However, investigations have revealed that even women on ARVs are not spared the effects. The drugs are reportedly subjecting them to physical disability.

Joseph Mkanda (43), one of the victims, said he developed strange symptoms plus growing breasts after consuming the drugs. Initially, he suspected the cause to be lack of a balanced diet.

But he soon realised that the main problem was the type of drugs he was taking.

“I feel very much ashamed to go out of my house, because I have developed breasts like a woman. …I fear that other people would laugh at me,” he said in an exclusive telephone interview from Mtwara.

“I went to one of the medical doctors in my village, who told me that such signs were normal for people suffering from AIDS who have been taking the drugs for a long time. At the moment, I don’t know what to do or where to go,” said Mkanda.

Salima Omar (36) from Mtwara said she developed strange symptoms after taking the drugs. Salima, a mother of seven children, said one of her daughters died shortly after birth in 2006 when she had undergone the HIV test.

Changes in body

One of her sons is also HIV positive and has been taking ARV drugs since October, 2007.

She explained they had both been taking the drugs, but due to unknown reasons, she started noticing changes in her body.

But she believes the changes were caused by the fact that she has been unable to follow the instructions of taking the ARVs.

She said the drugs were very strong and required the users to get a balanced diet. But Salima was unable to follow the instructions and at times stopped taking the medicine.

“These drugs are very strong; if you take them without enough food you become very weak. But there are days when I'm forced to take them without eating anything, especially when I get seriously sick. In other words, I take the medication irregularly,” she explains. The family lives off the earnings of her husband who repairs bicycles.

After paying for alcohol which Salima admits she likes very much, there is little left to support a big family like theirs, especially for buying food. Actually, Salima has been forced to sell all the family goats to pay for food.

Like many families in Mtwara District, Salima’s has been experiencing food shortage since 2007, a situation complicated by the recent long drought in the district, forcing many people to survive on only one meal a day.

Complications

She feels very weak on days she does not take the medication. “I have even started developing some complications …I believe it is due to my inconsistency in taking the drugs. My left side is developing rashes, and I suffer much pain," she says, as she shows me a scar.

Despite her HIV-positive status, Salima had until recently insisted on having more children. Three months ago she gave birth to twins. One died, and the other is very weak. While pregnant, Salima’s doctors gave her treatment to prevent transmission of the virus to her babies.

Hassan has agreed they will not have more children, although Salima is not convinced. She particularly dislikes his refusal to use a condom when having sex.

There is no alternative to taking ARVs by HIV positive persons, even though it is challenging to adhere to the treatment because of lack of resources to get proper diet.

According to health community reports certain drugs should not be used together because of the way they interact. For example, Idovudine and Stavudine should not be used together, and Zalcitabine should not be combined with Didanosine, Stavudine, or Lamivudine.

Dr Lilian Mtei, who has been working with people taking the life-prolonging drugs at Muhimbili National Hospital advised patients who develop strange symptoms to see a doctor immediately so that the medication can be changed.

She said there are many side effects caused by the reaction of different types of ARVs on an individual.

For his part, the Management Development for Health (MDH) and Africa Academy of Public Health (AAPH) Chief Executive Officer, Dr Chalamilla Guerino, said such strange symptoms in patients are caused by Stavudine and AZT drugs when taken by a person for a long time.

“Such patients need to see a doctor whenever they notice any strange symptoms developing,” he explained.

According to the doctor, Stavudine ARVs were phased out this year because of the symptoms, but AZT is still being given to people although it has the same side effects.

For her part, the Deputy Minister for Health and Social Welfare, Dr Lucy Nkya said all patients who have developed such strange symptoms should be referred to regional hospitals where they can get more assistance.

She clarified that AZT was also phased out and so could only be in the market illegally.

She explained that AZT was only given to pregnant mothers, but later the government decided to phase it out because of the side effects.

The deputy minister said that medical employees based in the rural areas receive training continuously especially those dealing with HIV/Aids cases so as to be able to face the challenges of helping the patients.