Perspectives
and personal views on current and cultural affairs, appearing every Monday and Thursday
As
World AIDS day is commemorated Tuesday, South Africa-still struggling with its racist
legacy-takes the stage as one of the fiercest hotbeds of the relentless disease
By Fred de Sam Lazaro and Nick Hayes
After decimating sub-Saharan Africa in
the 1990s, AIDS has now turned its full force on South Africa, threatening to squelch
hopes for a shining new nation on the crest of a new continent.
Nelson Mandela’s “rainbow nation” is also home to one of the
world’s most rapidly rising rates of HIV infection-as high as 12 to 13 percent of
South Africa’s population, the United Nations estimates. “It’s a biological holocaust,” says
Johannesburg epidemiologist Dr. Reuben Sher.
A nation struggling to shed a racist past is now faced with an epidemic that is
preying disproportionately on blacks. And
while the record or irresponsibility that has allowed AIDS to flourish began with the
apartheid regime, the new government also has been slow to respond, or even acknowledge
the crisis.
While the government now proclaims its commitment to ending racial discrimination
in the workplace, it shows little concern for HIV-infected workers (in one key industry,
mining, four workers are trained for every job on the gruesome assumption that three out
of the four workers will die of AIDS). The
traditional social structure of extended families and strong village communities is also
failing AIDS patients by ostracizing them. Even
the hospitals wash their hands.
Will AIDS be the unmaking of Mandela’s utopian vision? Having seen the toll of HIV and AIDS elsewhere in
the world-in the United States, India, Uganda and Russia-we set forth on a journey of
South Africa’s devastation.
Urban Magnet
In no place is the disparity between
dreams and realities of the new South Africa more apparent then in Durban, the urban
center of the province of KwaZulu/Natal, where one of every four people is HIV positive.
Located on the Indian Ocean, Durban has beachfront tourist hotels, a thriving
harbor lined with tankers and container cargo ships, and a trucking industry that fans out
to all of South Africa and sub-Saharan Africa. The
city is a magnet for the new economy. It is
also a magnet for HIV.
HIV comes with the refugees fleeing poverty and sporadic warfare in the surrounding
villages of KwaZulu/Natal and South Africa’s northern neighbors. The virus comes with the truckers who have easy
access to prostitutes at truck stops along South Africa’s freeway system. In Durban, the city’s underworld of narcotics
and prostitution puts the virus on the fast track to AIDS.
To find the faces of AIDS leave Durban’s beach hotels and follow Pickering St.
north. The first-world economy gives way to
the scenes of waterfront lowlife. Turn left
on Brown St. and you have come to the Ark. For
eight years those who are HIV positive have sought refuge at the Ark.
Built in 1916 as a hostel for black railroad workers, the facility today crowds
1,000-plus people in the second living space designed for 450. As you enter through the gates, you are confronted
by lines of men, women and children waiting for meals or medical attention, or just
passing time. Glancing about the two-storied
interior and its inner courtyards, you might think that you just stepped into the 19th
century poorhouses of “Oliver Twist.”
A middle-aged Afrikaaner greets you with a rye laugh: “Don’t worry, we’re not as bad as
we look. We’re much worse.”
The Ark was founded 17 years ago as a shelter for the homeless; today it is the
primary refugee for the growing number of HIV and AIDS cases in the city and the
KwasZulu/Natal countryside, says the Ark’s director, the Rev. Shirley Pretorius, a
transplant from England. She explains that
the main hospitals refuse to care for AIDS patients, arguing that nothing can be done for
them and that limited resources must be spent on the host of other diseases inflicting the
city.
Wally Hill, middle-aged and white, serves as AIDS counselor for the Ark. In the 1970s, he was a soldier of the apartheid
regime. On his right hand, a swastika tattoo
testifies to his earlier politics, and a severed thumb and index finger are reminders of
the violent street life he also left behind.
In the late 1970s, a succession of
divorce, unemployment and prison for armed robbery plunged Hill into Durban’s
low-life. He rolled through the 1980s dealing
and using drugs, pimping prostitutes and indulging in a lifestyle of “shared
needles” and “free sex.” In
1994, he learned he was HIV positive. Hill
says the Lord spoke to him and sent him to the Ark. Since
then, he has served his fellow HIV and AIDS patients.
I minister to human time bombs,” he says.
