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| AIDS IN SOUTH AFRICA | |
 July 10, 2000  |
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Fred De Sam Lazaro of Twin Cities Public Television reports on the AIDS crisis in South Africa, as health experts gather in the developing nation for the 13th International AIDS Conference.
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FRED DE SAM LAZARO: When democracy came to South Africa in 1994, it was supposed to bridge the huge gap between the two South Africans, one a nation of vast wealth occupied by whites, the other a country of third-world poverty inhabited by its black majority. |
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| One in ten South Africans HIV positive | ||||||||||||||||||||
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SPOKESPERSON: Thank you, ma'am.
SPOKESPERSON: What you're seeing over here is what we call floor bed, which is just a blanket on the floor with a pillow underneath a bed of another patient. FRED DE SAM LAZARO: Hospitals like this one in rural Kwazulu Natal Province are seriously overcrowded. Joeman Magizi is one of its 400 patients. JOEMAN MAGIZI (translated): I have not been able to work now for about six months. I'm unable to provide any support for my family.
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| HIV rates fueled by apartheid and democracy | ||||||||||||||||||||
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FRED DE SAM LAZARO: How did Africa's most modern nation find itself so much worse off than its far poorer neighbors in dealing with HIV? Experts cite several factors, beginning with the segregationist apartheid regime, which created a migrant labor system to build the modern nation. Black men traveled to distant urban and mining areas, separated from their families 11 months of the year, a recipe for disaster, says public health scientist Mark Lurie.
FRED DE SAM LAZARO: Ironically, the freedom movement that democracy brought only accelerated the HIV Infection rate. MARK LURIE: The levels of movement have increased dramatically in South Africa over the last few years. What's happened is that trade unions have been empowered to negotiate more flexible work contracts, transportation infrastructures have developed, so that people are much more easily able to move from one place to another, and HIV, like other infectious diseases which follows... which spread by individuals, will naturally follow the flow of the movement of individuals.
CHILDREN IN UNISON: AIDS. (TEACHER SPEAKING ZULU) CHILDREN IN UNISON: AIDS.
MARY CREWE: We've fought an epidemic which is at every level and in every respect irrational, and we've fought it rationally, so we've expected that people would take on the epidemic in a rational way when it's driven by absolutely irrational forces. FRED DE SAM LAZARO: Sexuality, that is. Crewe says it's an issue the leadership at many levels has been reluctant to address. Nelson Mandela, for example, only mentioned AIDS once in his tenure, in 1998. His successor, Thabo Mbeki, was criticized for seeming to reopen a debate over whether AIDS is caused by HIV. Scientists say it only distracts from the tough issues involved in implementing the AIDS plan.
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| Churches confronting morality and sexuality | ||||||||||||||||||||
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FRED DE SAM LAZARO: Churches in this mostly Christian country have long taken on the moral leadership role, but church leaders admit they failed where AIDS is concerned.
FRED DE SAM LAZARO: Dr. Nelda Swart and colleague Margaret Muchai, who work for a church-based health service, say the churches' squeamishness reinforces the stigma of AIDS. Many AIDS patients are abandoned by family and community. Like Louisa Godsha, they're often left to die.
FRED DE SAM LAZARO: Swart and Muchai say it is in fact people like Louisa Godsha who have forced churches to face the AIDS crisis. MARGARET MUCHAI, Christian Service Foundation: The rippling effect has now touched the church, where the church is sitting with having to give out food vouchers, where the church is sitting with having not just to do the funerals, but to take on the burden of taking care of those that have been left behind. I must say that, at the moment, the South African Church is very awake. |
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| A crisis of epidemic proportions | ||||||||||||||||||||
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FRED DE SAM LAZARO: There also has been little leadership from the business community, run mostly by whites who are not directly affected in large numbers by HIV, however, businesses slowly are starting to realize that they're losing customers, according to economist Whiteside, who in an upcoming book cites a study done by a large retail company.
