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The Human in HIV, the I in AIDS

Posted in Health, and Women's issues

Last year I met some women in Kwa-Zulu Natal who blew my socks off. KZN is the province most devastated by HIV/AIDS in South Africa. Almost 40% of the population there is estimated to be living with HIV. One in five children is an AIDS orphan.

School kids near Durban – the capital of KNZ listen to the Ultra-Marathon Team Talk

I was there with the Positive Heroes Ultra-Marathon team. We do outreach work in communities around the race routes. Nothing better proves that HIV is survivable than five healthy, fit people standing up in front of you saying “Hi I am HIV positive and I am running the Comrades Marathon (almost 90km /56 miles) tomorrow”.

That day we were visiting a secondary (high) school about an hour outside of Durban. Parents had trickled in to see what we were up to – and two ladies came over to me and offered me some eggs. They were so thrilled that we were at the school, that we had honoured them with a visit – they had come to welcome us.

But more than that – these eggs were from their own chickens. As we talked, I learned they had a business. They had grown from having one henhouse – supplementing their families’ food store; to building and maintaining three henhouses that held 20 chickens. They sold and bartered the eggs. Fed, housed and clothed their families with the proceeds. And, importantly, were able to send their kids to the school we were visiting. They were very proud of their henhouses and they offered to show them to me.

Not the Egg Ladies, I promised to keep their indentities secret. But very much how their business is conducted.

When we reached their village (a hot, 30 minute walk) I met the rest of the Egg Ladies; there were eight of them all together. They shared equally in the work and the profits. But they shared something else too. A secret only the eight of them (and then me and now you) knew. They hid their ARV (Antiretroviral) medication in the henhouses.

A lot of women discover they are HIV positive when their husbands get ill. They will quietly go off to get tested  – and then equally quietly, try to manage their situation alone. If they were to tell the husband (who most likely infected them), or confront him – often he will force them out of the home – leaving them with no financial support, no food and no shelter for them and their kids.

So they keep quiet and take their meds.

A selection of the ARVs that make up HAART – Highly Active Antiretroviral Therapy

But ARVs are a give away.  The free, SA Government-supplied, regimen requires three tablets to be taken together, twice a day. A whole month is dispensed at a time – so that’s a lot of tabs. The Egg Ladies couldn’t afford for their husbands to see them. So they hid their medication between their hens. A sister told a sister, who invited a friend … and slowly the group came together.

Poultry keeping is women’s work; the men have never found out. And the women grew their secret into a business that supported them. So if they ever did get kicked out – they would have someone to go to. And, the money to get there.

Unity – standing together – the first aim of World AIDS Day.

A friend called a couple weeks ago – distraught because her local hairdresser had to close her doors. I couldn’t quite understand why she was so upset – there are hairdressers throughout Harare (part of Khayelitsha an enormous informal settlement on the outskirts of Cape Town) where she lived. Hairdressers from every part of Africa – at least one on every corner. Couldn’t she just go to another?

“No”, she said: “it’s not that simple.”. This particular Hair Salon – set amidst a warren of informal dwellings – was really a place for my friend’s HIV support group to meet. People live so close together in the townships – very little is kept secret and HIV carries with it stigma, which often results in people being isolated by their communities, family and friends.

No the actual salon – that one needs to remain incognito

So what this group had chose was a venue where it would be completely natural for a bunch of women to gather on alternate Wednesday evenings. . We made a plan and helped the Hairdresser pay her rent arrears. And, far as I know – the gals are still there. SA’s most glamorous support group

Support – being there for people infected or affected by HIV/AIDS – the second aim of World AIDS Day

Last year a colleague asked me if I knew of an initiative that could do with a little help.  He had some money left in a budget he had allocated to HIV – and wanted to put it to good use.

Wille compares running a marathon to living with HIV

Just so happened that I did (no surprise there!). One of Our Ultra-Marathon Runners – Willie Engelbrecht, lives in Robertson – a small town about 90 minutes from Cape Town. When the team was in Cape Town to run the Two Oceans Marathon – we all went up to Willie’s hometown to do some outreach work. He arranged for us to visit two local clinics – Bergsig – in his own neighbourhood (primarily mixed-race**). And Nkqubela – in another informal settlement on the side of the highway (mainly black inhabitants**).

I was amazed out by the work these two clinics were doing. Between them, they see over a thousand people a week. Mostly patients in need of treatment for HIV and TB, but Bergsig also has a forensic nurse – incidence of rape and child sexual abuse is rife in the area. Many farm workers’ incomes are supplemented by free ‘dop’–cheap wine. And alcoholism is endemic. Each clinic does in community visits: caring for the very sick in their homes. Delivering ARVs and food to those who are bedridden.