Hill makes his rounds dispensing encouragement, meals and prayers to the HIV
community. He has brought many of them there
from the streets and clinics of Durban. Walking
down the corridors of the Ark, he points to an elderly white woman with AIDS who was
rejected by all her six children. He stops to
help a young East Indian man whose family had abandoned him to die of AIDS on the beach.
Health care is HIV care
In the country’s metropolitan
center of Johannesburg and its most famous township, Soweto, the epidemic is a year or two
behind Durban and KwaZulu/Natal but gaining ground fast.
At Baragwaneth Hospital in Soweto, the incidence of HIV was relatively minor just
four years ago.
Now, according to Dr. Glenda Gray, director of the maternal and child care clinic,
more than one-third of pediatric admissions and more than half of all admissions to the
hospital are HIV-related. “There’s
no life as a health-care worker without HIV anymore,” Gray said. Every morning begins with the recognition in yet
another infant of the telltale symptoms of HIV. Overwhelmed,
she confesses that at times “you don’t want to test anymore.”
The HIV children in Gray’s clinic at least have mothers present. Just beyond Johannesburg lie the crime-infested
districts of Hillbrow and “little
Nigeria” and a shelter for infants called Ethembeni, or “the place of
hope.” There, director Gail Schultz
takes the HIV babies whose mothers abandoned them in the maternity wards of
Johannesburg’s hospitals.
Ethembeni started as an orphanage but now takes in only babies with HIV and also
provides shelter for a few HIV-positive teenage mothers.
After the infants arrive from the hospitals, about one-third will develop AIDS. Death is a regular visitor to the shelter. Schultz, with her nurses and volunteers, gives the
babies the warmth of human touch and care for their short lives. Schultz has room for only 60; it’s never
enough.
Schultz relates how violence has accompanied the HIV epidemic and traumatized the
most vulnerable. “What we have on our
hands is an epidemic of child abandonment and violence,” she says. Sexual abuse and assault of children has risen as
the fear of AIDS from contact with adults had led men to victimize the young.
The politics of neglect
Why is AIDS able to take away the future of these newborns and the rest of three
million sufferers in South Africa? As in all
outbreaks of the global AIDS epidemic, from San Francisco Castro St., to Soweto, the
answer is political.
In South Africa, the roots of the epidemic lie in the legacy of apartheid. It provided less than second-class medical
services to its black majority while Pretoria poured resources into a world-class medical
system for the white minority. In the
post-WWII decades when South Africa could boast of world firsts in heart and organ
transplants, black Africans suffered epidemic rates of syphilis, tuberculosis and other
infectious diseases.
In the 1990s, AIDS followed the same pattern but a new geography. For more than half a century, the apartheid regime
entertained the delusion that it did not belong to the African continent. Thus, the new South Africa was unprepared for its
integration back into Africa and the waves of immigration that brought increased poverty,
social strife and disease from central Africa all the way to Cape Town.
Unfortunately, the record of irresponsibility did not stop with the end of
apartheid in 1994. The new government in
Pretoria reluctantly acknowledged that it had an HIV problem only in late 1997 in the face
of published reports by the United Nations and the World Health Organization that placed
South Africa in the epicenter of the global pandemic.
A year later, public health and education campaigns remain feeble.
“This nation is in denial about HIV,” said Baragwaneth Hospital’s
Dr. Gray.
Perhaps we can excuse Mandela’s government for choosing to fight other battles. Why should it divert resources from the pressing problems of housing, education and jobs to a campaign against HIV/AIDS that many believe it cannot win?
The same thinking a decade ago might have led Mandela to think that he could not
win the battle against apartheid. Today’s
South Africa must realize, as Gray said, that the nation that had the courage and will to
bring down a racist regime can mobilize itself to battle AIDS. This is the key hope in a country facing
devastating odds. In the coming years, HIV
will take its highest toll on the young, working population.
But beyond the statistical prognosis, we found the human faces of hope as well as
pain.
As we toured the Ark with Wally Hill, a swastika-branded hand reached out to touch
and East Indian AIDS victim hovering near death. A
former soldier of apartheid found a common ground of pain and compassion with a person of
color, giving hope that the “rainbow nation” of South Africa can indeed confront
the pandemic of AIDS.
-Fred de Sam Lazaro is executive producer of KTCA-TV’s “NewsNight Minnesota.” Nick Hayes is a history professor at Hamline University.