Grab and Bang – Man, Where’s the Condom? AIDS Crisis in South Africa Today
by Vonani Bila
In 1990, South Africa had an infection rate of less than one percent. By 1999, an average infection rate had peaked to 22.4 per cent. By the same year, a projected twenty-five per cent of all pregnant women in the country were already HIV-positive. In 2005, these figures had risen to nearly thirty per cent, and the death rate among women between the ages of 25 and 34 had more than quadrupled. In 2005, a government national household survey estimated that 10,8% of all South Africans – about five million people – were living with HIV. By 2006 the figure had risen to 5.5 million. International health agencies estimated that, in 2005 alone, 320 000 South Africans, mainly blacks, died of HIV-related illness; about eight hundred a day. All age and sex groups were affected – including infants, pensioned-off grandfathers and grannies. This catastrophic figure is estimated to reach one million deaths per year by 2008. Recent UNAIDS surveys indicate that HIV in sub-Saharan Africa is estimated to constitute about 64% of the global total of 39.5 million people living with HIV.
The Mpumalanga province which is number two nationally after KwaZulu Natal has the HIV/AIDS prevalence estimated at 32.5 per cent. KwaZulu Natal stands at about 40%. The highest hit district in Mpumalanga is eHlanzeni. There are 23 antiretroviral (ARV) rollout sites in the whole province, but there is an apparent shortage of human resource. According to the 2003 national survey, the shortage stands at 63%. Before site accreditation, the enormity of the processes involved simply defeats the purpose of having many rollout sites. Some have to bypass two to three clinics to access ARVs, even though some can be made step-down facilities. Most AIDS patients from far-flung rural areas don’t have access to reliable public transport, thus limiting access to ARVs.
Poverty, migration, disempowerment of women, unemployment, illiteracy and poor education are some of the factors responsible for the rising HIV pandemic in Mpumalanga, and generally in South Africa. Of course there are other modes of infection such as mother-to-child HIV transmission, blood transfusion, exposure to blood and injecting drug use. There are shocking stories of people abandoning their prescription so that they can deteriorate to be recommended for the AIDS grant. Such is regarded as a survival mechanism to escape poverty.
“Their wish is to recover and continue having a grant to beat poverty”, participants at the Phaphamani Home-based Care Centre’s strategic planning workshop pointed out. “The patients tend to stop taking treatment simply to access the AIDS grant. The death rate goes up even though these people are on treatment”, participants said.
Surely, for the unemployed and poor AIDS patients, the R780 AIDS grant, meager as it is, is certainly so useful and should not be taken away by the government when the patient starts to recover. “It’s senseless to get a grant for two to three months and it is taken away. If you get a grant you should go for regular [AIDS-defining]CD4 cell counts for six months, but some people have a fear that if I take my treatment well I might not get the grant [though I’m positive]”, participants observed. This dependency to grants reinforced by rampant unemployment – HIV/AIDS’ twin virus.
Phaphamani Home-based Care Centre in Kabokweni, White River in Mpumalanga, a small nonprofit organisation established in 1997, is aware of AIDS severity and several people who have died as a result of not taking their scientifically tested medication. The participants asked: “What’s the point of treatment adherence counselling when a person will stop taking medication in favour of ubhejani – the African cocktail?” Any person goes through adherence counselling before they are given ARVs. “They will come to a clinic and when asked about how their treatment is working, they usually say fine, even though they are not taking ARVs.” Reluctance to take the ARVs could be throttled by once a kleptomaniac Minister Manto Tshabalala’s obsession with the beetroot, lemon, ginger, garlic and the African potato and her emphasis that ARVs are toxic. It is clear that she is an avowed opponent of ARV therapy. Yes, remedies like mother’s milk and ginger can make a person feel better, but HIV clinicians are convinced that ARVs represent the only real treatment for HIV today – unless an HIV vaccine is discovered – which looks unlikely, at least in the next ten years.
The claim by bogus herbalists (as seen in newspaper adverts, leaflets and posters around major towns and cities) that they can cure rincilana (AIDS) is devastatingly misleading. Several AIDS sufferers spend huge stacks of cash seeking help from these healers who are only hell-bent on maximizing profits, similarly like the conventional heartless pharmaceuticals. Most of those who parade as traditional leaders are not even diviners or sangomas, but sheer conmen who take advantage of the AIDS sick to make quick cash.