Nkqubela Clinic and some of the staff

Bergisg was in good shape – the upkeep is supported by the local police station (where Willie works as a Janitor). Nkqubela was struggling a little. Surrounded by shacks and an ever-growing community of unemployed – they were inundated with patients. We spent three hours in their tiny, sauna-hot waiting room with people hanging through the windows: answering dozens of HIV related questions. None of us could bear to leave until everyone knew what they needed to.

So, yes – thanks R – I did know a couple of initiatives that could do with a little help. But what did they want us to do for them?  Fix the bathrooms so they had running water and a toilet that worked? Buy medical equipment? Provide training and information materials?

Nope – they wanted something else and they wanted the same thing. Both clinics wanted an intercom system and a loudhailer.

The long wait times, lack of bathroom facilities and small-capacity room at Nkqubela meant patients were often outside when their appointment was called and they missed it. Putting them back in a line for another week. Bergsig saw such a weight of people that the nurses would spend hours in a day walking up and down to call in patients.

The loudhailers were needed for the community. They would be able to be heard above the everyday din.

So a nice man called Pieter du Toit (a white Afrikaner**), did site visits for us, cost it all out, and installed the systems. He did us all proud – negotiating hardware from his usual suppliers that was way over what we could afford. And he has promised to service they systems for the next five years, for free

Unity and Support from three different communities** working together.

Waiting to be seen.

I wanted to tell you these stories because today is the 24th World AIDS Day. And I wanted to introduce you to some of the people behind the statistics.

We have 5.8 million people infected with HIV in South Africa. Out of a population of 51 million. Just to put that into perspective: our country holds 0.7% of the world’s population – but 17% of the world’s HIV infection. This is a huge challenge – no country on earth has the numbers we do.

But SA is doing a great HIV job in many areas.

Our Voluntary Counselling and Testing program – started by the Government in April 2010, is the largest in the world. Since inception – over 14 million people have tested for HIV.  Two million of them tested positive.

Our ARV program, again the largest in the world – distributes ARVs to 1,7 million South Africans every month. That figure will reach 2 million by 2015.

Healthy and Happy

Our Prevention of Mother to Child Transmission (PMTCT) program – now nine years old, is our stand-out success. 117 000 HIV-negative babies were born to HIV-positive moms in 2011.  Our Mom to Child infection rate has gone from  27% to 4 %. We’re well on track to reach the UN target of ZERO prenatal infections by 2015.

But still, there is work to be done. Every day in SOuth Africa: 500 people die from AIDS and 900 people are infected with HIV . Women of child-bearing age (15 -49 in SA) – 3 million of our 5 million infections – are bearing the brunt of it.

The third aim of World AIDS Day is to commemorate those who are affected or infected by HIV/AIDS. Which is what we are doing together right now. I wanted to share these stories (I had permission from the Egg Ladies and my Glam Friend) because each story of HIV or AIDS is individual – even though the theme is central.

And I wanted to show how the same problem can demand a different response – depending on who and where we are.

(NOTE:  ** I have differentiated between populations groups in this instance only to illustrate that this is a town of considerable diversity. Yet they all come together to solve a problem that affected everyone living there. Many communities are still segregated as a result of South Africa’s political past, through economic disempowerment and by choice – with groups chosing to remain close to those most like them. The Apartheid Policy was engineered by the (then) ruling Nationalist Party – composed mainly of white Afrikaners. Who are still widely reviled today. It is worth remembering that the NP worked closely with the ANC to release Nelson Mandela and facilitate a relatively bloodless move to Majority Rule.  The Nobel Peace Prize 1993 was awarded jointly to Nelson Mandela and Frederik Willem de Klerk “for their work for the peaceful termination of the apartheid regime, and for laying the foundations for a new democratic South Africa”.  Unfortunately old wounds are not as easily healed.)

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  1. silvia

    Thank you sofagirl, the work you are doing is so important and relevant to your country. What camparigirl is underling for the US can also be applied to Itay where very young etherosexual people between 14 and 21 are much more easily infected nowadays than in the past. And I’m afraid the trend is going to increase. Once a year is not enough to broadcast on the telly awareness campaigns when the other 364 days everybody seems to be blind and deaf.
    And this is the country where still today a worldwide known political orgasisation named the vatican recommends not to use condoms but to avoid having sex to fight HIV.

    December 3, 2012
    • THanks Karen – it’s been three days of talks and interviews and whatnot. Reminds me that the work I do is worthwhile. Even though it is sometimes frustrating or dispiriting.

      December 3, 2012
  2. These are such heartwarming stories and many thanks to the ladies who let you share them. Just because ARV’s are readily available (in most countries) and HIV is not a death sentence anymore, it doesn’t mean the conversation shouldn’t go on. A recent US study has determined that HIV infections among young people are on the rise, because of a false sense of security and lack of education.

    December 1, 2012
    • Especially in young gay men – they think ARVs are like popping asprin – so there’s lots of “I’ll think about it tomorrow.” Truth is it will be tomorrow and every single day of your life from then on.

      December 3, 2012

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