Kimberly Vrudny

Archive for the ‘South Africa’ Category

Participant 04

In 30/30 Participants, J. L. Zwane Centre, South Africa on August 12, 2010 at 7:30 am

“Participant 04” is a widow living in Guguletu who has opened her home to twelve orphaned and abandoned children. She wishes she could do more.

I live in one of the low socio-economic group areas where the large part of it is still informal settlements; where people live in shacks. This creates overcrowding and hygiene is not that much observed. In this area HIV and AIDS are rife. The government and some of the non-governmental structures are trying to educate people about prevention of HIV and AIDS treatment available for it—but it is still a problem because people are unwilling to disclose their status due to the stigma associated with HIV and AIDS. Some people would rather go to sangomas (witchdoctors) for treatment and end up dying. Parents die leaving behind orphans some of [whom] are also infected. Some of these children are abandoned with none to take care of them, or would be left with an elderly lady who also needs to be taken care of. This is very pathetic. This is what touched my heart and I opened my home to such children. I am presently staying with children whom I take care of, to see to their needs and love them. I would do more if I had means and make a difference to my community.

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Participant 05

In 30/30 Participants, J. L. Zwane Centre, South Africa on August 12, 2010 at 7:15 am

“Participant 05” is a seven-year-old boy who struggles with meningitis, among other opportunistic infections. His mother writes about their challenges in her journal entry.

In 1992, after being involved in a car accident, I was diagnosed HIV-positive. I knew very little about HIV and I had no sign of being ill or of the struggle that la[id] ahead for me and my family. I was healthy and fit until 2001, after I had fallen pregnant with my youngest son. I had two children already, so I thought it was no big deal. After a difficult pregnancy, I gave birth to a baby boy, [who] was immediately diagnosed as HIV-positive. His CD4 count was zero, like myself, and the doctors predicted a very short life span for him, for he had TB at birth. Today I thank God, for he has celebrated his seventh birthday in July this year. In spite of being a very sick boy, he also goes to school when he can, and when you look at him some days, he looks and plays with other children like any seven year old. I try to make his life as normal as I can for in a house with lots of grandchildren and friends, he is the only one who is very sickly and sometimes does not go to school for long periods at a time, and misses a lot of school work, but he at least gets some kind of education. He has been put on the second line of ARVs, because of his very high viral load and very low CD4 count. At the moment, he is suffering from slow meningitis, and I am suffering from cancer and four other opportunistic diseases. Through all our past & future struggles, I thank God for the strong support system I have at my church & support group that I joined about four years ago. They are with me every step of the way & it makes my life a whole lot better than it could have been. I am also an HIV & AIDS activist, for I know that HIV [and AIDS] are maintainable, if you take your [medicine], and abstain from sex or protect yourself, and surround yourself with family and friends as a strong support system. Aluta continua!, the struggle continues. . . .

Participant 06

In 30/30 Participants, J. L. Zwane Centre, South Africa on August 12, 2010 at 7:00 am

“Participant 06” discusses helplessness in the face of the pandemic. She has opened her home to her “daughter” and “grandson,” both living with HIV.

I do not know much about HIV, but I do know that it is a struggle that I won’t wish on anybody, as a mother staying with my positive daughter and grandson. [T]o see them struggling with this terrible disease makes me feel very helpless and heartbroken. When she first told me her status I was very worried, for I thought they would die soon, but after watching their struggle for many years, I do not know which is better, death or the struggle. I am thankful that they are still alive, but not being able to know how to help makes me feel like an outsider, watching my children die day after day.

My helplessness makes me very thankful to God for the J. L. Zwane Support Group and Centre, for, if it was not for their daily help I do not know where we as a family would be. They are helping my daughter with everything and by helping her, they help my whole family. My own congregation is helpless in this epidemic, they can only pray when they happen to get into contact with us. My health is also going down faster, because of my anguish when my children are sick. I also have the support of the J. L. Zwane members [who] are my neighbours. May God bless them richly for their help to us. May he also give them strength, patience, and wisdom to keep up the good work in our community.

Participant 07

In 30/30 Participants, Scalabrini Center, South Africa on August 12, 2010 at 6:45 am

“Participant 07” is a refugee from the DRC. She addresses in her journal issues of promiscuity, fidelity, grief, and care of orphans, advising men to be faithful to their wives.

I am a 56 year old widow. I tested HIV positive in 2005. My CD4 count was 134. [At t]hat time I had TB. I did not know that I had the virus before because I was fit and healthy. I know I contracted the virus from my late husband who was a drunkard and very promisc[u]ous. I was a very faithful wife and to this day I never slept with any other man. I would like to urge men out in the world to be faithful [and] to stick to one partner. At the present moment I am looking after three grandchildren orphaned due to AIDS. My daughter married a man who was also promisc[u]ous and she contracted the virus and they both died at an early age. The husband was 33 years old and the wife was 26 years old. People should be educated about these things. They should be made aware.

Participant 08

In 30/30 Participants, Scalabrini Center, South Africa on August 12, 2010 at 6:30 am

“Participant 08” shares how, even though she has lost trust in her promiscuous husband, she has learned to live positively with HIV. They are estranged but not yet divorced.

I discovered I was HIV positive six years ago. I was numb with shock and disbelief. “WHY. . . . HOW. . . . COULD THIS BE HAPPENING TO ME.” After the shock and disbelief I started wondering if my two sons were also HIV positive. I got flash backs of the times they ha[d] been ill and tried to figure out if perhaps they were HIV negative. Routine tests proved that they are negative. “GLORY TO GOD.” The love and trust I had for my husband vanished overnight. His denial left a bitter taste in my mouth. We are estranged. He does not want a divorce yet. He refused to use protection during sex. I made a choice five years ago to move out with my children. . . . I got a job. . . . [Now I] lead a healthy and fulfilling life. . . . and have been on ARVs for five years now. I have forgiven my husband but I can never get back together with him as the love and trust is gone.

Participant 09

In 30/30 Participants, Scalabrini Center, South Africa on August 12, 2010 at 6:15 am

“Participant 09” migrated to Cape Town as a refugee from Zimbabwe half a decade ago, after losing three of his children to HIV/AIDS. He believes stigma destroyed their lives.

Way back I could not believe that the story of HIV/AIDS was real because I had not seen anyone who was a victim of it. I came to know this when I got married and lost my loving kids, one after another, [within] 3 months. I believe it was of stigma—that’s why my first two kids just died and we could not get tested for this HIV/AIDS. I came to know of this problem when my third kid was ill and tried to save her life but she died. The doctors told us that she was HIV positive, so we got tested and the truth of HIV/AIDS was real. [T]hen I got tested and accepted the results and came to understand what it means to live with HIV/AIDS. This came about after going for counselling. Now I understand what it means to be with the HIV/AIDS and [to] be able to live positively. To all people who cannot believe if they should be tested and [find] their status—it is just good to know and live positively and that [it is] not the end of life. It has not been my wish to [lose] my three kids but because of stigma HIV/AIDS took advantage and destroyed their lives. My life still goes well though [I am a] refugee.

Participant 10

In 30/30 Participants, Inzame Zabantu, South Africa on August 12, 2010 at 6:00 am

“Participant 10” was tested for HIV only recently, and has disclosed his status to his wife, but not to his daughters. He advises others to protect themselves, and to be tested.

I’m staying in Brown’s Farm (in Siyahlal, an informal settlement). I’m married. I have two children. The first is 15 years old; the second is 8. They are both girls. I was only diagnosed this August [2009]. The first sign was shingles. I went to a private doctor. He said I must come to the clinic to check for HIV. I am still working. The children are in school. I have disclosed my status to my wife. She has been tested, and so far she is negative. The three-month window for retesting is almost here. My wife and I have agreed to use protection to prevent her from becoming infected. At the present moment, only my wife and I know. Even our daughters do not know. They are still too young. . . . Before I knew my status, I was drinking a lot. Since I got the news, I’ve stopped. I don’t know how I got HIV because I am an honest person. I’ve looked after my wife. My only advice is to use protection, and to share any information you have with your spouse. You must trust no one. You must protect yourself.

Participant 11

In 30/30 Participants, Inzame Zabantu, South Africa on August 12, 2010 at 5:45 am

“Participant 11” describes his situation in Samara, a section of Philippi, where access to food and water are scarce. He is especially concerned about the safety of his daughter.

I am from the Eastern Cape. I’ve been here for four years now; I came to Cape Town in 2005 looking for work. I was employed, and was on treatment in 2005. And I was married. But she was very sick—vomiting, with diarrhea. Her entire body was aching. She was unable to walk. She was not on medication; she did not go to the clinic to see what the problem was. Instead, we went to our church to ask the pastors to pray for her to be healed. But she passed away earlier this year—in June. We have a daughter who will be thirteen years old this year (grade 6). She is staying with me. We are alone now. This is the second month I have been unemployed because of poor health. I was losing my eyesight; I have gone completely blind now. Also, I had terrible pains on the right side of my chest. I went to the doctor to see if it was TB. I am still waiting for the results. I am underweight. We have very little food to eat, and no money. We are staying here in a very poor community. We live in a shack. More than 15,000 people share one tap of water here. Four families share every toilet. The situation is very difficult. The government distributes porridge to try to avoid a famine. When they are able, our neighbors sometimes give us their leftovers. Because I am HIV+, I may qualify for a grant to help subsidize us. We are waiting for the CD4 count to come back to know whether I qualify. But it is taking so long. It is terrible for my daughter. She goes to school hungry. I am worried about her. I’m worried she will be abused—that when I’m gone, people will offer her bread to sleep with her. We have no one to look after us. Can anyone help us? Please, can anyone help us?

Participant 12

In 30/30 Participants, Inzame Zabantu, South Africa on August 12, 2010 at 5:30 am

“Participant 12” works as a nurse in the communities most affected by HIV/AIDS. She speaks of the hope clinics like Inzame Zabantu provide patients accessing its services.

There is nothing as fulfilling as seeing someone smile having arrived at the clinic groaning with pain. I have seen people turn their lives around, walking through the entrance of the clinic on their feet having spent [a] few months of their lives in a wheelchair. Running an HIV/AIDS clinic before the roll out of the [a]ntiretrovirals was depressing but now that the [a]ntiretrovirals are available one is able to say that indeed there is life after an HIV-positive diagnosis. People who were once lost in hopelessness, lost in despair, are now full of hope and that is exactly what keeps them going and getting better day after day.

Participant 13

In 30/30 Participants, South Africa, Wola Nani on August 12, 2010 at 5:15 am

"Participant 13" is a member of the team at Wola Nani. She reflects on the changes she has seen in the lives of those now living positively because of the work of this organization.

I’ve been working with Wola Nani since 1994. We were working then only with HIV+ women. It was very difficult at that time because of stigma. The clients we saw—they didn’t want to attend the clinics. We used to do home visits: helping the people, washing them, referring them to the hospital. In 2002, most people broke the silence. We were assisting them to live positively in support groups. As a result, most of our clients were talking about HIV and spreading the word about the work of Wola Nani. Wola Nani planned to enter the townships, and played a big role in our communities—[in] Khayelitsha, Philippi, Guguletu, Mfuleni, and Nyanga, through support groups from these areas and in the IDC [Infectious Disease Clinic] at the Red Cross Hospital. So if I compare 1994-2000, and 2000 until now, I feel like Wola Nani changed a lot for the clients. They make paper maché bowls and bead work. Wola Nani trained them, and now they can be with their families, and do something to earn money. Most of our clients manage their HIV well. We’ve started a support group for children. Our staff taught even the children how to live positively, and to be confident about speaking about HIV. I’m very proud of the work we are doing at Wola Nani.

Participant 14

In 30/30 Participants, South Africa, Wola Nani on August 12, 2010 at 5:00 am

“Participant 14” is a counselor for Wola Nani. She informs HIV-positive expectant mothers how to prevent mother-to-child transmission of the virus.

I was diagnosed [in] 1990 in Cape Town. I found [out after] giving birth. [Then I] got sick with TB. By 1998, I treated it. So [during] all [those] years there was no medication. By 2003 I started the ARVs so that I [could] be healed. Because I was [at] Stage IV and my CD4 count was 175, I discover[ed] that I had pneumonia. By 2004, [I treated it.]. By 2005 I develop[ed] asthma, so I [have been] using [Asthavent] to make it better. I [joined] Wola Nani in 1998 at the support group whereby I get very strong and I [learned] that I . . . [am not] alone living positive. I started to do bead craft [in] that year. By 2000 I started to train the other[s in] doing craft[work]. By 2007 I started to work as a counselor at Wola Nani. [I have been conducting] the program of mother to child transmission. There I’m telling mothers to prevent their children [from becoming infected] by doing HIV test[s] when they are pregnant. When they [find] out that they [are] HIV positive there is a treatment that they get during [their] seventh month [of] pregnancy. They get dual therapy but if their CD4 count is less than 250 they go on ARVs to protect their babies. [I also teach them] about feeding options [that are] their choice: breast or formula feed[ing].

Participant 15

In 30/30 Participants, South Africa, Wola Nani on August 12, 2010 at 4:45 am
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“Participant 15” writes about her own quest to prevent mother-to-child transmission, and about how she works to empower others to do the same through Wola Nani.

I [was] born in [the] Eastern Cape. [In] 1999 [I] tested for HIV. [I t]ested positive. Not sick. Just [was] curious to know. Then [I planned] to have a child. 2001 get pregnant. Was hungry [to] prevent mother-to-child transmission (PMTCT) because I need to prevent my child from HIV. I [read a] book [about] PMTCT. Then my child tested when he was nine month[s] old. He was born [in] 2002. Tested negative because of PMTCT. [I w]as in need of support. I got lot[s] of support from my family. My CD4 count was 870 in 2003. Also attending clinic for myself. Because I was hungry [for] informationI [I] started to join a support group where I met others [where we could] also share our stories. Then 2003 NGO FAMSA [sent] me for intensive counselling course. Also 2003 started to join Wola Nani as a client. Attend support group each and every weekday. [We shared]  our ideas with others. Then 2004 I started to work for Wola Nani as a home carer. [This i]s whereby we visit sick clients [and] also check their meds (those [who] are using [them]). Also deliver food parcel[s]. Then 2005 January I have been promoted to work as a counsellor at Red Cross Hospital [through] information I have because I was . . . involved with TAC, ARK, and FAMSA [who] provide[d] me with training. At Red Cross I’m working as a counsellor doing pre, post-test counselling, adherence counselling. [I’m] also helping [with] interpreting for doctors. To work in a HIV facility, it empower[s] me a lot because I was helping clients to deal with stigma, denial, discrimination. Also [I am helping] them adhere to their treatment. Challenges that we [face include] denial [and] also disclosure which lead to adherence problem[s] but we deal with [these by] giving them information.

Participant 16

In 30/30 Participants, South Africa, Yabonga on August 12, 2010 at 4:30 am

“Participant 16” writes about the painful realities of working with children living with HIV/AIDS. She has served Yabonga as a peer educator and counselor.

