Silence equals Death

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By Rajiv Kafle

As I proudly sported my ‘Silencio = Mujerte’ t-shirt that morning and was heading towards the conference shuttle that would take me to the Walter E Washington convention center an elderly lady probably in her sixties greeted me warmly and said “I get re-energized and my blood starts to boil every time I see that silence equals death sign you know”. Even before I could ask her about her connections with those three words on my t-shirt from the Mexico AIDS conference 4 years back she added “AIDS activism in the eighties brought us all together and we were angry like hell with our government.” As she romanticize her good old days I just sat their and listened to her with a smile on my face as if to say to her that I am also a part of that great legacy just because I am wearing the t-shirts now.

I am from Nepal one of the many poorly run country in the world and even in my country there are no waiting lists when it comes to access to life saving ARV treatment for people living with HIV. When I came here in the United States to learn that half of the people who need treatment do not have access to these life saving drugs it just didn’t feel right specially because one third of resources that goes in keeping people on treatment in my country comes from US taxpayers. I kept thinking that either the US citizens are too generous and kind or the system here is screwed.  I have no doubt that American people are kind and generous but there still remained enough room in my mind to argue that the system is screwed and the silence is killing people.

It’s been almost a month that I am in the US now and there has not been a day that health care is not on the top of the political agenda since I have been here. I don’t know what incorporates the Romney/Ryan health care plan nor I understand the intricacies of the Affordable Care Act but I am simply trying to figure out as to why there is still waiting lists for those needing life saving treatment in this country and moreover why those on the waiting lists are silent.

I am now in New Mexico which is one of the few states which has no waiting lists for people who need treatment and that’s a pretty good news to hear for me coming from Nepal you know. But guess what an old friend of mine who I am visiting here recently was prescribed with (a pretty common diarrhea medicine in my part of the world called) ‘metronidazole’. As I looked into her prescription slip from the doctor it read in rather bold letters that she had saved 25$ because of her insurance in getting those 30 pills for just 10 bucks. I laughed my heart out reading those lines and she asked me what the reason was for this untimely burst. I said ‘are you kiddin me’ as I am catching up with few common phrases here and there – showing her the slip.  She asked me what would that cost me in Nepal. “Maybe 60 cents or most of the times nothing because it’s distributed for free under various schemes’ was my answer.

If I were an American voter I’d ask why I am paying more than a dollar for a 2 cent worth pill and why half of the people in one of the richest nation on earth are deprived of life saving medicines. I would certainly not just remain silent and listen to these endless debates as to whose healthcare plan is better.

I personally think that both are crap if these plans would not change anything and people living in one of the richest nation on earth are still deprived of basic healthcare and most ironically a handful of people are making a fortune out of this.

These are decisive times and those of us who pride ourselves in wearing the ‘Silence equals death’ t-shirts should step up our efforts in making our voices heard as we did in the past and more recently during the DC AIDS conference.

And as the lady on the bus reminded me of how powerful these three words are I wanted to share my story to my friends in US who have inspired me time and again to not to remain silent.


I dedicate this story to my friend Steve Garret who laid the foundation of an outstanding healthcare services for people living with HIV in the state of New Mexico where there is not a single person in the waiting list for access to HIV and HCV treatment.