recent study by Population Services International found that 32 percent of the prostitutes active in Luanda, Angola's capital city, are infected with HIV. These prostitutes average between 10 and 15 clients a week, and only 63 percent reported consistently using condoms. The consumption of alcohol was also found to greatly increase the risks of transmission.
- Military Hospital, Luanda
AIDS is the leading cause of death in Luanda's main military hospital. Arguably the best medical facility in Angola, the hospital does not even stock the expensive anti-retroviral drugs that can suppress the virus and prolong life. Many here do not know they are infected. In Angola, the vast majority of cases go unreported for two reasons: there are only a handful of HIV testing facilities in the country, and doctors are reluctant to give a diagnosis which they currently can't treat, and which is generally considered a death sentence. Anti-retroviral treatment is available to those who can afford to travel outside of the country, but this is beyond the means of most Angolans. More than 45 percent of the population is unemployed and the average income is $2.40 a day. Today, nearly 30 million sub-Saharan Africans are infected with the HIV virus, but only a tiny fraction are receiving treatment.
- Testing Troops I
At the Capanda Independent Infantry Division, based near the town of Onjiva, in Kunene Province, soldiers line up to get their blood drawn by military technicians -- the first step in the army's AIDS surveillance program. The troops are stationed just 10 miles from Namibia, and they frequently interact with prostitutes who work along the border. These prostitutes also consort with long distance truck drivers travelling from Namibia and South Africa, where HIV rates are staggeringly high. South Africa, according to UNDP, reports a 20 percent infection rate; Namibia, 22 percent. Botswana, which also shares a border with Angola, has the highest rate in the world, with nearly 39 percent of the population testing positive for HIV.
- Testing Troops II
The Angolan military's Division of Health is currently doing a study of HIV prevalence rates on military bases around the country. This survey is done "anonymously" -- the individual soldiers are not informed of the results and the names are not recorded. Dr. Joao DeDeus, the lieutenant colonel running the program, explains that the military does not yet have the capacity to properly counsel soldiers, and that giving them results would be irresponsible. "First, we have to find out the scope of the problem," he says. "Later, once we are better prepared, we will begin dealing with individual cases."
- The Rapid Test
After the blood is drawn, soldiers wait in line to hand a syringe containing their blood to a newly trained technician, who carefully transfers a few drops of blood onto the base of a special "rapid test." Until a few years ago, it could take several hours, or even days, before a lab test would give a result. Today, results can be obtained in ten minutes.
- Positive for HIV
This rapid test responds to the presence of specific anti-bodies that the human body produces after it has been exposed to HIV. A chemical agent reacts when mixed with a blood sample drawn from a person with HIV. Here, the test to the right is reading positive for HIV -- you can tell by the white clumps, which appear as the blood reacts to the chemicals in the test. The three rapid tests to the left are negative; the donor's blood is not contaminated with HIV. Rapid tests may not reveal the presence of anti-bodies to HIV until three months after initial exposure. Also, these tests are not 100 percent reliable, occasionally producing a false-positive result. Positive rapid test results should be confirmed by a second laboratory-based test
- Aids Educator
Captain Laurindo Filemone da Gamba, an officer recently trained as a peer educator, speaks with members of the Commando Battalion based at Cabo Ledo about the dangers of AIDS, how the disease is spread, and the importance of using condoms. Unless these soldiers learn to protect themselves from AIDS, the epidemic may undermine their ability to defend Angola. Militaries in other parts of southern Africa have already been hard hit. The South African Minister of Defense recently acknowledged that 23 percent of South Africa's troops were infected with HIV. Without access to medications, the prognosis is poor. Five to seven years after infection, most African victims of the epidemic will die, states Dr. Eric Bing, civilian coordinator for the U.S. Defense Department's anti-AIDS project in Angola.