I started knowing [my HIV+ status] in 2002 while I was sick. I had TB and it was for the second time and my doctor decided/advised that I should do an HIV test. It was something new for me and I did it. Unfortunately I tested +. I just thought it was the end of life for me but [the] one thing [that] kept me going was my child. I prayed to God that he must not take me because my son is still young. Apart from that was to join Yabonga support group in 2002 at M/Goniwe Clinic in Khayelitsha. The lady who was a team leader there gave me all the support that I needed and I felt very strong after that. In 2005 I was so lucky to be trained as a peer educator at Yabonga. Then [in] 2006 I started working and fortunately for me I was a youth counselor. I had to deal with children who are infected with HIV/AIDS and affected. Some of them are orphans through HIV/AIDS. Finally it started as something good for me because I was working, but later I discovered that, this is worse to deal with children’s challenges. I worked in different places where Yabonga is having containers at the clinics. [Shipping containers are used as freestanding buildings in many township communities.] I remember while I was in Kraai-Fontein [in] 2007, there were two children. [O]ne of them is HIV+ and their mom didn’t have any means to provide for them but because in our OVC programme we give these children all the support [they required] including [a school] uniform and some food, and they come to our centers after school for food as we have community moms to cook for them. These community mothers are our clients who volunteer themselves to cook for the children after school. The food and everything is from Yabonga and they just open their homes for our children. But with a [stipend]. So for some children it is a great priviledge for them to be part of Yabonga at least to have them all to get the support they need. Some of these children become infected, so we have to deal with these problems but we refer them to [relevant] places for counselling. There is a boy in Gugulethu who touched me. He is HIV+ and is always sick. He is [in and out of the] hospital. I was so worried when the doctors said they are going to stop him from taking ARVs because he doesn’t improve, but through our prayers, I again heard that there is doctor who said he wants to monitor him and he is not stopping medication. I think [his] story is touching everybody because he is really a fighter. That is not something nice. People might think we are happy because we have accepted our statuses and our families do, but what about the fact that [we are] going to be on medication for the rest of [our lives]? [the s]truggle continues

Participant 17

In 30/30 Participants, South Africa, Yabonga on August 12, 2010 at 4:15 am

“Participant 17” writes about how the Institute for the Healing of Memories conducts retreats to help caregivers cope with the trauma of HIV/AIDS.

I live in a community [where] people are confronted by the reality of HIV&AIDS on a daily basis. People choose to respond to the pandemic in many different ways. [The Institute for the] Healing of Memories and HIV/AIDS is about creating a safe space for those infected and affected by [this disease]. Many people infected and affected by HIV&AIDS continue to experience rejection and isolation. This [leaves] people with a lot of feelings, [like] pain and disappointment. [The Institute for the] Healing of Memories create[s] an opportunity for people to deal with the negative feeling[s] they have because of how we respond to those living with the [disease]. People are struggling with feeling[s] of anger because of a partner who infected them with the [disease], because of being isolated by family and friends. [Facilitators at the Institute for the] Healing of Memories listen to the pain of those who have been affected and infected to help people journey with strength and believe that they are not alone.

Participant 18

In 30/30 Participants, South Africa, Yabonga on August 12, 2010 at 4:00 am

“Participant 18” is a peer educator for Yabonga, and credits the organization for teaching him to live positively. He has turned his life around, and is studying for a bachelor’s degree.

I [was] born in 1968 [on] the 19th September in the North West Province of South Africa. I went to school in 1975 at Makgori Primary in Makgori Village. We then relocated to Tshidilamolomo in 1977. I continued with my education until 1985 when I pass[ed] my STD8 [standard eight, or eighth grade]. I couldn’t continue with my studies due to [a] lack of finance[s]. I stayed at home doing odd jobs to earn some income. [In] 1991 I went back to continue with my studies and I completed my matric. In 1994 I was employed as a temporary teacher. When my contract was terminated in 1997 I went back to do my odd jobs to earn some income. In 1999 I tested HIV-positive but didn’t believe in HIV/AIDS. I then moved to Cape Town where my brother is staying. I continued working in building construction as I liked working with sand and stones. In 2004 I went to do VCT [voluntary testing and counseling] again, hoping to be negative but FORTUNATELY I tested HIV-positive. I couldn’t do anything about it but to accept the results. I met the Yabonga HIV/AIDS Peer Educators who encouraged me to accept and forget about where I [got] the virus [from] but to continue living my life but differently. That’s changing my lifestyle. Living positively with positive mind. I joined the support group and that is where my future with Yabonga started. I went for an interview in 2006 at Yabonga and I went through. [In] 2007 I was trained to be an HIV/AIDS Peer Educator. I could speak openly [about] my status to everybody including my family and friends. A person living with HIV is a normal person. It was also my step forward. I am presently a student at the University of South Africa and am going to be graduating in years to come. Every person can fulfil his dreams living with the HI Virus. I am now taking my ARV medication and keeping well everyday. Thank you Yabonga for having me as [your] employee.

Participant 19

In 30/30 Participants, Ikamva Labantu, South Africa on August 12, 2010 at 3:45 am

“Participant 19” cares for an HIV-positive daughter and her children, sharing openly their struggles with alcohol and drug addiction.

I am a 67 year old mother of 2. [My] daughter is 44 and son is 42. In 1994 my first-born daughter was diagnosed HIV-positive. She grew up in the Eastern Cape [and was] brought up by my mother. At first I blamed myself [for] not bringing her up myself. But later I accompanied her to the clinic for counselling. It took time for her to accept [her status]. She kept saying it can’t be her blood. I kept taking her to different places to be tested. At last she believed it and kept it [a] secret at home. I tried to go to workshops to learn more about this disease. It is very difficult to live with my child. She turned to drinking and gets very aggressive when drunk which is almost every day. She has two sons. I brought them up myself and put them through education. They are both working but [are] affected by the situation. The younger one is on drugs. They all stay with me. I am only sane by the grace of God. We pray together most of the time. I support them with my pension. I struggle to have [her take her treatments]. It is a miracle she lasted so long taking medication and alcohol. I praise the Lord for all blessings. I[t] affects me [for] whenever she is in pain she comes to me and I can feel the pain. The big blow was this year when I phoned a place she went to for chest X-rays. I was told she has no lungs. I nearly died. All in all it is not easy to nurse someone who sometimes blames me for wanting her to die. I pay for funeral policies. She doesn’t get [a] disability grant because she drinks. It is depressing. I just trust in the Lord to make me strong when the time comes.

Participant 20

In 30/30 Participants, Ikamva Labantu, South Africa on August 12, 2010 at 3:30 am

“Participant 20” raised her grandchildren when her daughter passed away. She advises people to get tested in order to prevent further spread of the virus.

I am 59 years old. I live in the township[s] of Cape Town. Ten years ago I discovered that my 27-year-old daughter was infected with HIV. I was very shocked, not knowing what to do, and at that time I was still in the dark about HIV. I knew my daughter was dying. I didn’t know what to do, but I manage[d] to share with my neighbours, my church collegues, and my fellow workers. They supported me with prayers. She became very sick and there was no help of ARVs at that moment. There was nothing I could do but to wait and pray. 

Apparently, I came to Ikamva Labantu for help, and the only help I could get at that time was support. She was fully blown and after a long time she died. I was in a trauma of accepting the death of my daughter and [taking] care of her two children, a boy of 9 and a girl of 3 at that time. I was open about it although I was depressed, but through [counseling] I survived.

I raised those two children out of my income. Now the boy has turned 20 and the girl is 14. They are very beautiful and fortunately they are not infected.

I would like everyone to accept the d[i]sease, but to try and prevent it. If you happen to be HIV[-positive], it is not the end of the world. There is help at the clinics. [I]f you don’t know your status go and get tested before it’s too late.

Participant 21

In 30/30 Participants, Ikamva Labantu, South Africa on August 12, 2010 at 3:15 am

“Participant 21” lost two daughters to HIV, and cares for their children. A third daughter is also HIV-positive. She encourages parents to accept their children.

I am a 61 year old who lost children, 2 daughters: 1 in 1999 and 1 in 2005. And [they both] were infected by HIV. The eldest daughter left me with 2 children who are now at the age of 25 and a boy of 13. Fortunately they are not infected. The second daughter died in 2005. [She] also left 2 children, a boy of 20 and another boy who is now 4 years. I struggle to raise them, but with the help of Ikamva I do survive. I was very hurt, but what can I do? The d[i]sease is here and everybody must accept the fact that it is here. I miss my daughter. I pray to God that I can live longer to take care of the little ones, because I am the only hope for them.

I have [a] third daughter who is 31. [S]he is also infected. I sometimes think that I am cursed, but again I know that is not the fact. It is just that we must be careful, and try [to] educate our children about HIV. To the parents out there, I would like to send a message: Accept your children and support them. They need you as a parent to give them hope.

I would like to plea to everybody: let us hold hands as parents and support one another in this pandemic. We have become carers and I support them out of my little pension. Its not enough but I survive.

Participant 22

In 30/30 Participants, South Africa, Treatment Action Campaign on August 12, 2010 at 3:00 am

“Participant 22” is a treatment literacy trainer at the TAC offices in Khayelitsha. After trusting traditional healers to cure him, he joined TAC to help get the truth out.

I was born in the Eastern Cape, [in a p]lace called Sterkspruit in the former Tran[s]kie. Then I came to Cape Town in 1990. I have two children girl & boy. She is 8 years and the boy is 2 years old. In 2004 I was diagnosed with HIV on the 7 of August because I was very sick. [I had] shingles, [diarrhea], skin problem[s]. The nurses d[e]cided that I should do VCT [voluntary counseling and testing]. The result came back positive and my CD4 count was 34. I couldn’t believe when they told me that I am HIV positive. I then did not want to go to the clinic as we believe in traditional medicine most of us. I went to Free State where I met the traditional doctor who claim[ed] that he [could] treat & cure HIV & AIDS but I found out that I was not getting better. Instead things were becoming wors[e]. I came back to Cape Town very sick. CD4 of 9. The doctors suggested that I should start ARVs imm[e]diately. I started ARVs on the 8th of March 2005—but I had lots of side effects like [lipodystrophy], peripheral neuropathy, vomiting. But I am happ[i]ly married but my wife is still HIV negative because we take [pre]caution[s] or use condom[s] everytime we [have] sex. In 2007 I did spermwash cause I wanted a child. Now my 2 year old son is also HIV negative. My message is that living with HIV & AIDS is not the end of the world. I make sure that I protect my partner and adhere to my treatment correctly. I am a treatment literacy trainer in Khayelitsha. Now my CD4 count is 388 & the viral load is undetectable.


Participant 23

In 30/30 Participants, South Africa, Treatment Action Campaign on August 12, 2010 at 2:45 am

Among other roles, “Participant 23” works as a TB coordinator for TAC. More than anything, she wishes to be a healthy mother to a healthy baby.

Originally I am from Eastern [Cape] from the place called Butterworth. I was diagnosed HIV+ in 2002 when I was having TB of the pulm for the second time. At that [time] my CD4 was 39, and I had to start ARVs. I started ARVs on 13 of April in 2002. Two months after my CD4 was 90. I felt good. In 2004 towards the end I decided to get pregnant because my CD4 was very high at 880. My doctor advi[s]ed me to do the papsmear and CD4 and viral load for my pregnancy. I was referred to Hanover Park. That [is where] I delivered an HIV negative boy from the weight on 4.2 kg [9.25 lbs.]. I was working at the hospice in 2003 up to 2005. It’s where I’ve noticed that I have to work closely with HIV client[s] to give them the education and information that the community need[s] outside. In terms of stigma and discrimination I didn’t experience anything. I experienced lots of side effect because AZT, 3TC, Effavirenz. When I decided to get pregnant & was [switched] from Effavirenz to Nevirapine. Currently I am working for TAC since 2006 for the integration of TB and HIV clinic as a TB coordinator. I am good, healthy and my CD4 is 940. I want to s[t]ay a healthy mom to [a] healthy baby. Let’s come together and fight this epidemic. Alluta || continua || Amandla

Participant 24

In 30/30 Participants, South Africa, Treatment Action Campaign on August 12, 2010 at 2:30 am

"Participant 24" goes to clinics for TAC to share information about how to prevent HIV. She believes the South African constitution secures the "right to adequate healthcare."

Originally I am from Eastern [Cape] in the place called Carth-cart. I am 46 years of age. I started to know about my status in 1999. In 2001, I started my ARVs Effavirenz, AZT, 3TC. I had experienced asthma and I had TB and asthma. I joined TAC in 2000 as an activist. Now I am doing Prevention Treatment Literacy at the clinics and I joined the P-WA sector within TAC. Also I [am] participating at the women’s sectors as a chairperson. I know how to challenge the denialists of HIV. As [our] constitution says, “We have a right to adequate healthcare.” I know HIV treatment literacy and [challenge] the homophobia in our community. I am doing workshops, education within the community. To be an activist—it means a lot to me. Currently my CD4 is 775, but I started ARVs when my CD4 was 179. My concern is only asthma. I don’t worry about HIV. Alluta Continua!! Amandla.

AIDS Denialism

In AIDS Denialism, HIV/AIDS, Public Health, South Africa, Structural Drivers of the Pandemic on August 11, 2010 at 3:00 am

Denialists and Conspiracists

AIDS denialists deny that the human immunodeficiency virus (HIV) is the cause of acquired immune deficiency syndrome (AIDS). While some reject the very existence of HIV by perpetuating the myth that the virus has never been isolated, others promulgate the idea, following Peter Duesberg, a professor of Molecular and Cell Biology at the University of California, Berkeley, that HIV exists but is a harmless passenger virus rather than the cause of AIDS. Another group believes that researchers created HIV in a laboratory with the aim of using it as a biological weapon against people of African descent. Still another group claims that pharmaceutical companies created AIDS hysteria in order to turn a profit. That these views are opposed to scientific consensus is of marginal consequence; each view has acquired a following. Although the effectiveness of the anti-retroviral treatments has caused a large number of former dissidents and denialists to change their opinion, myths about HIV/AIDS continue to spread, mostly online, but also by means of misleading films.

The fact that HIV causes AIDS is considered scientifically conclusive. Fulfilling all three of Koch’s postulates, which serve as kind of a “litmus test” for determining the cause of any epidemic disease since the nineteenth century, HIV has been shown conclusively to be the cause of AIDS. According to a helpful article published by the National Institute of Allergy and Infectious Diseases, these postulates pertain to epidemiological association, isolation, and transmission pathogenesis. “With regard to postulate #1, numerous studies from around the world show that virtually all AIDS patients are HIV-seropositive; that is they carry antibodies that indicate HIV infection. With regard to postulate #2, modern culture techniques have allowed the isolation of HIV in virtually all AIDS patients, as well as in almost all HIV-seropositive individuals with both early- and late-stage disease. In addition, the polymerase chain (PCR) and other sophisticated molecular techniques have enabled researchers to document the presence of HIV genes in virtually all patients with AIDS, as well as in individuals in earlier stages of HIV disease. Postulate #3 has been fulfilled in tragic incidents involving three laboratory workers with no other risk factors who have developed AIDS or severe immunosuppression after accidental exposure to concentrated, cloned HIV in the laboratory. In all three cases, HIV was isolated from the infected individual, sequenced and shown to be the infecting strain of virus” (niaid.nih.gov).

Despite scientific evidence that has been supported by medications that have produced something of a “Lazarus effect,” bringing people even with CD4 counts of zero back to health, perpetuation of AIDS denialism is conducted mostly online, though two films have also been created to twist the facts and to mislead people into believing falsely that HIV is not the cause of AIDS. The Other Side of AIDS, a 2004 film by Robin Scoville (the spouse of Christine Maggiore, a prominent AIDS denialist who followed her infant daughter into death in 2008 after contracting several AIDS-related conditions), is predominantly a collection of interviews with people who have refused to take drugs, believing the opinion promulgated by Maggiore and others that drug companies were attempting to make profits off of common illnesses that have afflicted humans for centuries.

More recently, the 2009 film House of Numbers by Brent Leung has been criticized by a review for the New York Times as “willfully ignorant.” It resurrects the denialist’s claims by interviewing legitimate scientists, but then editing their words to promote Leung’s denialist agenda. According to Jeanne Bergman, writing for AIDStruth.org, “Leung in fact got the information he sought from the legitimate scientists, doctors, and advocates he interviewed, but he then edited it out of the film to deceive and confuse viewers. The audience is manipulated to reach the wrong answers.” More poignantly, Bergman goes on to articulate the implications of Leung’s willful ignorance and manipulative technique. “Since Leung leaves his own positions unstated, he dodges accountability for the film’s potential impact—namely, that people might decide that they don’t need to protect themselves or others from being infected with HIV, or that people living with HIV might reject medical care and the medications that could keep them healthy.” AIDSTruth.org has published an article to counter the untruths spread by the film.

To be sure, the history of AIDS denialism is a fascinating case study about how easily and effectively a body of information can be manipulated, challenged, and discredited in the minds of those so predisposed, often in this case by homophobic and racist viewpoints. Tragically, however, its impact has been extremely harmful. In South Africa, for example, people whose lives could have been prolonged by obtaining the medications that were available elsewhere were denied access under the ill-informed presidency of Thabo Mbeki, who subscribed to the denialist position, as did his appointed minister of public health. A Harvard University study recently estimated that 330,000 lives were unnecessarily lost between 2000 and 2005 as a direct result of that country’s government and its position on AIDS.