“What I like about sangomas is that they’ve given me a bitter cocktail that is meant to deal with the sores from inside. The sangoma told me that I must not mix her medicine with ARVs because she’s sure hers work better and faster than white man’s drugs. She has charged me a once-off payment of R700, which is affordable. She said there’s no way I won’t heal, and told me of people who were in sickbed for months that she’s healed”, recounts one of my relatives who believes he was showered with symptoms of AIDS by a wicked and jealous colleague at work. I insist, “brother, whether you’ve been bewitched or not, you must take the ARVs. Perhaps they’ll prolong your life to some more years.” Clearly, my brother with deep sunken eyes is going to join his ancestors. The man who used to weigh over 80kgs is so skinny that clothes hang around his tiny frame like it’s a hanger. His hair hardly grows, and the ones that grow can easily be counted. His body has patches of various dark marks and scars. His face is so dry, not even the thickest Vaseline petroleum jelly can stick on it for long. He insists, “I have ARVs on stand-by. I took them for two weeks to boast my immune system. But since consulting the expert sangoma in Khujwana village, I have stopped taking them. What is the use of taking ARVs that will not heal you inside, but only soften your face, arms and skin, then make you gain enormous weight? A man dies from inside – from the sores”, he reasons.
What is obvious is that AIDS patients would benefit a great deal if African traditional medicinal practice was made available in hospitals and clinics and properly regulated by the government. Consequently, the common AIDS stigma would be slightly eliminated, and the general dualism regarding ARV and untested cocktail drug use would be managed and monitored better.
A few years ago the government appealed a court decision that ordered it to provide ARVs to AIDS sufferers. Fortunately, the courts dismissed government’s appeal. In retrospect, even though the government is currently providing ARVs to about 350 000 AIDS sufferers, a commendable action though not good enough, it could be assumed that it is doing so reluctantly – and/or deliberately making the antiretroviral programme fail so that it could win the battle outside the courts. These mixed messages and tactics surely compromise the valued lives of AIDS sufferers, who, sadly, are likely to try every drug, herb and bark available in clinics and underground markets. And of course there’s a growing number of bogus prophets and the mushrooming churches who claim they can cure AIDS whilst they could be dying of it themselves.
Some AIDS patients have immediate family support, while others don’t. Treatment adherence is a major challenge. “A patient is left alone and can’t get treatment, and she’s taken care by children during school break because no older person is there to take care of her”, noted the Phaphamani participants. Often people die because they don’t take the treatment when they should. Others are delayed by those who should give them treatment. What worries my distant brother is diarrhea and that he lives alone in an apartment and since the wife packed her bags and left after the man got sick, there’s no one to cook for him. He fears he might die alone slowly and painfully. But he laughs at newspaper reports about AIDS patients on ARVs who develop large breasts, stomachs and have thin buttocks. “They age too fast because of consuming ARVs! Day and night” He says as he talks of the condition that is known as lipodystrophy.
Mpumalanga has about 700 doctors currently, but the province needs about 8000 to function like an oiled machine. What remains a worry is how will the health needs of the majority be addressed adequately by the government given the glaring shortage of the medical staff? The skills shortage is compounded by the flight of essential workers like nurses to countries like the UK and Saudi Arabia. The failure to produce doctors, low health budgets, grey hospitals and demotivated health workers means that the high rates of sexually transmitted infections will continue to soar, even though some are curable.
Attempts to address the AIDS scourge are in place, with the National AIDS Plan introduced in 1994, emphasizing abstinence, fidelity and condom use – the famous but less effective ‘ABC’ approach. Surely limited health budgets, a neo-liberal inspired cut on social expenditure, Apartheid debt servicing, purchase of jetfighters instead of feeding people, lack of reliable public transport system, poor and dense housing, inadequate sanitation, crime, corruption, unemployment and the known President Thabo Mbeki’s AIDS denialism as well as social conservatism, apathetic cultural and religious anti-condom dogma, continue to impact negatively on the efforts to fight the AIDS pandemic. The South African National AIDS Council (SANAC), once headed by current ANC President, Jacob Zuma (JZ) – a proud Zulu polygamist with several children who after sleeping with an HIV positive woman, took a shower to prevent getting the virus, is in place, but it hasn’t been able to communicate effective anti-AIDS messages to the people. Some of its ambassadors, like JZ, have dented its image. The Mpumalanga AIDS Council exists, but it is equally weak in altering people’s behavioural and attitudinal patterns. But even with the emphatic push by the Treatment Action Campaign for more people to be on ARVs, the state resources, coupled with the exorbitant price of drugs are some factors that hamper the efforts towards AIDS prevention and treatment.
