God, AIDS, Africa & HOPE

Reflections / Gedanken

Can I still work?

Stefan Hippler

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

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, Society and living environment, , , , , , , , , , , , , , , , , , , ,

Unstained by real life

Stefan Hippler

Unstained by real life  –  Why good intentions often fail in the face of African realities

We are celebrating Mass at Kolbe House, the University of Cape Town’s Catholic chaplaincy. This Sunday we Catholics recall Mary’s Immaculate Conception. It is a real challenge to explain this theme to students. A stainless conception – how is that supposed to work? What is that priest talking about? Related questions come up during a small workshop after the Mass. Of all days, it is on the feast day of the Virgin Mary that we are scheduled to discuss HIV/Aids and sexuality. I notice a poster on the wall. The poster, which bears the logo of the Southern African Catholic Bishops’ Conference (SACBC), was developed in cooperation with the Association of Catholic Tertiary Students. Beneath the image of a black cross with a red Aids ribbon is the slogan, “ABCD Lifestyle campaign: Catholic youth responds to Christ’s call”.

The acronym is an allusion to the ABC strategy which is being used around the world to promote HIV/Aids prevention, but which is also controversial because it neglects women and girls. As explained earlier, it stands for “abstain”, “be faithful”, and “condomise”. The students’ association’s approach to the first two points is identical, but it takes the opposite direction on the third recommendation and adds a fourth one. On the poster, C stands for “Change your lifestyle”, and D issues a warning: “Danger of not living your life to the fullest”.

So the students are called to chastity, asked to resist not just the enticements of Eros but also a series of other temptations. The content of that series of temptations takes me by surprise: crime, corruption, drug use, pollution and vandalism. I’m puzzled as to how sexuality and criminality can be linked in one breath. Even the reference to fidelity leaves a strange taste in the mouth. The young person is being challenged to be faithful to their bodies, families, friends and parish, but concepts such as girlfriends or boyfriends, life partners, wife or husband are not mentioned. And then C and D: change your lifestyle or you’ll risk not being able to live your life “to the fullest”, in line with the Gospel of St John (10:10). Because one might be a criminal. Or a drug addict. Or a litter bug. Or because you could be infected with HIV.

That is quite something from a Catholic organisation. How exactly do we know that a person with HIV cannot live her life “to the fullest”? Isn’t that a rather audacious presumption which contradicts our faith that for God nothing is impossible?

So we go through the poster, point by point, and I ask the students for their comments. Most of them contemplate the content of the poster for the very first time. They respond, hesitantly and cautiously – they are not used to discussing such things with a priest. He might be very nice, but he is still a representative of the institutional Church. Gradually the unease lifts, and it turns out that nobody here likes the link between sexuality and crime. And they are all reflecting on why a person with HIV should not be able to live a full life. Because they die so quickly, says a student. And because they can’t have children, adds another. Conclusion: the Church tries to give guidance but causes confusion.

I take this bizarre poster to the next meeting of the archdiocese of Cape Town’s Catholic Aids Network, and vent my anger. That sparks an exciting debate. What should all the children born with HIV think of being placed on the same level as criminal offenders? What are they supposed to think of being prophesied an unsatisfying life because they cannot live it “to the fullest”? Our meeting spontaneously resolves to write two letters. The first will be addressed to Cardinal Wilfrid Napier, at the time the bishop conference’s president. We want to know from him whether the content of the ABCD poster was ever collegial passed in line with the conference’s principle of consensus – after all, it bears the SACBC logo. The second letter will be sent to the priest who is responsible for the students’ association’s poster, asking him to clarify the meaning and purpose of this campaign.

It takes weeks before we receive a reply. The first comes from the cardinal. He explains that he is not responsible for the poster and never actually saw it in detail. Just how the SACBC logo found its way on to the poster will remain a mystery. Cardinal Napier suggests that we ask the originators directly. But that turns out to be not that simple. The priest at first doesn’t respond. When, after further approaches, he does, his answers are as vague as we had feared. Nobody is really accountable for it, we learn. And what these posters communicate to people with HIV, well, nobody really thought about it. Should I be angry? Or should I console myself with the idea that sometimes such things are just “typically Catholic”?

But considering that most Aids education campaigns fail or are misdirected, just how are we going to reach the youth? What can we do to stifle the rate of new infections? What kind of strategy is the Catholic Church in South Africa developing for the next five years? First we cared for Aids orphans. Then we opened clinics and hospices. Now we are concentrating on the distribution of medicines. But what are we going to do next? We haven’t arrived at a satisfactory answer yet.

But let’s look at that poster again. It recommends that black students should develop their conscience and live their culture. But we haven’t even started to understand African culture, and often know nothing about it. I’ll try to demonstrate this with three examples.

