I have read a LOT of books about HIV/AIDS in Africa. In most of these texts, people living with AIDS seem to play a surprisingly small role. They are the bit players in narratives dominated by scientists, doctors, aid workers, and politicians, many of whom are white westerners. Nicole Itano’s book is quite different, in that she connects the themes of the larger African AIDS pandemic with the struggles of three Southern African women and their families.

The author

goes beyond traditional journalistic methods as she eats, sleeps, and lives with the women who struggle daily with the raging epidemic of AIDS. Working from the personal accounts of a few real women, Itano traces their moments of discovery and diagnosis, their first symptoms, and the ways they cope with treatment and manage the news with their families. 

As the book opens, we meet Adeline, a well-educated young woman studying accounting in Maseru, Lesotho. As Adeline’s story develops, Itano parallels it with the response to HIV/AIDS in Lesotho. This section is entitled “Denial” for a reason. While Lesotho’s initial response to the pandemic was effective, politicians and top medical personnel lapsed into denial. This denial allowed the virus to spread to startling proportions. 

The second section of of the book, “Despair,” takes place in South Africa, and follows the Mathenjwa family. Living in the rural outpost of Ingwavuma, in KwaZulu-Natal, the Mathenjwa children have just lost their mother and eldest sister to AIDS. Their step-father died recently after years of working in the mines, and they are now orphans. They live in a large compound with their grandparents, and other orphaned relatives. Itano follows not only the Mathenjwa’s struggle to survive as AIDS orphans, but also traces South Africa’s response to AIDS. She highlights how people living in a rural setting can be affected disproportionately by crumbling infrastructure and social services. 

The final section of the book, “Hope,” takes place in Botswana. Here, Itano shadows a young mother named Seeletso. Seeletso’s child Thabang is severely disabled, and the mother-child relationship is tenuous. Many people have heard about Botswana’s ambitious and radical response to HIV/AIDS, in which the government rolled out treatment for all adults and children with full-blown AIDS. Itano digs deep to uncover the intricacies of the program, providing the full picture behind the headlines. 

To sum things up, I would highly recommend this book. Whether you like human interest stories or science writing, you should find this enjoyable and educational. Itano’s narrative is truly commendable because it personalizes the AIDS pandemic. Through this book, we can move beyond the numbing statistics and see the faces of ordinary people, who happen to live with HIV/AIDS.