Participants argued that the 32.5% HIV/AIDS prevalence in Mpumalanga is largely caused by the movement of people in the neighbouring Swaziland and Mozambique. It is argued that in their work-seeking or mobile forms of work tend to have multiple sexual partners, thus making themselves vulnerable to HIV. Other mobile workers who don’t necessarily have to be from other parts of Southern Africa, but very vulnerable to HIV include construction workers, seasonal agricultural workers, soldiers, informal traders, long distance bus, taxi and truck drivers, mine workers, business people and of course bo-makgosha.
The vulnerability of these groups to HIV is further worsened by the unregulated truck-stop prostitution, excessive drinking, polygamy, reluctance to use condoms, promiscuity and transactional sex.
A consequence of a high HIV prevalence rate and resultant AIDS deaths is an increasing number of orphans in the country. It is estimated that there are 2.5 million orphans in the country and half are HIV/AIDS orphans. According to a study by Metropolitan Life, the number of AIDS orphans in the country is expected to reach nearly two million by 2010 – the year of the much-talked about FIFA World Cup in our shores. This means child-headed families are on the increase since it’s more than a half of the children whose mothers have passed away due to AIDS. Usually, the orphans in extremely impoverished backgrounds are the worst affected by poverty, lack of care-giving and may end up staying with cruel relatives.
Sometimes a parent leaves three to five children behind, in dire poverty. What exacerbates the problem of orphans in South Africa is that the fathers are not known because in several incidents, the mother did not bear all the children with one father. As the cliché about the social worker goes, “these are not orphans because for these ones the father is alive, for this one the father is dead.” Some more children are left with grannies with little or no capacity to find their father. It’s difficult to trace this man who has left so many children all over the place. Clearly, casual sex with a multiple partners whose egg is ready to welcome your sperm can make you “King Solomon” who had hundreds of concubines. But perhaps in those biblical times, the threat to sexual enjoyment was gonorrhea and other curable STIs.
An orphan by traditional African customary definition, is when the father and mother have passed away. This definition may not be the legal one, since by law orphans are largely children without mothers. But if the father and mother are unemployed as it’s the case in our country with over 40 per cent unemployment, there’s little that can be done, even though the child struggles with basic human needs.
Sometimes in our heightened sexual madness, we forget that the HIV knows no boundary, age, race, social status, ideological inclination nor religious and cultural beliefs. It can affect any person. All of us, young and old, are at risk. Even known figures like Afro pop-jive muso Umanji, ANC parliamentarian Peter Mokaba and Parks Mankhahlana – President Mbeki’s former spokesperson succumbed to AIDS. So, it is not entirely true that AIDS is a disease of poverty. But there is a view that wealthy people, especially bo-bhuti madlisa can sleep with anyone regardless of the public knowing. Enlightened people with resources and negative attitudes tend to go to the illiterate and spread it with the I’m not going to die alone story. In their comfort of flashy sporting cars, big wallets, posh houses, whisky, brandy, rum, gin and wine – they bear the capacity to lure teenage high school girls and marinate their faces with rands, yummy food, cellphones and latest fashion wear – while pumping their tender bodies with the deadly HIV. The girl might ask, “How can a fresh and fit man behind the wheel be HIV positive?”
