Analysis AIDS spreads in South Africa
By COLETTE SPICER
Special to the National Catholic Reporter Mooi River,
South Africa
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
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