Among traditional Xhosas, one of the dominant nations in South Africa, it is quite common that a man will take four wives. So if he “lives his culture”, he breaches the Christian requirement for monogamy. But his aim is to produce many descendants, because not only does that ensure the survival of his clan, but also that he will be cared for in old age. I began to understand that principle through the experiences of an employee of HOPE Cape Town. She was about to become the second wife of a man, and was already pregnant with his child. But her future husband died shortly before the wedding. When I asked how her family was coping with these circumstances, her answer astonished me. The most important thing, she said, is that he now has a descendant. Her parents had already been concerned that at her advanced age she had still been without child.

The second example concerns sexuality. Those who live their African culture categorically don’t speak about it, and even less so about Aids. Even Nelson Mandela, the brave freedom fighter and South Africa’s first black president, would refer to it only marginally. Once, after his retirement, he pointed out that for men of his standing, brought up according to traditional values, speaking about sexuality isn’t easy. For a true African it is non-negotiable that body fluids will have to be emitted during sexual intercourse, and the use of a condom would preclude that. And many African cultures maintain the custom of dry sex. Men don’t want the woman’s vagina to be moist during intercourse because that supposedly enhances the experience. But it also significantly increases the risk of HIV infection.

The third example concerns illness and healing. A complex universe of gods, ghosts and ancestors still form the mind of many Africans. The ancestors exercise a strong influence on daily life – they protect or curse and reward or punish their descendants. And because every illness is a sign or call from an ancestor, the living individual is not responsible for it. The healing is the sangoma’s job. The traditional healer has the secret wisdom and knows the rituals to beat the sickness. His patients will consider themselves healed as soon as the symptoms of the ailment disappear. In terms of the asymptomatic phase of HIV, during which the immediate effects of the infection soon disappear, this philosophy can have fatal consequences.

One could raise more examples. I mentioned just three to demonstrate that the advice to live one’s African culture is just thoughtless. And that’s how many suggestions on the ABCD poster seem: thoughtless. Unstained by reality. But reality demands that we face different challenges if we want to fight the virus effectively. The African relationship to sexuality, to gender roles, to death, to traditions must be modified; African men must change. Africa needs a mental revolution.  And the church must learn, that universal and unique moral teaching might mean trouble for specific regions.

The Poster: ABCD

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, , , , , , , , , , , , , , , , , , , ,

The Wedding

Stefan Hippler

The Wedding  –  What to do when a spouse is infected?

Adopted, but never really accepted. Always the feeling that the inclusion in the foster family was an act of charity. Marriage and ascent into the middle class. At some point left by the husband; a new girlfriend, new happiness – for him. After a year he resurfaces and climbs into the marital bed as if nothing ever happened. After another year the husband is dead, officially from organ failure but in reality as a result of Aids. After all those years of fidelity a test produces the dreaded result: Charmaine is HIV-positive. The adoptive family cuts all ties, she is relegated from the middle class, becomes dependent on grants. A fate that many thousands of women share with her.

But there is a silver lining. She is admitted for treatment at Tygerberg Hospital. She assists at the hospital as an unpaid volunteer. She educates patients, performs care tasks, and supports herself by selling her pearl embroidery. But she has no steady income and remains dependent on the charity of patients and colleagues who give her money and food parcels.
I get to know Charmaine at this point. She has made contact with HOPE Cape Town and often visits our small office in the Ithemba ward. In mid-November 2005  I receive a letter from Charmaine and her new boyfriend Nigel. She writes: “We would be very happy if you had the time to conduct our wedding on 1 December. We are both HIV-positive patients and in treatment at the hospital. Because the hospital is such a great source of support, we would like to celebrate our wedding with other patients and hospital staff. By doing so we want to break the stigma against HIV-positive people and in that way give hope to other infected people.” I wonder how people like Charmaine still find the strength to motivate others after all her bitter experiences.
Charmaine’s story is just one of countless others about faithful spouses who get infected. The cases of emotional cruelty, the parting pains, the feelings of abandonment are innumerable – one could write huge tomes about that. Charmaine’s story is also a textbook case about the problems with the now universal ABC strategy. A for abstain; B for be faithful, C for condomise. For the Catholic Church, A and B play the decisive role, while as a priest I sometimes feel that the Church views C as diabolical.

