AIDS spreads in South Africa
By COLETTE SPICER
The HIV/AIDS problem in South Africa can best be likened to a natural disaster, an earthquake perhaps. All the signs of catastrophe are there, but most of the people are oblivious to the foreshocks. Almost a decade after attempts to educate the public about this disease began, statistics bear testimony to a bleak future.
The disease continues to spread at an alarming rate.
More than 1,500 new infections are reported every day. The virus is most prevalent among women of the 20-29 year age group. Further, the number of pregnant women with AIDS has increased by 35 percent in the past year. The high rate of HIV-infected infants is already placing a strain on the social welfare system, a burden that is likely to increase dramatically over the next 10 years. In 1997, the number of acknowledged cases stood at 2.6 million. According to reports in mid-1999, the number had increased to 3.5 million by 1998, suggesting that in relation to population numbers (an estimated 36 million), South Africa has one of the highest rates of this disease in the world.
Another factor placing an ever-increasing number of women in danger of contracting the disease is a high incidence of rape. Every 25 seconds, a woman or child is raped in South Africa. Given the prevalence of HIV and AIDS, those victims have received a death sentence.
Although the statistics shout for attention, South African authorities are faced with a number of stumbling blocks in dealing with the epidemic. The most notable problem lies with youth, the highest risk group. Government health and social welfare departments have opened major campaigns, dispensing free condoms at schools, universities and to the public. The campaign is so intense that teenagers themselves are asked to distribute the condoms.
Nevertheless, statistics continue to show an increase in infections, underscoring the ineffectiveness of the campaign. Personal observations have led me to believe that enthusiasm for AIDS awareness is short-lived among this group. Promiscuity among youth contributes to the rapid spread of the virus. Until a determined effort targets this group with an abstinence approach, the disease will not be effectively contained.
Another stumbling block to AIDS education among teenagers is apathy: AIDS will not affect me. This attitude possibly stems from the nature of the disease. In its early stages an infected person may live a normal, apparently healthy life. On the other hand, admitting to having contracted a sexually transmitted disease is generally a point of great embarrassment for people in most cultures, especially teenagers.
South Africa is still reeling from its turbulent past. Political changes over the past few years have brought with them attempts at rapid sociocultural integration, which has in itself facilitated a breakdown of traditional values. This is particularly evident in the official policy of paying lip service to a unified culture, de-emphasizing cultural and personal identities.
For some, the process of change is too slow. Disillusionment has left many people bitter and self-absorbed. An alarming tendency is emerging among young people, especially those in the 15- to 30-year age range. In an attempt to satisfy their sexual needs, young people consciously try to take as many partners with them to their deaths.
Among adults, the largest proportion of persons with AIDS have contracted the disease through multiple heterosexual partners. Although drug-users sharing hypodermic needles and sexually active homosexuals are targeted as high-risk groups, there are also many culturally prescribed rituals that have the potential to spread the disease. These include ritual earlobe piercing, circumcision and ritual scarring, to name but a few.
However, most AIDS awareness brochures completely omit these practices from their warnings. These are points that need to be reassessed by campaigners, especially when targeting rural areas where such practices are most prevalent. Generally speaking, it is the rural areas that are neglected in programs that communicate the dangers of transmission of the virus.
One of the greatest factors in the spread of this disease is the nature of the South African labor system. The vast majority of adult males are compelled to leave their wives in the rural areas to seek employment in the cities. Separated by vast distances, spouses are unable to interact regularly. Inevitably, the males look for recreational sex in the city. The practice is generally accepted, having its roots in the traditional practice of polygyny, which prescribed faithfulness to a restricted number of partners. However, the modern variant is limitless. It serves to spread the virus rapidly from cities to rural areas, and among the countries of southern Africa.
Financial limitations present another barrier to control of the epidemic. Until late 1999, only the financially well-off were able to get their hands on such medications as AZT. Even rape victims were expected to find and finance their own treatment. The average cost of treatment with these drugs comes to about 3,000 rands, more than double the average monthly salary of most working-class South Africans.
Discrimination against AIDS sufferers persists despite educational efforts to reduce it. An incident that highlights the problem took place in rural KwaZulu-Natal. The people living in this area were aware of the scourge of AIDS, seeing signs of it in the increasing number of emaciated sufferers being moved about in wheelbarrows by their relatives.
One young man suspected of infection was immediately cut off from his friends and excluded from the favorite weekend pastime of sharing drinks and food. He was fortunate that his exclusion was merely social. Others less fortunate have been beaten to death by ignorant people who are prey to hysteria.
What sort of future does this problem leave for South Africans? The conclusions are simple when based on the statistics, and they are dismal. The disease would be easier to combat if the majority of the population had more faith in authority, religious or otherwise. Perhaps the epidemic could be controlled if AIDS educational programs were promptly reassessed, possibly drawing on ethical elements shared across a diverse range of religious groups. But some of the consequences are irreversible.
Perhaps all that is left is to generate a culture of empathy for those who have received a death sentence, and to pray that a cure will be discovered soon.
Colette Spicer is a social anthropologist in South Africa
National Catholic Reporter, November 5, 1999