Uganda Perspective

The National Motto: “We Are Not Organized"

I need to take a break from The Reality of AIDS for a moment to get something off my chest. Why is it, with Uganda's tremendous oversupply of highly educated people, all those engineers, consultants, architects and scientists – and access to the world’s expertise just for the asking - why can’t they build a road?

Take a look at the photo included here. This is a brand new road in Mbarara that collapsed earlier this month. There is a “bypass” in Kampala that was supposed to be completed for the Commonwealth Heads of Government (CHOGM) meeting in Uganda a year ago and is not finished yet. A 60-mile road from Kabale to Kisoro, under construction for over a year, a very very expensive and very needed project, has been graded and smoothed but is not yet paved – and is washing away while it waits for macadam. The main roads in Kampala are paved while all others – thousands of miles of them connecting neighborhoods and back streets are dirt, eroded with ruts up to three feet deep.  Dodging potholes, people die on the Kampala-Mbarara Road every week. Here is a typical wreck.

Yet, the President vows major new road projects in the next two years. “It will help our economy,” he says. He’s said it before and he is right. But it’s all for naught if the roads don’t last more than a month.

“We are not organized” could be the nation’s motto. The chaos of society here is part of its charm for visitors, but it wears thin for people who live here. Nothing is maintained – half the solar/wind gizmos attached to light poles to impress CHOGM attendees are broken. The Nile River dam in Jinja that supplies most of the nation’s electricity is not “wukking” due to lack of maintenance so another dam is being built. To a nation desperately trying to build its economy, this one seems to be trying to fly with porous wings.

Traveling the only route from Mbarara to Kamwenge and getting a “road massage” as the car tackled the ruts, I saw a – wonder of wonders – a yellow Caterpillar grader parked alongside the road. I asked the driver why the machine was sitting idle when clearly the road needed grading. He said, “Oh, that is just the government responding to the local council. They want the road fixed.” He shrugged. “The government sends a machine and a man. The man grades just enough to show he has done something. Then he siphons the diesel out of the tank, sells it and spends the rest of his day in the bar. The next day there is no fuel so he cannot continue. What is he to do?”

Well, I thought, while he’s sitting in the bar, he could revise the national anthem to something like, “O, Uganda, We Are Not Organized.” There. I feel much better now.

The Reality of AIDS – Part 9: The Role of the Church

“The ironic thing about this curse is that the major transmission is through sexual relationship which is the passage of life for us. Why would it attack there? You really need to know Satan is playing a very serious role here, striking at the very temple of making life and turning it into a vehicle for death.”       – Archbishop Henry Orombi

If one should ever wonder about the role faith can play in beating back the AIDS epidemic, one need only go to Uganda to see the results firsthand. There are few documented examples; Google the subject and you will not find much. Helen Epstein in her book God and The Fight Against AIDS acknowledges the presence of faith but misses its depth. She reported in 2005 that the country is “in the throes of a Born-Again Revival” without understanding that it has been doing so constantly since the East Africa Revival of 1931.

 “Faith-based organizations (FBOs) have a really important role to play in stopping the spread of AIDS and they’ve been sidelined,” said Edward C. Green, a social researcher at Harvard University and author of Rethinking AIDS prevention. FBOs have been have been working for behavior change – pushing AB, abstinence and being faithful, since before Uganda’s official AIDS initiative began. They have been working with orphans and the sick and the dying and the bereaved but they haven’t been funded to work in AIDS prevention. Ignoring this very important factor of public health policy has no doubt cost millions of lives.”

President Museveni told me that mobilizing churches to broadcast the “Zero Grazing” and “AIDS Kills” messages was “the fastest way to reach the greatest number of people in all the corners of the nation.”

I spoke with Rev. Fr. Dr. Joseph Obunga, the Secretary General of the Roman Catholic Secretariat at his offices in Kampala.  “The Catholic church has been actively involved with fighting this disease since 1989 with our first pamphlet called “The AIDS Epidemic.” Later, we started a program called Save the Youth from AIDS. It is still a common topic in schools. These days we regularly organize field trips from one parish to another called ‘exposure trips’ so people can learn from one another. This is what the church is supposed to do – it is people loving their neighbors as themselves.”

