CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by Mike Pothier, South Africa, November 1998
THEME = AIDS
South Africa has been slow to tackle the crisis posed by the spread of AIDS
In the 1980s, while the disease was wreaking havoc in parts of central Africa, it had not yet reached the southern tip of the continent. There were a few isolated cases, predominantly among the gay community and those who had travelled overseas or were intravenous drug users
At that time, under the white minority government, little attention was paid by the health authorities to the impending arrival of AIDS in South Africa. Even when the disease's pattern of migration from the middle of the continent towards the South was established, no concerted campaign of education and prevention was initiated. It is also probably true to say that civil society, including Non-Government Organisations (NGO)s and churches, were preoccupied with the struggle for democracy. Although they had a keener appreciation of the threat than did the government, relatively little was done.
In more recent times, the effort against AIDS has been stepped up considerably. Government and civil society co- operate fairly well in awareness campaigns, and there is widespread educational work in schools, workplaces and the like. Enlightened legislative measures have been enacted, to prevent discrimination against people with HIV/AIDS when it comes to employment and membership of medical-aid schemes. Growing awareness and a willingness to alter lifestyles has resulted in a decrease in the incidence of AIDS among the gay community, echoing the trend in the developed world.
Unfortunately, the same cannot be said of the heterosexual population. South Africa now has the world's highest rate of growth in HIV infections, with an estimated 1,500 new infections every day. Although reeling off a list of statistics can become almost meaningless, it is impossible to avoid doing so if one wants to grasp the extent of the problem
At the end of 1997, a total of 3 million South Africans were infected; this is expected to grow to about 4.5 million by 2005. Given that HIV infections occur mostly among people of economically active age, it is calculated that, by the year 2000, up to 20% of the workforce will be HIV positive. Average life expectancy will drop from the present 65 years to 56 years over the coming decade.
The situation is even worse for the indirect victims of the disease, in particular, the children. Child welfare authorities estimate that 1.8 million children will be "AIDS orphans" by the year 2000. And then there are the elderly. Many of them will endure a poverty-stricken old age, AIDS having taken the children, on whom they would have relied for care and support.
Within the country the disease tends to spread according to a similar pattern to that experienced in the continent as a whole. Thus, the northern and eastern provinces show a much higher incidence than do the southern areas. In KwaZulu-Natal, for example, 27% of women attending pregnancy clinics were HIV-positive in 1997, compared to just over 6% in the Western Cape Province. There are also higher rates of infection in those parts of the country with high populations of migrant workers, such as the mining areas; and it is spreading rapidly along trucking routes from north to south.
These facts are a clear indication that far too little is being done to combat the spread of AIDS. Predictably, the main thrust of the government's approach has been the promotion of condom use. However, while the idea of "safe-sex" - or at least, "safer-sex" - may be of some effect, it does not seem to achieve the necessary change in sexual behaviour. Whether it be young people engaging in indiscriminate sexual activity, migrant workers contracting the disease while away from home and then transferring it to their wives, or the overall consequences of poverty, illiteracy and ignorance of the disease, the fact remains that, unless sexual behaviour patterns change, the disease will continue to spread. At best, condoms will reduce the rate at which it spreads.
Regrettably, neither the government nor many of the NGOs which dedicate themselves to AIDS awareness work, appear willing to speak forcefully on this point. It is objectionable, in their view, to "moralise" to people about their sexual behaviour; as if, somehow, sexual irresponsibility was devoid of moral consequences.
The social status of women in our society, and of African women especially, is another significant factor in the spread of AIDS. Women are still regarded by many men as possessions, theirs to treat as they wish. As a result it is almost impossible for a woman to deny sex to her husband, or to require him to use a condom, even when she knows or suspects that he is infected. In the same way, many men regard it is their right to have sex with a woman, whether or not she is willing, leading to South Africa having one of the highest incidences of rape in the world. Violence against women, rape, their lack of economic empowerment, and their second-class status in general, all contribute to a situation in which AIDS, and other STDs, flourish.
The churches are in the forefront of efforts to alleviate the suffering associated with AIDS. Church-run orphanages and homes are among the few facilities which cater specifically for those infected and those left behind. Remarkable work is being done by the Sisters of Nazareth, for example, among infants and young children with HIV and AIDS. The Catholic Bishops' Conference set up an AIDS desk some years ago, and a few priests and bishops have been prominent in lobbying and advocacy work.
But the churches have also failed to educate and inform their people. In particular, the message of sexual responsibility, and the value of fidelity and chastity, have not been effectively communicated.
South Africa is fortunate, in comparison to many other African countries, in the depth and sophistication of its medical and welfare services. Much research of the highest order is being done into AIDS prevention and treatment. The government is increasingly aware of the threat posed by this disease, and there are numerous NGOs and lobby-groups doing valuable educational and preventative work. The media play an important role in reporting on this issue.
For all that, though, the statistics tell their tale. It seems that we have not yet reached the point at which the enormity of the crisis is sufficiently apparent to persuade people to change their lifestyles. Until we do, we can only expect it to get worse.
END
CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
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