Charlene Smith on being misquoted by the president who last week accused her of ‘racist rage’ How do you measure a president’s success or otherwise? By examining those he chooses to blame for his failures. President Thabo Mbeki and the Democratic Party’s Tony Leon have sent long letters to each other about HIV and rape (Sunday Times, July 9). In this correspondence Mbeki noted that I was either “brave” or motivated by “racist rage” in writing in The Washington Post that rape was a characteristic of African society. I never wrote that. I wrote: “In Africa, even if we develop a vaccine or distribute billions of condoms, and the continent is already awash in latex, unless we begin working on male attitudes toward women – and that requires looking at the role of culture, tradition and religion; we will get nowhere. In doing this there is a need to reflect on how modernisation has warped cultural attitudes.” I added: “Writer on African cultural beliefs and African mystic Credo Mutwa notes that African society is traditionally matriarchal and women are considered to have two souls, one in their head and the other in their womb. He says the rape of a woman, in cultural terms, is seen as an attack on her second soul, her womb soul, and is unforgivable. That is why in some communities vigilante groups kill rapists.” My views are neither new, nor surprising. In The Lancet of May 27 Australian researcher Dr Basil Donovan of Sydney hospital and Dr Michael Ross of Houston’s school of medicine noted: “Many African women have little power to decline sex or to insist on safer sex, although they have often been the focus of HIV-education campaigns. The coincidence of sex with power structures that are commonly based on gender makes it clear that social justice and HIV prevention are intimately intertwined.” Mbeki’s letter also quoted research from the Centre for Disease Control in Atlanta, dated September 1998. That research suggested that triple therapy taken soon after a rape would probably ensure that 81% of patients would not seroconvert and become HIV positive.
Since then, research at Johannesburg’s Sunninghill hospital with more than 100 rape survivors showed that not one seroconverted after using AZT and 3TC. A study delivered to the Aids conference by Jean- Pierre Benais and a team from France had identical results. It showed that of 100 rape survivors given anti-retrovirals from five Parisian clinics since June 1999, not one had seroconverted. “Two perpetrators were known as HIV positive and the others refused testing.”
Mbeki, in his letter to Leon, relied on data on receptive vaginal intercourse. Rape is non-receptive, or as I noted in my presentation to the Aids conference: “When I was raped last year I was dry, which meant there was greater genital injury, which facilitates infection if the rapist is HIV positive. In the instance of a woman gang-raped in South Africa – which is true for 75% of those who are raped – more than one of her attackers may be HIV positive, their viral loads will tend to be high, she may be infected with more than one strain of the virus, it is likely the assailants have sexually transmitted diseases and it is unlikely they are on treatment for HIV. The raped woman or child therefore may have multiple exposure to HIV.” Mbeki’s use of two-year-old research shows a lack of understanding of HIV/Aids; anyone who even vaguely follows this most complex of viruses will tell you that nearly two years in the progression of HIV is a long time.
As an example, Judge Edwin Cameron noted that when he was diagnosed in the late 1980s the disease was considered fatal, by 1996 with the introduction of anti-retroviral therapy, and in particular triple therapy, Aids had become a chronic, but manageable, disease. Professor Roy Anderson of the centre for the epidemiology from the University of Oxford noted South Africa as a case of “failure” to manage the disease. “Protease inhibitors and active anti-retroviral therapy mean fewer deaths. HIV is the aetiological agent of Aids. Any discussion about that is a distraction from the enormous task that confronts us,” Anderson noted. And that is what Mbeki is involved in – a massive and inexplicable attempt to distract himself and others from the devastation of HIV/Aids in South Africa. This week Boehringer Ingelheim offered the anti- retroviral Nevirapine free to African countries to stop mother-to-child transmission. It will also pay for this to be shipped to countries. South Africa rejected the offer, asking who would pay for HIV-positive women to be tested. And yet each year South Africa loses 70E000 babies to HIV, according to Dr James McIntyre of Chris Hani Baragwanath hospital.
Ironically, both Senegal and Uganda, far poorer countries than South Africa, didn’t quibble endlessly, they acted against HIV and are seeing declining rates. Professor Thomas Coates of the Aids Research Institute at the University of California this week called the South African stance “genocidal”. Instead of Mbeki seizing initiatives to save South Africans at risk from the disease – and that is all of us – he has adopted a posture of blame. In accusing me of “racist rage” he refuses to accept causal issues around HIV or sexual violence. And yet those changes are precisely those that will generate the sort of momentum needed to advance South Africa as a true democracy respecting human rights; and as an economic engine. His problems are more serious than the criticisms of one small blonde.