In agreement with a statement by AIDSTruth.org, my intention here is not to debate denialist claims. “Debating denialists would dignify their dangerous position in a way that is unjustified by the facts about HIV/AIDS. The appropriate way for dissenting scientists to try to persuade other scientists of their views on any scientific subject is by publishing research in the peer-reviewed scientific literature. For many years now, AIDS denialists have been unsuccessful in persuading credible peer-reviewed journals to accept their views on HIV/AIDS, because of their scientific implausibility and factual inaccuracies” (AIDSTruth.org). Such a refutation of denialist claims has been conducted well, and this work is widely available online.

Rather, here I would like simply to direct people to some websites that are useful when trying to grasp the harmful impact of AIDS denialism.

To contrast the two positions, visit: AIDSTruth.org (one site promoting sound scientific approaches to HIV/AIDS), and VirusMyth.com (one site promoting unsound and unscientific claims in relation to HIV/AIDS).

To read arguments against each claim, one by one, I recommend articles published by AIDSTruth.org, the Treatment Action Campaign, and Aegis. Nicoli Nattrass’s article “AIDS Denialism vs. Science” is also thorough and instructive.

To understand the emergence, biology, and history of HIV/AIDS, several sites are beneficial, including one from the National Institute of Allergy and Infectious Diseases, the AIDS Education and Global Information System, and Tibotec, a pharmaceutical research and development company specializing in antiretroviral therapies. NOVA and Frontline, too, have broadcast high-quality programs in relation to HIV/AIDS. The Body and Avert also publish reliable information about HIV/AIDS.

Inequitable Access to Healthcare

In Health Care, HIV/AIDS, Public Health, South Africa, Structural Drivers of the Pandemic on August 11, 2010 at 2:30 am

1400 a Day

Despite the election of a president who is more astute in relation to the HIV/AIDS epidemic in his own country of South Africa than his predecessor, global funding to make medicines to treat an HIV infection widely available, and a network of community health clinics and NGOs working to distribute information about prevention and treatment of HIV/AIDS, 1400 people daily become newly infected with HIV in South Africa. These account for nearly 20% of the estimated 7,400 new infections occurring daily worldwide. Likewise, the actual number of deaths related to HIV holds steady at about 1000 a day in South Africa, again accounting for about 20% of the 5,500 people dying daily worldwide from complications arising from an infection.

Although South Africa is among the most severely affected countries in the world by this pandemic, only about a third of those testing positive in South Africa are accessing the antiretroviral therapies (ARVs) that can prevent the virus from multiplying, thereby restoring the immune system to healthy levels. The reasons for this are complicated, as 30/30 is attempting to document. In addition to the social and structural complexities that have been mentioned in this collection of essays, there are a host of complications around access to healthcare in South Africa. During apartheid, for example, the government focused on the development of providing primary care to the public through a nationwide system of hospitals, leaving the masses living in townships with little access to a network of quality care. Under the new government, community health care centers like Inzame Zabantu are being built and are increasingly providing access to primary care in impoverished communities, but the patient load at these clinics is astoundingly high, and clinics are still inaccessible to tens of thousands of people. Government grants are making it possible for people to access ARVs, but the odds are still stacked against the poor. Drugs are accessible to those who do come forward to test, who live near a community health center, who test positive, who return to take a second test to find their CD4 counts, whose CD4 counts measure less than 200, who navigate the application for a government grant, who wait for a decision in relation to their application, and who qualify for assistance. Moreover, the effectiveness of treatment relies on consistency and good nutrition. The drugs are not effective if taken on an empty stomach. Since most people on the drugs are living on about $1.75 a day, hunger remains a serious issue. Finally, despite the work of NGOs to blanket the community with information about HIV/AIDS, even in the post-Mbeki situation, the stigmatizing effects of an HIV-positive diagnosis continue to prevent people from seeking medical attention.

To add yet another layer of complexity to this difficult situation, information about the virus is received tentatively by a culture that is torn between African tradition and European ways. The denialism of Thabo Mbeki only fueled an already latent distrust of Western medicine in many African minds. Rumors of the virus coming in the needles of the “white man,” promises of herbal cures by medicine men, and traditional ritual treatments continue to compete for the allegiance of those struggling to survive in communities where the unemployment rate often hovers around 70%. Medical aid workers widely note that, despite testimonies of people “coming back to life” once on ARV treatments, there is a continuing resistance, especially among men, to seek treatment and live.

These realities and their attending statistics are inherently alarming. In trying to process them himself, Jonny Steinberg, a South African journalist, attempted to understand the situation to a greater extent than the newspapers and academic papers were able to provide. For eighteen months, he periodically visited a village in the Eastern Cape Province of South Africa in an effort to understand the choices of a man he calls Sizwe Magadla. Despite a high risk of having been infected, when Steinberg met him, Sizwe adamantly refused to test for HIV. The result of Steinberg’s investigation is published in a masterwork of literary journalism entitled Siswe’s Test: A Young Man’s Journey through Africa’s AIDS Epidemic. In it, Steinberg explores with tremendous insight what is often at stake for men in still traditional villages as they confront this modern-day disaster, navigating his way through the “architecture of shame” that surrounds the illness, the struggle to lift oneself out of poverty and the reality of envy which threatens to pull the successful back in, and the constant push and pull of cultures as traditional African beliefs and practices encounter, accommodate, and resist European beliefs and practices. Indeed, it is Steinberg’s navigation of these competing beliefs, and what is at stake in concession, that is pertinent here, for they point to a terrible albeit unforeseen complication that is the legacy of colonization in Africa and apartheid law in South Africa: the understandable even if catastrophic mistrust of white “man” and “his” needles.

Steinberg recounts a telling conversation he had with Sizwe, who shares with him a “black people’s secret”: ‘Some people believe that the whites have developed a cure for AIDS,” Sizwe told Steinberg, ‘but that they are holding it back. They are waiting for enough black people to die so that when we all vote in an election the whites will win and F. W. de Klerk will be the president again’ (138). Sizwe’s own distrust of the medicine of white men was corroborated by Kate MaMarrandi, a community health-care worker also interviewed by Steinberg in the Eastern Cape. She told Steinberg,

‘In 2003, Dr. Hermann came. He started to tell us he has got help—ARVs. Nobody believed him. Some said this one has come to kill the people. Even the doctors didn’t believe him. People thought he had come to destroy the people with his needle and his blood test. They believed AIDS was caused by politics, by white people.’

Steinberg reflects on these disclosures, writing, “For all our talk on the causes of AIDS, it had taken this trip . . . to out [Sizwe’s] strongest suspicion about the origin of the epidemic. It was brewed, not by witches and their demons, but in the vividly imagined laboratories of Western science” (146). Steinberg’s book goes on to try to understand this mistrust of Western medicine. First, he turns to tales of the ordeals experienced by Dr. Hermann Reuter, the doctor for the MSF (Medicines Sans Frontieres / Doctors Without Borders) who set up a clinic to bring ARVs to Lusikisiki, the region of the Eastern Cape where Steinberg’s story about Sizwe unfolds. He was told,

‘When [Hermann] arrived, there was a big crowd outside the clinic. Many were not sick; they had come to see Hermann. They said they had heard that here is a doctor who has come to inject AIDS into people. They came to see what he looks like. When he came out, they all stared at him, but no one said anything.’ . . . . During his early days in Lusikisiki, he had on two occasions arrived to packed clinic waiting rooms; some of the people assembled there had not come to be tested but to ask him to explain what was in his needle. He had had to stand in front of his audience and convince them that he had not come there to kill them (147-148).

Ultimately, Hermann won the trust of many of Lusikisiki’s residents by treating patients with ARVS, which rapidly put life back into those whose immune systems were shutting down, and by offering scientific explanations for what was happening in the bodies of his patients in an attempt to override any association of the onset of illness with the needle that pierced the skin to draw blood. Hermann also allowed his own blood to be drawn publicly, in order to dispel fear (156).

The fears in the community about which Steinberg writes are fears to which I, too, have been witness in my work in relation to HIV/AIDS—both in Minneapolis, and in South Africa. In 2008, I attended a service-learning conference sponsored by the National Youth Leadership Council in Minneapolis. A luncheon discussion featured the work of Dr. James Hildreth, the Director of Meharry Medical College Center for AIDS Health Disparities Research and Professor in the Department of Internal Medicine, who was sharing advances in scientific understanding of how the virus was transmitted, and of how it might be stopped pharmacologically. I sat at a table where the pre-lecture discussion ultimately turned to the origin of HIV/AIDS, and several attendees at my table disclosed how they very much believed HIV was concocted in a laboratory in the bowels of the CIA. When asked about this during the Q&A after his talk, Dr. Hildreth, having credibility in the African American community, said in no uncertain terms that HIV predates the technology that would have been required to develop such a virus as HIV—and that this is indeed a vicious rumor that must be stopped for the health of the disproportionately high number of people in the African American community now testing positive for the virus. It is a rumor that persists, nonetheless, both in America and in Africa. This became evident to me again in 2009. While facilitating a refresher course in systematic theology for pastors working in the townships outside of Cape Town, South Africa, we welcomed a guest from the ministry of health. She quite openly admitted that she believed that “white men” had devised HIV in order to bring harm to Africans.

Although it is easy to dismiss the persistence of the rumors about HIV coming with malicious intent from the laboratories of Western science as superstitious and ignorant, it is important to acknowledge episodes in history that contribute to the perpetuation of such “dis-ease.” In South Africa, such episodes are not in the historical annals that students study as some remote lesson from the past, illustrated by pictures of murky liquids percolating in glass flasks and printed on glossy textbook pages in sepia tone, but rather these are stories that occupy the modern-day press. Wouter Basson was on trial in 1999 for allegedly developing biological weapons, including pathogens, for the apartheid government. Although amnesty and an acquittal prevented his arrest, he was also widely believed to have provided lethal toxins to be used against African National Congress (ANC) activists whose resistance the apartheid government so feared. He continues to face legal proceedings for crimes against humanity.

Of course, South Africa is not alone in its history of mistreatment of people with dark skin pigmentation. The Tuskegee syphilis experiment is perhaps the most infamous example in the United States, when researchers, between 1932 and 1972, undertook to study the progression of syphilis in people of African descent. Penicillin had become the standard treatment for syphilis by 1947, but in order to continue their observations, the scientists for the U.S. Public Health Service prevented nearly 400 African American subjects from gaining access to the drug that could have treated their illness. In addition to this notorious example, Harriet Washington has provided many other episodes in her book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. Among them are these:

In 1945, Ebb Cade, an African American trucker being treated for injuries received in an accident in Tennessee, was surreptitiously placed without his consent into a radiation experiment sponsored by the U.S. Atomic Energy Commission. Black Floridians were deliberately exposed to swarms of mosquitoes carrying yellow fever and other diseases in experiments conducted by the Army and the CIA in the early 1950s. Throughout the 1950s and ’60s, black inmates at Philadelphia’s Holmesburg Prison were used as research subjects by a University of Pennsylvania dermatologist testing pharmaceuticals and personal hygiene products; some of these subjects report pain and disfiguration even now. During the 1960s and ’70s, black boys were subjected to sometimes paralyzing neurosurgery by a University of Mississippi researcher who believed brain pathology to be the root of the children’s supposed hyperactive behavior. In the 1990s, African American youths in New York were injected with Fenfluramine—half of the deadly, discontinued weight loss drug Fen-Phen—by Columbia researchers investigating a hypothesis about the genetic origins of violence (Nelson).

In the long and winding path that has been the history of public response to HIV/AIDS, both in South Africa and globally, the world community faces another fork in the road. In one direction, there is death. In his recent presentation to South Africa’s parliament, the health minister spoke of his fear that the population of South Africa would soon begin to decrease as the numbers of deaths in his country threaten to surpass the rate at which South African babies are born (Kgosana). In the other direction, there is life. The situation truly is this stark. The reversal of the trend toward a decreasing population largely attributable to HIV/AIDS depends on a successful campaign to make drugs accessible to the two-thirds of the positive population still going without treatment. The issues that attend access to these life-saving and life-prolonging medications, as this essay has shown, are complicated to be sure, for in this multiply wounded society there are reservoirs of resistance that betray the naïveté of even the most benevolent attempts to provide treatment. According to projections through 2012, the lives of 1.2 million people in South Africa hang in the balance, dependent upon the rate at which the government is able to scale up access to ARV treatment (Walensky, et. al.).

Such a campaign in the direction of life is going to require the unified effort of government, academic, and religious sectors to shift the paradigm in which response to HIV/AIDS is conceived and conducted. This shifting of paradigm is a service to which 30/30 attempts to contribute, such that the direction we take at this critical juncture, rather than in favor of death, celebrates life.

Mistreatment of Vulnerable Persons

In Elderly, HIV/AIDS, Orphans, Public Health, South Africa, Structural Drivers of the Pandemic on August 11, 2010 at 2:15 am

Elders and Orphans

In 1993, the Henan provincial health council in China decided to establish blood collection networks in order to supply blood plasma to biomedical companies, who used it in the manufacture of medicine. More than 200 stations were established throughout the province. However, an unknown number of illegal stations also operated throughout much of the rest of the decade. Peasants were paid the equivalent of $5.00 (U.S.) for 400cc of blood. The Japan Times reported that illegal stations “collected at one time from a number of donors who share[d] the same blood type. Afterward, the blood [was] pooled, the components needed for medical use [were] separated and the remaining blood [was] divided up and re-infused into the original donors. This unsafe procedure expose[d] people to the blood of six to 12 other donors every time they donate[d], facilitating the spread of not only HIV but hepatitis and other serious diseases” (Chan). The practice was banned in 1998, but official action came too late. In villages like Wenlou and Donghu, infection prevalence rates were measured at one time to be as high as 65% and 80% respectively. According to Xie Yan, a woman who tested positive for HIV and who was interviewed by The New York Times in 2002, “‘I try not to think about myself since I know I won’t be cured,’ she said. ‘But at night I can’t sleep—I have nightmares and wild thoughts—worrying about what will happen to the [children]” (Rosenthal).

Xie Yan’s question is one that has haunted leaders in HIV/AIDS response for over a generation. What happens when parents die, leaving behind millions of orphans?

According to The Orphan Foundation, there are more than 143 million orphans in the world today—a number that far surpasses the expectation announced a decade ago that there would be 100 million orphans in the world by 2010. When combined with 20 million children who have been “displaced” in the world, the number of orphaned and displaced children number more than the entire population of Russia. Fewer than 50% of these will live to see their twentieth birthday, and half of those that do will end up working in organized crime or sex work, or will become addicted to drugs. In many countries of the world, orphaned and homeless children are recruited as child soldiers to fight in wars and in militia movements.

It is not an overstatement therefore to say that the impact of HIV/AIDS on children has been profound. In 2004, the United Nations published a volume called The Impact of AIDS. The volume dedicates chapters to the impact of AIDS on demographics, households, firms, agriculture, education, the health sector and economic growth. Taken collectively, the report paints a sobering picture about the impact of a pandemic that has to date directly affected 58 million people, .008% of the world’s current population of 6.8 billion, with ripples that emanate outward, affecting a range of enterprises, from the world’s ability to conduct business to its production of the food supply.

Because the numbers are so large, it is difficult to process the staggering statistics that fill page after page of the booklet. Unlike most of the chapters, however, the article on the impact of AIDS on households is immediately jarring, so basic are its observations. The authors write, “The HIV/AIDS epidemic threatens the social fabric of the most affected countries. . . . The evidence shows that the AIDS epidemic is having severe effects on households” (39). The report goes on to outline “three kinds of economic impacts,” as well as four social implications (39). The economic impacts include loss of income, higher household medical expenditures, and indirect costs related to caregiving:

The first is the loss of the income of the family member, in particular if he or she is the breadwinner. The second impact is the increase in household expenditures to cover the medical costs. The third impact is the indirect cost resulting from the absenteeism of members of the family from work or school to care for the AIDS patient. . . . If a household member dies from the disease, the funeral, mourning and other costs may also add to the burden of the household (39).

