God, AIDS, Africa & HOPE

Reflections / Gedanken

History: The minister recommends beetroot

Bartholomäus Grill

History: The minister recommends beetroot – The long silence and the mainly scandalous Aids policy of the South African government

The first time I heard the joke was in Cape Town’s Company Gardens, the exquisite park in the heart of the city which the Dutch settler Jan van Riebeeck had planted after landing in Table Bay in 1652. In one corner of the Gardens, as the locals call it, there is a Victorian toilet block. Sitting on a bench in front of it, a young man told his joke. “Did you hear? The toilets are going be converted into an anti-Aids station so that everybody who has just had sex can shower off the viruses.”

To understand the gag one must know that Jacob Zuma, then the former vice-president of South Africa and a top leader in the ruling African National Congress, had been charged with rape. The accuser, a family friend of Zuma’s, is HIV-positive. Asked by the trial judge whether he wasn’t concerned about having had unprotected sexual intercourse with his accuser, Zuma answered that he had protected himself by taking a shower after the act. Since then, many South Africans have mocked the future ANC president for his “delayed precaution”. But the tragic truth is that quite a few people regard it as a valid protective measure.

I have heard the Zuma joke in Namibia and in Kenya, even in a remote village in Lesotho. It is emblematic of how the African élite deals with the disease. Many ministers and parliamentarians carry the virus, but so far few have mustered the courage to out themselves publicly. There are notable exceptions: Zambia’s former President Kenneth Kaunda publicly revealed that his son Masuzgo Gwebe died from Aids-related causes in 1986. Later, Nelson Mandela openly acknowledged that the death in 2005 of his last surviving son, Makgatho Mandela, was Aids-related, as did Inkatha Freedom Party leader Mangosuthu Buthelezi after losing his son, Prince Nelisuzulu Buthelezi, the year before.

The ubiquitous silence is especially striking in South Africa, the country with the highest prevalence rate on the continent. The Mbeki government’s Aids policy was marked by expurgation, minimisation and bluster, and several members of the cabinet simply denied the facts. They held on to the wisdom pronounced by the former leader of the influential ANC Youth League and member of parliament Peter Mokaba, who said in a 2002 interview with The New York Times: “HIV? It doesn’t exist.” So the virus doesn’t exist, it’s a fiction, and Aids is an invention of “white” pharmaceutical corporations who want to force poor country to buy their wonder drugs. Mokaba again: “Where the science has not proved anything, we cannot allow our people to be guinea pigs. Antiretrovirals, they’re quite dangerous. They’re poison actually. We cannot allow our people to take something so dangerous that it will actually exterminate them. However well-meaning, the hazards of misplaced compassion could lead to genocide.” Making the rounds in ANC circles was a 144-page document which spoke of a “syndicate of white interest groups” which supposedly directs a massive political and commercial campaign for antiretroviral drugs; that “omnipotent” body seeks to subjugate, exploit and kill Africans with their poisonous medicines.

No wonder that the South African author Rian Malan – who has written nothing worth reading since his international best seller My Traitor’s Heart – was roundly applauded by the ruling faction when he claimed in the British journal The Spectator that a “powerful alliance” of pharmaceuticals, Aids activists, aid organisations, economists and hysterical journalists deliberately inflate Aids statistics. The multinationals, Malan maintained, are driven by naked greed. Such conspiracy theories are common in South Africa, and the people have good reason to think the worst. During the apartheid years one Dr Wouter Basson, a cardiologist, led a research team commissioned by the racist regime to investigate ways to sterilise the black population or to exterminate whole townships under the cloak of deliberately unleashed diseases.

Mokaba, the firebrand Aids denialist, died from Aids-related causes. Every ANC comrade knows it, but nobody will say so. Presidential spokesman Parks Mankahlana shared Mokaba’s fate. His family bars the press from writing the truth. “He died of an illness,” it said in the officially sanctioned obituary. R.I.P. – requiescat in pace – nobody must speak ill of the dead.