The same consumerist men splash money like leaves also prey on varsity students, and sometimes poverty is a big factor in these types of transactional sex. Later when the student graduates from varsity and let’s say after three years of joblessness and utter frustration, one grey-haired former Bantustan chauvinist in government promises her a job on the condition that the interview takes place in his office, behind closed doors and with both parties naked on the couch. Let’s say she accepts the strange offer to be bonked by the grey-haired married fellow who has never used a condom in his lifetime. So she gives him the condom and he smacks her face with it. “My girl, how can you eat a banana with its leaf?” He asks angrily. The girl yields, and the job and big salary are secured – but provided she, this young and newly appointed Personal Assistant, is available to accompany the boss to meetings, workshops and conferences in hotels and share the same room and incestuous bed. She says yes, though anger and self-rejection are brewing inside her. She’s got a faithful boyfriend that she truly loves. They studied together at varsity. “Ah, maybe that’s how most women get jobs in this country”, she consoles herself.
Then with a fat cheque she buys an elegant car and weds a fellow professional. The newly weds then decide to make a baby, and later take out an insurance policy – a life cover. They are suddenly shocked when the life cover application is rejected on the basis of medical reasons. Their hope to enjoy the hard-earned money in a liberated South Africa is thwarted after discovering that the AIDS dragon is around the house – its claws growing inside the woman’s womb and hell-bent on spoiling the fun. No wonder the rate of suicide among young professionals is high – this can be attributed to levels of depression and psychological catharsis caused by AIDS. The same depression is sadly evident in most exiles, who after freeing the country, started to be eaten away by the AIDS bug.
“I’m sure most parliamentarians are HIV positive. Why don’t they publicly declare their HIV status if they care about the voters? Look at the way some of them drink, it’s excessive and unacceptable! They are alcoholics. It’s like they are burying some problems in the liquor bottle”, a friend tells me after narrating the story of his brother, a former Mkhonto weSizwe cadre who died of AIDS. His words, “parliament is sick” remain a refrain at the back of mind. Maybe he’s right.
I think of some local government councilors whose lifestyles have suddenly changed since tasting power. They drink malted whisky, and they’ve moved to former whites-only suburbs. They throw bash after bash and like to caress young and maiden girls. These are the people, now called ama-bourgeoisie, who used to earn slave wages and suddenly they can afford mortgage bonds and pretty girls. I see them wiped away by AIDS if they don’t stop being reckless.
I think of some band of ANC-deployed managers in government whose passion is to attend workshops and conferences every day instead of delivering on the Reconstruction and Development Programme’s mandate. They are many, and some of them were guerillas and didn’t find adequate time to study further than mastering how to detonate a grenade. Now they wear the latest hot Italian fashion and drive estate cars with a wheel at the back. They carry gold and platinum cards, and the energy is geared towards luring the young and sexy girls to bed. And of course they get the girls who are crazy about cars, and that’s why they’ll kick the bucket if they carelessly fuck without a condom. Their ways are deplorable – the same people who preach Batho Pele.
An extremely vulnerable group though, is surely sex-workers, especially street walkers who are derogatorily called bo-makgosha by the same men who demand their services. They are usually female, black, poor and often times from rural areas – all adorned. Of course there are lots of South African whites and migrants from as far as Russia, Poland, DRC, Mozambique, Zimbabwe, China and other parts of the world who exchange their bodies for cash in all major cities of South Africa, especially Johannesburg and Durban.
“If you go out and be a sex-worker and know that you’ll be infected it is the same as going out to kill yourself”, the participants remarked during the Phaphamani workshop. Prostitutes work day and night, illegally, though. Their clients who may be equally vulnerable to HIV sometimes include married and rich men.
In Mpumalanga you’ll find the hookers in Nelspruit, some to halfway Sabie, but some go to areas where they will not be recognized – wearing their mini skirts, red lips and often times no underwear. In Limpopo you’ll find sex workers in Musina, Louis Trichardt, Polokwane, Mokopane, Naboomspruit until you reach Gauteng. They are usually young girls, and one street girl in Polokwane told me that her clientele is varied, “but Italians and Portuguese like sex a lot”. Perhaps she’s correct. These must be the guys in the construction industry, far away from Europe!
Given that sex work is illegal and criminalized in South Africa, the hookers can’t easily access essential health services. They are easily brutalized by the pimps and the police who are supposed to uphold the Sexual Offences Act of 1957 [which prohibits sex work] are the first to water their mouths at the scene of girls dressed in mini skirts, stomach-outs, organza jackets and expensive perfume. The police break the law by taking bribe from prostitutes and, as most people know, sleep with them, sometimes without paying. Prostitutes – from Hillbrow to Nelspruit are exposed to hostile working conditions. Rape, exploitation, crack, beer, a host of STIs, abortion as well as HIV are rampant in this centuries-old trade.