There are also four social implications that the book outlines, including “change in household composition, with the gradual disappearance of the parental generation and children being cared for by grandparents and other relatives . . . [or] an increase in one-generation households headed by the older children” (39). In addition, the book outlines how many children withdraw from school as the result of an infection in the household, how many households enter into poverty, and how welfare is correlated to the willingness of the community toward helping households in need (39-40).

All of these implications of high HIV/AIDS prevalence rates are painfully evident today in South Africa, among other places. Grandparents—grandmothers, in particular—are caring for their grandchildren, even in the midst of mourning over the loss of their own children. Participants 19, 20, and 21 in “30 Years / 30 Lives” all share stories of children acquiring an infection, leaving grandchildren behind for them to look after. Others, like “Participant 04” in “30 Years / 30 Lives” who opened her shack to twelve children not biologically her own, are stepping up to care for children without family to look after them. She recognized an enormous need in her community, and she refused to turn away.

The UN document on The Impact of AIDS on households goes on to discuss this impact of AIDS on older persons. “Recent survey data . . . confirm that orphaned children are more likely to reside with grandparents than with other relatives or non-relatives” (45):

[O]ne effect of the disease is to change the structure and composition of households. In many affected regions in developing countries, more and more older persons are taking care of AIDS orphans. Older parents may also provide end-stage care to their adult children afflicted with AIDS. A study conducted in Zimbabwe showed that older caregivers were under serious financial, physical, and emotional stress owing to their care-giving responsibilities. . . . The AIDS epidemic not only puts more stress on older persons, but it also impoverishes them at the very same time they themselves may need to be taken care of. . . . [S]urvey data confirm that substantial proportions of the older population of many countries are living in skipped-generation households and that such households tend to score lower than average on an index measuring quality of housing and household amenities (45).

The three stories that participants in “30 Years / 30 Lives” shared with me upon meeting them at Ikamva Labantu, an organization providing integrated care for seniors and orphans, confirm these findings. On a tear-filled morning in Cape Town, I sat down with all three. One by one, they wrote their stories into the journal, reading their own entry aloud to us at the table when they were finished. We wept for the daughters they had lost and for whom they were providing care—and they spoke of caring for the little ones their daughters left behind.

But the stories grow more complex even still.

In 2006, I visited with a director of a senior center in one of the townships outside of Cape Town. When I asked her about the impact of AIDS in her community, she explained how senior citizens, in the post-apartheid situation, often live off of a governmental pension check equivalent to about $100/month. She spoke especially poignantly about how many young adults in their late teens and twenties, experiencing hopelessness from grinding poverty, inadequate education, and joblessness, are becoming addicted to drugs. And then she spoke about how these two disparate observations about seniors and their pension checks and young adults and their drug addictions are connected. One of her seniors, she told us, leaning in and speaking softly, had been locked into the public toilet facility in her community. After she stole her mother’s monthly pension check, the drug-addicted daughter used the money to buy drugs.

Jonny Steinberg, in his book Sizwe’s Test, recounts a similar story. Sizwe, the young man from the Eastern Cape Province in South Africa who Steinberg shadows for a period of eighteen months, approaches an elderly woman on a late Sunday afternoon. The woman is negotiating with a taxi driver to take her out of the village of Ithanga, and Sizwe bids her farewell, insisting she come back often.

‘Who is the old woman,’ [Steinberg] ask[s].

‘She is a customer of mine,’ [Sizwe answers]. ‘She has been coming to drink since the day I opened.’

‘Why is she leaving?’

‘Because of the gangsters. She has been robbed twice.’

He points to a hilltop on our right. It is among the highest in the village and is particularly steep. A solitary round hut sits incongruously near the summit. It appears as if its inhabitants might open their front door, step outside, and roll down the hill.

‘That is her home. It is very isolated at night. Twice, on the night after pension day, very late, maybe one in the morning, they have knocked on her door, and when she opened they pointed a gun at her. After the second time, she said enough is enough. She has gone to live with relatives. . . .’

To be sure, the HIV/AIDS pandemic has focused the spotlight on complexities of social safety nets. Monthly pension checks, intended to provide food and shelter for the elderly, do not necessarily secure the future, but endanger it. Access to antiretroviral therapy, intended to prolong lives so as to limit the number of vulnerable children left without parents, is threatened by constriction of the global economy, drying up the financial wells from which the treatments have been funded. When access to the drugs that enabled a Lazarus-effect that encouraged more and more to be tested and to be enrolled for treatment is reversed, more and more lives will be lost. Children will again be made vulnerable. Seniors will be expected to care for them. And not everyone throughout the world was able to afford access in the first place.

“Perplexity is the beginning of knowledge.” —Kahlil Gibran

“To know and not to do is not to know.” —Ancient Proverb

Religious Fundamentalism

In HIV/AIDS, Public Health, Religious Fundamentalism, Shame, South Africa, Stigma, Structural Drivers of the Pandemic on August 11, 2010 at 1:30 am

Deconstructing the Architecture of Shame

South African journalist Jonny Steinberg has been acclaimed for his book Sizwe’s Test: A Young Man’s Journey Through Africa’s AIDS Epidemic, not least of which for insights he provides into the “architecture of shame” that frequently accompanies an HIV/AIDS infection. In order to understand the limits of efforts to make ARVs accessible widely in the country of Steinberg’s birth, over a period of eighteen months Steinberg accompanied Sizwe, a young adult man in his twenties who lives in the Eastern Cape Province of South Africa. Steinberg is curious about why so many South Africans, like Sizwe, refuse to be tested for HIV. In the process of writing the book, Steinberg discloses how the pandemic brought into sharper relief in his own mind a parallel that existed between his privileged white South African upbringing and Sizwe’s own marginalized upbringing within a rural village in the same country. Both men faced the culture’s stigma in relation to HIV/AIDS. After considering the ramifications a positive diagnosis would have on Sizwe’s livelihood even beyond the infection, and after listening to Sizwe’s rationales for so opting, Steinberg dug deeper into his own experience for a framework in which to make sense of Sizwe’s decision. By sharing indiscretions of receptionists and of medical personnel who failed to protect Steinberg’s privacy and who then passed him off to another clinic under the guise of concern, Steinberg constructed in his book what he calls the “architecture of shame,” and the scrutiny under which those who agree to be tested live, regardless of the outcome of the test. Shame is internally present, stigma its external driver. Knowledge of shame is what he shared with Sizwe, along with its accompanying and requisite fear of social ostracization.

At [shame’s] root lie myriad watching, judging eyes that look at one and see a disgusting and gluttonous figure. They are the eyes of others, but one has internalized them. They are strangers’ eyes whose watchfulness is nonetheless experienced in secret on the inside. When one stands in a crowded room and a person shouts ‘HIV,’ the very name and embodiment of one’s shame, the secret opprobrium expressed by the strangers inside heads for the real strangers on the outside like electrons in a force field. You are suddenly struck with the sickening feeling that the contemptuous eyes have always been on the outside; that is their natural home (Steinberg, 293).

In a conversation with Edwin Cameron, a judge in South Africa’s Supreme Court of Appeal, among the first public officials to disclose his status and to advocate for nation-wide accessibility of pharmaceutical treatment, Steinberg records the judge’s reflections in relation to self-contempt and, as such, to shame. “‘I knew my status for eleven years before I started treatment,’ [Cameron] said. ‘During that time, I did not realize that this virus inside me represented an enormous contamination, a sense of self-rejection. I only began to understand these things when I realized that the drugs were working. Once the viral activity had been stopped in my body, I stopped feeling contaminated. . . . There’s a liberation from a sense of self-disentitlement which successful treatment brings’” (Steinberg, 181-182). The tragedy of this statement is that, by shadowing Sizwe for all of those months, Steinberg was studying the limits of the reach of ARVs on a population that, for many reasons, continues to resist white “men” and their needles.

Steinberg and Cameron’s reflections provide three-dimensionality to the concept of stigma, shame’s more public companion. Ervin Goffman, a Canadian sociologist, defined stigma as the process by which the reaction of others spoils normal identity (Erving Goffman, Stigma: Notes on the Management of Spoiled Identity [Prentice-Hall, 1963]). By definition, stigma is “a mark of disgrace associated with a particular circumstance, quality, or person.” Scholars differentiate individual stigma from social stigma, the latter of which is “severe disapproval of personal characteristics or beliefs that are perceived to be against cultural norms.” According to AVERT.com, “AIDS-related stigma and discrimination refers to prejudice, negative attitudes, abuse and maltreatment directed at people living with HIV and AIDS. [This] can result in being shunned by family, peers and the wider community; poor treatment in healthcare and education settings; an erosion of rights; psychological damage; and can negatively affect the success of testing and treatment.” (See the article in full for an excellent overview of the stigma associated with an HIV/AIDS infection athttp://www.avert.org/aidsstigma.htm.)

Although different contexts will express the phenomenon differently, stigma has trailed the virus everywhere it has spread. The nuances in which it is expressed in a culture like ours in Minnesota, at a Catholic University where I teach courses in Christian doctrine, are instructive, for these stigmatizing forces are prevalent even in a climate where it is most uncomely to speak of them. They come to the surface, however, when I require students to participate in service projects related to HIV and AIDS. In doctrine classes, for example, students are required to work several shifts at Open Arms of Minnesota, an organization in the Twin Cities that prepares meals for and delivers meals to people living with HIV/AIDS, ALS, MS, and breast cancer. For some of my students, perhaps a quarter, the reluctance to engage is both rigid and immediate. Even once orientation to the project is complete, when fears about contracting the virus by paper cuts or whatever other ridiculous stories they’ve heard are dispelled, many of my students would prefer to engage in projects for other, it is revealed in class, more “worthy” recipients.

When we discuss this reaction, I ask, “In your mind, what makes people living with HIV/AIDS unworthy of the kind of care and concern we could offer by, say, delivering a meal through the work of Open Arms of Minnesota?” For these students, it always comes down to a judgment about very private behaviors they consider sinful—and which this virus makes public. These perceptions are the very root of the shame and stigma associated with HIV/AIDS and, as such, it is vitally important to investigate them, in order to overcome them. And so something like the following conversation ensues every semester. It is a compilation of numerous exchanges with students across years of teaching and, while the majority of students do not express verbally the attitude of the student depicted below, one cannot help but to sense that those who do speak up represent a fair number of students whose desire to be politically correct prevents them from uttering aloud similar thoughts.

“So,” I begin, “let me see if I am understanding this correctly. Firstly, you are making assumptions that the people to whom you are serving meals are HIV-positive when Open Arms delivers meals also to people who are living with breast cancer, ALS, and MS. Secondly, you are making assumptions about how the people acquired the virus, but regardless it automatically falls into the category of ‘sin.’ Thirdly, you are imposing your own religious views onto the person even though you don’t know if they share your view as their own and, moreover, you are making assumptions that the supposed sin has not been absolved. And, lastly, you are judging that person therefore to be unworthy of your own very valuable service hours. Am I tracking this correctly?”

“Well, basically—yes.”

“And if the people to whom we deliver meals have indeed committed an act that the church considers to be sinful—let’s say they’ve had intercourse outside of marriage—what if they have confessed their sins to a priest and have received absolution?” I go on: “They have received God’s forgiveness, but not yours? Does the recipient of care need to ask for your forgiveness, as well? And what about the person that delivers on Thursday? Shall they seek that care provider’s forgiveness, too? Do you expect them to confess to everyone who comes to the door?”

“I guess not. I never thought about it from their perspective before.”

“My suspicion, though, is that the mere idea of having sexual intercourse outside of marriage doesn’t offend you nearly as much when a sexually transmitted disease isn’t part of the equation.”

“I’m not sure what you mean.”

“The rumor in the quad is that lots of your classmates go to parties on the weekends. More than just a few are probably not going to their bedrooms alone afterwards. Do you shun them in the cafeteria?”

“I’m not the partying type, myself. I don’t shun them. I just hang out with a different crowd.”

“Fair enough.” Stopping for a minute to think about how to redirect the line of argument without losing the point, I say, “But what if one of your classmates were to get sick?”

“What are you asking?”

“If your dorm organized a food service, would you deliver him or her a meal?”

“Sure. Why not?”

“That’s all I’m asking you to do for the clients of Open Arms.”

“That was tricky,” my student says, defensively. “But my classmates aren’t like the people that Open Arms serves.”

“Now you’ve lost me,” I reply. “What do you mean they aren’t like the people that Open Arms serves?”

“C’mon Dr. Vrudny. You know what I mean.”

“I’m afraid I really don’t.”

“Most people who have AIDS in Minnesota are gay.”

“That is statistically true. What is your point?”

“That is my point.”

“Should we not deliver meals to people who are gay?”

My student was silent.

“Because that is what we’re doing. We’re contributing to the vision of Open Arms. They believe that no one who is sick ought to go hungry. Kevin Winge, the executive director of Open Arms always says: ‘It’s about food.’”

My student says nothing.

“Let me ask you this: Did you know that in Minnesota, epidemiologists are watching with great concern the numbers of people in between the ages of 16 and 24 who are becoming infected, because there is a disproportionately high number of new infections in young people, both homosexual and heterosexual?”

“I heard that during the orientation, but I’d forgotten.”

“And did you know that worldwide more than half of people living with HIV/AIDS are women?”

“No. I thought they were mostly gay men.”

“And do you know that many infants and children are living with HIV today, as a result of something they call ‘vertical transmission,’ or mother-to-child transmission?”

“Yes, I know about that. But I thought that was a small number.”

“Worldwide, more than 2 million children are living with HIV/AIDS today. That’s not exactly a small number.”

“Right. It isn’t.”

“There are also about 140 million orphans today, largely due to HIV/AIDS.”

“I can’t even get my head around that number.”

“I know. It is a particularly staggering statistic. That one keeps me up at night.”

“Hmmm,” my student acknowledges, nodding slowly.

“Do you know that many wives who have been loyal to their husbands are infected by the double standards in many cultures that tolerate married men having more than one sexual partner, but not married women?”

My student nods.

“And in places more numerous than I care to number, many people are poor and hungry. They are desperate for money. Women and children are often sold by families, often unaware, into human trafficking rings, or many women sell their bodies for money.”

“That can’t be too many.”

“I wish you were right. But I’m afraid you’re really in error . . . .” My mind trails off to memories of visiting a group of young children in a township in South Africa. The oldest was probably eleven. They told me they wanted to be engineers and doctors when they grew up. Then we drove up the road maybe a half-mile, and got out of the car to talk with a group of young women who were playing net ball. They were all sixteen to eighteen years of age. We asked them how HIV was affecting their community. They told us that they were playing net ball to build skills in sports. They thought maybe if they could make it athletically, they wouldn’t have to sell their bodies in order to survive. I emerge from the township again when I hear my student assert, “Still, if people would be responsible for themselves, infection rates would go down.”

“Yes, yes,” I say, holding my forehead for a minute. “And certainly no one is suggesting that we cease efforts to get information out there about how dangerous it is to have more than one sexual partner. But may I ask you a question?”

“I suppose.”

“Have you ever thought about what your responsibility is in relation to the pandemic? I mean, you’re talking a lot about responsibility. But the responsibility about which you speak seems to be ‘theirs.’ So I’m asking: what is yours?”

“What do you mean? I’m only twenty. I’ve not been infected, and I won’t infect anyone else. I’m a very responsible person.”

“Right, right,” I say, gathering my thoughts. “But I didn’t mean only your responsibility in sexual encounters. What I mean is: what is our collective responsibility as human beings toward people who have been impacted by this public health crisis of the modern day?”

“It isn’t my fault that so many people are getting sick.”

“I’m not suggesting it is your fault. Rather, I’m asking: what is our responsibility in the face of this illness?”

“I didn’t think I had any responsibility at all in relation to a pandemic impacting people half way around the world.”

