It could be a routine modelling assignment. Larry Mims and Carlos Cordero, fashion-shoot veterans, have flown to an exotic location to exhibit their muscled perfection against a lush backdrop. Vigour is the theme and they do it well, strutting, striding, exuding zest. But this is no photo shoot, and Mims and Cordero are no longer models, at least not in the conventional sense. They are emissaries to Africa’s forsaken and the message they deliver is intended to shock and inspire: both men have had HIV for well over a decade.
In the west that revelation would barely arch an eyebrow thanks to widespread Aids treatment but in poor countries with no such medicine it verges on preposterous as most people diagnosed with the virus turn skeletal and die within 10 years. So when Mims and Cordero roll up at a war zone in the Democratic Republic of Congo to tell a roomful of impoverished women with full-blown Aids that they, too, can have the drugs and be saved they are greeted with disbelief.
A few years ago few would have dreamed that drugs concocted in American and European laboratories for rich westerners would end up here, in Bukavu, a town of widows, prostitutes and refugees in the eastern part of DRC where the massacres happen.
Even fewer would have envisaged such improbable delivery men. An American and a Puerto Rican, one a former Hollywood body double, both gay, occasionally camp, sporting designer trainers and careful to eat the right carbohydrates, Mims and Cordero are more FHM than Heart of Darkness.
By visiting a place rife with infectious diseases they risk their own fragile health but, as HIV treatment advocates, they want to be where need is greatest, they say.
Preaching positive thinking, self-respect, nutrition and the miracle of medical science, they are DRC’s first California-style lifestyle gurus.
”We are going to show skeletons becoming human beings. It’s easy for people with HIV to curl up into a ball. Here they can’t believe that somebody with the virus can live so long and be so healthy,” says Cordero (40). ”I was diagnosed in 1992. I was in a wheelchair, I had skin cancer and looked like a dalmation. My immunity was zero. I was supposed to die in August 1996. And look at me now.” He smiles and flexes a smooth, muscled arm. He dances, too, when the Congolese refuse to believe he is not white. ”I give them a bit of J-Lo shimmy so they see I’ve got rhythm.”
Towering beside him is Mims, well over 6ft and with a body-builder’s chest and the lightest New Jersey accent. Diagnosed in 1987, he has never been sick, he says, thanks to a positive outlook, eating well and exercise. He is 42 but could pass for 32.
His physique, which doubled for Denzel Washington in several films, is kept in shape with daily work-outs. In the absence of a gym in Bukavu he uses chairs and tables to do his push ups and crunches. He met Cordero at a HIV/Aids conference several years ago. They are friends, not a couple.
In Bukavu their task is to prepare dozens of Aids patients for the complicated and fraught anti-retroviral treatment which has extended their own lives. It is part of a pioneering initiative by the non-governmental organisation Médécins sans Frontières (MSF) to use Aids drugs in conflict zones. With 30-million people with HIV in sub-Saharan Africa the need is huge and dramatic reductions in drug prices have made continent-wide treatment an economic possibility. But many patients are poor, badly educated and living in volatile places like Bukavu. Such people cannot be trusted, say some experts, to take certain pills every day for the rest of their lives. They might stop taking them once they feel better, or sell them, or share them with sick relatives, or they may be forced by war to flee into the bush beyond the reach of clinics.
The risk is not just of wasting resources but of swiftly creating a strain of virus resistant to the drugs, rendering the pills useless. A well-meaning but bungled distribution of drugs to a few individuals now could doom future generations of Aids patients, warn the experts.
Enter Mims and Cordero. If they succeed, and Bukavu’s patients adhere to the strict pill regime, an important precedent will be set, bolstering the case for continent-wide treatment. If they fail, the consequences could be ghastly. ”It would be a disaster if a drug-resistant strain emerged,” admits Cordero.
He started in June, coaching those due to begin treatment in batches of 10 every month from October, building up to more than 100 by next year. It is a drop in an ocean of need but offering treatment to even a few boosts HIV prevention by encouraging others to be tested for the virus, says Cordero.
Treatment also tends to reduce stigma, a huge problem which inhibits people being tested and seeking treatment. Bukavu is conservative and Catholic and Cordero and Mims do not tell people they are gay lest it cloud the message. In any case the thought does not seem to occur to the female staff and patients who eye the two handsome foreigners strolling through the general hospital grounds.
A storm is brewing over Lake Kivu as they enter a clinic packed with HIV patients, almost all women dressed in their Sunday finery, who are shortlisted for treatment. Cordero’s routine to explain the virus includes a motorcycle helmet and keeling over, among other theatrics, but today’s prop is Mims.
His French translated into a local langauge by a nurse, Cordero focuses on nutrition. You must supplement the staple fufu, a doughy-like maize, with protein-rich fruits, he admonishes. ”Look at Larry,” he prods a bulging bicep. ”He didn’t get like that by eating fufu”.
Cordero continues, in a honeyed voice: ”But eating well costs money and you have no money.” The women nod vigorously. ”But what do we have here mesdames? Earrings, oh how beautiful! And this necklace, so pretty! And those exquisite scarves … ” The women laugh and blush. Cordero concludes: ”What is more important — your health, or your image?”
Mims, who arrived in Bukavu just a few days earlier, speaks no French and hopes to move to treatment projects in Zambia or South Africa where he can use English. The day after the clinic he visits a school and astonishes children by taking an HIV test and showing the result — positive. The idea is to erode stigma by showing you can live and thrive with HIV, but some pupils shake their heads, convinced the test is fake.
Privately, some in MSF fret that Cordero and Mims could backfire, that people might misunderstand and conclude the HIV tests are unreliable, or that HIV is nothing to worry. ”We have no idea what their impact will be in this cultural environment,” says one doctor. Others mutter that more lives would be saved if the money was spent on conventional MSF projects.
Cordero and Mims dismiss the doubts and point to Mama Josephine Bakaya (50) who, since starting treatment in October, has gained weight and become outspoken about HIV, going on radio to declare her status. ”I did it to give courage to the others. I want people to know about the disease and that it can be treated,” she says.
David Tu, a Canadian doctor with MSF in Bukavu, says that people like Mama Josephine could spearhead a grassroots movement to emulate the success of South Africa’s Treatment Action Campaign. Maybe. But in a society as shattered as Congo’s it could take decades rather than years for robust civil society activism.
The Bukavu project fears that the second group of patients that started in November may be less reliable than the October group. Side-effects such as vomiting, diarrhoea, headaches, fatigue and depression are strong incentives to skip pills, a temptation that grows as full-blown Aids recedes and the patients feel better.
Skip too many, or sell or share some pills, and, Cordero, says he will not hesitate to kick people out of the project. ”I have no respect for people who don’t want to live.”
Both counsellors are optimistic that things will go well and they beam with the news that two of the patients scheduled for treatment have become engaged. You can offer drugs and counselling but none of it will matter unless the patient has something to live for, they say. For Cordero and Mims, it is clear that that something is their job. – Guardian Unlimited Â