Be faithful! That’s easy to say, and often we nod sagely and think that fidelity is pure common sense. But that is one of the most difficult commandments because it can work only if both partners stick to it unfailingly. Fidelity by itself offers no guarantee against infection. I think here about Lorraine*, a 21-year-old Coloured woman. She was with me as we drove to Tygerberg Hospital for the official launch of our HIV/Aids project on 29 October 2001. She was uncharacteristically quiet in the car. Only later did I learn why: she had just returned from the doctor who had delivered the shattering test result. Lorraine had always been faithful to her boyfriend; he unfortunately not to her. Only 21 years old and HIV-positive: what prospects…

Be faithful! That recommendation also reminds me of Desiree, a young Xhosa mother, whom I met during one of many house visits in the townships. She had been with her boyfriend for a few years and had two kids. During her second birth an Aids test was taken, a precautionary obligation that now applies to most expecting mothers in South Africa. The result – HIV-positive – came as a shock to Desiree. How could that happen? In her desperation she turned to her boyfriend. He had no qualms about admitting to all sorts of adventures and affairs, but take a test? No way! He was insulted by the mere idea that his girlfriend suspected him of having such a disease. He moved out and into a shack two doors down. Alas, the same sad story will repeat itself: new love, new bliss. And, quite probably, soon a new infection.

Be faithful! Perhaps a wife or girlfriend will turn to one of the many Protestant churches that support affected women with prayer meetings and house visits. I don’t see much of that kind of help and solidarity in my church – with some exceptions, my brethren barely acknowledge the problem because they usually don’t know any “such” people. And when they do, they counter with a reproach: “It’s their own fault”. If people followed the Church’s teachings, they’ll say, none of this would happen in first place. Which is true. And yet I wonder why it that such a big chasm exists between the ideal and reality.
Is it a blip in God’s creation? Or a human error in reasoning?

Charmaine and Nigel’s wedding is a poignant celebration. Guests come from all departments in the hospital, and patients form a guard of honour. The mood is happy, relaxed and, yes, defiant. Newspapers, radio and TV cover this unusual event. In all reports the message is the same: there is a future with the virus after all, a livable future in God’s mercy. And that is good.

* Name changed

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 Prevention, HIV Treatment, HOPE Cape Town Association & Trust, HOPE Cape Town Trust, Medical and Research, Networking, Politics and Society, Reflection, Society and living environment, , , , , , , , , , , , , , , , , , , ,

Right to life or death penalty?

Stefan Hippler

Right to life or death penalty?  – The contradictions in Catholic moral teachings

How does your church react to the pandemic? What guidance does it give? What measures does it recommend? What is it doing? These are the kind of question Catholic priests are likely to face in the era of HIV/Aids. In theological terms, the Church has no official, defined teaching on the question of HIV/Aids: there are still no answers to the fundamental challenge we are facing. So far a few cautious inferences have been voiced with reference to Church teachings, manifesting the immense gulf between theory and practice. They do not equip the pastor with spiritual tools but more likely drive him to struggles of conscience.

When it comes to care for Aids patients and those affected by it, the Roman Catholic Church is at the forefront. Many consecrated women and men literally sacrifice themselves in the service of suffering people. In many developing countries it is in particular Catholic establishments that carry the greatest load in supporting the Aids-affected because state institutions often are overextended. Many Church leaders around the world have emphasised this service to humanity. My home diocese of Trier pointed out as early as the 1980s that it is an ancient obligation that the Church must stand in solidarity with the suffering and the dying. The diocese stressed that any form of discrimination or stigmatization of HIV-positive people is unchristian. Some theologians even refer to the Body of Christ as having Aids, thereby creating a way to view the disease theologically.

These brave notions stand in contrast to the rigidity and ignorance of many bishops and priests who are still not prepared to tackle the issue of HIV/Aids. Some of them even deny that the disease is a problem in their dioceses. Their resistance ranges from the pious observation that Aids is a punishment from God to a priest asking an HIV-positive parishioner to leave his congregation. Those in charge of the Church are intimidated by HIV, Aids and the implicit association with sexuality. They don’t want to confront these issues because to do so they must enter the minefield of moral theology.
The Church teaches that sexuality belongs in marriage, and only in marriage. It may be practised only in a life-long partnership between a man and a woman who remain faithful to each other. Everything else – premarital sex, homosexuality, multiple partners, one-night stands, cohabitation, polygamy – is sinful. Within the institution of marriage, sexuality was reduced to the dictum of the Church Father St Augustine who taught that every sex act must be open to procreation. Artificial contraception is regarded illicit with reference to the encyclical Humanae vitae, issued by Pope Paul VI in 1968. In an official handbook for confessors, approved in 1997 by Pope John Paul II, the late Cardinal Alfonso López Trujillo, then prefect of the Pontifical Council for the Family, emphasised the unequivocal teaching authenticity of Humanae vitae: “The Church has always taught the intrinsic evil of contraception, that is, of every marital act intentionally rendered unfruitful. This teaching is to be held as definitive and irreformable.” And God wills this regulation, according to the pope as the supreme guardian and teacher of the magisterium. The will of the Almighty permits no discussion, and accordingly there are no ways of dispensing believers from it. Thus millions of people become sinners because they live in defiance of God’s will as defined by the Vatican. And so they must bear the consequences of their godless behaviour, at least as far as fundamentalist theologians are concerned.