“As well as here,” I quickly interject. Thinking it is time to share some of my own thinking about responsibility, I say, “I see the world as greatly interconnected. One country’s economy affects another’s. Some are winners in that contest. But the costs are high for the losers.”

“So? What’s your point?”

“So, as a human being, and as a Christian human being, I want to contribute to the creation of a world where the interconnectedness of humanity is honored, where we recognize that if one person goes hungry, we all are deprived.”

“I don’t get it. I’m rarely hungry.”

“How does that make you feel—that you rarely go hungry in a world filled with hunger?”

“Happy that I live here and not there. Grateful for my life. Blessed, even.”

Ignoring the projection of hunger to “over there,” when I know that there is too much hunger here, as well, I say, “‘Blessed’ is a theological word.”

“Yes. I am a Christian.”

“I see.”

“Catholic even.”

“Lovely. . . . So, when you say you are ‘blessed,’ does that mean that God does not bless, say, those who go hungry? So hungry that they are desperate for money? So desperate for money that they sell their body for money in order to buy food and contract HIV as a result? Are they forsaken by God, whereas you are blessed?”

“I never thought about it that way before.”

“I know. I know. It’s okay. I’m just trying to get us to think about all of this in relation to God. It is a theology class, after all.”

“Very clever.”

Pressing on, I say, “So what do you think God wants of us in this situation? To just shrug our shoulders, and to say: ‘too bad.’”

“I suppose not,” my student said, quietly. But I could see there was more. When pressed, my student relents in a whisper, “But my priest has said AIDS is a punishment from God.”

“Do you agree with him?”

“I’m not sure. I try not to think about it.”

“The idea that AIDS is a punishment from God is a fairly easy one to dismiss, you know,” I offer.

“Really?”

“Yes, really. We are taught to think of God as a Father, right?”

“Right.”

“Well, if your earthly Father intentionally exposed you to a virus in order to punish you for whatever you’d done wrong and it killed you, he would be tried for murder.”

“I follow you.”

“So, we arrest a human Father for murder for this kind of behavior, but we worship and praise God for the same behavior on a massive scale?”

“But he’s God.”

“Yes?”

“Nevermind.”

After stopping for a moment to let the previous analogy soak in, I continue. “The other side of the argument that often comes is that God sends HIV/AIDS in order to test us—to see if we’ll respond compassionately.”

“I’ve heard that, too.”

“Again, to use a parenting analogy: Let’s say that I have two kids. And let’s say that I shoot the first one to see if the second one will respond compassionately.”

“I see where you’re heading. You’re going to be carted off to jail, again.”

“Exactly.”

“I understand. But I still don’t know why God sends HIV/AIDS.”

“Are we sure that God sends HIV/AIDS into the world? Maybe it is just a natural thing—like a fungus that kills a beautiful tree, only this virus happens to kill humans?”

I was happy that my student was still hanging in there, and still listening. But it was time to bring it around to my main point, so I say, “Let me ask you something your generation seems to be asking yourselves quite often these days: What would Jesus do?”

“How am I supposed to know?”

“Fair enough. But what do you know about him?”

“He died on the cross to save us from our sins.”

“That’s a good start, and we’ll definitely be talking about all of that in due course. But I mean—what do you know about how he spent his time? What do you know about what he taught?”

“He called twelve disciples. And he went from place to place healing people. He taught people about how to inherit eternal life. And then he was crucified.”

“I see. And what did he say—I mean, when he taught about how to inherit eternal life? How do you inherit eternal life?”

“I dunno. I can’t remember.”

This time, I was silent.

Finally, my student answers, “You believe in him, maybe?”

“He talks about this rather directly. According to the Gospel of Matthew, in a rather forthright account providing a string of information about the kingdom of God, he talks about those who inherit eternal life. May I read it to you?”

“Is that a rhetorical question?”

Picking up my Bible, I read from the 25th chapter of Matthew, beginning with verse 34: “Then the king will say to those at his right hand, ‘Come, you that are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me.’ Then the righteous will answer him, ‘Lord, when was it that we saw you hungry and gave you food, or thirsty and gave you something to drink? And when was it that we saw you a stranger and welcomed you, or naked and gave you clothing? And when was it that we saw you sick or in prison and visited you?’ And the king will answer them, ‘Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me.’ He goes on to say that those who serve people in this way are welcomed into eternal life.”

“Are you trying to frighten me?”

“No, not at all. We are going to spend a great deal of time in class talking about the grace that makes it possible for us to feed the hungry, give drink to those who thirst, welcome the stranger, provide clothing to the poor, and care for the sick. In time, knowledge of grace should eliminate your fear. For now, I’m trying to get us to look at what God might expect of us according to a Christian understanding. . . . Does it make you think that maybe we have a responsibility in relation to the pandemic?”

“I’m beginning to understand what you’re saying.”

I smile. “May I say just one more thing about this?”

“If you must.”

“In my reading of Bible, Jesus doesn’t seem to think that anyone is unworthy of his time or attention. He reached out to all of the people who were excluded in his culture. All of the ‘untouchables’? He touched them. Lepers, menstruating women, Samaritans. He touched them all—even on the Sabbath, apparently. He befriended tax collectors and prostitutes, alike. The widows and orphans who had no one to care for them—he cared for them. So, if we were to take the question, ‘What would Jesus do?’ seriously, how might we respond?”

“I guess we should try to figure out who the untouchables are in our culture, and try to do likewise?”

“That is a really beautiful idea. Who are the untouchables in our culture? Who are the ones cast aside by our social systems?”

“Well, let me think for a minute. The homeless, maybe? Prostitutes, still? There are immigrants in my hometown. I’ve heard some pretty unkind things said about them. So they seem to be cast aside. And the uninsured, too.”

“That’s a great start. Anyone else?”

“Yes. I know where you are heading. You are wanting me to say: People living with HIV/AIDS. I suppose they’re like the lepers of Jesus’ day.”

“It’s been said.” Not exactly comfortable with the analogy given the cruelty of humans to those they perceive to be different, nevertheless I press on. “So. What am I saying? What is our responsibility in relation to the pandemic?”

“You’re saying that if I care for someone who has HIV/AIDS, I’m caring for Christ. And it is what God desires for me to do in this situation.”

“And what do you think about that?”

“It’s hard.”

“Is it? Lots of my students, by the end, talk about how ridiculously simple it was—to give an hour or two a week to pick up a cooler packed with food, and to get it to people who are not feeling well, but who need nutritious food to feel better.”

“Really?”

“Yes. Really. And you know what I hope?”

“What?”

“I hope that, one day, you might look back and think how meaningful it was—this experience, doing something that seemed so off-putting at first, doing something as simple as handing a person a bag of food across a threshold. Someday, perhaps years from now, you’ll hear something said about someone who is gay, or someone who has contracted HIV/AIDS, and maybe you’ll stomach will turn a little bit because you don’t like to hear such derogatory talk. I hope that this simple kindness you are offering this semester ignites a love in you that becomes your source of greatest joy.”

“That might be aiming kind of high.”

“I tend to do that.”

“I don’t get it,” my student persists.

“For now, that’s okay. You don’t need to get it. I just wanted us to have a straightforward conversation to get to the root of what troubled you about the assignment and in order to discuss what, in my mind, HIV/AIDS has to do with theology.”

“Quite a lot, as it turns out.”

“Yes,” I nodded, smiling. “Quite a lot. And we’ve only scratched the surface.”

Sighing, my student looks into the distance.

“Listen,” I say, pausing. “Give it a chance. Deliver a shift of meals at Open Arms of Minnesota, and we’ll talk again. And I promise: all of this will make more sense as we study theology this semester.”

“Do I have any choice?”

“Yes, of course you do. You can drop the course. There are lots of other sections in which you can enroll, even yet this semester.”

Thinking for another few seconds, I hear, “Okay. I’ll give it a shot.”

“Lovely! In the end, you may not agree with me. And that’s okay, too. But who knows?,” I suggest gently. “Maybe you’ll discover the face of God along the way.”

+  –  +  –  +  –  +

This imaginary yet all too realistic dialogue with a student demonstrates how deeply entrenched attitudes are about HIV/AIDS in our culture in Minnesota, if not nationwide, even still. Teenagers coming to college are under the impression that AIDS is only present among gay men and, given its presence in a population that engages in sexual activity the students consider to be offensive to God, they legitimize an unresponsive posture. Their immediate condemnation and judgment in relation to it all is the root cause of the shame and stigma that heap insult upon insult for someone living with the virus. There is something that we can do about these attitudes by analyzing them, addressing them, and working to eliminate them. In this case, we are able to do so within the context of a course in Christian theology, the very source of so much of the judgmental stance.

The service-learning project is intended to bring this kind of conversation into the open in the classroom, where we can reject ideas that marginalize, hoping ultimately to transform students’ lives into something more beautiful, even more Christ-like, by semester’s end. When we talk about human nature, which we call theological anthropology in systematic theology, students wrestle with prejudicial thoughts they may have had in relation to HIV/AIDS, thoughts that would otherwise remain unreflected upon if it were not for our engagement in the issue in the community through service learning. Students are forced to weigh that realization—that they themselves have had prejudicial thoughts—against their widely held belief in the essential goodness of humankind. And when we bring this recognition into conversation with the person and work of Jesus Christ, and contrast our own judgmental instincts with Christ’s wide embrace of humanity, we are able to talk about sin and redemption in a way that seems more relevant than it did before we engaged in service learning of this kind. And lastly, when we study the nature and mission of the Holy Spirit, we are able to get more deeply into the issue of altruism, and whether goodness is, indeed, naturally occurring or whether, just maybe, it is made possible by the gift of divine grace.

The issue of HIV/AIDS grounds our discussions in the real world and in the challenges that confront us, today, as a global community. The entire exercise points us to the vitally important issue of education in relation to HIV/AIDS—not only in terms of getting information into the public arena about what HIV/AIDS is and how it is transferred, and not only in terms of the ABCs of AIDS prevention, but also in terms of how we can shift the conversation about HIV/AIDS, especially within the churches, into a more constructive, even life affirming, pattern.

If our goal is the creation of a more just, a more forgiving, and a more beautiful global society, then this is our calling.

Violence Against Women

In HIV/AIDS, Public Health, South Africa, Structural Drivers of the Pandemic, Violence Against Women on August 11, 2010 at 1:10 am

“It is a fact that a woman born in South Africa has a greater chance of being raped than learning how to read.” —Carolyn Dempster, British Broadcasting Corporation

“When someone perpetrates an act of rape, it’s about reclaiming a sense of power.” —Kelly Hatfield, People Opposing Women Abuse

In 1973, Adrienne Rich published a collection of poems called Diving into the Wreck, including one called “Rape.” The poem explores how the survivor of rape is traumatized again by the male-dominated criminal justice system. This is evident from her first point of entry, when a male police officer records the woman’s account of the crime. His voyeuristic titillation by her disclosure implicates him in something of a gang that continues to perpetrate violence against her.

And you see his blue eyes, the blue eyes of all the family
whom you used to know, grow narrow and glisten,
his hand types out the details
and he wants them all
but the hysteria in your voice pleases him best.

The full text of the poem is available here.

Rich’s poem is an artistic observation about the banality of violence inflicted against women, so enmeshed is it with culture that it is scarcely recognized as out of order. Today, almost forty years since the poem’s publication, there has been little progress in addressing Rich’s critique, even while voyeuristic curiosity about violence committed against women is increasingly satisfied by online access.

Recognizing that the process of sharing painful memories can foster healing, but wishing to provide a space for storytelling beyond the criminal justice and psychological services sectors, many web pages have been launched to give survivors of rape a format by which to share their stories. While some sites have password protection so that visitors need to create accounts to gain access to the postings, others are accessible by nothing more than the click of a mouse, introducing the ambiguities of online access. Nonetheless, by sharing their stories, women who recount their experiences participate in a healing process by refusing to acquiesce to the culture’s desire that they bear their pain in silence.

Postings to web pages of this kind are numerous in South Africa, which has the highest ratio of reported rape cases per capita (per 100,00 people) in the world. Estimates suggest that a woman is raped every 26-36 seconds in South Africa, where a child is raped every 15 minutes. South Africa also has a high number of incidents of infant rape or “baby rape,” as it is more commonly called. Indeed, 41% of those raped in the country are under the age of 12, according to South African police reports. “A nine-year study by Cape Town’s Red Cross Children’s Hospital, published in the South Africa Medical Journal in December 2002, found that the average age of children raped was three. Research has shown that 40 percent of those raped in South Africa are at risk of becoming HIV-positive if they do not receive PEP [post-exposure prophylaxis].” (See Charlene Smith, “Rape has become a sickening way of life in our land,” Sunday Independent, 26 September 2004.) TIME magazine recently reported that more than a quarter of men in South Africa admitted to having raped. “46% of those said that they had raped more than once” (Lindow, TIME, 20 June 2009). As much as 75% of rape in South Africa is believed to be gang related.

In an effort to understand the underlying causes of the violence in South Africa, where democracy came only sixteen years ago after widespread brutality had been inflicted by the white government of apartheid against 80% of the population that was designated “black” or “coloured” (people of mixed ethnic heritage), scholars have articulated at least six theories that attempt to uncover the root causes of the violence directed against women in contemporary South Africa. These theories go beyond the obvious conclusion that individual men have made violent choices. The truth probably lies in an interweaving of theories that the individual choice to commit sexual assault against women is correlated to a combination of factors, including poverty, circulation of myth, persistence of cultural norms related to the subordination of women, male disempowerment, broken familial structures, and lack of legal deterrents.

1. Endemic Poverty. Most of the incidents of rape reported in South Africa occur in the poorest neighborhoods, including both township and rural types of communities, although according to Megan Lindow reporting for TIME Magazine, surveys have found that many of the men “most likely to rape . . . had attained some level of education and income.”[i] In a policy brief released by the South African Medical Research Council, its authors confirm, “the overwhelming majority of victims are found among the working classes and the poor.”[ii]

Poverty and unemployment are barriers to men and women accessing traditional sources of well-being, status and respect. Inequality in access to wealth and opportunity results in feelings of low self-esteem, which are channeled into anger and frustration, and violence is often used to gain the sought after respect and power, whether through violent robbery, rape, fighting between men, severe punishment of children or violence against partners.[iii]

Of course, there are many places in the world where there is a concentration of poverty without similarly alarming statistics pertaining to sexual assault. All the same, when perpetrators explain their behavior by saying that it was too expensive to pay for the services of a woman, the correlation between poverty and rape merits mention.[iv] When poverty is combined with additional factors described below, the situation foreseeably erupts, such that societies can expect to see increasing numbers of acts of aggression targeted against women when multiples of these factors coalesce.

2. Circulation of myth. As has been widely reported, there is a myth that has been circulated in South Africa, where HIV/AIDS rates are among the highest in the world, that it is possible to cure AIDS by having sex with a virgin. Although research has yielded mixed results in terms of evaluating the degree to which the myth is believed, it seems that the myth has greater tenability in some regions of the country than in others. The continuing circulation of the myth certainly does nothing to improve the number of incidents of rape in South Africa, though Helen Epstein, in The Invisible Cure: Why We are Losing the Fight Against AIDS in Africa, discusses how myths of another kind are playing a role in the spread of the epidemic in Africa. She writes, “In precolonial times, chiefs of the Sotho tribe would sometimes allow other men to have sex with their wives to secure the men’s loyalty. This was considered statesmanlike behavior and is celebrated in traditional myths and poems. Contemporary gang rape may be a violent reprise of this male-bonding tradition.”[v] Thus, mythic understandings of what it means to be male and cultural traditions practiced to secure alliances are implicated in violence against women in South Africa.

