Seven hundred people a week are dying from AIDS in Zimbabwe. "It's like two fully booked jumbo jets crashing every week killing everyone on board," says Dr Reginald Matchaba-Hove, a medical practitioner and chairman of ZimRights, the country's largest human rights organisation. He concedes the figure could be closer to 1,000 dying every week.
It is a catastrophe for a young country like Zimbabwe. With a population just over 11 million, one-tenth are infected with the HIV virus.
In Africa, Zimbabwe is second only to Botswana in HIV/AIDS incidence. A recent UN report showed that a decade ago, the average Zimbabwean could expect to live to 61 years. AIDS has demolished that. A decade later you will be lucky if you reach 40.
It shows. You see it on the streets, on the faces, in the weight loss; in the excuses for malaria or stomach trouble, at the funerals, in the days missed from work for sickness, in the increasing numbers of people joining burial societies to help to pay the costs of funerals.
You watch it in the beer halls; the casual sex, the recklessness, the complete disregard for oneself and one's partner. You witness it brutally in the rural areas. Whole villages of just young and old. Nothing in between except those crouched in huts who have come home to die.
And you read it in the papers, most poignantly in the death columns, recording those in their 20s, 30s and 40s. You are reminded in a small news item from the city health department of the month's fatalities.
During the month of September 1998 253 persons were registered as having died from AIDS or HIV-related illnesses in Bulawayo. This figure represents 32.9 per cent of all deaths recorded in the city during the month.
It means very little to the average Zimbabwean. The deaths are there every day of relatives, friends, and work colleagues. Still not openly acknowledged as the cause of death, AIDS is everything from a "long illness", "a short illness", "sickness", "malaria", and "TB". The stigma surrounding HIV/AIDS is widespread, although most people know one relative or other who has died from associated diseases.
A 21-year-old mother of two died recently of pneumonia in Bulawayo. "She was healthy, there was nothing wrong," dismayed relatives recall. With so many deaths every day, the dead are afforded little dignity.
Urban and rural HIV/AIDS awareness campaigns seem to have had little impact. Condoms are freely available at clinics, as is pre- and post-test counselling.
The first case of AIDS in Zimbabwe was reported in 1985. But the government denied there was a problem. Not until this year, when officials from the Ministry of Health visited Uganda, did HIV/AIDS prevention, care and control take on significance. Uganda has been widely applauded for tackling the epidemic early, implementing a strong national programme to reduce the spread of HIV.
Zimbabwe meanwhile is still trying to carry out a national policy, the second draft of which has just gone through parliament.
AIDS has spread through the country like a bush fire. A National AIDS Co-ordination Programme (NACP) report says: "By the end of 1997, an estimated 1.5 million people had been infected with HIV since the beginning of the epidemic." It says that more than 320,000 of these had actually developed AIDS.
The report, HIV AIDS in Zimbabwe, outlines a variety of reasons for the high rates. These include: multiple sexual partners; high incidence of sexually transmitted diseases; high vulnerability of women due to their low socioeconomic status; migrant labour pattern; a worsening socio-economic situation and unemployment.
Certainly cultural patterns have not contained the situation. Men see it as their privilege to have as many sexual partners as they want. Urban polygamy, where a man has a wife and several mistresses, is common.
Culturally, a man is expected to have a younger wife, testimony to the prevalence of HIV peaking for women in their 20s while for men, it is 10 years later.
The impact of HIV/AIDS on the country in the long run is going to be very severe. There is a huge loss in the most economically productive part of the population, and a loss of investment in education and training.
A tremendous strain is being placed on grandparents and communities as the numbers of AIDS orphans increase. Zimbabwe is expected to have as many as 600,000 orphans by the year 2000.
Hospitals and clinics are finding it difficult to cope. Treatment in most cases is very basic. Most Zimbabweans can barely afford the good nutrition-based diets that doctors recommend.
Substantial gains in health and education are being steadily eroded. Tuberculosis, once under control, has resurfaced and poses a huge risk for the whole population. Ten years ago the child mortality rate was 53 deaths per 1,000. That is now set to rise to 80 per 1,000 by 2005.
Zimbabwe is beginning to realise, as the NACP report says, that neither drugs nor vaccines will reduce the heterosexual spread of HIV in the next few years. Behavioural change is the cheapest, surest and most sustainable solution.