Aids myths?
Myths, quasi-myths and questions about Aids abound. Donald McNeil Jnr attempts to demystify the epidemic in Southern Africa
Donald G McNeil Jnr
Despite its size, South Africa is number one in the world in several fields: rugby, cricket, tuberculosis and Aids. One hears too little about the last two.
In 1990, a New York Times colleague of mine stationed here, Chris Wren, wrote a story that, in hindsight, is remarkably prescient.
It begins with Dr Nthato Motlana, then better known as an activist physician than a tycoon, describing a sick young man he had suggested an Aids test to.
“That’s white man’s propaganda,” the man replied angrily. “I’m not homosexual.”
Here was the first wave of Aids myths breaking over South Africa. The young man could be forgiven. The first 215 people to die of Aids in this country, the article said, were almost all gay white males; 26 were flight attendants. What he didn’t know was that up to 60 000 black South Africans were already infected, probably including him, and the number was doubling every eight months.
Poking around the office files, I found some sad and scary things. One was a speech given in 1990 at an Aids conference – by Chris Hani.
It contains these words: “Those of us in exile are especially in the unfortunate situation of being in the areas where the incidence of this disease is high.
“We cannot afford to allow the Aids epidemic to ruin the realisation of our dreams.
“Existing statistics indicate that we are still at the beginning of the Aids epidemic in our country. Unattended, however, this will result in untold damage and suffering by the end of the century.”
An African National Congress health desk document, released the same day by Alfred Nzo, acknowledged that there might be 60 000 infections.
It suggested abstinence, condom use, an end to ostracism of the infected and an end to African taboos about discussing sexuality.
There are now three million South Africans infected with Aids, almost all of them black. Someone messed up.
I also found a clip from the Sowetan of May 30 1990. The headline is: “Condoms are out: Jo’burg women want `sperms not rubber’.”
The reporter, Ali Mphaki, interviews women in Soweto and begins: “Despite worldwide efforts to combat Aids, many women give the thumbs down to the use of condoms. Many contend the condom deprives them of the joy of sex and some even say it should be abolished.”
One – a teacher, for God’s sake – says: “I want sperms not rubber. If my boyfriend loves me, he should know that love begins in bed. I would fire him if he wanted to used the damn thing.”
Another says she never met a man who suggested one, but if she did, “I will tell him not to come and waste my time. Just imagine the whole night with rubber in you. It just does not work.”
Another woman says “Sperms have proteins and I need those proteins.” Another says “I only use plastic when it is raining.” And another: “It should be flesh to flesh.”
The men he interviewed, he said, “dismissed the Aids scare as hogwash” and said “only after seeing an Aids patient would they resort to condoms”. One assumes they have now seen an Aids patient. One hopes the same survey today would get very different answers. One hopes the attractive women whose photos accompany the article are still alive.
I got here in 1995. I was mystified then by the relative silence about Aids, especially from the top. Endless talk about housing, none about all those soon-to-be-vacant homes. Where was President Nelson Mandela on this?
I thought it was because a man who could barely bring himself to discuss dating with a young whippersnapper like Allister Sparks wouldn’t touch such a tender subject, but I was recently set straight by an American UNAids officer who lived here back then. Mandela talked briefly then about Aids and even condoms. The officer assumed he stopped on becoming president because it was undignified. But last month Mandela said he stopped because it upset people.
In 1991, when he endorsed safe sex to some Mpumalanga parents, he said, “I could see they thought I was saying something revolting. After, they came to me and said, `How can you talk about this? You want to encourage prostitution among our children?'” So he quit.
What a pity. The failure to counter myths can be fatal. The conviction, for instance, that the old government’s condom campaign was a sneaky effort to cut the black birth rate was understandable – but ultimately cost many black lives.
Here are some myths, quasi-myths and big questions that I’ve already heard making the rounds in the country or that, given the history of the disease in the United States, will be here soon.
n Quasi-myth: Not everyone infected gets Aids.
It is certainly true that not everyone who has unprotected sex with an HIV-positive person gets infected. Pardon my graphic language – but an intact, wet, un-venereal- disease-infected vagina is a pretty good barrier against infection. Nonetheless, it’s still a dangerous crapshoot.
Then among the infected there are a few people known as “slow progressors”. For some reason, the virus doesn’t attack them as virulently, and they don’t get very sick. No one yet knows why. They’re being intensively studied, of course. It may just be luck.