Among the proscribed artificial instruments of contraception are condoms. These are, as we know, the only effective means of preventing the exchange of bodily fluids during sexual acts. The Church’s teaching on condoms, still controversial and puzzling to many, refers solely to procreation, but extends now to questions of life and death. The moral theologian Carlo Caffarra – now archbishop of Bologna – in 1989 even called for an end to sexual activity within marriages in which one partner is HIV-positive. Our Church held on to that approach for years. Only a few bishops dared to invoke the difference between protection and procreation of life.

The Belgian Cardinal Godfried Danneels pleaded for the use of prophylactics when one spouse is infected. “Otherwise one sin – breaking the sixth commandment (Thou shalt not commit adultery) – is compounded by another sin, breaking the fifth commandment (Thou shalt not kill).” The German theologian Professor Johannes Reiter called for condoms to be tolerated in some cases as“disaster prevention”. But such ideas have failed to penetrate the centre of the Vatican. Perhaps the Vatican’s new doctrinal study into the use of condoms in the fight against Aids commissioned by Cardinal Javier Lozano Barragán will usher in a change; it reportedly has been circulated already to Pope Benedict XVI and the doctrinal congregation. Cardinal Barragán was the Vatican’s de facto health minister, and he has exercised his mind for some time on the question of whether marital condom use can be licit on the grounds of self-defence when one partner is infected.
As things stand, there is no deviation from the official teachings of the Church. Indeed, the 1968 Königsberg Declaration in which the German bishops emphasised spouses’ freedom of conscience is at risk of being withdrawn so as not to impugn on papal primacy. It seems that papal infallibility is being virtually expanded to include pronouncements which have not been issued ex cathedra, i.e. the official decisions declared by the pontiff in college with the Church under the guidance of the Holy Spirit which are to be regarded as infallible. So people with HIV, who already have sinned, must now also accept that the only available method of protection for their partners is proscribed. Those who use condoms commit one sin on top of another. Of course there is an alternative: abstinence.

But doesn’t our Church teach that celibacy is a gift from God and not intended for every one?

There is a big contradiction in the teachings of our Church: in its support for and care of those with Aids, the Church is a leading light, but at the same time it also contributes to the discrimination of these people. It seems perfectly schizophrenic to call people to a full life with intimacy in holy matrimony, and then deny infected people that intimacy. Catholic moral teaching places the right to life at its centre. But then it puts people who follow that teaching at risk of infection by a deadly virus. The ultimate tragedy resides in our Church’s refusal to reconcile the principles of its moral theology with the insights from sociology, psychology, sexual research and other social sciences. I would add my perception that the Church lacks in humility – the humility to realise that all human knowledge is like patchwork, that nobody has a monopoly on all truth. That’s why the Church does not perceive HIV/Aids as a Sign of the Times, one that not only questions the conduct of individuals, but also that of the Church in its totality. In theological terms, I see the suffering and dying of Aids-infected brothers and sisters as a cry from God. The Church, the Body of Christ, is infected with the virus, and in that body there are only those who suffer and those who suffer with them.
But, one might demur, is it really that important what the Church thinks and does in these permissive times? Does it still have a substantial role to play in global terms? There are so many other churches, congregations and faith movements, and many people have abandoned religious traditions altogether and believe in nothing. That objection is easily rebutted: the Catholic Church has 1,2 billion members. It is the biggest cohesive religious community in the world. As the world’s largest institution it could fight against HIV/Aids like no other. It really could – if only it wanted to.

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, , , , , , , , , , , , , , , , , , , ,

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, , , , , , , , , , , , , , , , , , , ,

Blog Categories

Follow God, AIDS, Africa & HOPE on WordPress.com

You can share this blog in many ways..

Bookmark and Share

Enter your email address to follow this blog and receive notifications of new posts by email.

Join 2,711 other subscribers

Translation – Deutsch? Française? Espanol? …

The translation button is located on each single blog page, Copy the text, click the button and paste it for instant translation:
Website Translation Widget

or for the translation of the front page:

* Click for Translation

Copyright

© Rev Fr Stefan Hippler and HIV, AIDS and HOPE.
Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Rev Fr Stefan Hippler and HIV, AIDS and HOPE with appropriate and specific direction to the original content.

This not withstanding the following applies:
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.