Ntombifuthi Zuma (22) tries to breastfeed her restless baby while describing the illnesses that first killed her father in 1998 and her mother last year.
In detail, she describes their chronic diarrhoea and bleeding, headaches, general weakness and wasting. Both were bedridden for more than a year before they died.
She does not know the name of the disease that killed her parents. If her parents knew what was killing them, they did not tell her or her four younger brothers.
Although her parents’ symptoms are consistent with opportunistic diseases associated with HIV/Aids, when I ask Zuma if she knows anyone with HIV or Aids, she is doubtful.
”Maybe one person who lives by the taxi rank,” she answers.
The community volunteer who keeps an eye on Zuma and her four younger brothers on behalf of a children’s organisation, Thandanani, blushes, shakes her head and hides her face when I ask about Aids.
”No, no. No one talks about that here,” she says.
But she nods vigorously when I ask whether there has been an increase in deaths, particularly among younger people, in the district. ”Yes,” she agrees. ”Too much.”
This is April 2003. In Richmond in the KwaZulu-Natal Midlands — as in many other places in our country — people are dying in their prime and younger.
According to the Medical Research Council, 40% of deaths in 2000 of those between the ages of 15 and 49 were Aids-related. Each year, the percentage increases as the epidemic matures. But communities are still not talking about HIV and Aids.
Psychologists tell us that an initial phase of denial in the face of a massive problem is normal. But after a little while, people usually click into action and try to come to terms with the problem.
But we are still an ostrich nation, refusing to identify what is killing us. Lack of political leadership is the usual suspect, and Minister of Health Dr Manto Tshabalala-Msimang’s recent disintegration into an angry caricature makes her an easy target for blame.
But the failure is both at the top and the bottom. At the bottom, ordinary people do not want to admit that they, and their loved ones, have contracted a sexually transmitted disease or are even vulnerable to getting HIV.
At the very top, President Thabo Mbeki refuses to give HIV/Aids special status as an extraordinary threat. He mentioned HIV/Aids in one sentence of his February State of the Nation address, but preceded this sentence by naming tuber-
culosis (TB) as ”the leading killer-disease”. Although HIV is driving the TB epidemic, Mbeki failed to mention the link between the two.
Mbeki’s deputy, Jacob Zuma, is supposed to be the country’s HIV/Aids leader and chairs the South African National Aids Council (Sanac). But Zuma’s energies have been tied up in overseeing peace talks in the Democratic Republic of Congo and Burundi.
A revamp of the unrepresentative Sanac has been promised for months. But at Sanac’s most recent meeting a few weeks back, the council had to extend its own term of office as it had failed to get new nominations.
Parliament has addressed HIV/Aids half-heartedly, perhaps again because South Africa has a party list system that makes MPs beholden to parties and not constituencies.
One of the few African National Congress MPs who did try to take up HIV/Aids in a concerted manner, Pregs Govender, battled to get support from fellow ANC MPs for her committee’s recommendations on how to mitigate the effects of HIV/Aids on women and children. Govender resigned from Parliament last year.
In contrast, Botswana and Uganda’s Parliaments both have standing committees devoted entirely to HIV/Aids. Botswana offers free anti-retroviral drugs in public health, while Uganda was recently awarded a Global Fund grant to start offering the drugs. Namibia aims to get anti-retrovirals to 200 000 people in the next two years while Mozambique, one of the world’s poorest nations, says it will give 100 000 of its citizens anti-retrovirals in the next five years.
Last year 180 Ugandan MPs out of a total of 280 attended a meeting to discuss how they could promote an HIV vaccine. Yet no more than three of South Africa’s 400 MPs invited turned up at a national meeting of Aids orphans in late 2001.
Taking their cue from national officials, few ANC members of provincial legislatures and local councillors have taken up HIV/Aids in their constituencies.
Dr Alex Coutinho who heads The Aids Support Organisation (Taso) in Uganda says MPs in his country are community leaders in the fight against Aids. ”They know that they will not be re-elected if they don’t do anything,” he says.
Next year is an election year, and HIV/Aids is likely to once again become a political football.
But ordinary people, beyond the Treatment Action Campaign’s activist base, need to claim back HIV/Aids from the politicians and demand better prevention and treatment programmes.
Unless there is general acceptance that HIV/Aids is a serious threat to society that needs urgent action — rather than a private shame to be borne in silence — the official apathy will continue.
We can expect little from politicians without this pressure, particularly as those on party lists are guaranteed their positions no matter how ineffectual they are. — Health-e News Service