Though the prostitutes are aware of the dangers, they need cash especially to pay rent in derelict Hillbrow hotel room, glistening diamond rings and branded fashion to shine in the dark alleys of the night and dance floor ahead and during the Soccer World Cup in 2010. Interestingly, will the adventurous international tourists in 2010 feel comfortable to trade their Euros, Dollars and Pounds for the South African hookers who operate illegally, and extremely vulnerable to HIV?
“But prostitutes – the breed that we always deride and condemn, insist on condoms”, a truck-driver who gives me a lift from Makhado to Polokwane says. “Those who don’t always use condoms are the hungry whores in taverns, beerhalls and shebeens”, he reasons. After talking to him, questions buzz in my head: Do women who are aware that their boyfriends have a string of girlfriends insist on condom use? Do wives whose husbands are known cheats play it safe in the bedroom? How about lunch-hour quickies in offices? I remember the words of a Joburg prostitute originally from New Castle in KwaZulu Natal I met in 1996 at the Diplomat Hotel who unflinchingly said, “I drink, smoke and dance naked on the stage. You may judge me, who cares! Even though I’m fucked by 7 to 10 men per day, I’m not like the rest of the stupid women in nice dresses and long skirts who are embarrassed to carry a packet of condoms in their handbags”. Ah, I stare her right in the eyes.
“Those women hardly condomise. That’s why they make babies like rats! Me, it’s the condom or voetsek! I carry the strong ones, the latex type for rough riders. I don’t use the cheap government plastic nonsense. They smell and burst easily. Sometimes if I doubt my client, I tell him, bhuti, wear two of them simultaneously so that even if you take an hour fucking, the rubber can stand the heat and not melt or burst!” I nod repeatedly saying ja, ne! as the young woman with a clean-shaven head, bulging belly and drinking an Heineken beer carelessly recounts her crazy moments as makgosha. On stage I see girls dancing, some wearing only a g-string to blaring house music. Men whistle and cheer. Others, perhaps they are the notorious taxi drivers, want to grab and bang the butt, rip off the g-string, put a finger in the vagina and lick the breast in delight. But it’s just a strip show. Some of these debauched men who look stoned are professionals. And I’m there watching the strip-tease! I live in a secular state that my beautiful country became after the 1994 Mandela miracle. My friend who is in his late twenties is earmarking a white prostitute. He whispers, “these whores are fresh. They will make a lot of cash in 2010, come the World Cup. I want the blonde chick. Once, just once… I want to stir a revolution between the thighs of a white girl. White men have been piercing thighs of the black maids in the kitchens for all these years. It’s my time to taste a white girl’s pussy!” Let my rural buddy enjoy the benefit of democracy, as long as he uses a strong condom –ijazi lomkhwenyana!
Though men must wear condoms, the leprous saga surrounding government supply of millions of defective condoms in 2007 might scare people from using the ‘raincoat’. After all, a defective condom is like a cheap fong kong raincoat that makes you wet though you feel protected. It hasn’t been established how many new infections occurred because of these fraudulent condoms and government negligence, and importantly, what recourse the infected has. Given that most people who use these free government-supplied condoms all year round are generally the working class and poor, government’s casualness can therefore be equated to mass slaughter of the citizenry, who by virtue of their weak economic power base, don’t feature in government’s BEE plans.
Men can be hot all year round, and since quality condoms cost an arm and a leg, the chances are that these men might have unprotected sex when the budget for the condom is low, other than sleep and look the other way in a warm, adorned and seductive bed. The absence of the condom thus increases lovers’ vulnerability to HIV and other sexually transmitted infections and the female partner can fall pregnant, though reluctantly. Worse still, if the man is uncircumcised, like most men in Botswana and KwaZulu Natal, the chance of contracting HIV is high. Perhaps it’s time the government turned a circumcision programme into public policy. Sangomas and Jewish Rabbis would do the job perfectly – not in Summer, but in Winter, and as long as they use clean syringes! After all how do you take a shower, say in a public gym, when your penis is layered with a whip that can’t crack enough? Once I heard a female friend who dumped an uncircumcised man because making love was a frustrating and nauseating mission.