Under Mbeki, South Africa’s high and mighty pursued a culture of denial, so it isn’t surprising when the wildest rumours circulate amid the population, and when particularly rural people, misled by government policy, solve the problem in their own ways. There is the story about a young girl from Bergville, in the northern Drakensberg, who was stoned to death after revealing her HIV status. There is the old sangoma who announced that he can cure Aids in liaison with the ancestors. There are the unhinged pastors who consider Aids “God’s punishment”. There are any number of sugar daddies – older, prosperous gentlemen – who are absolutely convinced that they can immunize themselves from HIV by having sex with virgins. There are two-year-old infants who are raped by men who believe that their barbaric crime will guard them from the virus. And everywhere in the private sphere that silence, even though no other state spends so much money on public Aids education. “Nobody talks about it, which I’ll never understand,” says the American anthropologist Susanne Leclerc-Madlala, who married a South African. One only whispers about “this thing”.

That silence has followed us to the top: into the chanceries of bishops, the ministerial office, the presidential setting. Question time in South Africa’s parliament in Cape Town, October 2001. President Thabo Mbeki is scheduled to discuss his cabinet’s Aids plan. But he doesn’t answer any questions. He just reads his prepared text, monotonous and unwavering, with a shot of the arrogance which comes with power. The president expresses doubt about South Africa’s high rate of infection and quotes outdated statistics from the World Health Organisation. The foreign observers in the press gallery shake their heads in disbelief. How can the president of the country with the world’s highest number of HIV cases – even then already 4,7 million people – trivialise the situation? What makes him dispute the causal relationship between HIV and Aids? What is he trying to accomplish with his statement that he doesn’t know a single South African who has died of Aids?

The pundits offer simple explanations: Mbeki is acting like a typical African – he is obstinate and stubborn. He is, the commentators say, like so many politicians on the continent, a disciple of “voodoo science”.

But is it really that simple? To understand Mbeki’s stance we must once more take into account how the Aids pandemic is perceived around the world: as a “black” condition which emerged into the light at the end of the 20th century from the medieval darkness of Africa. It was here that the virus jumped from beast to man; it was here that it began its morbid passage around the globe. In the popular imagination, the catalysts for the calamity were primitive jungle people who eat monkeys. It is further received wisdom that Africans spread the virus through their uncontrollable sexuality. They just like to screw around, say the chattering classes and the debate societies around the office water coolers. But these prejudices are peddled even in sophisticated circles. They correspond with the preconceived image of Africa, backed by a long tradition in Europe. Africans project the wild, brutish, uncivilised – “because a black man is something abominable”, as it goes in the libretto of Mozart’s Die Zauberflöte.

A politician like Mbeki, who drafted the vision of an African renaissance – a continental regeneration – must be anguished by these perennial stereotypes. As an African man he already has fundamental difficulties speaking about sexuality. Add to that the fear of racist prejudice by whites who, as Mbeki sees it, regard Africans as rampant sex beasts who can’t control themselves. And what is he supposed to think when he receives an e-mail from a white engineer declaring that Aids can’t spread fast enough so that all the “kaffirs” might die? Mbeki belongs to a generation which dedicated its life to the struggle against apartheid, a system that cultivated such perverse mindsets. Now that apartheid has been conquered, the liberated are dying. Hands are wringing in search for an explanation. And in the process one discovers the hypotheses of David Rasnick or Peter Duesberg, two of the so-called Aids dissidents from the United States. They speak about the “virus lie” and “deadly deception”. They dispute that HIV is sexually transmitted or that it leads to Aids. They insist that poverty is the real reason for the accumulation of deaths. South Africa’s power élite lapped up such false doctrines, because these allowed them to ascribe the pandemic to the abject living conditions that are a legacy of apartheid.

The most outlandish rumours are making the rounds about the origins of the pathogen. According to one, it was spread by white doctors in the guise of a polio vaccination drive in Congo. Or the Pentagon in Washington developed it for military purposes and tested it on black people. Or Aids is a phenomenon of the perverted culture of the North, a gay disease spread by Californian men who are at it like dogs on heat (incidentally, that kind of nonsense is also bandied about beyond Africa). The ostensible proof for that dull-witted theory is that the virus was first isolated in the blood of homosexuals in 1981. The lowest common denominator in any of these conspiracy theories always refers to the mortal danger having originated elsewhere, from those who also perpetrated slavery and colonial terror. Hell always is other people – a classic defence manoeuvre in Africa.

