As Ethiopia grapples with HIV/AIDS, it has received relatively little foreign aid. Lifesaving anti-retroviral drugs, widely available in the West, are just an expensive rumor here.
In December, the U.S. government started paying for treatment of 14,000 HIV-infected Ethiopians. The Bush administration wants to expand the program to reach 210,000 people in the next five years.
Wosene Maru cares for orphans whose parents have succumbed to AIDS. "They are still just kids," she said. "I know they don't have anybody."
(Photos Emily Wax -- The Washington Post)
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But since 1998 the Ethiopian government has also launched a campaign to prevent AIDS, calling it "a calamity unforeseen even during the Great Famine of 1984," according to government handbooks on the disease.
Every high school has an HIV-prevention club, run by HIV-positive youth. Buses and billboards have life-size posters of masculine-looking music stars holding condoms. The posters also show a group of Ethiopians sitting around a basket for serving the country's staple food, a napkin-like bread called injera, which people eat with their hands. "It's okay to share food," the poster reads. "No matter what your HIV status."
So many mothers are passing AIDS to their children that the country has started another program to provide pregnant women with free HIV testing. They will also be providing nevirapine, a drug that in most cases prevents mother-to-child transmission during pregnancy and birth. Still, in rural Ethiopia, two-thirds of mothers don't have access to a health clinic and sometimes only suspect they are sick.
"The impact on our country's children is immense," said Birru Birenji, policy and advocacy team leader for the Ethiopia HIV/AIDS Prevention and Control Office, a government-run group. "This means the most productive members of our future are parentless, sick and in serious trouble. A big change must happen here."
'When Will It End?'
As Adelaw Astake was waiting her turn, another young mother, Etenesh Geremew, was pleading with Tamrat for help. Her voice was hoarse, the edges of her mouth were white and her face was swollen with bumpy sores from HIV-related sicknesses.
Death would come soon, perhaps in the next few weeks. Already she was vomiting blood, and a thick chest cough made her wheeze.
"I will leave them quietly," whispered Geremew, her eyes on the floor. "They won't know their mother is going."
Geremew explained that as she had grown increasingly ill, her husband told her to leave their home. After that, she survived by begging in the dusty alleys and intersections of the capital with her two children. As she worked, Yibeltal Ademe, a chubby-faced 4-year-old, waddled by her side. Workone Ademe, 2, with a head full of curly hair, bounced along on his mother's back.
"My husband, he gets so drunk. He makes the house crazy. He hurt me so much," she said, weeping. "Now that we are homeless, we don't have access to food. I don't want them to remember me like this."
Tamrat also started crying, slow tears rolling down her face as she told Geremew there were no spaces for her children. In fact, there was a waiting list of 150.
"Day to day, the number increases. I ask myself, when will it end?" said Tamrat, who helped start the center in a one-room apartment with two chairs several years ago. "You know, I haven't cried in a long time. Because you can't let them see. You have to stay strong, maybe just for the children. They fear when you cry."
Lonely for Their Parents
Six-year-old Radeat Behonegn used to spend hours at the window of the Hope for Children orphanage, waiting for her parents to return.