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"Keep your chin up, Miss!"

[Chad] Gisèle Ngamada, from Chad, lives with HIV since 2000. Her parents took her children away from her and she’s helpless.
Gisèle Ngamada, who has lived with HIV since 2000, has tried to break the stigma surrounding the virus (IRIN)

Gisele Ngamada, who is 36, found out she was HIV-positive five years ago. She has lost custody of her children, she has given up sex and now has a single aim in life - get to Europe as soon as possible for treatment.

In Chad, where 200,000 people are believed to live with HIV/AIDS but where talk of the epidemic remains taboo, Gisele is one of the very few people to have come out openly to talk about her condition in public.

"As soon as people here realise you've got AIDS, you become like a witch with 1,000 heads," she told IRIN. "Everyone says they'll help me, but then ... they do nothing. I have to get to Europe."

Gisele's friends and family began worrying about her state of health following the death of her boyfriend Emmanuel, the HIV-positive son of a diplomat. In the interests of discretion, they shipped her off to Maroua, in northern Cameroon, hundreds of kilometres away from the Chadian capital, Ndjamena.

"Everyone who attended Emmanuel's funeral in February 1999 knew very well he'd died of AIDS but nobody would talk about it. People just said he had died of an illness that was too powerful for science," she said.

"So my parents began asking themselves questions, and the following year a brother-in-law gave me 40,000 CFA francs (US $80) to take a test in Maroua.

"It came out positive, and the doctor said: 'Keep your chin up, Miss'."

"Three months later I came down with tuberculosis and my health got worse and worse by the day. I felt very weak but was cured of the tuberculosis quickly."

Tuberculosis is the leading infection among the so-called "opportunistic" diseases that affect people weakened by the HIV virus. It is also the leading cause of death among carriers of the virus, although it can be cured if caught in the early stages.

Feeling too weak to work after the illness, Gisele resigned from her job as a secretary for a building firm in the southern town of Doba.

Deprived of a steady income, she decided her only solution was to tell her friends and family that she was HIV-positive and needed support to pay for antiretroviral (ARVs) drugs. These improve the health of people living with AIDS and help them to survive longer.

"I gathered my parents and friends together to talk to them and some influential people agreed to help me look after myself. They rented a room for me so I could stay away from my children and they gave me money for the ARVs. I stopped drinking beer on the advice of my family and I no longer make love."

Her two daughters, now aged 10 and 14, were placed in the care of an aunt and she often leaves the poor busy district where she lives to visit them. Gisele sells beer from time to time to make a living. In December she organised a party that brought in $1,000, enough for several months of ARV treatment.

But her health and living conditions are declining. She has lost almost 50 kilos, half of her original weight, and is having more and more trouble buying boxes of triomine 30, the antiretroviral drug that she buys at the full commercial price of 15,000 CFA francs ($30 dollars) per month.

The Chadian authorities said last month that low-income earners would be able to buy ARVs at a third of this price from January. But Gisele said the decision had not filtered down yet, meaning that the 1,500-odd Chadians who use the drugs are still paying through the nose for the treatment.

"I realised I just couldn't look after myself any longer, so I went to see the public health ministry. I met the director of the hospital and I even met Aziza Baroud, who is now the public health minister. They said they were going to take a serious look at my case, but since then ... nothing.”

Gisele is sceptical too about the help she and others can hope for from the associations battling HIV/AIDS.

"I went to see them too. They wrote my name down on a list and made promises they never kept. Most of these associations were set up to make a living for the people who run them," she said.

As for her family, "some of my relatives have begun to think I'm just someone with no money who's found a smart way to live off them," she said. "The family is tired of buying the drugs for me and some of them are beginning to doubt that I'm HIV-positive."

One doctor she is related to even suggested that she take a new test to make sure whether or not she was HIV positive. "He said that normally I'll die after 10 years of being positive because I don't eat well, I live in a hot country, and I live in poor conditions."

But what was most difficult to bear, she said, was the stigma and the discrimination that people living with the virus have to put up with in Chad.

"Members of the family try to avoid us, some of them refuse to kiss me. It's hard to take. Sometimes, when I ask people to sit down at my table they refuse to eat a meal with me. People in fact do not understand how HIV/AIDS is spread."

Gisele, however, does her best to inform others on how the virus is transmitted and how best to prevent its spread.

"Many women friends who are infected come to see me seeking advice about how to live with the virus. They come at night because they believe AIDS is a shameful disease because it is related to sex."

"I give them advice but they can't stand the situation they're in. Ndolassoum, Caroline, Juliette and Germaine have all died since 2001 because they stopped eating so they could die quickly. I understand the way they acted, and since then I've stopped campaigning.”

Last year Gisele's youngest sister Malagné tested HIV positive, but it has made no difference to her response. "Malagne is still afraid of coming near me," Gisele said. "They say that if you approach me you die."

This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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