Some people survived bubonic plague in the 14th century, too. But the odds were poor – it killed a quarter of Europeans in three years. With Aids, if you are a black person from Southern Africa, the odds against you seem to be particularly bad – see below.
n Quasi-myth: Aids comes from grey monkeys.
I don’t know how this weird one got started here, but it’s actually partially correct.
There are three strains of HIV. HIV-1, the most common here, comes from a strain of SIV (simian immunodeficiency virus) found in the Pan troglodytes troglodytes chimpanzee that some Central Africans eat and use for muti. (Sounds crazy, but I’ve seen it with my own eyes and talked with a Cameroonian sangoma about it.)
But HIV-2, the biggest killer in far West Africa, comes from an SIV in sooty mangabeys, which are eaten there. A sooty mangabey is, literally, a grey monkey.
Forget monkeys. Your Aids risk is from sex.
n Myth: There’s a miracle cure.
Nope – not Virodene, not Pearl Omega in Kenya, not oxytherapy, not Kemron, not the African potato, not the swill brewed by Billy Chisupe in Malawi, not dozens of other “cures” sold the world over.
Not AZT either. Some drugs in combination with AZT seem to hold down the virus level. That’s “suppress” not “cure”.
They also seem to be able to prevent – sometimes – transmission from mother to child.
Many things, including plain old vitamin C, “boost the immune system”. But saying something that does that can stop Aids is like selling silk shirts labelled “bulletproof vest”. Buy one if you like the colour; don’t test it.
Drug companies test hundreds of compounds, many of them poisonous. A few always show early promise. But some don’t work for long; some help only some people; some kill the patient.
Weeding out the winners takes lengthy testing, overseen by good scientists who – and this is crucial – are not in line to make money from the results. Virodene isn’t there yet.
n Myth: Organic food and/or vitamins will shield or cure you.
Irresponsible celery-suckers in the vegetarian/vegan/homeopathic/ organic/mega- vitamin/macrobiotic lobby push many variations of this one.
Look, there are excellent reasons for eating pesticide-free fruits and vegetables, avoiding meat and alcohol, quitting smoking, taking vitamins and getting exercise.
It will cut your chances of dying prematurely of heart disease and cancer.
If you are HIV-infected, you may survive longer by living healthier. But it won’t save you from eventually dying of Aids any more than it will save you from drowning.
Dodging new infections – avoiding unsafe sex, avoiding people with colds – may be as important to longevity as what you eat.
n Myth: HIV brewed itself when live polio vaccine was grown in the kidney cells of African monkeys in USlabs in the 1960s; monkey virus must have mutated into human virus and been injected back into African humans during anti-polio campaigns in Zaire.
This had real currency for a while because it sounded so plausible. But HIV has been found in the frozen blood of people infected before polio vaccine was invented.
n Myth: Aids was invented by the CIA in a US Army biological warfare lab in Maryland to kill black people.
I have read that this started as a piece of Soviet disinformation in the 1980s, appearing first in a Moscow magazine citing a report from a magazine in India.
Actually, say people who researched it, the Indian magazine had nothing. The Moscow article had details that made it sound real: the US Army does have a germ warfare lab in Fort Dietrick, Maryland. It’s not a secret.
But there are all sorts of common-sense reasons the US Army or CIA couldn’t have “invented” Aids to kill black people.
Firstly, no one, including nature, has yet invented a disease, from colds to cancer to smallpox to leprosy, that only kills one race.
Human DNA is 99,9% the same; skin colour is an utterly unimportant genetic difference. Only human stupidity makes much of it, as it does of religious differences.
Does anyone think black albinos don’t get the diseases other blacks do? That blacks don’t catch the Hong Kong or Sydney flu? That white and black people who sleep together can’t pass on the Aids virus?
Secondly, lots of the first Americans killed by Aids weren’t black – nor homosexuals, nor junkies. They were haemophiliacs, some of them children, and people who had transfusions after surgery or car crashes. If the CIA was targeting black people or homosexuals for extinction, would it test its disease on white children and white moms and dads first?
Thirdly, the first person known to have died of Aids died in Kinshasa, then Leopoldville in the Belgian Congo, in 1959. Some of his blood was kept frozen and tested two years ago. In 1959, that USArmy lab didn’t exist.
n Myth: I don’t use condoms because:
l They’re no fun – they’re not no fun, they’re slightly less fun. The alternative is death. How fun is that?
l They’re un-African – aw, c’mon. If you can use a cellphone, a ballpoint pen or paper money and still be African, you can use a condom.
