Allies of AIDS / Among warring factions in Congo, disease
Allies of AIDS / Among warring factions in Congo, disease is
Newsday - July 9, 2000
Laurie Garrett, Staff Correspondent
Kampala, Uganda-It was born out of war, spread in war and may
mutating into an explosive nightmare amid war. HIV, soldiers,
and prostitutes: These are the elements that spawned and
Africa's horrendous AIDS epidemic.
For at least thirty years military forces have served as
vectors for the deadly virus. Today, HIV has found unwitting
in the war raging in the Democratic Republic of Congo.
Surprisingly, the war in Congo has indirectly affected
information at Los Alamos Laboratory in faraway New Mexico. In
enormous computers there are stored the genetic details of
analyzed strain of HIV viruses, with the earliest sample
1959. Dr. Bette Korber and her colleagues have noticed
that, "something strange is going on in Congo. It's as if
African HIV clades [subtypes] are mixing there, forming
recombinants. We're seeing variants never seen before."
At least seven different countries are fighting against one
in battles meant to decide the fate of Congo, formerly known
Zaire, and its valuable oil, mineral and gem resources.
The Congo War, which began as a civil war in 1996 overthrowing
dictator Mobutu Sese Seko, originally placed rebel leader
Kabila in power. Guerrillas, representing various Congolese
groups, are fighting Kabila and one faction or another is
military forces from Uganda, Rwanda, Zambia, Namibia, Zimbabwe
Angola. Congolese rebels also have been moving freely in
Burundi, Sudan and the Central African Republic. South Africa
attempted to broker a peace, but all sides are tugging at the
influential nation, hoping to drag it, too, into the fray.
This spring, hostilities took turns for the worse as Rwandan
Ugandan troops-supposedly fighting as allies-opened fire on
another. In May, Kenyan President Daniel arap Moi and
President Benjamin Mbaka brokered a peace deal but fighting
continued. In northern Tanzania, government officials said
the war will soon spill over into their Kagera District.
Until recently, one of the "remarkable features about
HIV" was the
geographic restrictions seen of various subtypes, or clades,
virus. In the Lake Victoria region (Uganda, Kenya, Tanzania
Rwanda), nearly all HIV was of either the D or A clades. In
Africa, where the epidemic is comparatively newer, C clade has
dominated. The C clade has also been the major form of HIV in
Ethiopia and the Horn of Africa. West Africa, in contrast, has
dealing mostly with A, G and D clade viruses.
But now, Korber said, "recombination is happening so fast
that we see
the clade distinctions beginning to blur," and viruses
that have genetic bits of, for example, Ugandan D clade HIV, C
pieces that look Zambian and A clade material that appears
It is not possible to predict whether this Congo HIV mlange
to greater dangers.
Maj. Ruranga Rubaramira of the Uganda Defense Forces
that AIDS is taking a serious toll. In a May speech at an AIDS
in Kampala, Uganda's vice president, Dr. Speciosa Wandira
declared the epidemic "a security issue," implying
that her country's
advances in rolling back HIV incidence could be threatened by
brought home by returning soldiers.
It wouldn't be the first time soldiers brought HIV home to
Ugandan wives and girlfriends.
In 1962, Uganda gained its independence from the British
bringing Milton Obote and his military right-hand man, Maj.
Amin, into power. Amin then overthrew Obote in a coup in 1971,
commencing what is commonly called "the Ugandan Reign of
bled the national economy dry, expelled the nation's Asian
and ordered the torture and execution of an estimated 500,000
Ugandans, about 3 percent of the population, during his eight-
Amin directed much of his brutality against the Baganda people
Uganda's Rakai District. For three years Amin's soldiers, many
them mere boys, occupied the district, exacting
"tributes" in the
form of sex with village women.
On Oct. 30, 1978, Amin's army, bolstered by arms supplied by
launched an invasion of neighboring Tanzania. The troops
Rakai District and rolled unopposed across the border, seizing
Kagera District of Tanzania. Six months later, the Tanzanian
reclaimed Kagera with a force of 45,000 and, upon seeing the
destruction, rape and brutality Amin's soldiers had exacted
their fellow countrymen, descended upon hapless Rakai with a
"They stayed here a very long time," Serapio Semanda,
age 75, recalls
in Kibumba village in Rakai. "They were just brutal,
women, roaming like vagabonds."
Amin retreated to Kampala, recalls attorney Sophia
was then a student at Makarere University. Even then,
Mukasa-Monico, Amin said, "There is a very, very bad
disease that is
passed by sex and it is from Tanzania. It is venereal and it
"And that was 1978," said Mukasa-Monico, who heads
group, The AIDS Support Organization. "Even at the
University we were
saying some of the boys had this new disease-be careful. And
Idi Amin's time something fell in the morals. And sex was the
But the disease wasn't from Tanzania-though by then infected
Tanzanian soldiers were spreading it. Thanks to the Amin
and the movement of soldiers in the area, AIDS soon exploded
Kagera District of Tanzania.