Information about HIV/AIDS is everywhere: on television, radio, newspapers, billboards, t-shirts and all kinds of media – but it is scandalous that the virus continues to rear its ugly head and cause immeasurable damage and pain in society. The disabled, especially in rural and forgotten areas, might be the ones that are clearly ignored in most of these messages, and hardest hit by HIV, since some members of the community regard them as asexual. Even though they suffer discrimination as a consequence of their disability, they are, especially the visually-impaired, often coerced into sexual intercourse by the drunken physically able. The community will simply notice a pregnant blind woman, and when the perpetrator resurfaces, it’s Mr so and so in suit and tie.
In 2005, one person in seven civil servants was reported to be infected with HIV/AIDS in South Africa. This frightening situation means uncontrollable worker absenteeism, pitiable morale, low productivity and huge staff recruitment and training costs. It is also reported that HIV among soldiers, security guards, nurses, educators, truck drivers, prisoners, musicians, refugees and homosexuals is rife. This is trouble. The HIV dragon permeates every layer of the societal fibre and mourners, grave-diggers and undertakers can’t cope anymore.
Although I consider myself informed, I only became sharply aware of HIV/AIDS when my partner was pregnant and undergoing the antenatal tests. For reasons that are foolish, we had unprotected sex without knowing our HIV status – in a desperate effort to make a Vonani junior – (as if someone had said we are infertile and cursed). The truth is that, unlike most young people in a romantic sexual relationship who will use a condom for a week, and abandon it afterwards, we used the condom consistently for almost two years. In fact we used all types of condoms, and rarely Choice, the government brand. But now, the pathologists had to furnish us with HIV results. For a week we waited for the results. It was the longest period in my life and I plotted all sorts of scenarios incase the results were against our planned parenthood free of AIDS. Fragile as I am, suicidal thoughts crowded my head. It even lessened my appetite for food – I mean all types of dishes! No wonder mental distress and disorders coupled with increased anxiety are highly prevalent among people living with HIV. Luckily, the tests were negative, and my nightmares vanished away like spring rain. That day I roamed around the house a free man, playing all types of my favourite music.
When Mhlahlandlela my son was born, people congratulated us, and my mother, mhani Fokisa, who shook my hand sternly and graciously when I told her that my partner was pregnant knew her mission in life of having all her children blessed with kids had finally dawned. Mhlahlandlela is her official 25th grandchild, a wonderful gift from her last born son who is expected to take care of his late father’s house – and whatever legacy he’s left behind. But how do you take care of your father’s house when you don’t have a child – a boy for that matter? Call me sexist if you have the guts! This question raged in my head for years, especially after messy relationships with some of my former girlfriends. They were like vampires, always demanding this and that as if I’m Fumani gold mine – yet calling me a fool behind my back when they’re in the loving hands of their other boyfriends. Now that I am a daddy, my father will surely rest in peace.
The birth of my boy, in one hand, much as I love him, can be viewed as bottled-in pressure to meet unwritten social and customary conditions to become a man and stay relevant and accepted in the African family setting. I’m reluctant to accept this logic though. Once the baby was born, some friends teased me, “it was difficult to address you old-young man, but now we know you are papa Mhlahlandlela”. The message was as clear as the sky: age was catching up with me. I had to find a wife and make a baby, fast! Someone sarcastically hinted, ‘we know you can write excellent poems and speak eloquently about socio-political problems, but who’ll carry the Bila lineage and legacy after you great activist poet?’
Oftentimes the pressure to be a biological parent can lead you to indulge in unprotected sexual lifestyle, just to prove ‘I’m not docile, I’m not barren’, especially when friends and peers alike have children – and you no longer fit to discuss parental matters. Worse still, when close family members firmly expect grandchildren, you may simply oblige in order to satisfy unwritten and unspoken laws of a complete and stable family. Where I come from, at Shirley village, even when the couple is unemployed and poor, the child who is regarded as always sacrosanct will grow as long as the grandmother is a pensioner and the aunts and uncles are alive. But in this age of AIDS, surely one of the colossal challenges facing young and romantic lovers is to start HIV-free families, uncompromisingly.