Working alongside Fr. Obunga at the Uganda Catholic Secretariat is Ron Kamara, who chairs the HIV/AIDS committee for the Inter-religious Council. This organization acts vigorously to be a common point of information gathering and dissemination for all the religious entities in Uganda – Catholic, Evangelical, Muslim and any other interested parties. “The AIDS environment changes almost on a daily basis,” Kamara said.

Anglican Archbishop Henry Orombi told me, “The Church of Uganda is clear in its theology of passion. Nationwide we speak to young people especially those 13-25 years to let them know their sexuality is God’s gift to them. We want them to make a decision to work with God’s will and to realize that AIDS is not a disease but an attack on faith. We teach that condoms give artificial permission for people to take relationships beyond what God wants. We also show people how to have compassion for those who are infected and for them to be accepted by society. The more we can show them compassion, the longer they will live. But the essence of our AIDS education is it will get you if you are not diligent.”

 

The Reality of AIDS: Part 8 – The ABC Method, C is for Christ

When His Excellency President Museveni declared the AIDS crisis in Uganda a behavior problem in 1986, he had no idea he was poking a stick into a very large hive of bees.

It took some years for the magnitude of the epidemic to become known to world’s public health institutions and for them to formulate a workable solution to slowing the spread of the disease. The institutions – the World Health Organization, the United Nations (ultimately UN-AIDS and The Global Fund), the Center for Disease Control in the U.S. – and others – were challenged to come up with a solution that would work worldwide. The Uganda President’s pragmatic solution – tell the people what causes the disease, tell them to abstain from sexual relations before marriage, tell them to be faithful exclusively to their spouse or partner – was simply dismissed as unworkable by Western aid institutions. They sought a solution that was based not on ideals but on tangible results. Their solution was the condom, a device that had been available in Uganda since at least 1980. To the world’s public health community, the condom was a practical and tangible way to fight AIDS. But selling the population on the device was not easy and so the field of “social engineering” was born. This approach conflicted directly with the “social vaccine” of behavior change and in fact also required people to change behavior.

The President’s initial campaign of abstinence and being faithful became known as the A-B Method. Not many years later when the condom was interjected, it became much catchier, the A-B-C method. But there was vast resistance to condoms by churches (you are giving people a vehicle to not change behavior), government (you are forcing to do things your way and not our way), the health department (condoms are not 100% reliable; abstinence is) and by people themselves (we do not need such things). The tension between abstinence people and condom people became known as the “Condom Wars,” and will be the subject of another blog.

The interesting thing about Uganda is, the preachers, evangelists and youth workers turned A-B-C to their advantage by saying C is for Christ, not condoms. “You see,” the pastor says from the pulpit, “If our young people have Christ, they have the love they need to grow strong – without finding it in the banana patch. If our young people know that keeping themselves pure until they are married makes Christ smile, they will do it. And if they cling to Christ to avoid sinful sexuality, they will live to become productive adults.”

Rev. Ben, who traveled the countryside for 10 years preaching to young people said, “In this country, we know this message has power because, among Christian kids, the age of first sexual encounter averages nearly 18 years. That’s astounding for African society. So, A-B-C: Abstinence, Being Faithful and Christ, not condoms. That will kill this disease here.”

The Reality of AIDS – Part 7 – One Family’s Story

When you talk to people in Uganda about AIDS, you get used to hearing the words, “They died.” I lost three sisters. They died. The person who was paying my school fees. He died. The people I knew in that town. They died. The man who was her boyfriend, he died, she died.  You hear it so much, the words lose meaning. Yet every one of these deaths was preceded by long and painful suffering, a withering of the body and the spirit into oblivion. The anguish extends to the caregivers and the relatives, the friends, the villagers, the loved ones not just as a relationally shared pain for the disease but also for the anxiety of ‘who else is carrying the virus and am I next?’ For those who have lost multiple family members or multiple neighbors in a village, the anguish is numbing. Dying is taken for granted. It is less tragic. It happens too often. The true tragedy, however, falls on the innocents, those people left behind, often children who have no means to support themselves.

On one visit to Uganda, I stayed with Amos and Mabel Twinamasiko in their home in Mbarara. The house could have been a modest home in suburban Florida, built of concrete-block-and-stucco painted pastel with a tile roof surrounded by a sedgy lawn and fruit trees. Dr. Amos is an ophthalmologist in the local hospital and over breakfast one morning, I asked about his family. “Well,” he began. “I came from a family of 10 of which only four of us are left. Mabel comes from family of nine of which only three are left. And for those who died, each left multiple children behind. We just buried a niece who had been recently married and left four kids.”