Since the global AIDS pandemic first exploded out of warfare
Uganda and Tanzania, military activities-both conventional and
guerrilla-have played a key role in spreading HIV around the
continent. In April, when President Bill Clinton declared the
epidemic a U.S. national security threat, the rising infection
among African militaries were crucial to his move.
In Uganda, military affairs were also what originally awoke
Yoweri Museveni to his country's AIDS crisis shortly after he
overthrew the government in a military action in 1986.
"Because in 1986, after the president came to power, they
guerrilla force," recalled Dr. David Kihumuro Apuuli,
head of the
Uganda AIDS Commission. "They wanted to transform it to a
conventional army. So they sent 50 generals to Cuba for
18 turned out to be HIV-positive, and Castro called Museveni
said, 'You have a problem.' And Museveni felt so sorry, so
because these were comrades who had fought with him in the
Maj. Rubaramira, who fought alongside Museveni and became
with HIV in 1985, said that Museveni "talked about HIV
even when we
were in the jungle. He wrote a message to all officers to be
of the new disease."
Following Castro's startling phone call, Museveni decided to
whole nation, starting Uganda's large-scale and candid AIDS
A similar chain of events befell the Zimbabwe Armed Forces, as
related by Brigadier General David Chiweza-but with a markedly
different outcome. Chiweza fought alongside Robert Mugabe in
Rhodesian Civil War of the 1970s, and once Mugabe became
the renamed nation, Chiweza rose through the ranks of
"This is where I come in," Chiweza explained.
"I got a vision 10
years ago. I was in China as Zimbabwe's defense attach."
China had a mandatory HIV testing law for all foreigners. The
under Chiweza's command were screened, "and the Chinese
called me in
and said, 'Look, we can't accept them in the country.' And I
lot of my guys were HIV-positive. It was 1990 and 13 out of 60
HIV-positive, and 30 out of 60 had" sexually transmitted
diseases. "So that was a shocker for me. As a military
man I never
thought about HIV. For at least a week I was not myself. I
because I couldn't believe I would be well when so many of my
countrymen were not."
Chiweza retired from the military in 1995. Today, he notes,
are soaring among Zimbabwe's military personnel. And unlike
Mugabe has remained nearly silent on the subject of AIDS
his 20-year rule of Zimbabwe.
HIV rates in African militaries all over the continent have
frightening proportions, with the highest seen in South
spring a malaria survey was conducted of the South African
Defense Forces stationed in the state of KwaZulu- Natal. It
decided as an afterthought to screen the blood samples for
percent turned up positive for infection. Soldiers in a base
Mozambican border tested 70 percent positive, prompting
across South Africa to declare that three-quarters of the
soldiers were infected.
Seventy-five percent is the current infection rate of the
Army. And Zimbabwe's Army, in a recently disclosed survey that
been meant to remain secret, turned up 80 percent positive.
Earlier this year the U.S. Central Intelligence Agency
estimates of African military infection rates, indicating that
60 percent of Congo's and Angola's armed forces, 20 percent of
Nigerian military, and 30 percent of Tanzania's army are now
"Amazing, no?" asks Apuuli. "So definitely war
is going to perpetuate
HIV/AIDS on this continent."
Marked features of contemporary African warfare are famines,
refugee movements, widespread rape of village women and
levels of prostitution in urban areas by women desperate to
means to feed their children. All of these outcomes may
sexual behaviors that spread HIV.
"So, soldiers die of HIV in Congo-is anybody surprised by
indignantly asks Dr. John Rwomushana of Uganda's AIDS
Commission. "They shouldn't be. This whole region is a
setting. These issues must be addressed. A success story of
[AIDS control] is nothing in a sea of HIV/AIDS. The war is
demonstrating this. For HIV there are no boundaries. Leaders
put down their arms and fight a different war-against
Zimbabwe, where one of four adults is HIV-positive, is taking
opposite course, however, spending roughly twice as much
money on the war in Congo-a nation with which it shares no
as on health.
"I have to defend Defense," Minister of Health Dr.
insisted. "It's a very unstable continent...We are
reluctantly in the
DRC [Congo]. None of us want our people to be killed on
Chiweza, the retired general, was stunned.
"I think it's always better to serve the highest, rather
immediate goal. In the end you will be confronting
In Uganda, Major Rubaramira was more adamant, and angry.
war," he shouted, pounding his fist on the table.
"If there is any
strategy to fight AIDS it should be used. And if someone
that, that person is an enemy for humanity...the spread of HIV
fault of the leaders.
"And I think if they are not going to listen we should
mechanism of infecting them."