The village that unleashed AIDS on Africa

Kyarisima Annet (24) with her son Evans (4 months) in Kasensero, Uganda. Her husband is a fisher man. The fisher men are the best customers of the prostitutes, but she is convinced that her husband is faithful.Photo: Philip Hedemann

Two girls in the main street of Kasensero, Uganda.Photo: Philip Hedemann

HIV positive Aids counselor Moses in front of his house in Kasensero, Uganda.Photo: Philip Hedemann

Customs toll bar at the main road of Kasensero, Uganda.Photo: Philip Hedemann

Farmer and village elder Abdu Senkima (60) in Kasensero, Uganda.Photo: Philip Hedemann

Nantongo Rose was the first. Her skin turned yellow and her hair turned grey; she became skinny, while her limbs swelled up. Seven months later she was delivered from her pain by an attack of fever. At first the people of Kasensero, a small fishing village on the banks of Lake Victoria, thought that the 30 year old had been bewitched by a muteego curse which can kill whole families. Maybe she stole something from a trader in nearby Tanzania? Was the deadly curse a form of revenge? It was years later before scientists explained to them that Nantongo had not been killed by a curse, but by a new disease. 32 years ago AIDS broke out as an epidemic in Kasensero for the first time. Today, many of the inhabitants of the bleak village are still infected with the deadly disease.

"Mr. Kawnaga was the second. He had the same swellings as Nantongo. But his skin did not turn lighter, but darker and darker. He was suffering from diarrhoea, he lost weight, a few months later he was dead as well. I can't remember who number three was," Abdu Senkima says while torrential rain rattles on the sheet-iron roof of his scrubby hut. The farmer is sixty, which makes him one of the oldest in Kasensero. More than 20 members of his family have died of AIDS.

In October 1978, Ugandan dictator Idi Amin invaded neighbouring Tanzania. In 1979 Tanzanian troops entered Kasensero. They defeated the Ugandan army and Amin fled to Saudi Arabia. "Idi Amin warned us, that the Tanzanians would infect us with a horrible disease and that we would lose our hair. That is exactly what happened," says Abdu Senkima.

The farmer remembers how family members' and friends' limbs would rot off, while doctors watched helplessly; how daughters lost their parents and gave birth to children who later grew up as orphans themselves. "Because the ill became so thin, we called the sinister disease, which soon beset every family, 'slim'. The life in our village nearly came to a complete standstill. Hardly anybody had the energy to go fishing on the lake. Those who were still fit had to bury the dead. Only the tailors were busy, making tight shirts for the skinnies," says Abdu Senkima.

For a long time nobody knew where the disease came from and how it was transmitted, and so it quickly spread through the whole village, from there through the fishermen on the banks of Lake Victoria in Uganda, Kenya and Tanzania, via truckers and prostitutes along the East African Highway in East Africa.

"I think in one year more than 300 people died in our village. When we wanted to move somewhere else, we were outlawed. The doctors injected the people with some ineffective stuff and used the same needle again and again. We did not know that this would make everything worse. And we did not have condoms here in those days", Abdu Senkima remembers.

Today, there are condoms in Kasensero, but using them is not very popular. "Sex with a condom costs between 5000 and 10000 Shilling (£1.22 to £2.45), without starts at 20000 Shilling (£4.90 pounds). Most customers want it without," says Proscovia Birungi.

Every day, she receives up to five men in a dingy hut which is not much bigger than her bed. She does not tell her tricks that she is HIV positive. Most of them do not want to know, anyway. For three years the 25 year old has worked as a prostitute in Kasensero. "Many girls do it without condoms, I do it only with, though I get less money and have nothing to lose," the woman says through missing front teeth. Allegedly, she only had unprotected sex with the father of her son. "He infected me, then he left me," Proscovia  says.

The hairdresser originally came to Kasensero, which smells of despair and old fish, to work as a barmaid in one of the many drinking holes. When her boss stopped paying her, she had to sell herself to support her son. "I lost my dignity. I know that god can take me anytime. But my son is only five. He is healthy. One day he shall become a doctor to help the HIV positives," says Proscovia who, as did not have any customers yet today, must go as the men are returning from the lake.

At the dirty beach, the fishermen are unloading the catch. Many of them are drunk; some of them will visit Proscovia or one of her colleagues later today. "Only with condom," babbles 27 year old Vincent Kiyimba and his colleagues laugh, even though all of them have seen relatives and friends dying of AIDS. But his colleague Dan yells: "I never use a condom. No fun!" The 45 year old has known that he is HIV positive for 7 years. Dan, who smells of fish and cheap booze, does not care what happens to his numerous partners.

Such men make Moses look like Sisyphus. The former fisherman found out that he is HIV-positive eight years ago. Since then, he has worked as a voluntary HIV counsellor in Kasensero. "I tell people about the infection risks, distribute condoms, and make sure the patients take their drugs regularly. But the fishermen are often reckless, especially when they are HIV-positive, or drunk, or both," says the 42 year old. Moses saw three of his children die. The cause of death was never investigated, but Moses, now separated from their HIV positive mother, knows the reason.

Professor Joseph Konde-Lule, epidemiologist at Makerere-University in Uganda´s capital Kampala, is convinced that enough is still not being done to fight AIDS. "We don´t know how to heal AIDS but for 30 years we have known how to prevent infections. We have to improve prevention. But that is expensive and Uganda is a poor country. We need more support from abroad," he says.

According to UNAIDS, the United Nation´s Programme on HIV/AIDS, 47% of the infected population in poor countries had access to AIDS drugs at the end of  2010, while the year before only 39% had access.

Yet, in Kasensero, not everybody is happy about this. Village elder Abdu Senkoma says, "In the days when we called AIDS slim, you could easily see who was ill. Nowadays, it is more dangerous."