FRED DE SAM LAZARO: But Bongali Khumalo expects that all those who have stood back in the past -- business, churches, and government -- will step forward. Khumalo is a corporate executive who was recruited by the government to spearhead the overall AIDS effort.
FRED DE SAM LAZARO: What has perished for many South Africans is the dream of a prosperous, hopeful nation at the helm of a continent. Pastor Fano Sibisi ministers to a rural church in Kwazulu Natal. REV. FANO SIBISI: I think it's one of the darkest periods in the history of this country. Having overcome apartheid, having gained our freedom, we're dying, and are not able to experience it.
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FRED
DE SAM LAZARO: But an already difficult task has become much more complicated
by one of the worst HIV epidemics in history. The modern infrastructure,
the new democracy have not helped, and the numbers are staggering. Already,
one in ten South Africans is HIV-positive, and as more HIV infections
convert to AIDS cases, the epidemic is becoming visible. 
FRED
DE SAM LAZARO: Families are especially hard hit. One in five pregnant
women in South African clinics is HIV- positive. The AIDS virus accounts
for most pediatric cases in hospitals. And the worst is yet to come,
since most of the infected have not yet developed AIDS symptoms. In
fact, most don't even know they're HIV-positive, and many still feed
an infection spiral that is creating about 1,700 new cases every day.
So dire are the predictions that economist Alan Whiteside says a new
word has been created to describe the situation. 
ALAN
WHITESIDE, University of Natal: I came across a term which I hadn't
come across before, used by some people from the World Bank, which is
emiserization, and it describes the process of becoming more miserable.
The levels of misery and impoverishment that we're going to see in rural
and peri-urban South Africa are just not appreciated yet, and it's something
that fills me with horror. 
MARK
LURIE, Public Health Scientist: If you wanted to create the conditions
conducive to the spread of HIV, What you would like to do is find as
many young rural men as you could, remove them to urban centers, give
them easy access to commercial sex workers and alcohol, and very soon
you'd have an HIV epidemic on your hands. 
FRED
DE SAM LAZARO: Unlike other African nations, South Africa had resources.
Soon after the new government took over in 1994, it crafted a comprehensive
AIDS plan that looked at care, treatment, research, human rights, and
with private groups launched an AIDS awareness campaign. 
FRED
DE SAM LAZARO: So why didn't awareness translate into changed behavior?
Why is condom use much lower than in many African countries where they're
far less available? Why did the grand plan fail to yield results? Mary
Crewe has a theory. She runs the center for AIDS study at the University
of Pretoria. 
MARY
CREWE: People didn't recognize that to implement the plan took a lot
of courage: Giving real creative leadership, of giving some vision of
tackling the difficult issues of how South Africans behave sexually,
and what the kind of breakdown of family life has meant for the epidemic;
and for a real vibrant leadership to say, our behavior is wrong, and
what we're doing is wrong, and not wrong in a moral sense, but wrong
in the sense that that's what's driving the epidemic, and that we have
to address it. 
DR.
NELDA SWART, Christian Service Foundation: You cannot do AIDS education
without addressing sexuality and sexual behavior. Those are not topics
that the church has ever been comfortable with, especially not from
a pulpit or not as part of an organized church program. 
LOUISA
GODSHA: The future... It's done for me. It's done for me. Even if I
die, I will have nobody to... to bury me. My son is too small, ten years
old. Nobody helps. I'm struggling on my own. 
BONGALI
KUMALO: The question of credibility, as far as the leadership of government
is concerned, is very, very critical, and that is where I'm going to
be assisting government to provide leadership, to provide championship
and encouragement, so that we participate in this fight against HIV
and AIDS by stimulating participation without usurping responsibility
and initiative from the people who are taking part. If we lose this
fight, we perish. 
FRED
DE SAM LAZARO: Even if the epidemic is stopped in its tracks with no
further infections, the HIV epidemic and its deadly AIDS sequel will
still be among the gravest ever witnessed, and could claim the lives
of up to a quarter of South Africa's 38 million people.