National

Saved by 'township treatment'

Mia Malan

30 Years after the first cases of Aids were reported, 17 since the end of apartheid -- here's a story about how the virus has helped bridge division.

Taxi to Soweto, the 1990s hit comedy movie, flashed through the two sweating men’s minds as they drove towards South Africa’s biggest township early one morning in November 2009.

But the scenario in which Duncan du Toit (39) and Derrick Mommson (31) from the Johannesburg suburb of Greymont found themselves was no comedy. They were racked by tension.

“We told each other: ‘We’re white people here sticking out like sore thumbs in this black area.’ Soweto felt like a different planet. It felt like we were never going to get out alive,” Du Toit said.

In an effort to break the strained atmosphere inside their car they nervously giggled that their old two-door Opel Corsa, with its dented doors, certainly was not out of place in Soweto. “No one in their right minds would hijack us, right?” Du Toit said, joking.

But nothing eased their anxiety. “It was our first time ever in a township,” said Mommson. Ahead of their departure, Du Toit’s mother had added to the panic when she wagged a finger at him and barked: “My kind, jy moet versigtig wees, hulle gaan vir jou doodmaak daar in Soweto!” [My child, you must be careful, they’re going to kill you in Soweto!]

Du Toit and Mommson did not need this to fuel their concern. At the time they already had plenty to worry about. Both had recently discovered that they were infected with HIV and needed treatment urgently and neither had medical aid or money to pay for the antiretroviral drugs (ARVs) they needed to keep them alive. They also could not afford the accompanying laboratory tests that cost almost R3 000 each.

The couple initially approached a public health clinic in Bedfordview for ARVs, but Mommson said they were “sent from pillar to post” to such an extent that they fled the centre, “confused and without hope”.

It was in this frame of mind that the men felt “forced” to make what would eventually be both a physical and a mental journey: from their lower-middle-class and largely white suburb to the Simon Nkoli Health4Men Clinic, run by the Anova Health Institute at the Chris Hani Baragwanath hospital.

They had read about the “gay friendly” facility on the internet—which they did not believe. “A gay-friendly clinic in Soweto? Come on!” Du Toit remembers thinking. But after a tense discussion he and Mommson decided that Simon Nkoli was their only hope.

Once at Baragwanath’s sprawling premises, they could not find the clinic. Their panic mounting, they called receptionist Lucky Mofomakwane for help. He agreed to meet them at a nearby petrol station. “We told him he won’t find it hard to spot us—we’ll be the only two white boys hanging around,” Mommson said. But despite Mofomakwane’s friendliness, Du Toit remained ill at ease. Just a few months before he had been admitted to a public hospital in Brits, where he said he received “horrific” treatment. “I was basically left to die by nurses after a black doctor prescribed the wrong treatment.” Du Toit’s condition deteriorated and, to save his life, his mother “dug deep” to pay R130 000 for a transfer to a private hospital.

When they eventually arrived at Simon Nkoli clinic, Du Toit and Mommson joined a queue of about 50, “mostly unemployed”, HIV-infected people. They tried to avoid eye contact with their fellow patients. “Everyone was staring at us; it felt like we were under a microscope,” said Du Toit. He and Mommson engaged in “meaningless” conversation with each other to try to ignore the scrutiny with which they were being regarded.

After waiting for “hours and hours” Mommson felt his “nightmare was coming true”. His partner, too, was undergoing “intense” mental torture. “In my head I was wondering: ‘Is this God’s punishment for me getting Aids?”’

What the two men did not know was that their presence was causing turmoil similar to what they were enduring. The news that Simon Nkoli clinic was being visited by two white patients had spread like wildfire. It had “alarmed” Dr Oscar Radebe.

A few years ago, during his community service, Radebe had several disconcerting experiences with white patients. “One simply refused to be touched by me,” he said. Another declared that he would rather have a white doctor operate on him; once he saved the life of a young white woman who had taken a drug overdose. “She left the hospital without so much as a thank you,” he said, still smarting at the slight.

These experiences “scared” Radebe. “It made me believe white patients mostly don’t think I’m qualified enough to treat them. I felt that a young black doctor like me doesn’t fit their picture [of a competent medical practitioner]. It hurt me.”

Simon Nkoli clinic’s staff members are all black, with the exception of its British manager. Like Radebe, they feared they would not meet Du Toit and Mommson’s expectations. After all, they reasoned, white South Africans had been exposed to the country’s excellent private health sector: how would they compare? The pressure, in a way the facility’s staff had not felt before, was on them to deliver a quality service to the two whites.

In the waiting room Du Toit and Mommson slowly moved to the front of the queue. But after many hours of waiting, both men still felt “intimidated by everything”—not least the “loud” isiZulu of their fellow patients that assailed their ears and of which they understood not a single click.

Then a young black man appeared. The waiting room fell silent. “This is obviously the doctor,” Du Toit thought. “This is it,” thought a perspiring Mommson—simultaneously relieved and terrified by the sight of the doctor.

Then something happened that shocked the men and, said Du Toit, caused them to glance at each other in “total surprise”: the doctor called out both their names. Noticing their reaction, Radebe told them: “I can consult with you guys as a couple, if that’s what you prefer.”

In white Johannesburg, said Du Toit and Mommson, their doctor had never behaved in this way. He always insisted on seeing them separately, never acknowledging that they were a gay couple and always seeming uncomfortable in their presence.

Du Toit and Mommson entered the consulting room. As they took their seats Radebe asked them: “So, hoe het julle die pad Soweto toe gevind?” [“So, how was the road to Soweto?”] This young black man working in the dark bowels of Baragwanath was speaking to them in perfect Afrikaans. Again the white men looked at each other. Again they were “caught totally off guard, not knowing what to think”, Du Toit said.

