-Caveat Lector- Ignorance Feeds Deadly S. African AIDS Epidemic Spurred by Myth and Social Mores, Infection Rate Reaches Crisis Proportions By Lynne Duke Washington Post Foreign Service Tuesday, February 16, 1999; Page A01 RIETVLEI, South Africa-Sex in South Africa is a game of "African roulette," some say. But Thenjiwe Dzanibe didn't even know she was a player. Dzanibe, 37, was admitted last month to Rietvlei hospital, where she was diagnosed with tuberculosis and tested for the virus that causes AIDS. It was then that she began to wonder whether AIDS caused the tuberculosis that killed her husband in 1995. And though her boyfriend refuses to be tested because he fears the results, she says, it occurs to her that maybe AIDS is what has caused him to lose weight and cough up blood. Dzanibe conceived a child with him, and now the baby is sick and has a fungal infection of the tongue. Could it be, Dzanibe wonders, that 8-month-old Zimbini has developed AIDS, too? The depth of her crisis sank in when she asked, during an interview: "Can I be cured of AIDS and these other diseases that are coming out?" No, she was told gently. Days later, her blood test confirmed that she has AIDS. "I have understood," she said sadly, but added: "The one thing I know for sure is I'll never tell the father of my child." Dzanibe is among the millions of South Africans caught in the complex and deadly web of ignorance, denial and misplaced cultural beliefs that is fueling South Africa's AIDS epidemic, which is among the most aggressive on the continent. More than 16 percent of South Africa's nearly 40 million people are infected with the human immunodeficiency virus (HIV), which causes AIDS. By 2010, the national infection rate is projected to reach 25 percent, on a par with that of neighboring Zimbabwe and Botswana, confirming southern Africa as the center of the world AIDS epidemic. The infection level among South Africans between the ages of 20 and 30 already is approaching 20 percent. New infections are being reported at a rate of 1,500 a day -- two-thirds of them among 15- to 20-year-olds. Health experts say this means that the age group once thought to be most receptive to AIDS awareness messages already is heavily infected. Although HIV is running rampant in South Africa, too many people here do not understand or believe how deadly it is until it is too late. Women bear the brunt of the crisis, experts say, because of polygamy, male promiscuity and sexual mores that allow men to dictate norms of intercourse -- including refusal to wear condoms -- and to put women in danger if they raise too many questions. Unlike Uganda, which is renowned for an aggressive AIDS-prevention campaign that has reduced its high rate of HIV infection and made condom use the rule, South Africa has been slow off the mark. Analysts say this is partly because the government has been bombarded with an array of policy demands since the 1994 transition from white-minority rule to multi-racial democracy. Since late last year, the government has made AIDS prevention a high-profile priority, and last week President Nelson Mandela lent his voice to the AIDS crisis in his state of the nation address. But with AIDS-awareness and prevention measures only recently undertaken, people here have filled the information gap with myth and stigmatism. "It's this ignorance that's so difficult to break through," said Nono Simelela, national director of the government's HIV, AIDS and sexually transmitted disease programs. "We are dancing with death all the time." Many South Africans, for instance, believe that bewitchings are the cause of AIDS, or that racist whites have injected oranges and bananas with the disease, or that tribal ancestors are displeased and are wreaking havoc on the living. Some people believe only prostitutes get AIDS. Some men extol the virtues of fat women in the mistaken belief that only thin women can transmit AIDS. Some women believe that AIDS can be gotten rid of by giving it back to the source of the infection. Here at Rietvlei Hospital -- situated in largely rural KwaZulu-Natal province, where the 27 percent HIV-infection rate is the highest in the nation -- examples abound. Veronica Mngoma, 35, has been diagnosed with AIDS, but she has trouble accepting what it means. Deep down, she says, she suspects that she is sick because a vengeful co-worker poisoned her. "In 1996, I was given a [cake] by a girl, and it had poison on it," Mngoma said. "This poison made me become sick. I got thin and thin and thin after that." She consulted a sangoma -- a traditional healer -- who told her to drink four small buckets