Even though AIDS has been with us for years here in South Africa, communities have not yet dealt with the stigma. “The fact that we are dealing with HIV/AIDS especially to the point that there’s a special clinic for that is a big problem. At Themba Hospital, once you take the right turn they say you are positive,” Phaphamani participants lamented.
Participants also highlighted a sad phenomenon that HIV carriers are often people who are working on the HIV/AIDS sector – the supposedly conscious activists themselves! Some of them greens, reds and self-declared feminists. “If you go to a conference organised by an HIV/AIDS organization, you find that the beds never stop shaking”. In these conferences, you’ll hardly see condoms, but you’ll notice young people disappearing to their hotel rooms. If this is true, then ours is a sorry fight against the AIDS pandemic.
Handling the AIDS crisis means the uncles who sleep with their nieces because their wives have passed away must simply stop this terrible habit – which in some countries is punishable by stoning and death. “The uncle will buy her a mobile phone and for us here at Phaphamani it is sometimes too difficult to discover these types of stories because families hide them for reasons only known to them”.
On the other hand, there’s the story of poor young girls as little as thirteen who ceaselessly make babies with the hope to receive the Child Support grant. Then there are some church pastors and a broad spectrum of the religious right who still see sex and sexuality education as a taboo – the sanctity to be enjoyed by married people. This arrogant attitude is a shame, given that it’s the same pastors who burry AIDS victims week in and week out in villages, slums and townships.
Another challenge in the fight against AIDS is rampant rape that is so imminent in villages, townships, servants’ quarters, shack communities, offices and cities. About 53 000 rape cases were reported to police in 2000. I can only imagine that the rapists have little time to wear a condom! Without doubt, South Africa has some highest rates of violence against women, and in instances where the women depend on these hardened male bastards for livelihood, the inability to control the actions of these beasts is evident.
The risk of HIV infection tends to be high, since a powerless woman can hardly demand a condom use, lest she’s accused of being sfebe – the whore, by the same man she’s mothered children whose noses and ears look like him. If she says she’s tired because of daily household chores and that she’s not in the mood for sex, the man she calls a husband might assault her and leave her face and body fractured with bruises. “Since when did I marry you to question my authority and deny me my conjugal rights I’ve paid for?” the man might fume –blood rushing to the head. Yeah, even in a blessed marriage union, a woman can be raped! Sometimes it’s very complex to understand rape. “One woman reported a rape case and later paid bail for the suspect to be freed.” She argued: “Who’ll buy food and clothes for the children while my husband rots in jail? I am jobless!”
What I find disgusting is the act of bestiality that is characterized by men, especially he rural folk, turning goats, cows and chicken into hidden romantic sexual partners and unlawful wives. There are also cases of women turning dogs into sexual instruments. Whether this barbaric sexual act has bearing on the spread of HIV or not, the point is that no moral society can justify such bizarre sexual deviance among men and women.
Sodomy in most South Africa’s populated prison cells is another frightening phenomenon and little seems to be happening to alter the behaviour of inmates by the Correctional Services and NGOs. Inmates continue to infect one another with HIV unabated. It appears condoms are not well distributed in prisons, so are other risk reduction measures like voluntary testing and counselling, as well as treatment.
What remains unclear to me is whether same sex unions which are guaranteed in South Africa’s constitution automatically condone sodomy – men who sex with men – since gay men are likely to have penetrated anal intercourse without a condom for their pleasure, thus increasing the chances of spreading HIV. What I fear the most about incarceration in a South African prison cell are thugs high on drugs ready to grab and bang my backside and pump me with the infectious HIV. If sodomy remains less attended, our society is therefore a moribund one, perpetually incapable of stemming out HIV.
There is a myth that if an HIV-positive man rapes a child or a virgin, he will be cleansed of the virus – the curse. The fact that society hardly talks with children about sexual matters, coupled with the culture and custom of seeing sex as dirty or something only to be enjoyed by married people, is hitting us hard in our faces. Now children are dying in greater numbers, drastically reducing the life expectancy of South Africans. Currently the average life expectancy of South Africans is less than fifty years, a sudden drop that can be attributed to the rapidly increasing AIDS deaths.