Radebe asked them at length about their backgrounds. “Our previous GP would hardly greet us, then get straight into our medical problem. Dr Radebe wanted to know about us as people. He asked: ‘Where are you guys from? Tell me about your family. Are you scared today?’”

They were not used to “being treated like human beings”, said Mommson. He and Du Toit were more accustomed to being “treated like statistics”—just more numbers on a South African path strewn with cold and clinical measurements of death and despair.

The couple returned home so astonished by the service they received at Simon Nkoli clinic that they told everyone in their HIV support group in Rosebank about it. In the next two months the Soweto clinic registered more than 20 white patients—mostly Afrikaners, some gay, some straight, some driving in from as far as Vereeniging and Boksburg. And so began what Radebe described as an “extraordinary path” for clinic staff and their white patients. “You know, Aids is an issue that usually divides society, but in this case it did the opposite.”

But the road to a new consciousness was not smooth, acknowledged Dr Michael Laurino, the clinic’s manager. “White patients had attitudes. They wanted to be seen immediately — They saw themselves as a bit better than everyone else,” he said.

“This is true,” said patient Hendrik Lategan* from Edenvale on the East Rand. “At the clinic, while waiting, I counted the hours I was missing at work. I was angry, frustrated. It felt like they were deliberately making me wait for longer because I was white.” But he said he later realised that “this was just my perception. Everyone waited. White and
black ...”

Du Toit and Mommson’s glowing reports about Simon Nkoli clinic clearly created unfair expectations. Because, despite Radebe’s liberalism, the facility remains a township clinic like most others: understaffed and overburdened. Like other white patients following in their footsteps, Hannes Muller* of Boksburg fired off an angry email to the clinic indicating “extreme dissatisfaction” with its service.

Although clinic staff insist they take such communications seriously, they are also sometimes offended by them. “Such emails are different to the way in which black patients complain. In our culture we rather come and speak to someone personally, even if it’s not directly to the person you are complaining about. You would never complain in such an impersonal and rude way,” said Radebe.

But the clinic “took on board” the white patients’ grievances, he said. It has since introduced a strict appointment system, which means patients wait an average of half an hour to see him, compared with the previous norm of well over two-and-a-half hours. “A system like you find in doctors’ rooms in the white suburbs,” Radebe said, adding: “We all have something to learn from one another.”

Through it all Radebe has remained “unsettled” by the isolation experienced by most of his white patients. “Because white patients generally stay on their own, whereas blacks live with their families and in township communities, I find that white HIV-infected people usually have very little community and family support. All they basically have to rely on is a GP.”

Radebe soon concluded that he had to treat his white patients differently and had to become a “different kind of doctor”.

“I realised I needed to become a kind of counsellor to them and help them to start support groups,” he said. “I had to move away from a traditional doctor’s role, just treating people medically.”

Sometimes, he said, laughing, he has to deal sensitively with the relationship issues often experienced by his gay patients. On one occasion, Radebe said, Du Toit and Mommson did not enter his surgery together, as they usually did. “I asked Derrick: ‘Where’s Duncan?’ Derrick replied: ‘He is waiting outside. He made me cross last night.’” But the doctor would not tolerate this and compelled Du Toit and Mommson to reconcile. Such personal service is clearly appreciated by the men, who now bake a cake for Radebe ahead of each appointment with him.

“We always take something nice along to Soweto to give to someone,” said Du Toit. “These black people have become our own family. And the clinic people always give us personal thank-you cards for the gifts we bring them. That is so very thoughtful.”

For its white patients the township clinic has become a “home” where they feel “normal”, said Mommson. “You feel so judged when you have HIV. On top of that we’re gay. That’s double judgment. But when we go to Simon Nkoli we feel like ordinary people. A receptionist isn’t glaring at us over her glasses. We don’t feel like bad moffies with Aids.” Instead, said Du Toit, they feel loved in a place where they previously thought only “hate for the white man” existed.

Simon Nkoli is a place where minds have shifted, perceptions and prejudice shattered—on all sides.

“I heard good things about Simon Nkoli but I still never thought a black doctor would deliver a good service,” said Henk Wiewers* of Boksburg. “I was wrong, big time. Dr Radebe knows more about Aids than any white GP I’ve ever visited.”

Radebe said the transformation in attitudes among his white patients has also changed him, forever. “I grew up with many of my own problems with white people.” As an example Radebe cited the language of most of his white patients. “As a child born in 1976, Afrikaans was the tool of white oppression,” he said. “It was the language of my enemy; the language one simply did not speak.”

But now, just as some of his white patients are learning rudimentary isiZulu from fellow patients in the queues at Simon Nkoli, Radebe is learning Afrikaans—from his patients and from a dictionary he recently bought. He said he has had to learn Afrikaans to communicate better with his new clientele. “It was about necessity as well as respect. Like I always say—it’s not just whites who need to change in this country; it’s all of us.”

Back in his cottage in a backyard in Greymont, Du Toit knows that “something very special” has happened to him and his partner as a result of their Soweto experience. “I don’t think I’m exaggerating when I say I’m alive today because of a township clinic,” he said. “Because of this clinic I have come to know black people as human beings. In turn, I feel more human.”

Mommson agreed. “When we were told we had Aids we thought we were dead. It sometimes makes me smile to think that, instead of dying, this situation has made us more alive.” Du Toit glanced at his partner, nodding his head. “Ja, it’s unbelievable. The experience of Aids and the things that have happened at Simon Nkoli have become a window through which I look at the world to separate right from wrong.”

* Not their real names.

Mia Malan works for the Discovery Health Journalism Centre at Rhodes University


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