“What happens to these children,” I asked

“We try to take care of them,” Dr. Amos said. I had heard this time and time again about Uganda: A million parents dead. A million and a half children cut off from their only means of food, shelter and care in a nation without a public welfare system.  Some 700,000 of these had been taken up by family, friends or caring people in the village. Ben had told me of the children he had supported through University including his nephew Herbert and this on a miniscule missionary’s income. A woman known as Aunt Jocelyn, somewhat prosperous with shops and a farm, cares for multiple children in her home and employs them in her businesses. A prominent local women’s rights consultant named Jolly Bibarikamu and her husband Erik reported raising and educating some 19 children to date through university level. “We ourselves currently support five kids with school fees,” she told me. “The number varies, but there are always four.”

“And what of the rest of the children,” I asked over tea.

“The rest,” Dr. Amos said. Mabel turned her head to hide the tear welling in her eye. “The rest we pray for.”

The Reality of AIDS – Part 6 – One Village’s Story

Six months after Ben launched his ministry called Juna Amagara in 2004, I traveled with him and a group of Americans to his home village of Kishanje in Uganda. To get there from Mbarara, it is two hours on the main road to Kabale Town. Then it is two hours by twisty, rutted dirt roads around Lake Bunyonyi to get “across the water” to Ben’s tiny house. 

It was after dark when we arrived at Kishanje, but the sound of a van on the road and the mere presence of headlights in a place where electricity is unknown signaled our arrival to people for miles around. In the morning, quiet murmurs woke us from sleep. We heard the shuffling of bare feet on earth outside our window. When we went to investigate, we were surprised to find a line of maybe 30 Grandmas dressed in the typically wild cacophony of colored dresses and headscarves, each with one or two small children, some with infants in their arms.  They had heard their neighbor Ben started an organization to help orphans and they had come to hand over their children. "Here," they said.  "You take them. We cannot care for our dead children's children any longer."

Ben spoke to them in the local language for a long while, gently, talking through a certain sense of surprise. "We have just started," he said. "There is no money or organization to take care of children in this place. We are praying for it. You must pray too.  But, I'm sorry.  For now, we cannot take them; we can only promise we will do something."

 “But you must,” the old women argued as if insisting hard enough would make it happen.

 “We cannot,” the Reverend said. The Grandmas just stared silently, their eyes saying – you have been to America, you bring us Americans, America is rich – we do not believe you.  But they knew in their hearts this man would not lie to them.  They hung their heads in thought.

 “I had to turn them away,” he said to us once inside the house. This was the only time I ever saw the lips tremble on his strong, round face. Outside, the old women trudged up the hill, barefoot, a little more bent, leaning on walking sticks, hand in hand with raggedy little children stumbling to keep up.  Little girls tightened infants in a sash on their backs. Their dresses were explosive in joyous color but their bright hopes had been ground into the earth. We watched them go, all of us with tears in our eyes.  They would deal with it. They would survive as they always had.

God touched our hearts for AIDS Orphans that day.  Keep reading this blog and you will see how the prayers of those Grandmas are being answered today.

 

The Reality of AIDS – Part 5: Discovery - The Medical Team Reports

President Museveni told me he rushed back to Kampala from the meeting in Harare and called on his Minister of Health and a panel of doctors to determine once and for all what caused the disease. “We need to know,” he said them, “Is it the bite of an insect? Is it something in our food or water? Is it people breathing on each other. We need to know.” One week later they returned to the President with their findings. Richard Goodgame, an American missionary doctor at Makerere University at the time was on that panel. Now teaching at Rice University in Houston, he recalls, “We reported to His Excellency that we had examined every means of disease transmittal. Our conclusion? The disease is spread through the exchange of vital bodily fluids… as in sexual contact and transfusions and the sharing of hypodermic needles and blood rites.

“I remember Museveni sitting back in his chair,” Goodgame said. “He relaxed a bit and showed the hint of a smile, the kind you’d see on the face of a man who’d been wrestling with a puzzle for many days and had suddenly found the answer. ‘This is good news,' he said. 'This AIDS is not a medical problem. It is a behavior problem.’”