3. Persistence of cultural norms related to the subordination of women. Researchers have long recognized that male “domination is often so deeply embedded in social practices and the unconscious that the dominated scarcely perceive it as [dominance].”[vi] Research suggests male-inflicted violence against women is “pervasive yet largely unseen,” as it is “exercised through everyday practices in social life where political, educational, religious and economical macro structures are based in the ideology of gender differences.”[vii]

South Africa’s men from across the racial spectrum are raised to see themselves as superior to women and taught that men should be tough, brave, strong and respected. Heavy drinking, carrying weapons and a readiness to defend honor with a fight are often seen as markers of manhood. The violence that ensues between men often has very severe consequences. With most men perceiving that women should submit to control by men, physical and sexual violence are used against women to demonstrate male power, and thus teach women ‘their place,’ and to enforce it through punishment. Thus gender inequality legitimates male violence over women, as well as being accentuated by the use of such violence.[viii]

Gillian Paterson writes a concise synopsis about this normalization process in her book, Women in the Time of AIDS.[ix] “Physical violence against women . . . becomes accepted as part of the ‘normal’ way that things are.”[x] She goes beyond the description of the process, however, to suggest how HIV/AIDS is prompting a paradigm shift since survival itself is at stake. Throughout the book, she promotes a way forward through a participatory development model that wishes not to alienate men, but to involve them in the process so as to secure a lasting shift. Epstein, too, underscores how important it is to address male responsibility in programs aimed at reducing rape statistics in South Africa: “The epidemic of sexual violence in South Africa is part of a wider war between men and women that is as fierce and partisan as any other on the African continent, and it has been raging far longer. Empowering individual women without addressing the attitudes of men and society in general risks creating empowered women who antagonize men [thereby] playing right into the rapists’ hands.”[xi]

4. Male disempowerment. Sociologists have observed how men who are disempowered politically and culturally in colonized systems direct their power to spheres of influence that remain open to them. In a similar context of oppression as experienced by the indigenous peoples of Australia, Germaine Greer, for example, has argued in a book called On Rage that “the centuries of disempowerment, dispossession, discrimination, defamation, marginalization, murder,” and torture of Australian males has left a legacy of substance abuse and violence in Aboriginal communities that is directly traceable to oppression under an Australian version of apartheid policy.[xii] The pattern that Greer describes has parallels in many places, South Africa among them. According to Epstein,

[R]ape is an assertion of male power, not sexuality. [University of Pretoria anthropologist Isak] Niehaus speculates that men . . . found in acts of violence against women temporary relief from the humiliations of living in a society based on the presumption of white superiority. But these acts were not only misdirected expressions of racial anger. They were also ‘desperate protests against men’s loss of control’ over women. . . . The epidemic of rape may be a reaction to their perceived loss of status. In response they are reviving ‘scripts of male domination’ with deep historical resonance.[xiii]

5. Broken familial structures. In his book Spots of a Leopard, a collection of essays about male identity shaped by hundreds of interviews conducted with men throughout Africa, Aernout Zevenbergen asserts, “rape is a signal of a society that is sick to the core.”[xiv] Pointing to South Africa’s long history of migrant labor, Zevenbergen believes apartheid’s practice of migrant labor, of sending men to work hundreds of miles from home to work in mines, resulted in the breaking apart of families that “set the stage ‘for an epidemic of young men who, in the absence of positive male role models, are now consumed by a sense of anger and entitlement. What we have are the wounds of men creating wounds in women, creating wounds in children. . . . Who is going to stop the vicious circle?’”[xv] The South African Medical Research Council lends credence to Zevenbergen’s assertions:

South African families are highly unusual by global norms. In South Africa, growing up as a child in a home with two biological parents is unusual. A majority of children are born outside marriage and there is generally no expectation of fathers having a social involvement in the lives of these children. They often also provide no financial support. Frequently children are raised by family members who are not their biological parents. Without their parent’s protection, children are extremely vulnerable to abuse and neglect. Whilst this is a problem in its own right, it also gives rise to intergenerational cycling of violence. Girls exposed to physical, sexual and emotional trauma as children are at increased risk of re-victimization as adults. Exposure of boys to abuse, neglect or sexual violence in childhood greatly increases the chance of their being violent as adolescents and adults, and reduces their ability to form enduring emotional attachments. Trauma during childhood impacts on brain development, enhancing anti-social and psychopathic behavior and reducing the ability to empathize.[xvi]

Related to broken familial structure is widespread abuse of alcohol and drugs, for “South Africa has one of the highest per capita alcohol consumption levels per drinker in the world.” [xvii] The Medical Research Council again reports that many “acts of fatal and non-fatal violence occur after alcohol and drug abuse, especially fights, some types of homicide, and rape. Many victims of violence are also rendered vulnerable by alcohol.”[xviii] The report acknowledges the cycle of violence that alcohol and drug abuse perpetuates. “In a vicious cycle, victims of violence often start drinking heavily to deal with the trauma they have experienced, but their drinking makes it harder from them to escape from violence in their lives. Children are often left very vulnerable by their parents’ drinking.”[xix]

6. Lack of legal deterrents. It is estimated that less than 10% of reported rapes will result in a conviction in South Africa. The election of Jacob Zuma to the presidency in 2009 has not helped, for even he was accused of rape during his campaign, though he was later acquitted of the charges. In an interview with The Guardian, co-director of the Sonke Gender Justice Project, Dean Peacock is quoted as saying, “We’re at a complicated moment in South African history with revived traditionalism and there’s a danger of gender transformation being lost. We hear men saying, ‘If Jacob Zuma can have many wives, I can have many girlfriends.’ The hyper-masculine rhetoric of the Zuma campaign is going to set back our work in challenging the old model of masculinity.”[xx] Again, the Medical Research Council has stated,

With society accepting the use of violence in many circumstances, and the community very often protecting perpetrators, it is not surprising that law enforcement is generally very weak. Widespread corruption and general under-resourcing within the police force, as well as challenges of transformation and restructuring in the detective services, contributes to the problem. Few perpetrators are effectively punished, with the result that laws fail to provide deterrence and victims often have little faith in the system. / Despite the massive problem violence poses to the country, there has been a conspicuous lack of stewardship and leadership in the area of violence prevention from Government. The current policy of the Government which, simply put, is to ‘get tough’ on criminals, is unlikely to be a useful response to violence in the long term. Without widespread social and economic reforms, it fails to address the roots of violence and, equally problematically, it is both rooted in and serves to perpetuate many of the very ideas of manhood that underlie the problem of violence in society.[xxi]

All of this is to say that where poverty, myth of sexual cures for dreaded and prominent illnesses, cultural norms of male domination, male disempowerment, broken familial structures and lack of legal deterrents coalesce, risk is high for high incidents of rape and sexual violence to be committed against women. Where there are high incidents of rape and sexual violence committed against women, there is a high risk of HIV/AIDS infection.

Professor of medical anthropology at Harvard University Medical School and founder of Partners in Health, an organization devoted to provided high-quality medical services and pharmaceutical access to people living in the poorest communities throughout the world, Paul Famer has written extensively about gender inequality, poverty, and AIDS. Although his books tend to focus on his experiences in Haiti, the public health challenges he describes are relevant elsewhere, as the patterns to which he bears witness in Haiti have, in an age of globalization, replicated in many places throughout the world. In his book Women, Poverty, and AIDS: Sex, Drugs, and Structural Violence, Farmer explains how women are both biologically and socio-economically more vulnerable to an infection than men:

Certain studies suggest that per-exposure transmission from man to woman during genital-genital intercourse is two to five times more efficient than from woman to man. Other investigations have prompted researchers to argue that HIV is up to 20 times more efficiently transmitted from men to women than vice versa. HIV is more highly concentrated in seminal fluids than in vaginal secretions and may more easily enter the bloodstream through the extensive convoluted lining of the vagina and cervix. Vulnerable penile surface area is much smaller. . . . One recent study suggests that certain strains of HIV may grow better in a type of cell lining in the vaginal wall.[xxii]

Farmer also explains how female risk for HIV goes beyond biological risk factors alone.

[B]iological risk alone does not explain soaring infection rates among women. Women’s precarious social status, a direct result of gender inequality and amplified poverty, magnifies each of these biological predispositions. In addition to the gendered power differentials characterizing most sexual unions, women are denied equal access to economic resources, housing, health care, legal protections, land, schooling, inheritance, and employment in the formal sector of most societies. Wage-earning women may be obliged to supply sex to supervisors as a condition of employment. Domestic workers are particularly vulnerable to this kind of abuse. Women who work in the low-wage informal sector may also be forced to supplement meager earnings with sex work. Still others can find no employment in the informal sector except sex work. Male violence, whether threatened or actualized, is also all too commonly used to control women throughout their lives and increases their vulnerability to infection. In many cases, such violence is legally as well as socially sanctioned.[xxiii]

Any effort, therefore, to minimize the risk for replication of South Africa’s statistics pertaining both to sexual assault incidents as well as to HIV/AIDS prevalence rates must be multi-dimensional, addressing opportunities for income generation for both genders as well as financial independence for women, campaigns to distribute factual information about the biology of HIV/AIDS and its treatment, as well as information targeted to raise awareness about gender domination and its alternatives. South Africa has many NGOs working in these areas and their work is invaluable to the lives that are touched by their efforts and services. Also underway are governmental efforts to broaden the impact of endeavors aimed at eliminating poverty, ending the age of AIDS denialism, challenging a culture of female subordination, empowering males by creating meaningful work in every region of the country thereby also shielding familial structures from the harsh impacts of migrant labor, and enforcing laws already in place and revising unhelpful laws for the protection of women and children.

NOTES

[i] Megan Lindow, “South Africa’s Rape Crisis: 1 in 4 Men Say They’ve Done It,” TIME (20 June 2009; http://www.time.com/time/world/article/0,8599,1906000,00.html, accessed 30 August 2011).

[1] Ibid.

[ii] R. Jewkes, et. al, “Preventing Rape and Violence in South Africa: Call for Leadership in A New Agenda for Action,” MRC Policy Brief (November 2009), 1; http://www.mrc.ac.za/gender/prev_rapedd041209.pdf (accessed August 30, 2011).

[iii] Ibid.

[iv] Nicole Itano, “South Africa Begins Getting Tough on Rape, WENews (24 February 2003;http://www.womensenews.org/story/rape/030224/south-africa-begins-getting-tough-rape, accessed August 31, 2011).

[v] Helen Epstein, The Invisible Cure: Why We are Losing the Fight Against AIDS in Africa (New York: Picador, 2007), 228-238, esp. 234.

[vi] Diana Gibson, “Rethinking Domestic Violence: Case Studies from the Western Cape, South Africa,” in Amsterdam School for Social Science Research, Working Paper Series, October 2004.

[vii] Ibid, 3.

[viii] Jewkes, 1.

[ix] “His and Hers: A Note on Gender Analysis” in her book, Women in the Time of AIDS (Maryknoll: Orbis Books, 1996), 30-35.

[x] Ibid.

[xi] Epstein, 234-235.

[xii] Germaine Greer, On Rage, Melbourne University Publishing, 2010; see also Gideon Polya, “Book Review: On Rage by Germaine Greer,” MWC News, 27 June 2009.

[xiii] Epstein, 232-233; quoting Isak Niehaus, “‘Now Everyone Is Doing It’: Towards a Social History of Rape in the South Africa Lowveld,” research working paper presented at Sex and Secrecy, a conference of the International Association for the Study of Sexuality, Culture and Society, July 12, 2003.

[xiv] Aernout Zevenbergen, Spots of a Leopard: On Being a Man (Laughing Leopard Production, 2009); see also Lindow.

[xv] Lindow.

[xvi] Jewkes, 2.

[xvii] Ibid.

[xviii] Ibid.

[xix] Ibid.

[xx] David Smith, “Quarter of men in South Africa admit rape, survey finds,” in The Guardian (17 June 2009;http://www.guardian.co.uk/world/2009/jun/17/south-africa-rape-survey, accessed August 31, 2011).

[xxi] Jewkes, 2.

[xxii] Paul Farmer, Women, 47.

[xxiii] Ibid, 50-51.

Xenophobia / Xenophilia

In HIV/AIDS, Public Health, South Africa, Structural Drivers of the Pandemic, Xenophilia, Xenophobia on August 11, 2010 at 1:00 am

Last year, more than sixty people died as a result of xenophobia in South Africa. Typically, xenophobia refers to the unreasonable suspicion, distrust, or even hatred of foreigners. Although factors contributing to the xenophobic violence in South Africa are complex, it is clear in every report about it that tensions are running high because the country is experiencing unemployment rates nationwide of about 40%, a rate which soars above 70% in many so-called “coloured” and “black” townships established during apartheid, and in the informal settlements and shantytowns that continue to build up around them. Tensions erupted in 2008 when perceptions circulated that “foreigners” were taking jobs that could go to native-born citizens, creating a distrust that was fueled by accusations that drug trafficking was largely attributable to immigrants who, it was alleged, were bringing illegal substances across the border when they entered the country. These rumors caused immigrants in South Africa to become targets of attacks that captured the world’s attention in 2008.

In order to provide a sense of the scope and brutality of the attacks, consider an excerpt from this article published 19 May 2008 in the Mail & Guardian Online (Africa’s first internet-based news source begun in 1994, reputable internationally for quality reporting from inside Africa):

[P]olice recovered the hacked body parts of a Malawian national on a sandy road in Ramaphosa township and, near Primrose, one person with Mozambican identification papers in his pocket was found dead. Two other Mozambicans were seriously beaten.

In Zamimpilo, outside Riverlea on the West Rand, at least 50 shacks were burned. Foreign nationals in the area were taken to safety at a community centre.

In Kya Sands, an industrial area close to informal settlements, groups of people began throwing stones at each other after a community meeting, but the situation was brought under control, said police spokesperson Superintendent Lungelo Dlamini.

In the Jerusalem informal settlement, near Boksburg, police came under fire as they tried to stop a group of about 500 people from looting shops there.

Police in Cape Town were identifying possible flashpoints for xenophobic violence and would have units on standby, the city administration said on Monday.

These summary reflections by journalists for the Mail & Guardian about the week’s unrest, and the article in full, point to a further tragic dimension of the xenophobic violence in South Africa. The crimes are directed against those who are already suffering in townships and informal settlements where sometimes people are living in cardboard and tin-covered shacks built on nothing but dirt. An immigration status adds another degree of jeopardy to already jeopardized lives. Indeed, many of those who continue to flee here are leaving terrible and terrifying conditions, most arriving today from Zimbabwe and the DRC (Democratic Republic of Congo). They come here hopeful that they might find the refuge to which their designation as refugees attests—an illusion that is often broken swiftly when they enter a country with high rates of unemployment. On top of this, they too read the chilling words of those arrested for conducting the attacks, and the attempt of those involved to justify their activities. One unemployed man, for example, from his jail cell after he was arrested for destroying a few shacks in the Gauteng Province (in which Johannesburg and Soweto are located), is reported to have said, “We will keep on going; [the police] can’t stop us. . . . Foreigners are taking our jobs and our wives.”

Imagine, then, the increased anxiety felt by those immigrants who come with an HIV-positive status, or who acquire HIV once they have crossed the border. Their costume, accent, and location may already “target” them as “foreign.” To add fuel to the fire, in societies where all sexual subjects are taboo, word about an HIV infection present in the body of a refugee can fan the flame of violence all too ready to erupt.

Indeed, the issue of stigma was an omnipresent reality during my time at the Scalabrini Centre. The staff discussed with me how their clients often felt vulnerable, such that even coming to the HIV support group was difficult for them. When I presented the project to the members of the support group and invited each one to participate, two women made reference to the stigma of an infection when they politely and understandably declined the offer. Although two of my subjects permitted me to photograph their faces, one kept hers hidden for fear of being identified in her community. And all three asked that their names be kept absolutely confidential. Though one mindlessly wrote it nevertheless in the journal entry, I have used Photoshop to erase it from the subject’s journal page on the still life in order to honor the subject’s request for some degree of anonymity.

Of course, xenophobia is not the only option. Jesus himself drew on the ancient laws in his own Jewish tradition when Matthew records him to say, “I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me” (Matthew 25:35-36). The tradition upon which he was drawing was written in the ancient Israelite Code of Law: “When an alien resides with you in your land, you shall not oppress the alien. The alien who resides with you shall be to you as the citizens among you; you shall love the alien as yourself, for you were aliens in the land of Egypt: I am the Lord your God” (Leviticus 19:35-36).