of a milky purgative brew. She vomited, as prescribed. And got sicker. Busisiwe Chiya, 43, who was admitted to the isolation ward at Rietvlei with severe pelvic pain and other symptoms, also does not understand AIDS. When she was diagnosed HIV-positive -- and admonished to get closer to her god before it was too late -- her only question was whether she could have more children. She has one child. Later, in an interview, there were more questions. She asked if she could get rid of the disease by passing it back to the boyfriend whose sexual promiscuity she has endured but hates. "I want him to take it and go to the other women and give it," she said from her bed, her voice a weak chortle. Beyond individual tragedies, the social, economic and cultural effects of South Africa's AIDS crisis are profound. Some analysts predict that sectors of the economy, such as trucking and mining, are threatened by the AIDS crisis with a loss of manpower and profits. A survey in a gold-mining area near Johannesburg showed that 20 percent of mine workers were HIV-positive, as were 75 percent of prostitutes that service them from a nearby township. "Eight to 10 years from now, in that portion [of the population] that's supposed to be working, earning and driving the economy, there's going to be nobody," said Simelela, the director of government AIDS programs. "Somewhere along the line we need a miracle." Before that miracle comes, projections indicate that South Africa will have more than 2 million orphans as a result of AIDS. In some areas of KwaZulu-Natal, health workers say, the generation between children and grandparents already is missing. In a country that is 80 percent black, whites are a small proportion of the AIDS epidemic, although they, too, are registering rapid increases. It is among blacks that AIDS is most severe, especially -- but not exclusively -- among poor, undereducated blacks who live in areas, like KwaZulu-Natal, that have suffered decades of social and political instability. Another key factor in the AIDS epidemic is South Africa's migrant labor system. Rural men from KwaZulu-Natal and elsewhere traditionally have found work in big cities, such as Johannesburg or in the gold mines around it. It is common practice for such men to have wives or girlfriends in their home regions as well as in the urban areas where they work. To a lesser extent, women left behind by men also take up other sexual partners. Dzanibe's late husband was a migrant worker, as is her current partner. This is a culture in which male promiscuity traditionally has been admired and female subservience is expected. Men do not like to wear condoms, and for a woman even to ask for such protection means risking an argument or a beating over whether she has had sex with with other partners. "If you try to show him that I think [using a condom] would be the best thing, he will say, 'Where did you learn these tricks? Have you been running around?' " Dzanibe said. Many AIDS-prevention messages here are ill-suited to such a culture. "Most of the material says stick to one partner," said Alfred Mikosi, director of the U.N. AIDS program for South Africa. "Does this relate to a man who has got three wives?" Women also bear the brunt of the deep stigma that has grown up around AIDS. They fear that their men will leave them, that their families will shun them, and that their neighbors will ridicule and ostracize them and call them prostitutes. Such fears are well-founded. A KwaZulu-Natal woman, Gugu Dlamini, who publicly acknowledged her HIV-positive status on World AIDS Day last year, was beaten to death for revealing something that her community felt brought it into disrepute. The women at Rietvlei express fear of what will happen if their communities learn they have AIDS. "That would be bad for me because, according to the people's belief, we ridicule and laugh at people who have got AIDS," Dzanibe said through an interpreter. "If it happens that they know, your heart can stand still. Especially the in-laws. To have AIDS among people, it's a disgrace." But the weight loss that typically accompanies the illness makes it impossible to hide. "The moment you become slim, they say you have got it," said Mngoma, whose weight dropped from 136 to 79 pounds by the time she went to the hospital. If such lessons have enlightened these women about AIDS, their attitudes do not reflect it. Chiya, Mngoma and Dzanibe all said they will not tell their partners that they have the disease. Dzanibe said that perhaps the affliction, for her, is God's will. All she can do is try to continue normally as long as she has strength. She