The residents of the townships are all the more receptive to these tales because Mbeki’s minister of health, Dr Manto Tshabalala-Msimang, believed them. For years she blocked the authorisation for the use of antiretroviral drugs because she considered them harmful and even deadly. It required a judgment in Pretoria’s High Court, upheld by the Constitutional Court in July 2002, to force the government to change course. Tshabalala-Msimang, a medical doctor by profession, continued to insist that too little was known about the toxic side-effects of anti-Aids cocktails. In any case, she declared, her country offered adequate medication in the fight against opportunistic infections which Aids patients suffer. She recommended garlic, beetroot, olive oil – preferably cold pressed, that is really cheap in the slums.

The stubborn health minister should become the Ambassador of Blondes, one acerbic columnist suggested, referring to the stereotype of blondes as being not very bright, which also persists in South Africa. The president shielded his health minister, and shared many of her cranky beliefs, and so she could continue in her office for the rest of Mbeki’s term to commit all manner of nonsense.

Stefan Hippler had the opportunity to speak with Tshabalala-Msimang at a national Aids conference in Durban. The exchange was initially rational, but when the conversation turned to antiretroviral drugs the minister reverted to the fantasy world that has caused her to become an international joke.

And all the while an estimated 2,000 people were infected every day in South Africa. The government was not prepared for the disaster and reacted much too late. Dr Mamphela Ramphele, now a director at the World Bank in Washington and previously the head of the University of Cape Town, criticised the Mbeki-government’s Aids policy as “irresponsible, bordering on criminal”. The world can learn a lot in South Africa, about making hair-raising mistakes and culpable negligence, about abjuration and denial and trivialization, about taboos and myths, about superstitions and obtuse conspiracy theories, about culpability and opprobrium and humiliation in the shadows of a tragedy. But the world doesn’t learn, because it is a member of a cartel of silence and disavowal.

It was not until World Aids Day on 1 December 2006 that the Mbeki government adopted its dangerous health policies, presenting in alliance with representatives from business and civil society a new Strategic Aids Plan. This was announced by Vice-President Phumzile Mlambo-Ngcuka, who was commonly regarded as a key figure in the fight against the pandemic. For the first time since apartheid a top official document acknowledged the dramatic situation, noting that the increase in mortality rates among mothers and children belong to the most devastating consequences and represent a massive threat to South Africa’s ability to accomplish the Millennium Goals of development. After years of denial and trivialization, such an admission signified a radical transformation of the national Aids policy. In 2010 the government of South Africa under President Jacob Zuma acknowledged before the Soccer World Cup 2010 the magnitude of the pandemic and changed complete course, initiating a country-wide drive for testing and treatment which continues until today. The game has certainly changed in our days, but it took too long and the cost was too high.

Translation from:
Gott – Aids – Afrika
Hardcover: 207 pages  –  Publisher: Kiepenheuer & Witsch GmbH (August 31, 2007)
Language: German  –  ISBN-10: 3462039253  –  ISBN-13: 978-3462039252
Gott – Aids – Afrika
Paperback  – Bastei – Luebbe  –
Language: German  –  ISBN-10: 3404606159  –  ISBN-13: 978-3404606153

Filed under: General, HIV and AIDS, HIV Prevention, HIV Treatment, HOPE Cape Town Association & Trust, HOPE Cape Town Trust, Medical and Research, Networking, Politics and Society, Reflection, Society and living environment, , , , , , , , , , , , , , , , , , , ,

HIV, Development and HOPE – thoughts of a Catholic priest

Being a Roman - Catholic priest and working in the fields of HIV and social development in Africa has its challenges. You will find stories and reflections about my work, about the church, South Africa and Africa, about politics and whatever triggers my interest. You are most welcome to leave a comment or to get in touch with me. Blogging means to initiate thoughts and discussions and for the writer to formulate what is loosely running around in the heart and mind in need of being sorted and spoken out.

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