All of this is to say that the Judeo-Christian tradition advocates against xenophobia in preference for “xenophilia”—a love and a deep, abiding respect for the inherent dignity of the foreigner in our midst. Certainly political questions become rapidly complex as priorities are juggled with limited Rands, Dollars, and the rest to be allocated to relieve varying competing and significant needs—but as “People of the Book,” these verses should guide our deliberations. First and foremost, we are called to recognize the “strangers” in our presence as also created in the image of God (imago Dei), possessing by virtue of their very existence a dignity that is absolute—a dignity that is inviolable.

Ikamva Labantu

In Elderly, HIV/AIDS, Non-profits / NGOs, Senior Citizens, South Africa on August 10, 2010 at 3:00 am

For more than 30 years, Ikamva Labantu (“The Future of Our Nation”) has been involved in building up communities broken down by the brutalities of apartheid. Today, it is an umbrella non-profit, non-governmental organization supporting the social development of tens of thousands of people through more than 1,000 projects fitting under four broader foci: health intervention and food security; educational access; skills and enterprise development; and land and building provision. Ikamva Labantu builds and supports crèches (pre-schools), schools, senior centers, and youth centers. It provides skills training programs, and undertakes building initiatives. And, finally, it develops programs for the disabled, the elderly, and orphans.

It was the creativity behind Ikamva Labantu’s senior care program that first captured my attention. Recognizing the pressure that seniors were under, given increasing responsibilities to care for grandbabies even in the midst of mourning for children taken by a virus or by violence, on top of demands from family and from community for a portion of the small, monthly pension they receive from the government, Ikamva Labantu created a place for seniors to find rest and play, as well as support and encouragement. In a day at any of the seventeen senior centers that have been established in the Western Cape Province, visitors might find seniors enjoying a meal, visiting with friends, exercising their bodies, playing a game, making crafts, tending a vegetable garden, or attending special events. Additionally, the centers provide assistance for seniors who are completing applications for pensions, social services, or disability grants.

Proudly developing “solutions by South Africans for South Africans,” the organization emphatically strives to maintain community ownership and direction of its initiatives. This principle is easily seen in today’s senior centers. They are being transformed into “Integrated Activity Centers” where child-care facilities, after-school and sports programs, life skill training workshops, and guidance counseling are offered for the young ones who are living with their grandparents. The integrated approach provides support and relief to over-extended grandparents, simultaneously providing high-quality care for the children. The idea for this integrated approach grew out of the community, and has been implemented by an organization that is listening carefully to those it aims to serve.

Equally significant is Ikamva Labantu’s program for vulnerable children. With the assistance of a grant from Remgro, a South African Investment Holding Company, Ikamva Labantu launched a pilot program in 2006 in Philippi, an impoverished community outside of Cape Town, to develop a program that could be replicated in other parts of the country. Ikamva Labantu standardized a model of intervention for vulnerable children that supported 73 families caring for 271 children over seventeen months and for just over R5/day. The model, called Siyakathala (“We care” in Xhosa), involves no fewer than eight stages:

  1. Identifying children in the community through informal talks and referrals;
  2. Assessing needs through standardized interviews with the children and/or caregivers;
  3. Obtaining documentation of birth, parental death or proper identification for grant applications;
  4. Applying for grants;
  5. Caring for children by offering emotional support through grief and loss counseling as well as by supporting their education by the sponsoring of uniforms, stationary, and school fees;
  6. Supporting care givers by providing training and reliable information;
  7. Fostering independence by providing peer-support group facilitation and entrepreneurial development;
  8. Disengaging from families when they become independent, while remaining open to the possibility of providing future support should it become necessary.

Please support the work of Ikamva Labantu, if you are able. Among the organization’s unique opportunities to provide support is its “Adopt a Grandparent” program. For R150/month (approximately $20/month), you can support a Grannie’s transportation to the Center, as well as ensuring her a daily nutritious meal. Other opportunities for giving are outlined on Ikamva Labantu’s website:

http://ikamva.org.za/donate-now/us/

Account Name: Ikamva Labantu Trust
Bank: First National Bank
Branch: Adderley Street, Cape Town, South Africa
Account Number: 62054752467
Branch Code: 250655
Swift Code: FIRNZAJJ
Once you have completed the wire transfer, please e-mail the amount donated, your contact details, and the name of the program you are supporting to fundraising@ikamva.co.za. If the e-mail does not specify a particular program, Ikamva Labantu will allocate the funding according to its discretion.

Inzame Zabantu

In Health Care, HIV/AIDS, Non-profits / NGOs, South Africa on August 10, 2010 at 2:45 am

Community Health Centre

Inzame Zabantu Community Health Centre is a medical clinic situated in Phillipi, in an area called Brown’s Farm, about 20 kilometers from Cape Town’s city centre. Whereas many governmental clinics in South Africa are dreary structures, worn by time and lacking funds for proper maintenance, Inzame Zabantu is light and airy, with windows that wash the waiting area with warmth and sunlight. The walls are painted with bright colors, and the grounds are well tended, even with a garden outside its front door. In completing the portraits and still lifes for 30/30, I interviewed Zethu Xapile, an administrative nurse at the Centre, to learn more about this remarkable Clinic in the new South Africa.

Please tell me about the community in which the clinic is located.

Brown’s Farm is an informal settlement that was developed immediately after apartheid was overturned in 1994. Many people are still living in shacks in Brown’s Farm. Even those who live in houses made of brick and mortar have shacks behind their houses, as many families attempt to shelter extended family on the same plot of land. It is common to have about ten or twelve people living in a house with only two bedrooms.

The area has an estimated population of about 80,000. The unemployment rate stands at 60%. Those who are employed are working as laborers and domestic workers, and earn very little income. Pensions and social grants generate an average income per household of around R800/month. The situation is very difficult. Teachers from the local schools sometimes bring children to the clinic who have collapsed due to hunger; nurses learn that they have gone for days without food.

What is the history of the Clinic? Was there a medical facility here prior to the building of this structure?

In 1994, members of the Brown’s Farm community approached the government with the request for a health facility. They received a donation of old shipping containers from a company called Safmarine. Wellconel, a pharmaceutical company, also donated used shipping containers. The government then prepared the containers and furnished them. The health centre started operating in 1994. The facility was given the name “Inzame Zabantu,” a phrase in Xhosa that means “the people’s initiative.” From 1997 to 2003, the administrators of the facility repeatedly submitted requests asking the government to build a proper structure, but they did not allocate funds for this purpose.

Meanwhile, the facility formed a partnership with the J. L. Zwane Community Centre. The clinic benefited from this partnership by receiving donations of medical equipment and non-pharmaceuticals from partners in the United States. In the year 2000, a woman from Dallas, Texas, donated five more shipping containers to give the clinic more working space and a roof over the containers to create a waiting space for the patients.

Please tell me about the process of winning the grant to build the new clinic?

In 2003, Professor Househam, Head of Health in the Western Cape, visited Inzame Zabantu. The staff stated its case, explaining how the containers were very cold in winter, and how the heat in summer was equally trying. He immediately set up a team to work with Zethu Xapile, an administrative nurse at the Centre, to generate a design and plan for the new building. The current building, which was officially opened in September 2006, is the beautiful result of that visit.

Please, describe the clinic.

The new facility consists of six consulting rooms, a treatment room, a dressing room, a preparation room, a reception area, a pharmacy, a boardroom, a staff tea room, an office, and a waiting area.

How many people are on staff here?

The government employs the clinic’s staff, which consists of one medical doctor, three clinical nursing practitioners, one professional nurse, two nursing assistants, one pharmacist, two pharmacy assistants, two administration clerks, two general assistants, and two health promotion officers.

How many patients does the clinic service daily, on average?

200 clients a day visit the Centre, on average. The clinic could not cope without its partners including individuals and non-governmental organizations. The Antiretroviral Service is run by an NGO called Absolute Return for Kids (ARK). Lay counselors do the pre- and post-test counseling. Additionally, a pharmacist from the United States worked at the Centre for a year on a voluntary basis.

Inzame Zabantu operates at a Primary Health Care level, providing curative, preventative and promotive health care, which means it is the first point of entry in the health care system for residents of Philippi and its surrounding area. The clinic sees clients from the age of thirteen and up. The service is free. As the only facility in the area, the clinic adds services that are much needed in the community.

What are the most common illnesses that are treated here?

The most common illnesses are chronic diseases of lifestyle, like diabetes, hypertension, and HIV/AIDS. Clients who need further management are transferred by an ambulance to secondary and sometimes tertiary health care providers.

Do you offer services here for clients who are HIV-positive?

The rate of HIV/AIDS in the area is 1:5. For this reason, the antiretroviral service is growing very fast. Inzame Zabantu started offering this service in July 2007, and up to now, has registered 1,202 clients on antiretrovirals. 77 more clients are awaiting the start of the regimen. The facility is too small to manage so many clients.

What are your limitations? For what kinds of illnesses/tests must you send people away in order for them to receive treatment elsewhere?

As this is a small facility, with limited space, there are services that we do not yet provide, but would love to offer at a future stage:

Inzame Zabantu does not have a tuberculosis service. Rather, nurses investigate and diagnose clients, but then send them to another clinic for treatment. As tuberculosis is one of the opportunistic diseases associated with HIV/AIDS, the Centre would like to make it easy for its clients by providing both ARV and TB service under one roof.

Maternal health is a must for any health care facility but, in the case of Inzame Zabantu, there are not enough rooms to be able to provide such a service. Maternal health includes family planning, cervical screening, and basic antenatal care. Residents of Brown’s Farm have to travel more than 10 km to access such a service.

There is no x-ray facility, so again residents of Brown’s Farm travel on foot about 10 km for this service.

Do you have plans/hopes for expansion, or replication?

Given all of this, it is clear that Inzame Zabantu wishes to expand to be able to render a quality service to its clients, and to attend to every one who comes to the facility. All the same, its beautiful architecture, graceful garden, and warm interior design expresses the care this facility provides to the residents of Brown’s Farm, who took the initiative to develop a proper health care center in a deeply impoverished section of the townships outside of Cape Town.

Thank you for providing this information.

Inzame Zabantu stands as a place of hope and promise in the community. Please support its work, if you are able: https://www.westerncape.gov.za/facility/browns-farm-community-health-clinic.

J. L. Zwane Center

In Non-profits / NGOs, Religious Fundamentalism, South Africa on August 10, 2010 at 2:30 am

The drive into the townships is a startling exercise in contrasts. As border crossers leave Cape Town behind them, with its crowded promenade that runs along the ocean, bustling shopping centers, and active tourist industry, they encounter heavily concentrated areas where people designated “black” and “coloured” under the apartheid regime live in a variety of small homes: tens of thousands of shacks, government issue houses, and pride of ownership homes jumbled in a tangled network of neighborhoods built on every scrap of ground available between freeways offering access in and out of these poor but vibrant communities. The overwhelming sensation in the area is dryness: sand, dirt, concrete, and cardboard compete for attention. Water taps and toilets are shared by tens or hundreds of people, depending on the density of the population. Corrugated iron and sheets of metal form roofs and walls of places people call home, all of which seem strung together with cables of wire in a complex and unsafe network of electrical power. John de Gruchy, a longtime professor of theology at Cape Town University, writes about the striking disparity between Cape Town and the townships in this way:

Cape Town is a city of contrasts, awesomely beautiful, tragically ugly. Lying beneath Table Mountain, which rises sharply out of the Atlantic Ocean, it is situated on a peninsula that is the heartland of one of the six floral kingdoms of the world. The southern tip of the peninsula has been described as both the Cape of Good Hope and the Cape of Storms, depending on how it has been experienced by those who have sailed around its craggy sentinel. Cape Point represents the end of Africa, or its beginning, cleaving the icy cold waters of the Atlantic from the warmer currents of the Indian Ocean. Tourists are awed by what they see. Those who climb Lion’s Head to watch the summer sun set over the Atlantic are stunned by the beauty. Yet the city and its environs are saturated with aesthetic and moral ambiguity, the co-mingling of exuberance and pathos, creativity and destruction. A city of many cultures and political persuasions competing for space and control, yet bound together as one in the need to shape a common destiny.

As a human construct of several centuries, Cape Town embodies beauty in its architecture and its gardens. But alongside this beauty, whether natural or constructed, lies another, ugly reality, much of it the creation of colonial and apartheid legislation and oppression, an architecture that reinforces alienation from social others and the environment. Natural beauty has been scarred by greed and racism; by highways that separate citizens from the sea and its beaches; and by public works that reflect modernity at its worst. The stylish homes of the wealthy often reflect a vulgar opulence rather than the beauty of the surrounding habitat. Not too far from them, though designed to be out of sight and sound, are conditions of widespread poverty. These have spawned street children, gangs, drug trafficking, prostitution, and violent crime. The contrasting worlds of Cape Town are no different from those of many other cities around the world where rich and poor live and work cheek by jowl. But there are few cities where the contrasts are experienced so keenly simply because the beauty of the city and its environment is so breathtaking (de Gruchy, 176).

But rising out of the midst of all of this in Guguletu is a clock tower, creating an unmistakable landmark in the area representing hope to the impoverished community surrounding it. The J. L. Zwane Church was founded by Jeremiah Zwane who came to Guguletu in 1952 to reestablish the church as a vibrant presence in a region devastated by apartheid’s brutal practices. Operating initially out of a poorly constructed building, the church was a center of anti-apartheid activity until the elections voted the African National Congress into power in 1994, overturning decades of the cruel and racist practices of the former regime. In the same year, the J. L. Zwane Centre was established as a joint initiative of Stellenbosch University, the Church, and the Guguletu community to meet the needs of the people. Instrumental to all of this was the work and vision of Rev. Dr. Spiwo Xapile (his name means “gift” in Xhosa), who came to the church in 1989. In his tenure, he has developed a model for community-focused ministries made possible by creating strategic partnerships with people in business, academia, and government. By 2002, he had raised enough money to build the Centre with its striking architecture, hopeful interior, and tasteful art. He has nurtured the leadership potential of many men and women who have come through its doors by surrounding himself with an extremely capable and dedicated staff, among them both Edwin Louw (a Presbyterian minister who serves as project director for the Centre), and Bongani Magatyana (an accomplished musician and composer who works with the musical group Siyaya), and by thinking with precision about programs that will impact the community in a positive and sustainable way.

There are many such programs at the Centre, and readers can learn more about each one on the Centre’s website. Here, however, I will highlight only three:

The HIV/AIDS Support Group meets weekly to offer a safe haven to those who have tested positive. Members come together to share their struggles and challenges with one another. Staffed by social workers, members receive counseling and acquire quality information about the virus in a society still reluctant to receive medicine and information from the West. Through one another, they learn how to live positively and productively with an infection.

Siyaya is a 16-member musical group that practices daily at the Centre and takes its message of hope into the community to educate children about the dangers of sexual promiscuity and drug use due to the high prevalence rates of HIV/AIDS in South Africa. The group has traveled internationally, and has won acclaim for the quality of its music, message, and movement.

The Rainbow After-School Program hires teachers to sit with children from 3:30 to 5:00 p.m. Monday through Thursday to provide homework support and nutritional supplement to students from the township. As many as 150 children come for an after-school snack before settling in at tables in various facilities at the Centre to complete homework, play games, and socialize after a full day of school. The snack is provided through a wider program of nutritional support to feed the community, many of whom are undernourished due to high unemployment rates.

The J. L. Zwane Centre is a remarkable place with a staff that welcomes every human being who crosses its threshold. It lives out a spirituality of recognizing the inherent dignity of every human person in a context rife with racial, economic, and cultural tension and division. Please visit its website to learn more about this place of refuge and hope in Guguletu.