will maintain her relationship with the man in Johannesburg; to do otherwise would invite trouble. "I will go to 'Jo'burg' to see him, because now I cannot start with anybody else," she said. "If I don't go to 'Jo'burg,' he will think I am bewitched." South Africa's AIDS Curse HIV, the virus that causes AIDS, has infected more than 16 percent of South Africans and may create as many as 2 million orphans by 2010. Polygamy, cultural mores, migrant labor and a lack of education make the fatal disease particularly hard to control. HIV INFECTION RATES in South Africa have risen to more than 16% of the population HIV infection in South Africa by province Northern Province: 8.2% Eastern Transvaal: 22.6% KwaZulu-Natal: 26.9% Gauteng: 17.1% North West: 18.1% Northern Cape: 8.6% Free State: 20% Western Cape: 6.3% Eastern Cape: 12.6% SOURCES: U.N. Development Program, Metropolitan Life Scenario 80 Assuming that 50% of the population is under 15yrs old(normal for a developing eg black country) then this leave 500000 adults......which gives an hiv level of about 50% amongst adults.....then if you assme that the people over 50 are passed sex and theya re about 20% of adults(of course there are exceptions ?) then you ar coming to HIV levels in the order of 60-70% amongst sexually active adults. i talked witha local Aids researcher . She had recently dropped out and moved to the blood transfusion services. I asked her why and she responded she couldnt take the interference by the government. She wouldnt tell me what discrepincies were and if the govt were hiding information(it come come back to her) . she did admit(by nondenial) that the 15/1 black/(white& indian) figures were still in place ----------------------------------------- AIDS poses serious crisis for Swaziland James Hall MBABANE - The first comprehensive review of the effect of AIDS on Swaziland's economy confirms what most employers already know: the disease is significantly compromising the Swazi work force. One major manufacturing concern at the Matsapha Industrial Site says five workers a week die of AIDS-related illnesses. The education ministry reports three to four AIDS deaths a week among the nation's 8000 teachers. A survey sponsored by Unicef and released last week says 293000 Swazis out of a population of slightly less than 1-million are infected with HIV. AIDS will have "a severe social and economic impact between the years 2000 and 2015", with an estimated 30000 to 40000 deaths annually, says the report. Swaziland has a work force of 80000 in the public sector and 20000 public servants. "The Swaziland AIDS epidemic could be worse than in other countries due to the nation's small size, and the limited response to the epidemic," says the report. The epidemic has made orphans of 112000 children - 22% of all children below 15 years of age. About 4% to 5% of Swazi children are HIV-positive. People with the greatest risk of contracting HIV are those between the economically productive ages of 15 to 29. The report blames government complacency, a culture of denial, the "low sociocultural status of women", and a lack of an AIDS strategy for the disease's proliferation. http://www.bday.co.za/99/0329/world/w15.htm Assuming that 50% of the population is under 15yrs old(normal for a developing eg black country) then this leave 500000 adults......which gives an hiv level of about 50% amongst adults.....then if you assme that the people over 50 are passed sex and theya re about 20% of adults(of course there are exceptions ?) then you ar coming to HIV levels in the order of 60-70% amongst sexually active adults. i talked witha local Aids researcher . She had recently dropped out and moved to the blood transfusion services. I asked her why and she responded she couldnt take the interference by the government. She wouldnt tell me what discrepincies were and if the govt were hiding information(it come come back to her) . she did admit(by nondenial) that the 15/1 black/(white& indian) figures were still in place. The Aids figures above may be inaccurate or misreported, so the calculation is subject to correction DECLARATION & DISCLAIMER ========== CTRL is a discussion and informational exchange list. Proselyzting propagandic screeds are not allowed. Substance—not soapboxing! These are sordid matters and 'conspiracy theory', with its many half-truths, misdirections and outright frauds is used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRL gives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. CTRL gives no credeence to Holocaust denial and nazi's need not apply. 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