I like umqomboti (traditional home-brewed beer) – up to a point. Be flexible.
The dumbest Western invention in history is the necktie, a portable noose. It’s about as African as a moon shot, and yet the “African renaissance” men here wear it as a uniform. Only Mandela, in his shirts, is a lone Adam’s apple crying in the wilderness – the long gulp to freedom. But the fashion looks ready to die with him. I do wish people would stop telling Madiba to shut up.
Incidentally, this “un-African” argument is also popular among some young black Americans, even those whose closest connection to the motherland is having seen Amistad three times.
I find this funny. It’s only three generations since my McNeil ancestors shucked their kilts and left the Hebrides for Brooklyn – fewer than most African- Americans have been American. But after a few New York winters, we figured out that underpants were a smart move, even though I am reliably informed that they are un- Scottish.
The first condom I ever saw was the old dried-up thing my mother found in the pocket of my father’s World War II US Navy kapok jacket, along with a clip of .45 ammunition. (Luckily for him, this was in 1965, and they hadn’t met until after the war.)
A friend of mine described his father’s navy experience in the Philippines: after a big night out, each American boy who hadn’t been bright enough to use a condom was handed a rubber bulb by a medic. He had to fill it with iodine solution, stick the thin end in his penis and try to blast the stinging iodine up as far as possible – ideally to his bladder. The screams were said to be hideous.
If that were the medical option nowadays, I imagine many men would decide a condom was a lot more African than the bulb.
l They’re a plot by white men to cut down the black birth rate; Aids stands for the “American Invention to Discourage Sex”.
Aw, c’mon again. If white American men were really that evilly brilliant, wouldn’t we have figured out the logical flaw there? Either we do want to trick black men into wearing condoms so they won’t make more black babies, or we don’t want black men to wear condoms so they’ll die slow and painful deaths. We can’t have it both ways.
l South African condoms are no good.
This is a myth, but it’s one that I, to my great frustration, am partially responsible for.
Last December, I wrote a 2 000-word article for my faraway paper saying that for years South Africa had been a dumping ground for substandard condoms.
That’s true – but I also made it clear that the vast majority of condoms here are perfectly safe, and that the government has since improved the way it buys them.
When Business Day here ran a ripped-off version of the piece, it was chopped to 400 words and all the explanations dropped, so it started a scare.
But it was true then and is true now that most condoms here are perfectly good. And frankly, even a condom that might tear is better than none.
n Small unanswered question: Thabo Mbeki wore a red Aids ribbon during his victory speech, but why didn’t he mention Aids?
n Medium unanswered question: Why was Aids policy in this country so paralysed for so long and why is Minister of Health Nkosazana Zuma at the centre of so many fights?
I don’t know; I’m not a psychologist. The Ministry of Health is in a death struggle with the pharmaceutical industry over high prices and monopolistic practices.
Some USAids activists hate the industry; others see it as their only hope.
The companies are correct in saying that each new drug involves huge research costs that they have to recoup or go bankrupt.
On the other hand, they make big profits. Suspicion over that runs high in the US too – it was, after all, the country that wrote the world’s toughest anti-monopoly laws.
In South Africa, children and rape victims are the chief pawns in this fight.
One of the world’s premier Aids conferences is to be held in Durban this year. Some researchers are so offended by Zuma’s policies that they are lobbying to get her disinvited as a global slap in her face. The struggle should be interesting.
n Big unanswered question: If the disease started in Congo or Cameroon, why are only about 5% of the adults in those countries infected, compared to 10% of Uganda, 25% of Zimbabwe and Botswana, and 30% of rural KwaZulu-Natal?
Scientists are baffled, and testing all sort of theories. Do people in Southern Africa have more sexual partners? Is migrant labour responsible? Marriage customs?
Do southerners have different habits, like “dry sex” or “wankie,” that cause tears in the penis or vagina?
Does non-circumcision, as among Zulus, lead to more venereal-disease sores? Are there fewer clinics treating venereal diseases?
Or is there something genetic? Was there some sort of proto-Aids epidemic, far back in pre-history but after the Bantu began migrating south, that killed many Central Africans but left more resistant survivors?
No one knows – but for some reason, Southern African peoples seem particularly vulnerable. Watch out.