Within a year, the President mobilized the leadership from all the churches, the schools and the government to impart a single message: Be sexually abstinent until marriage. And be faithful in marriage. That was it. The message poured from loudspeakers in the streets, from pulpits across the land, in newspapers, flyers, in schools at all levels. “Zero Grazing” was the theme. “AIDS Kills” was the message. In other words, to all the truck drivers, prostitutes, horny college students, lusty teenagers waltzing hand in hand into the banana patches, the hookers, married men with mistresses and all the sugar daddies, “stop screwing around.” It also meant the age-old custom of brothers comforting their siblings’ dead widows must stop. Ritual circumcisions must be done with sanitized tools. Wiping the knife on your pants before using it again doesn’t count. Those who heeded the message are alive. Those who did not are dead.

The message to young people in schools was and still is: Be abstinent. Do not have sexual relations until you are married. “Just as there are kinds of food you are forbidden to eat as a young person, there is this behavior. You must listen to people who are grown up and know about these things before you partake. Eat the grown up food when you are grown up and not before.”

Did the President’s approach work? Museveni told me, “We used to have STD kiosks all around Kampala. People with a little rash could go get a shot of penicillin. They were very popular. But, within two years of our telling the people they had to change their behavior, the kiosks were all gone. Out of business. No more customers. That was the first sign that our campaign was working. We proved people would change habits if doing so would save their lives.”

Museveni’s observation – calling the spread of AIDS a behavior problem and not a medical problem - was underscored by U.S. Surgeon General C.Everett Koop in the first Surgeon General’s Report on AIDS dated October, 1986.Africa  This is an important point to remember as we explore the condomization effort of the UN yet to come.

The Reality of AIDS – Part 4: Discovery - Castro's Secret

HIV/AIDS was already rampant throughout Africa before the first government leader on the continent learned what caused the disease in 1986. The credit for that discovery goes to Yoweri Museveni, the man who, in that year, wrested Uganda out of the hands of the last dictator Milton Obote and returned the nation to the people in the form of a parliamentary democracy.

A friend of Ben’s arranged for me to meet with Museveni, the President of Uganda, one Sunday at the State House. Once we passed through a serpentine of crash barriers, an iron gate topped with razor wire, past the boyish, dull-eyed sentries fingering ancient rifles and after we left all cameras, cases, telephones and recording devices in the car, we were escorted to an unassuming two-story stucco structure, an office building, set amid manicured lawns and robustly blooming flowers. After a short time in a parlor, we were called into the conference room. Waiting there was His Excellency, smiling, apparently glad to greet us. TV cameras rolled. Three nattily dressed ministers of state sat poker-faced at the table with their hands folded. There were a few formalities. Along the way, Ben told His Excellency, known as H.E., that I knew a few words of Rukiga, the President’s tribal language. “Tell me,” he said. A challenge.

I gave him the full repertoire. “Mukama asiimwe, oweishemwe. (Praise the Lord, Brother). Nebanyeta Mzee Twesigye,” I said (They call me the trusted old man) “Ninduga Chicago America. (I come from Chicago in America). Nkaba ndi omusiisi. Hati, Jesu na kanjuna (I was a sinner but now I walk with Jesus). He listened with a sparkle in his tiny eyes and an amused look on his face. Surely, I had thoroughly butchered his mother tongue. But when I had finished, he clapped his hands with glee. “It is good to hear you speak my language,” he announced and burst into a chorus of tukutendereza. Then he began to talk about AIDS.

“You know how I discovered we had a problem?” he said. “Fidel Castro told me.

“Only six months after re-establishing the government here, I was invited to attend a meeting for the non-aligned African nations in Harare, Zimbabwe. Many countries were trying out Communism then and they wanted to recruit more, so they invited those of us who were not yet Marxist/Leninist/Socialist/Communist to a meeting. I had no intention of becoming a Communist. Idi Amin and Obote were Communist. All the other newly independent states in Africa that tried “African Socialism” were in ruins. But I was curious. Maybe they would build us a road.

 “I was there only one day when Castro took me aside. He said, ‘Mr. President, I think you have a problem.’ I thought: I have more than one problem. The idiot dictators ruined our country. I have no economy, no infrastructure, an incomplete government, an empty treasury, too big an army, refugees everywhere, a starving population… what else could there be? I asked Castro. He said, ‘Your predecessor, Obote, sent 80 soldiers to Cuba for military training. We do blood testing of foreign trainees and, of those 80 soldiers, we found 46 to have the Mysterious African Wasting Disease. I thought you would like to know.’ I had heard of this disease on the short wave while fighting in the bush. And I knew if the soldiers had it, the population had it. But I didn’t know how bad it was. This was, indeed, a problem.”

