A quiet 24-year-old medical student from Kisumu, Daniel Ochieng had at first hid his sickness from his family and friends. But the effects of AIDS soon became impossible to disguise. Unable to fight off infection, Ochieng's body was breaking down. Severe coughing and chest pain led to a diagnosis of tuberculosis, followed by intense bouts of diarrhea and a urinary tract infection. Ochieng suffered from oral thrush, a painful infection that caused his mouth and throat to be coated with a thick white substance that resembled cotton. That May, Ocheing had permanently lost sight in his right eye due to cytomegalis virus.
Dr. Mamlin had already seen dozens of young Kenyan men and women infected with AIDS waste away and die. He realized that it shouldn't have mattered that this particular patient, too weak to raise his arms to feed himself, was a medical student. But it did matter. Something about Daniel Ochieng laying next to another patient in the same bed, waiting for death in the dark of Bay 3, challenged all of the well-settled reasons why HIV/AIDS was not being treated in Africa.
Shaken by his encounter with the dying Ochieng in Bay 3, Mamlin left the hospital that night and walked slowly to the house Indiana University rented a half-mile away. By the time he reached his computer and logged into the glacially slow dial-up connection to the internet, Mamlin had made up his mind. He began to compose an email to Dr. Bob Einterz, the Indianapolis-based director of the Indiana-Moi partnership. Mamlin wrote that, with Kenyans like Ochieng dying by the hundreds each week, the partnership simply could not continue on as before. Indiana University must fully engage in the struggle against HIV/AIDS, Mamlin insisted, or it should fold its tents and go home.
Mamlin immediately started Ochieng on the drugs. For a month, Ochieng, who was nearly 50 pounds underweight, was still too weak to leave his bed. But soon the anti-retrovirals' nearly magical power-so potent it is widely described as the "Lazarus effect"-took hold in Ochieng. Mamlin remembers walking between hospital wards one day and noticing that the patient sitting on the grass soaking in the sun was Ochieng. It was then, Mamlin said, that he knew Ochieng would survive.
The First to Survive
For a year, Ochieng remained the only Indiana-Moi patient receiving antiretrovirals. But his dramatic recovery made it even more difficult for the Indiana-Moi physicians to stand by and watch other AIDS patients die without treatment. "Daniel's recovery was the first hope that any of us saw in Kenya," Dr. Bob Einterz says. The cross-continental calls, emails and visits continued, evoking Ochieng's successful treatment and questioning the idea that HIV/AIDS could not be treated in sub-Saharan Africa. Out of those discussions came the Indiana-Moi Academic Model for Prevention and Treatment of HIV/AIDS (AMPATH), which has grown into Africa's largest and most comprehensive HIV/AIDS treatment and control program.
Daniel Ochieng is now 30 years old, married, and the leader of AMPATH's outreach efforts. Ocheing helps insure that the 48,000 HIV-positive patients that followed him take their medicine and comply with their treatment. Ochieng insists that this treatment not only saved his life and the others who are already HIV-positive, it provides the key to the prevention efforts that are focused on encouraging HIV testing and safe practices. "Knowing there is treatment for the disease makes people take the test," Ochieng says.