A comprehensive and integrated plan to deal with the AIDS challenge is needed. “We can’t accept a situation where certain employers resist to hire HIV positive persons. We must fight against families who fire the maid because she is HIV-positive”, Phaphamani participants stressed at the workshop. They also stressed the importance of women claiming power by defending their rights as embedded in the country’s Constitution and various statutory documents. Captains of the commercial firms care so much about profit, and I don’t see them paying a new recruit they are not aware of his HIV status a large salary. I think they’ll always press for workers to disclose their status so that worker productivity levels can be managed better, where possible.
Material and social status play a huge role in increasing the infectivity. Fourteen years into our democracy, we need to build a solid AIDS consciousness among men and women, business people and workers; the youth; religious leaders and their followers; farmers and farm workers; the unemployed and the professionals; the rich and the poor – all of us, because AIDS doesn’t discriminate. That means husbands must begin to use condoms in their own homesteads, and wives must exercise power in the bedroom by negotiating safer sex practice because, clearly, women’s low social and economic status puts them to bear the brunt of the AIDS pandemic.
But then there’s the female condom story!
“But when you go to collect femidoms they will write your name down and give you numbers. Some girls were taking femidoms and making bracelets out of the ring!” The truth is that femidoms are not easily available. Others say they are not comfortable either! You must wear it hours before sex, sometimes even when you are cooking in the kitchen.
You also have to pin your hopes that your partner will have sexual appetite upon coming back from work. And if he’s tired and moody – roughed up by bosses, what do you do with the female condom? Flush it away? The truth is that even after taking a shower to refreshingly seduce your partner, you’ll have to wear another femidom – unless there’s no danger in washing and reusing the old rag! What I know about the male condom is that only morons wash and wear it after use!
The government says the femidom is expensive, thus it is hardly found in hospitals and clinics. Does that suggest it’s better to let the people die, than supply them with the available instrument which will at least protect them from being infected? Some participants felt the need for Phaphamani to negotiate with relevant government departments, especially Health and Social Services, to have female condoms distributed to the public without the nightmarish logistics of taking down people’s names.
Clearly, the fight against HIV/AIDS must involve all members of the community, but there will be an added value if HIV clinicians, retired nurses and the entire contingent of medical personnel could actively join hands with orgnisations like Phaphamani, since they have full knowledge of the HIV/AIDS. The home-based approach and a host of other strategies adopted by Phaphamani such as voluntary counselling and testing, taking care of orphans and income generation are appropriate and require full execution by all layers of the organisation in partnership with its strategic partners. In this regard, Phaphamani restores the dignity of the infected and affected, and integrate them fully into society.
Key to reversing the impact of HIV infection is massive testing that must redoubled, and priority should be given to young people in schools, universities, churches and other public and private settings. With AIDS death covering the country, those who wield power, particularly the political heads should learn to call a spade by its name, and use whatever resources in hand to facilitate HIV testing on a mass scale, with early treatment therapy linked to it. Every public platform: schools, government offices, hospitals, post offices, driving schools, Home Affairs offices and churches should be used as mechanisms to get more people tested. In fact, testing should be made compulsory if South Africa is prepared to arrest the HIV pandemic.
What is obvious is that the fight against AIDS is larger than an individual organisation. To reduce HIV infection, all critical stakeholders: be they pastors, donors, educators, learners, nurses, social workers, traditional leaders, sangomas, taxi drivers, sex workers, truck drivers, the police, researchers, media personalities, all types of professionals and the leaders and officials in all spheres of government – should come on board and wage war against the HIV/AIDS pandemic relentlessly like proud South Africans did against the Apartheid monster – with a greater measure of success.
South Africa’s ferocious enemy today is nothing but the devastating infectious AIDS epidemic, and politicians like President Thabo Mbeki who likes to flirt with dissidents must not pretend not to see the elephant in the room. He should be the first to undergo an AIDS test, whatever the outcome, at least the inertia that’s gripped the land would certainly evaporate and more people would find an exemplary leader who cares in him.
Vonani Bila is a poet, editor, publisher and community activist. His poetry books include No Free Sleeping, In the name of Amandla, Magicstan Fires and Handsome Jita. He is currently the director of the Timbila Poetry Project in Polokwane.