Reality of AIDS - Part 3: More Proliferation

Every Ugandan in every village had heard about or had experienced “bad times” in their history, whether it was famine, rebellion or disease. These were things they could not change. As a nation of subsistence farmers, they had learned they could simply wait it out. Yet, well into the 1980s, the “Mysterious African Wasting Disease”  gained momentum killing, mysteriously enough, only adults. A husband would die of the Slim. His brother would, according to custom, comfort the widow by taking her into his home and into his bed. She would infect him. He would infect his wife. Then he would die. Another brother would step up. The women would die. And the disease spread.

Rev. Frank Isingoma, an associate pastor at All Saints Cathedral in Kampala told me: “Around 1984, my family moved from Mbarara to Rakai. The immorality was so high there, in three years, we saw people dying from ages 13 to 50. Entire villages closed because everybody died. You could go for miles without seeing people. The images of entire groups of sick people haunted me even until I came to All Saints in 1995. For more than three years, we held two or three funerals every day, a minimum of nine per week. The dead were from all walks of life including doctors and engineers. It finally slowed down about 1998."

In the cities, prostitution was a common profession for women struggling to feed themselves and their children. Yet, even as people began to die from the disease and its sexual cause was heavily communicated, the number of prostitutes did not decrease. The United Nations pressured the government to make condoms available in “high risk areas,” which included bars and wherever the Commercial Sex Workers plied their trade. The women soon discovered condoms were good for business in that they learned they could extract a premium price for a client who wanted to go “bareback.”

“SEE?!” the evangelists yelled as they pointed bony fingers at the people. “God brings his wrath on the wicked!!” This was a nice sermon but bad reality because many of the evangelists also died of the disease. It was, and to a certain extent, still is common for prosperous middle class men to have “a girl on the side.” Young women, often university students short on cash, often sought out “sugar daddies” who provided them with apartments, clothes, cell phones and took them to clubs. In the end, they all died until, at one time, 38% of the Ugandan population was HIV positive.  

The Reality of AIDS – Part 2: Proliferation

I wanted to take a turn off the Mbarara road to travel through Rakai, a district on the shore of Lake Victoria. Many local people I spoke to including two physicians agreed that it was here in the late 1970s that a boat with fishermen infected with HIV came ashore. Though the disease existed elsewhere in the region, it was this place that sparked its wildfire spread throughout Africa. Rakai was vibrant then, a popular stop on the freight route across southwest Uganda. Trucks laden with goods from the port of Mombasa in Kenya and manufactured goods from Jinja would ride all day across the flat plane of the Great Rift Valley and stop for the night in towns here before completing journeys to Tanzania, Rwanda, Burundi or Eastern Congo.

Every truck driver and passenger bus stopping in the towns of this district – Masaka, Lyantonde, Lukaya, Kinoni was like the prodigal ant being welcomed back into the colony. There were “hotels,” mud-walled rooms with sleeping cots lit by the flame of a tea candle. There were densely packed bars where a man could get a warm Nile Extra Beer, a long story and a too-loud laugh. And there were women who would make themselves available to the drivers, the captains of 18-wheeled ships for only a few shillings more than the beer. Little did any of the sex workers know that the fishermen who were also their customers had given them a deadly disease they would pass along, a biological time bomb whose devastation would not be known for years. The women gave it to the drivers. The drivers gave it to others all along the route and their wives  when they returned home and their girlfriends who passed it to other lovers.

By the early 1980s, people throughout this district began wasting away. Then, as now, it was normal for people to have bouts of malaria or diarrhea or open cuts and sores, but in these days the casual sicknesses did not subside and wounds did not heal. People with minor ailments mysteriously withered and died from a condition known as “Slim.”

Then, suddenly, it seemed everyone had the disease. No one knew where it came from. No one knew what caused it. Witch doctors blamed curses sent from Tanzania. Others blamed God for sending punishment for reasons known only to Him.

