Can I still work? – After HIV-infection life goes on
A 24-year-old woman, her mother and a nurse sit in my little office for a consultation. It is hot and humid, and one can almost cut the nervous tension. I have been asked to give the young woman the dreadful news of her HIV-test result and at the same time help her process and understand her new realities. She stares at me with wide-open eyes and seems detached as I give my explanations. The mother bows her head to hide her tears. In the end, the young woman wants to know just one thing: “Can I go back to work tomorrow?” What a banal question in the face of such a personal disaster, one may think. But it’s the most frequently asked question I get in such sessions, and I’m not surprised.
It can take a long time before the illness sets in. In South Africa it typically takes four to eight years between infection and full-blown Aids. That is an inconceivably long time, so inconceivable that it is meaningless for people living by the day in poverty. For them, only the here and now counts, and perhaps the day after. They wonder whether their families will have enough to eat tomorrow. Their perspectives are short-term – life can be short in South Africa which records the highest rate of sexual violence in the world, where murder is a daily routine, and where about 40% of the population in townships is unemployed.
The poor don’t plan for years ahead – every day is about pure survival. Many of the poor don’t pay much mind to the potential implications of a little sexual pleasure, they just want to enjoy the brief moments of fun and joy they can have in their dreary lives. The poor must produce as many children as possible so that they will be taken care of in old age. There is no time to waste on moralistic considerations. They follow the direction of the traditional leader – the chiefs, the elders and the sangomas. Those who catch the virus because traditions couldn’t save them stay silent and suffer quietly on their own. They blame themselves, stigmatize themselves and surrender themselves to the vicious cycle of ostracism.
We Christians from the enlightened West like to say that death is part of life, and yet we do anything to suppress the idea of death. In Africa, that is not so easy, because death is ever-present, day by day. The average life expectancy has dropped to well below 40 in some regions, child mortality is very high, and the pandemic claims millions of lives. Every day in South Africa about a thousand people die from Aids-related causes, and the economically most active age group, between 15 and 49 years of age, is particularly hard-hit. The banality of death is always shocking for those from the sheltered and contained North.
Once I had to go to Cape Town’s mortuary to identify a tourist who had died in an accident. The waiting room was a hive of activity, with black families waiting and kids running around the corridors. They had come to see their loved one a last time. Somehow one strikes up a conversation and hears the most awful stories about killings and murder. Now and then children would excitedly call their mother because the uncle was ready to be viewed. Brown paper bags containing the personal effects of the deceased changed hands. And in the midst of it all, undertakers were looking for their corpses.
The boisterous kids, the silent tears and empty looks, and the tales of misfortune –I was reminded once again of the proximity between life and death in my adopted home. The daily confrontation with the end, the pervasive disease, the constant battle for survival in a world without safety nets – these are quite different existential threats than those faced in distant Europe. And in such an environment Western methods of social education are not going to be effective.
Sometimes I am appalled by the attitude of some aid organisations, which act as if their motto is: “Let’s show these blacks how to do it”. At some point, that arrogance will be corrected by the encounter with reality. Such aid workers must learn how to deal with the sense of unawareness and indifference of poverty. They will have some sobering experiences, such as when donor money goes missing.
I am horrified when I recall my smart proclamations as a youthful, naive peace activist in Germany. “We are saving humanity!” That’s how simple, how obvious, it seemed then. Today I know that I am able to act on behalf of the people of the South only because of what I have experienced learned and felt. One needs to be active in the field of action to know; it is not enough when the representatives of the many aid organisations jet around the world’s poverty zones to evaluate projects from time to time. I am convinced that we, as the Church, should review this humanitarian landing strip circus in our own circles. But I digress, that is another argument entirely…
As far as the work with HIV and Aids is concerned, only in situ is it possible to understand the sheer width of the chasm between the prosperous North and the impoverished South. And only when we comprehend the size of that gap can we start to build bridges and arrive at a true partnership.
Translation from the book:
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