Scalabrini Centre

In HIV/AIDS, Non-profits / NGOs, South Africa, Xenophilia, Xenophobia on August 10, 2010 at 2:15 am
Immigrants to Cape Town, including refugees and asylum seekers, often have needs that are not uniformly and cordially met by governmental agencies and welfare programs set up to serve citizens, an observation made long ago by John Baptist Scalabrini who, in 1887, founded the Scalabrini Order in order to serve the welfare of migrants. More specifically, because millions of Italians were fleeing from Italy in the closing decades of the 1900s as crushing poverty coincided with political strife as the Holy See and newly formed Italian state were hammering out their differences, a priest by the name of Giovanni Battista (John Baptist) Scalabrini became concerned that his parishioners were in danger when they left for America without money, jobs, or knowledge of English. He felt compelled to assist his parishioners in their efforts to migrate, first by writing for them letters of introduction which they could carry with them, to deliver to a priest on the other side of the ocean wherever and whenever they settled. Once he was installed as Bishop, his social activism progressed:

In the next few years, while emigration continued to increase in the face of continued Italian poverty, the bishop involved himself in several large projects to help the poor. Scalabrini established a society to aid the mondine, impoverished women harvesting rice in the paddies of northern Italy. He also opened an institute for the deaf and mute in his diocese. During the famine year of 1879, he turned his episcopal residence into a soup kitchen, dishing out 4,000 bowls of soup each day, selling his horses and even a bejeweled cup, a gift of the pope, to keep the soup kettles boiling. But the immigration question kept preying on his mind (Robb).

Soon, the Bishop would write to the Vatican to request permission to form a religious Order devoted to the care of emigrants from Italy. His charter included the objectives to protect emigrants, assist migrants in finding work, provide migrants with material aid, fight human trafficking, and offer religious guidance. Today, the Scalabrinians are present in over 30 countries, and have more than 600 religious, both male and female, on the rolls of the Order. Their mission worldwide is “to safeguard the dignity and the rights of migrants, refugees, seafarers, itinerants, and people on the move.”

The Scalabrini Centre in Cape Town welcomes refugees and asylum seekers coming to South Africa primarily from Zimbabwe and the DRC (Democratic Republic of Congo), because of war and unstable economic conditions being faced by these countries north of the border. The Centre welcomes newcomers to the city through its weekly welcoming program which offers material support in the form of food parcels, clothes, and blankets. The Centre also links refugees with social services available in the city, operates an employment help desk, offers courses in English and digital literacy, runs a sewing laboratory to help women start sustainable businesses as tailors, and prepares food in its soup kitchen, also for displaced and homeless people. Finally, the Centre also oversees the Lawrence House, “a place of hope . . . where refugee children can regain their childhood and prepare for their future.”

Since it opened in 1994, the Centre has grown increasingly aware that where there is migration, there is HIV/AIDS. In response, the Centre has added programs to increase awareness about the virus in the refugee community and how to prevent infection. In addition to offering workshops on HIV/AIDS awareness and management, the Centre provides testing and counseling through a support group to enable those who have tested positive to share their stories, struggles, and insights with other immigrants to South Africa who, like them, are living with a positive status.

While my family and I have been in South Africa, we have gotten involved with the Scalabrini Centre in three ways: we’ve served meals in the Scalabrini’s soup kitchen during the welcoming program on Wednesday mornings; together, too, we’ve volunteered to cook meals on Saturday evenings for the children at the Lawrence House (the Scalabrini Centre’s home for orphaned and abandoned children). Lastly, for the past month, I’ve visited the HIV/AIDS support group weekly to listen to what is on the minds of refugees to Cape Town who are living with HIV/AIDS.

The stories I’ve heard, in session and in the corridors of the Centre, are painful to be sure—but there is an indomitability to the human spirit that is almost tangible in this place. This was especially evident one morning when I waited for the HIV/AIDS support group to assemble. Seated in the reception area, I introduced myself to the only other person who had come early—a woman who had fled, I learned, from the Congo six years earlier. As we engaged in conversation, she shared with me how she had witnessed the death of her husband. He had been shot, she told me, and when “they” came, referring to the men with guns, everyone ran. It happened so fast that she became separated from three of her four children. She, along with her then three-year-old daughter, fled to South Africa. They were joined in Cape Town sometime later by the woman’s mother, who had found the other children and emigrated with them. Subsequently, the woman learned she was HIV-positive. She had a baby six months ago. The test for the baby’s HIV status had just come back negative, she shared with me when we spoke, moving her hand to her heart in thanksgiving. But, she whispered, “I’m still suffering. There is no work. And I have to feed my baby formula. I cannot afford to buy can after can of baby formula.”

The three people I met through the Scalabrini Centre who are featured here likewise share in their journals complicated stories, where gratefulness is evident alongside sorrow for what has been lost, for what has been left behind. In their own words, they have responded to my invitation to share what they want people to know about them and their perceptions of HIV thirty years into the pandemic.

The Scalabrini Centre is doing important work that recognizes the inherent dignity of refugees and asylum seekers arriving in South Africa; please support its HIV/AIDS program if you are able. For more information about the work of the Scalabrinians, see:

http://www.scalabrini.org.za
http://www.scalabrini.org
http://www.cedomis-scalabriniane.org/en/links/default.htm
http://www.sedos.org/english/scalabrini.htm

Treatment Action Campaign

In AIDS Denialism, HIV/AIDS, Non-profits / NGOs, South Africa on August 10, 2010 at 2:00 am

The deaths of two men in South Africa quickened the founding of the Treatment Action Campaign (TAC). Simon Nkoli, an anti-apartheid and gay rights activist, died from AIDS even when ARVs were available to wealthy South Africans. Shortly after Nkoli’s death, Gugu Dlamini was murdered due to his HIV-positive activism. In response, on International Human Rights Day (December 10) 1998, Zackie Achmat and ten other activists launched TAC, a South African AIDS activist organization that uses direct action techniques borrowed from South African trade union and anti-apartheid movements in order to achieve its aims. So far, the organization has been enormously successful—though not without nail biting suspense as each goal is achieved. TAC has been credited with South Africa’s implementation of a country-wide mother-to-child transmission prevention program, as well as forcing the reluctant South African government under its former President, Thabo Mbeki, to make ARVs widely available to South Africans.

The group’s methods are memorable, which perhaps explains their effectiveness. Very early on, members of the group (positive and negative alike) fought AIDS stigma by wearing HIV-positive t-shirts. Recognizing the vast inequities in access to pharmaceuticals, Achmat pledged not to take ARVs until all South Africans could obtain them. As Achmat grew weaker, TAC was instrumental in ensuring that generic medicines would be made available in South Africa at an affordable price. However, when the government blocked their roll-out, TAC staged a thousands-strong march in 2003 to pressure the government to make ARVs widely accessible. Building upon the energy from the march, TAC began a civil disobedience campaign in March 2003, and distributed unlawfully acquired drugs to its members, ceasing its activity when it received word that there was some progress in Parliament. Only then, when Nelson Mandela himself, in unison with members of TAC, pleaded with Achmat to take the drugs did he relent, having grown very weak in the meantime. In the autumn of 2003, the Cabinet overruled the President, and voted to begin a roll-out of antiretroviral access through the country’s still poorly developed system of public clinics.

Despite this maneuver, Mbeki continued to endorse the denialist position, as did South Africa’s minister of Health, Manti Tshabalala-Msimang. She became a target of TAC’s activism. She was removed as Health Minister in 2008, after President Mbeki left office. Access to antiretroviral therapy is now an official policy of the South African government. However, TAC continues to protest and file lawsuits to influence the speed of the rollout.

With its vision of a “unified quality health care system which provides equal access to HIV prevention and treatment services for all people,” and its mission to “ensure that every person living with HIV has access to quality comprehensive prevention and treatment services to live a healthy life,” TAC “has become the leading civil society force behind comprehensive health care services for people living with HIV & AIDS in South Africa.”

For its efforts, TAC has received worldwide acclaim including a Nobel Peace Prize nomination in 2004. Please support its work, if you are able.

Wola Nani

In HIV/AIDS, Non-profits / NGOs, South Africa, Violence Against Women on August 10, 2010 at 1:45 am

Wola Nani is a Xhosa phrase, meaning “through our embrace, we develop one another.” Founded by South African activist Gary Lamont in 1994, Wola Nani’s mission is, simply put, “to improve the quality of life for people living with HIV and AIDS.” Without denying services to anyone, Wola Nani has focused on bringing relief to the communities hardest hit by HIV, recognizing that women have been disproportionately infected with and affected by HIV/AIDS. The organization’s concern for the welfare of women is evident in its areas of focus which fall broadly into three categories: client support; education and awareness; and skills development.

Client Support:

Client support is a fundamental aspect of the work of Wola Nani. Through its family and community support center in Khayelitsha, its Cape Town drop-in center, and non-medical voluntary counseling and testing (VCT) site in Guguletu, Wola Nani provides a full spectrum of services related to an HIV-positive diagnosis. By counseling those testing positive, encouraging involvement in Wola Nani’s support groups, providing home-based care and health monitoring, operating an emergency food relief service, giving clients referrals to the services of other NGOs, conducting workshops about how to access government grants, medical services, and legal services, and caring for vulnerable children by running child daycare facilities, assisting in the placement of orphaned children, and monitoring the vulnerability of children in the communities served, Wola Nani’s impact in the lives of those living positively with HIV and AIDS is thorough.

Education and Awareness:

Having been created in the very year of Nelson Mandela’s inauguration to the new South African presidency, and enduring the years of Thabo Mbeki’s denialism, Wola Nani places great emphasis on educating those testing positive about the virus and how to treat it, and on raising awareness about HIV and AIDS in order to foster greater support for those infected with and affected by the virus in the wider community. Wola Nani conducts the famous “Red Ribbon Campaign” each year, to keep HIV and AIDS awareness alive in the public square. As its own website proclaims,

Wola Nani has coordinated and run this major, high profile awareness and fundraising event since 1994. As part of the campaign, Wola Nani has lit up Table Mountain red as the world’s greatest living memorial to AIDS, waved Red Ribbon flags from a procession of Harley-Davidsons and fired a 6 cannon salute from Signal Hill in Cape Town. Activities vary from year to year but may include wrapping a prominent building in Cape Town with a giant red ribbon, distributing red ribbon and collection boxes in the streets, local shops, and restaurants, and live outdoor broadcasts with popular local radio stations. The Red Ribbon Campaign has become an event which allows people to acknowledge HIV/AIDS, a time when the whole City wears a red ribbon and sends a message to the millions of South Africans living with the virus that they are not alone and the people of the nation support them.

In addition, Wola Nani runs educational programming in the communities where people are most vulnerable to an infection to promote safer sex and prevention of transmission. For those who have become infected, Wola Nani offers seminars and workshops so that people understand the medical condition and their treatment options (including ARV treatment literacy), as well as rights and entitlements persons testing postive have under the law.

Skills Development:

Wola Nani has also been entrepreneurial in spirit, wishing to provide women with a practical means to support themselves financially. Income generation rapidly was identified as an urgent need for women testing positive with HIV. Soon, Wola Nani branched into sales of crafts, featuring products ranging from papier maché bowls and picture frames, as well as beaded bangles and AIDS ribbons. These products are marketed and sold overseas as well as at shops nationwide. When I visited Wola Nani’s administrative center in the Observatory of Cape Town, I was shown the storage room filled with craft supplies, as well as the bustling office where bowls and light bulbs were being shipped to European retailers. At present, about sixty craftswomen are employed by Wola Nani, enabling them to earn a regular and sustainable income. These women report that Wola Nani has provided them with a means by which to feed their families, send their children to school, and live positively.

Below is a list that gives a sense of how dollars will be used by the administrators of Wola Nani:

$25 will buy Home Health Kits for five clients;
$50 will enable ten child clients to receive supplemental, wholesome meals twice a week for a month;
$200 will provide HIV diagnostic testing procedures for 50 individuals;
$500 can fund the purchase of materials needed by a craft maker to create 1,000 papier maché bowls for sale and income generation;
$2,000 will allow 10 clients to be trained as certified home caregivers;
$5,000 would enable Wola Nani to hire 2 HIV counselors on a part-time basis for one year.

More information about each of Wola Nani’s projects is available on its website, which also features stories about the women whose lives have been greatly impacted by the organization’s vision. Please support their work, if you are able.

Yabonga

In Healing of Memory, HIV/AIDS, Non-profits / NGOs, Political Violence, South Africa on August 10, 2010 at 1:30 am

Within a few years of experiencing the ousting of the apartheid regime in South Africa, it was clear to educator Ulpha Robertson that high-quality school readiness programs in underprivileged areas would not be among the priorities of the newly elected government. Therefore, she collaborated with Austrian-born Ursel Barnes, herself a parent with an interest in shaping the direction of education within South Africa’s emerging democracy and, in 1998, together they founded Yabonga (a Zulu word meaning “they thanked” or “they saved”).

Educare Program. With an aim to strengthen young children’s preparedness for mainstream schooling, Yabonga focused initially on establishing educare centers—places that were dedicated to preventing an achievement gap from taking root in at-risk children from birth to age five. Today, Yabonga has assisted in training teachers at ten educare centers in underprivileged communities, and has established two preschools. However, within two years of Yabonga’s founding, the staff encountered their first child living with HIV—an experience that caused them immediately to expand their focus to provide education, support and skills development for mothers testing positive, so they could be present to their children to support them as they grew into adults.

Peer-Educator Program. In 2001, Yabonga began piloting its peer-group education program. Today, more than 200 women have undergone a four-month training program that equips them to educate peers within their communities about prevention and treatment strategies in relation to HIV/AIDS. Candidates showing potential are trained in home-based care, lay counseling, and youth counseling. By talking openly in their communities about the facts behind HIV/AIDS, these women are working to overcome the shaming and stigmatizing patterns that have isolated people living with HIV/AIDS.

HIV/AIDS Support Centers. As local clinics became aware of Yabonga’s peer educators, they created a demand to have the educators present in community clinics. Therefore, Yabonga worked with local businesses to purchase ten shipping containers (that function like trailers) to establish support centers. The centers maintain a staff comprised of a team leader, peer educators, lay counselors, home-based carers, and youth counselors in order to respond to the needs of those testing positive in the communities that are experiencing the highest rates of infection. In addition, Yabonga has a presence at an additional 20 clinics and 20 schools, providing HIV education, voluntary testing services, voluntary individual and family counseling sessions, support group facilitation, and nutritional support.

Income Generation Program. Access to reliable information about the virus and its effects on the body enables people to live positively, raising their own children and relying on their own abilities to generate income to support their families. While the support centers raise awareness, Yabonga’s income generation program equips participants with skills in beading, sewing, fabric painting, cooking, baking, wire working, or gardening, depending on the peer-educator’s preference. The items produced by Yabonga’s income generation program are available for sale from the Yabonga website: http://www.yabonga.com/site/support/.

Orphan and Vulnerable Children (OVC) Program. In addition to its educare and peer-education programs, Yabonga has supported 350 orphaned and vulnerable children by purchasing school uniforms and books, providing nutritional assistance and counseling, and supporting life skills and leadership workshops for children who wish to develop strategies for coping with the trauma associated with HIV, poverty, abuse, and the death of a parent.

Community Mothers. Community mothers provide a safe haven for children involved in Yabonga’s OVC program. The mothers are hired to provide a nutritious meal as well as homework support to the children. Trained in skills required to counsel children in relation to issues associated with HIV/AIDS, community mothers provide a safe place to talk about HIV directly in the communities where the children live.

Men’s Program. Lastly, Yabonga has established a men’s program. Fifteen men have been trained to run support groups for men living with HIV/AIDS. In addition, the men’s program aims to empower young men to stay away from drugs, alcohol, and gangs by running sports and enrichment programs for youth. By organizing community-based education programs in taverns (legally operated bars) and shebeens (bars that run without a license), the program attempts to raise awareness about HIV/AIDS and its attending issues in communities where the prevalence rates are as high as one in every three.

In all, Yabonga employs more than 100 people to run the network that supports the non-governmental organization’s extensive HIV/AIDS programs that have, to date, served more than 600,000 people. The reach of Yabonga’s programs is, indeed, impressive, as the peer educators participating in “30/30” attest.

Please support Yabonga’s work, if you are able, by sending food, clothing, toiletries, blankets, toys and stationary to:

Yabonga
2 Main Road
Wynberg 7800
South Africa

or by wiring a donation to:

Beneficiary: Yabonga
Nedbank Branch Code: 145209
Account No. 1452012563.