Dr. Phinehas Tukamuhaabwa, now a Professor in the Agriculture Department at Makerere University was a university student at the time. Between terms, he and scores of other students would ride the bus home for the holiday. The road from Kampala to Kabale Town was not paved which meant the trip took two days, requiring an overnight stop. On the way home, the students, exhausted from exams, generally slept. But returning to school, rejuvenated with home cooking, plenty of sleep and some shillings in their pockets, they felt their oats. Phinehas recalls, “The boys would yell and jump and scream and try to make time with the girls. And when the bus stopped for the night at towns such as Lyontonde, Masaka or Kinoni, they went wild. They would go to the bars. They went off with the women. But some of us did not get off the bus. The others taunted us, calling us names. We ate food we had brought with us. We sang quiet songs together. We prayed all night.

“In the end,” Phinehas said, “All the people who got off the bus died within a short time. Some before they graduated. There were many university degrees granted posthumously. Those who stayed on the bus lived.  Rakai became a district of ghost towns.”

The Reality of AIDS – Part 1: Origin

“For people in the West, AIDS is a distant theory, someone else’s problem.  But for us, AIDS is personal. We have all watched relatives wither and die.  We have attended too many funerals.”             - Bishop Zac Nirungye, Kampala

Until recently, after more than 25 years of research by health organizations worldwide, there were two competing theories about how HIV/AIDS actually started, both of them based on the idea that a virus found in monkeys called Simian Immunodeficiency Virus (SIV) somehow mutated to humans. The first was the “cut hunter” theory where hunters in Zaire (now the Democratic Republic of Congo) ate meat from a diseased monkey, assimilated the disease and began passing it on sexually. The second was the “Polio Inoculation” theory where an experimental anti-polio serum developed in Europe from chimpanzee or macaque substrate was tested on people in the Belgian Congo in the 1950s. This theory surmises that the virus substrate was taken from diseased animals which allowed it to mutate into humans upon being injected into its test subjects. Conspiracy theorists loved this scenario but a vial of the 1950s serum was recently discovered and, after rigorous testing, it was determined that there was no SIV or HIV virus present. That leaves us with one theory.

In any case, it is widely agreed that the severe poverty conditions with poor sanitation, lack of nutritious food and clean water, working in noxious environments and overwork created a population of people whose physical immunity was extremely debilitated to the point where their bodies allowed the mutation to occur. In Zaire/Congo, such conditions existed in the south and East where massive mining operations had been exploiting workers for decades. In neighboring Uganda, conditions were not much better as the population had struggled with famine, rebellion and a ruined economy almost from the day the nation declared its independence from Great Britain in 1962. Disease was rampant in rural towns such as those in the Rakai district where people struggled to survive day to day. Through the 1960s, 70s and 80s, many countries in Africa were in turmoil, causing millions of people to struggle for daily survival. Tens of millions of people were in poor health and ripe for disease.

Many factors come into the discussion when talking about how the disease spread so quickly. The first of course is the exchange of body fluids through sexual transmission. In Zaire, Europeans ran the massive mining operations, where the work force was primarily men housed in what can only be described as slave quarters. They worked for pennies. Food was poor. Disease was common. And the opportunity for homosexual liaison was strong. One hunter infected with the newly mutated HIV could easily have introduced infection to an entire work force. Then, because government and business operations were driven by Europeans, travel from Africa to Europe was common. When we see that AIDS first appeared in Europe and in North America in the gay community in the '80s, it is easy to understand the connection.

But other factors for transmission also existed: rebel armies rife throughout Zaire/Congo from 1960s up to and including today would make sure their conquest of a rival village was complete by raping the women of all ages. The practice, based on ancient tribal customs of conquest, ensured that not only would all the men earn the disease, but so would the victimized women who would pass it along to other innocents or the next army. Other means of transmission included hands with open sores touching the bloody wounds of infected people – a common means of transmission of the virus to children. Or ritual circumcision rites for a dozen or so young men all carried out with the same knife.

There is no one scientific theory about how AIDS traveled to Uganda though the country has a long, porous border with Congo, with may truckers and smugglers. My own theory pieced together after speaking to people in the area is the fishermen from Rakai District took a break from their labors on one of the hundreds of Ssese Islands in Lake Victoria where they were either bitten by monkeys infected with SIV or they ate the meat of diseased animals they had hunted. The virus mutated in these men to become HIV and Michael rowed the boat ashore. Ah-lay-looooo-yah.