Hopkins doctors look for clues to AIDS in Africa

July 02, 1995|By Michael Hill | Michael Hill,Sun Staff Correspondent

BLANTRYE, MALAWI — BLANTYRE, Malawi -- Dr. Taha E. Taha and Billy Chisupe are both trying to do something about the spread of AIDS in this small southern African country. One is a scientist from Johns Hopkins, the other a rural farmer with a dream.

Dr. Taha spends hours at his computer terminal in this, Malawi's biggest city, working over the statistics that chronicle the spread of AIDS from mothers to their children.

Mr. Chisupe, who lives in a small settlement less than 100 miles to the north, chops bark off a tree and soaks it in water to make an elixir, following the instructions he says he received in a dream last August.

Work by Dr. Taha and others throughout Africa has brought into focus the nature of the continent's AIDS epidemic. But the picture is of such bleakness that it drives thousands to seek out people like Mr. Chisupe.

Scientists from the Johns Hopkins School of Hygiene and Public Health have been in Malawi for a decade, full time for the past six years on a project funded by the National Institutes of Health.

When epidemiologists spread out over Africa in the mid- to late 1980s, they were doing the groundwork for what was expected to be trials of potential AIDS vaccines. When no vaccines materialized, the emphasis shifted to finding other ways of stopping the disease. The Hopkins Malawi project concentrated on mother- child transmission.

Dr. Taha, a native of Sudan who received his doctorate from Hopkins in 1991 and has been in Malawi for two years, now records an AIDS infection rate of 30 percent among the thousands of pre-natal patients at Blantyre's major hospital who are in the Hopkins study. That means about 10 percent of all babies born in the city will develop acquired immune deficiency syndrome.

It is a figure echoed in cities across this region of Africa. Urban women of childbearing age are thought to have the highest rate of infection, so, while an exact extrapolation is impossible, it probably means an overall infection rate of 10 to 15 percent in these countries.

Though there is evidence that the AIDS educational effort is paying off, the devastating impact of the disease on all levels of these societies is irreversible for the immediate future.

"Two people came to me in a dream," Mr. Chisupe, 70, said of his inspiration for getting into the AIDS business. "They were people long dead. They asked me if I knew of this disease that has no medicine. I said that I did."

Sitting in a small one-room structure with dirt walls and a thatched roof where he consults with those seeking his advice, Mr. Chisupe told of how these two men took him into the bush, showed him a tree and chopped bark from it.

They took the bark back to his house, soaked it in water in a bowl, poured the colored liquid into a cup and said to drink it. When Mr. Chisupe awoke, the bowl and cup were empty. He found the tree in the bush and it was untouched.

That night, Mr. Chisupe said, the men came back in a dream and told him that the drink would cure those with AIDS and prevent others from getting it. But people had to come to him to get their drink. And he was not to charge them, though he could accept money they offered.

The news of Mr. Chisupe's dream spread, first by word of mouth, then through the news media. Thousands came, crowding his house, breaking its windows.

The road to his home was re-graded. Pit toilets were dug. Malawian Red Cross tents were erected to house those who waited days for their drink. As with pilgrimage stops at churches with valued relics in the Middle Ages, a small village sprang up to sell items to the throngs.

The flood of people that engulfed Mr. Chisupe has receded in the past few weeks, but on a recent day a steady stream still LTC came -- all with plastic cups in hand, taking their drink of the brown liquid. Some left money behind; others just left.

"These people are desperate," said Dr. Taha. "I understand why they go there."

Dr. Taha thought that a study just concluded would give some hope to this country and others like it. Working from data that showed the first twin born to an HIV-positive mother was much more likely to contract the virus than the second, the Hopkins team studied the effects of cleansing the birth canal just before delivery.

Unfortunately, preliminary results show that the cleansing had little, if any, effect on transmission.

Dr. Taha said another study now being prepared will give pregnant women vitamin A supplements, since it is known that mothers with low levels of vitamin A are more likely to transmit the human immunodeficiency virus to their babies. Vitamin A is inexpensive, so the intervention could be used almost anywhere.

Malawi officials asked that Hopkins do some of the laboratory work locally to aid in the training of health technicians.

Several Malawians also have been given fellowships to the Hygiene and Public Health School.

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