DAR ES SALAAM, TANZANIA -- One of the youngest clients of Theresa Kaijage's AIDS counseling organization was a month-old infant found abandoned in a muddy ditch last April.
The baby, barely alive and suffering from exposure and malnutrition, was taken by police to a local hospital. Routine tests revealed that she was carrying the HIV virus, which causes acquired immune deficiency syndrome, or AIDS.
With little hope of saving the infant's life, hospital officials contacted Kaijage, recognizing her as Dar es Salaam's chief counselor and friend of the city's HIV carriers, known colloquially here as "body positives."
"I got there as soon as I could, but the baby died within minutes," said Kaijage, a professional social worker who last winter founded this east African country's sole advocacy and counseling group for people with AIDS. "The baby had no name, and her mother and father couldn't possibly be traced. So I took responsibility for arranging a burial."
One by one, Kaijage contacted the members of her group called Wamata, a Swahili-language acronym for "people in the fight against AIDS." Dozens of "body positives," as well as widows and widowers, former lovers, surviving children and parents of AIDS victims, gathered at a city cemetery, where the funeral was conducted according to Islamic custom. The infant had been found by police in a predominantly Moslem neighborhood.
"No one in the area ever confessed to knowing who this baby was or why she ended up in that ditch," recalled Kaijage. "But it was a very moving funeral. So many people wept. I think all of us shared a feeling that she was somehow a part of us."
Nearly five months later, Wamata continues to struggle against the despair, alienation, loneliness and official apathy that often characterize the lives of AIDS victims and those close to them here. On a continent of 450 million people, where the disease is growing exponentially and where many experts fear widespread destruction of an entire generation of young Africans, Kaijage views her work very much "like a war."
More than 13,000 Tanzanians out of a population of nearly 25 million officially have tested positive for the virus, but the number is thought to be far higher. The western region of Kagera, between Lake Victoria and the Ugandan border -- just south of the very heartland of the disease in Africa -- is particularly damaged by AIDS. Many young parents in Kagera have been killed, leaving tens of thousands of impoverished orphans.
The World Health Organization estimates that 5 million people in Africa carry the HIV virus, about half the world's total, but some experts figure the number may be as much as twice that. In some of sub-Saharan Africa's major urban areas, including Dar es Salaam, some epidemiologists figure as much as 40 percent of the population may be infected.
Pope John Paul II, during his recent four-nation visit to Africa, ranked AIDS among the gravest threats to Africa's future in a sermon he delivered here, urging Tanzanians to avoid the disease by remaining faithful in marriage and observing biblical teachings.
In Africa, AIDS is spread mostly through heterosexual sex, especially prostitution, in contrast to the United States and Europe, where homosexual sex and the sharing of drug needles are the primary means of transmission.
Kaijage struggles as much with dire issues and consequences relating to those who have the disease and their families as with the various methods of preventing its spread.
As chief of social work and family therapy at Tanzania's National Hospital and Social Welfare Training Institute, Kaijage said she was struck by how many thousands of lives AIDS has affected in Tanzania and how little the state, churches and others seemed to be doing to cope.
"There is still a great stigma attached to AIDS, of course," she said. "It is like leprosy. People would simply prefer to ignore it. But what do you do when the problem becomes so great that you can't ignore it? I think that is where we are."
Last year, Kaijage attended an international social workers' conference on AIDS management and counseling in Montreal and was inspired, she said, by the degree to which people with the HIV virus actively took part in the discussions and debates.
"At most of these conferences, you see people with AIDS from Europe and America all taking very active roles in policy making," she said. "But I have not once seen an African at one of the meetings or even heard of one standing up and saying, 'Yes, I am positive, and this is what I think needs to be done.' The whole continent seems so silent on the subject."
"That is the main reason I wanted to start Wamata," she said. "I want Africa to be heard."
Kaijage raised small donations from family, friends and colleagues, and secured voluntary help from students of social work. She found a small, free office in the house of the Catholic Brothers of Christian Instruction here.
Marked by a modest Wamata sign, the office is located off a quiet dirt street in eastern Dar es Salaam. Upon hearing of the group by word of mouth, AIDS victims and their loved ones have come by the dozens in recent months, bearing stories of pain and hoping for help.
A 28-year-old mother of four tearfully told counselors how her husband, a professional accountant, recently had died of AIDS and how his relatives angrily blamed her for his death -- "a very common reaction in many Tanzanian homes," said Conrad Mushi, a Wamata counselor. "The wife is subject to terrible abuse in a family stricken with AIDS." The woman's house and possessions were seized by her husband's sisters and brothers, who banished her from the premises. She and her children spent several weeks living on a downtown street.
Wamata found a sympathetic lawyer who is seeking legal redress for the widow. The group is providing her a subsistence allowance.
A young school teacher named Wilbert Mutalemwa sought counseling from Kaijage after he tested positive for the HIV virus last year. The social worker said Mutalemwa was frightened and ashamed and for weeks could not face his family without crying. Kaijage said she convinced him that the best thing he could do for his loved ones was to face up to his trouble realistically and to tell his wife and children. A month later, she said, Mutalemwa accompanied her to Kagera to attend a meeting of health workers to discuss the AIDS epidemic there.
"The meeting had been going on for an hour or so when Wilbert suddenly raised his hand. He said he had AIDS and that if we really wanted to help people like him and their families we should be more sympathetic. We should encourage them to speak out and not to hide," recalled Kaijage. "It was wonderful. You could have heard a pin hit the floor. That was literally the first time anyone in Kagera had ever publicly declared he had AIDS. Wilbert just inspired everyone."
In March, Mutalemwa died, but his memory lives in the weekly meetings of Wamata's "body positives." In the shade of a gazebo in the backyard of the friary, Kaijage leads discussion groups of HIV carriers and their loved ones.
Recently, the "body positives" talked about strains in their relations with family members, finding homes for orphans and ways to make sure they stay in touch with each other and keep up-to-date addresses so no one dies or suffers alone.
One of the speakers was Dinah Mutalemwa, the 27-year-old widow of Wilbert. She recently has tested positive herself, she said. She volunteered to talk with foreign physicians at a meeting of Tanzanian health workers.